Problem Solvers

Deliveries: Bringing Order to Chaos

How information technology can play a much larger role in managing HME providers’ deliveries and service calls than simply tracking vehicles.

When we think about using technology to improve delivery management for an HME provider business, we often think about the logistics planning side of the equation: tracking the trucks in the field; ensuring they’re getting optimal gas mileage; making sure route planning is efficient.

But that’s only one side of the equation. There are issues much closer to the customer service, inventory control, and documentation side of the business that must be managed as well. And, in fact, this might be where information technology can make an even bigger difference, as well as in terms of customer service, inventory management, employee retention, and the bottom line.

To explore this topic, I sat down with Lisa Anderson, education and outreach director for Universal Software Systems (, which offers its HDMS Mobile Driver solution, to discuss IT’s larger role in help providers.

HMEB: How far has technology made its way into HME deliveries?

Anderson: As consumers, we’re all very advanced in our daily lives at home. When we get to our HME offices — what we find as a software vendor with our clients — is that it’s all very delayed; it is very old school. When it comes time to get in the delivery van and get out to the client’s house, or respond to an urgent call or an urgent service problem, the system completely breaks down because there is not a lot of cross-communication between the office and then what is really going on out on the road.

We see this as the biggest opportunity to really push the HME industry into 2019 and into the future, and really just make everyone’s life so much easier.

HMEB: What have been HME providers’ top concerns and issues, when it comes to managing their deliveries and their repair calls?

Anderson: The most common thing that we will hear from our clients is that there are all these moments where an exception happens on the fly. Most of their day, in delivering or servicing equipment, sounds like an exception more than the rule.

Something that happens all the time is, our providers will send their fleet out on the road for all of the in-home deliveries for the day. And then the hospital will call with a sudden discharge, or an oxygen client or someone that’s on a life-sustaining vent. Or those little more, urgent types of services will interrupt the normal process.

How do you communicate that out to the driver on the road? The drivers are then put in the situation where, not only are they in a heavy vehicle hurtling down a freeway, but they need to stop, and look at a map. They’re writing out handwritten delivery tickets based on what they’re hearing over patchy cellphone service. They’re writing down 16-digit serial numbers and trying to figure out if they have the equipment in the back of their van — some extras — because they’re nearby, that they could squeeze things in.

That was always the scenario we were hearing: they made a plan and then very quickly that plan went out the window. So that was probably the most common.

HMEB: It has a cascade effect, doesn’t it?

Anderson: Absolutely. Because then the family is always in upheaval. “Are they coming? When are they coming? Where are they?” It’s always the home base trying to manage the care for the patient and then they can’t get ahold of the driver. The driver is getting bits and pieces. I feel like the delivery techs of these HME businesses are the unsung heroes because they’re in make-it-work mode all day long.

But what they come home with at the end of the night is a clipboard full of handwritten, scratchy, crazy, documentation. They were trying to capture everything while they were there with the patient for the best of their company — to not have to send another truck back out another day. But because it is all very segmented and not using technology or any kind of transparency, then that’s a manual work order someone’s keying in. And maybe it doesn’t get confirmed as quickly to turn into revenue because it’s an exception. So someone had to look at it and piece it all together, where the normal workflow just followed along in a little assembly line.

Right from the get-go, the best intentions always go out the window by 10 a.m. when we’re talking about a large, local fleet.

HMEB: What does this mean from a bottom-line perspective? For example, there might be providers that have really good billing software in place but not necessarily any sort delivery-management software. What’s this doing to their business?

Anderson: The biggest problem we see that they have is turnover because these people just get burnt out. The delivery techs have to provide better service than even your retail storefronts because they’re delivering a level of trust and comfort like none of your other employees are, because they’re in that person’s home.

… What we see happening is, without any kind of technology there, it is very manual. There’s emergency on-call shift, where someone has to be available to take a late-night delivery and it’s all very labor-intensive. So we knew that they had to start embracing technology to avoid some of that burnout that comes along with a manual process.

HMEB: So, how can providers better manage their mobile deliveries and their service calls, and how does technology fit into that?

Anderson: One of the things we see that makes it a lot easier is staging. In every warehouse of our providers that keeps their own equipment in stock, we know that it’s not the driver that climbs around and grabs stuff. They have people staging truck bays so that the delivery techs can show up and help load. That’s a very ironed out process: The work orders are generated for the day, the list of what inventory is needed for the truck and then someone is collecting all of that and organizing it into, “Okay, these 10 things need to go in truck A. These 12 things need to go in truck B”, and so on and so forth.

But what we found is that a lot of providers don’t tell the software that that’s happening. So there were no economies that could be made there. There were no efficiencies that could be realized because you weren’t telling us what you were doing. You were just doing it in real life. So we took that model and thought, “What would it look like to put that staging in software? What if the staging crew started entering in all the lot numbers and all the serial numbers for the equipment that’s going into the truck, so that when the driver’s on the road and delivering the stuff in the home, they’re not scratching down all these illegible numbers that your billers need in order to confirm those orders to create revenue?”

You hand someone a tablet of the 10 or 12 orders that they’re basically picking and packing, with a barcode gun or you have a little barcode reader attachment on a mobile device. And while staff is out in the racks of your warehouse, they’re just scanning those things and it’s capturing all that information.

And then when it’s on the truck, the driver just has to drop it off. He gets to stand there and shine and give the real service, which is him and his information and education. But he’s not on the ground looking at the barcode underneath the wheelchair seat, trying to write that down so he doesn’t get yelled at later.

HMEB: Because it’s already been packed. I imagine if any of this stuff requires signature release, then it’s all associated against those serial numbers, as well.

Anderson: Absolutely. And you have a lot more control and transparency of where your inventory is. Let’s talk about a realistic inventory evaluation. Now we really know, “Oh, that item’s on Bob’s truck; it’s committed.” And when he gets back to the shop tonight we can do a reconciliation and find out what actually took place — or even do that in real-time, because we can do that as the driver is dropping things off it can signal back to home base what’s going on. So everything is accounted for and there’s no gray area. You know if something’s out for delivery and if it’s been delivered or not.

HMEB: What is the actual technology that’s making this happen, the telemetry? Is it just the drivers’ smartphones? Or is there a specialized device?

Anderson: All the different software providers develop on different platforms. What is very common right now in our lives as consumers is apps. So most of the time when you bought a billing, a revenue cycle management system, that wasn’t an app. That wasn’t something you downloaded from the Play store. You went through an integration and then an installation that’s on a server or it’s hosted in a cloud environment.

As these software vendors grow and see the need for mobile delivery like we did, they developed apps. So, you’ll hear terms like native; it’s a native app. Meaning that it’s an actual application that you download from the Play store to any mobile device, your personal cell phone, your work cell phone, your work tablet, any device and we’re coding in that technology even though it’s different from what you’ve installed on your computer but we make them talk to each other because we’re the author of both so that they’re easily deployable to a lot of people on any kind of device and you’re not having to buy specific things to make this happen. You can just use your existing suite technology.

HMEB: How do emergencies fit into this scenario? Say a respiratory client is having trouble. How can technology address those situations?

Anderson: Each and everything is an emergency with customers and patients in this stage of their chronic care management. So, mobile solutions has to have a way to add a delivery in when things come up. With Mobile Driver, or with a mobile delivery service, the office would simply add that order in and then assign it into that driver’s route. And then when the next time he picks up his device and it refreshes, it’s alerting him, “Hey, you have a new delivery. We’ve rerouted it into your map, your directions. So maybe it makes sense to do that one next based on the setup time, or where it’s located in your route.”

And when we train people or even talk to people about our product, what we normally find is that for those big, life-sustaining items that they’re supporting, they keep a few extras on the truck. So, they keep a extra oxygen concentrator, or an extra vent. And so because the staff can see the inventory in that truck, they know what’s already spoken for or committed, but they also know what’s in that truck that’s on hand for those emergencies. So, they can start to leverage that and push in those urgent or last-minute deliveries right into their route.

HMEB: When does a provider start reviewing these sorts of IT solutions? In other words, when is a provider’s delivery organization big enough that it should start looking into this? Is there a scale issue, or is this really attainable for any provider?

Anderson: I think it’s all about priorities. In my mind, it’s attainable for any provider that has more than one delivery method going on. The more people that you start to add and certainly the more exceptions or the more urgent product lines that you wade into, if you are a really well-known provider in your community, meaning all the community that are referring people to you, then you’re dealing with the hospital and you’re dealing with those urgent situations. So I really think that this is for everyone. I can see where, still, some of the really small shops that just have one driver might be a little priced out. Some of these solutions are kind of new, and so what we love about technology is that as more people come in and start to compete, the price comes down.

For some of those really small providers, they might still think that it’s not worth the investment yet. But it’s definitely something to keep an eye on. Because I would say probably the best value you’re going to find is by talking to the provider that you’re using for any of your other pieces of technology. Even if you don’t have an inventory management system but you have something for revenue cycle management, or your front-end, your patient-account management, it’s a very real possibility that those people are developing into that area. And they already know you and trust you, and likewise, they will probably give you the best deal. So, we say, start shopping even if you’re not completely sure that you need this yet.

This article originally appeared in the Aug/Sep 2019 issue of HME Business.

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