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.
- By David Kopf
- Aug 01, 2019
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 (universalss.com), 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
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 August/September 2019 issue of HME Business.