Over the past seven years, HME information technology (IT) has blossomed from its earliest role as a basic billing and customer relationship management tool. From optimizing operations, work flows and inventory to helping you navigate delivery routes and the myriad rules and code changes of an industry in constant flux, HME IT has sprinted from being a convenience to rooting into the very foundation of business success.
But as the healthcare, technology, demographic, reimbursement and regulatory landscapes continue to shift and transform in considerable ways, it’s worth asking: what does the future hold for HME IT? Well, let’s first look at where HME-specific software has brought us:
“Advancements in IT have provided HME businesses the opportunity to optimize their business through better and more detailed analysis of data,” said Jon Bell, Market Analyst, QS/1. “Software can now help businesses track not only their financial performance but also spot trends and identify areas where they can improve. Another recent game-changer is the ability to obtain electronic signatures for documentation and delivery services. This enables delivery personnel to collect the patient’s signature, acknowledging receipt of the product and safety information digitally for better documentation while simultaneously decreasing the time between delivery and billing.”
Dave Cormack, President and CEO, Brightree, pointed out that the reduced reimbursements that came about as a result of competitive bidding have forced providers to adopt additional IT solutions to create similar efficiencies throughout their operation. One example, he said, is electronic document management, a tremendous improvement over paper processing and files. With digitized documents, providers eliminate wasted time and steps searching for patient information and documents. Intelligent document management streamlines processes to create better workflows and, along with the EDI, lets providers more rapidly respond to audits.
To be successful, HME IT providers must look into the future, know where the industry is heading and determine how technology can help their businesses get there. HME Business magazine asked some of the industry’s top IT minds to discuss the future of HME IT and share tips how technology will continue to shape business success.
Richard Mehan, President, Noble House
Technology is moving more and more to a paperless environment, allowing all departments within an HME business to share information electronically. These processes include the initial patient intake, ordering and distribution of supplies and products to the patients and then, ultimately, the submission of claims to the payors. Wireless connectivity, from handheld tables and smart phones, are starting to be a necessity to optimize efficiency.
HME providers are now becoming more educated in the IT portion of their business. The days of high-profit margins are nothing but a memory. It has become the responsibility of HME providers to maximize the efficiency of each department within their organization, including streamlining operations, eliminating unnecessary delays and providing a quick turnaround from patient intake through claims reimbursement. Taking advantage of what technology has to offer will assist the provider in minimizing expenses and maximizing profits. As the paperless environment becomes more acceptable, you will continue to see more pieces of the HME sector communicate with each other. Maximizing profits and efficiency is the key to success in today’s HME business.
Kimberly Commito, Director of Product Management, HCS Division of Mediware Information Systems
Some statistics state that HME providers and health-care providers in general use only 60% of the automation available in their software solutions. Many times, additional features, such as electronic documentation, are not adopted initially because it is overwhelming to consolidate years of manual documents into an electronic format.
The need to automate processes to improve efficiency within an organization is paramount for HME providers today. There are a tremendous number of software solutions available today, addressing various operational needs. As a result, the potential for integration between those software solution platforms becomes evident. Providers will be required to become educated on the sharing of information between these platforms as it pertains to patient and business sensitive data. Any solutions considered should be evaluated for how adequately they address security, especially as they relate to integrations and sharing of information.
The evolution of technology is so fast paced that providers should look for intuitive solutions to minimize operational impact when updates are released and new features are introduced. Ease of use in the applications that providers adopt should be at the forefront of the decisions made regarding those solutions along with security implications.
As more and more providers move to solutions on the web and look to automation for options to automate, the above issues should be taken into consideration. At Mediware we always keep the security of our data at the forefront of our development.
Dave Cormack, President and CEO, Brightree
Currently, industry pressures are forcing providers to adopt technology at faster-than-normal rates in an effort to counter reduced reimbursements and deal with the regulatory changes. Over the next few years I see that that pressure shifting to interoperability and the need for all of the healthcare players to be connected to seamlessly share information.
Brightree is providing integrated interoperability technologies that help providers monitor a patient’s sleep therapy compliance and that help patients easily re-order HME supplies. We have integrated electronic purchasing technology in place with most major manufacturers and distributors to eliminate friction in the supply chain and facilitate one-touch drop shipments.
I believe this interoperability trend will accelerate. As payment models change from ‘fee-for-service’ to a value-based reimbursement model, the need to share information between acute and post-acute care organizations will become more critical. Providers will be required to demonstrate such things as reduced hospital readmissions, improved patient satisfaction and higher quality of care. Brightree is the only HME software vendor to be part of the CommonWell Health Alliance, established to help solve the longstanding problem of interoperability in the healthcare industry.
In order to meet these emerging interoperability challenges, providers should make sure they are implementing the right technology today. They should look for a modern system that is ideally cloud-based, software-as-aservice (SaaS) technology that is architected with interoperability in mind.
These systems are much more capable of handling the technical challenges required to deliver this interoperability. Older generation client server-based technologies are very poorly suited to an ever-changing, more interconnected healthcare environment.
By taking steps now to partner with forward-thinking software vendors, providers can streamline their current operations and prepare themselves for this more interconnected environment in the future.
Jon Bell, Market Analyst, QS/1
HME businesses have had to make many changes over the past few years. Whether it’s competitive bidding or the increase in audits affecting business, there are tools available to help keep a business going. With a decrease in margins for most items, becoming more productive and organized is vital.
Make sure that you are using tools such as report generators, electronic documentation storage and accounts receivable posting. Often under-utilized, a report generator can be a great benefit for your business. Reports can be generated to show trends in your business based on patients, items or accounts receivable postings.
In the future, your software will also play an even greater role as more changes are mandated. The start of ICD-10 codes will possibly require your software to have dual access to ICD-9 and 10 codes for some time. Depending on the readiness of the carriers this could require you to bill ICD-9 and 10 codes to different carriers. Also, Medicare’s bundled payments program could be expanded in the future. Your system must be able to manage this if your business will be billing these items.
Christopher Dobiesz, President and CEO, Universal Software Solutions Inc.
It is the responsibility of the technology service providers to continuously create and expand its offerings to HME providers so they can do more with less. All HME providers must continue to evaluate on a regular basis, ideally annually, their current technology configurations.
It is well known that the reductions in reimbursements, rising labor costs and other external threats are forcing changes in how the HME of today functions compared to those in the last five years. Organizations that continue to operate in the same way they had in the past will have a dismal future ahead of them.
Currently, there is a surge and an urgency to move toward mobile technology. This is an innovative and exciting time with regards to what the future may provide. However, mobile technology and the supporting services needed are still evolving. The ultimate goal of having everything at the employees’ fingertips and being completely paper free is still in its infancy.
There are workable mobile solutions available today for drivers, technicians and therapists who are continuously travelling and interacting with patients on a daily basis. The HME provider should start to evaluate and consider these types of solution for their organization. Not all solutions are the same. It is important that the information is safe and secure and follows the proper HIPAA and HITECH requirements. Not all solutions may provide this functionality.
A device should not store any information about the patient or any other critical data unless the provider can guarantee that if it is ever lost or stolen the data stored on it may never be accessed. If the mobile device stores information, it will be the burden of the HME provider, not the software provider, to protect its contents.
Wireless technology is still evolving and will continue to improve in the future. Being totally mobile for all employees is not realistic for all providers. Urban areas may have a nearly complete cellular and Wi-Fi coverage area, but this is not always true just outside the city limits and surely not the same in rural areas. Providers will find themselves behind their competition if they try to wait on the sidelines for the communication technology to completely catch up for all of their needs before making this kind of technology improvement.
Creativity is the key to success. Whenever possible, using more than one cellular and mobile service for its connectivity will provide not only the flexible mobile coverage needed, but also a backup solution should there be technical issues with the other one.
Once again, back to reality. There will still be those employees who will not have a reliable wireless connection for some time or maybe never. They will still need to do business the old-fashioned way. Providers should not let the fact that a small percentage of their workforce is unable to use mobile technology and sacrifice all the benefits and gains this type of automation offers.
To be a successful provider in this market, there must be an examination of all the inflows and outflows of information to and from the organization. Integration with external sources of business data will greatly reduce operation costs and improve the accuracy of information. A successful integration will require a flexible, stable and robust Application Programming Interface (API) that is designed to work within the organization’s information system. Without an API into the database, the provider is limited with its integrations or is exposed to additional risks.
Having any kind of direct access into the database table structure puts the provider at risk with future updates to their primary software or even exposes a risk to data corruption. Developing integrations will be much slower and costly without an API that is provided by the software vendor of the information system. As providers grow and need these advanced integrations, they may need to seek a replacement to their entire practice management system if it is not able to offer the flexibility and robust interoperability that it will need to be successful.
Information technology is dynamic and continues to offer innovated solutions to the provider with the automation of manual tasks, mobility and integrated access to critical business data. Technology exists today that will greatly improve operational performance and reduce overall costs, but it requires HME providers to continuously examine themselves and develop the necessary strategic plan to implement these new types of tools for their business.
Small continuous bites, a little at a time, will permit providers to overcome and succeed with the larger technical challenges they face. Jumping all in quickly without a well thought plan and, also equally important, a technical solution partner that will stand alongside them, will be very costly and most likely end up being an unsuccessful implementation of these new technical options.