The Internet and HME

How will the 'Net impact providers over the near term?

You cannot do business today without some element of information technology. In the same way that disciplines such as sales, service and accounting are considered a core component of any business, IT has become a fundamental component that no enterprise, large or small, can do without.

And that goes double for the homecare industry. Information technology helps providers wrangle complex tasks such as organizing delivery schedules, managing complex documentation, tracking billing to multiple sources of funding, and communicating with patients.

Furthermore, the Internet — the most important IT development for doing business since the spreadsheet — is playing an increasingly important role in HME providers’ IT strategies. Already many HME software systems are offered on a “software as a service” (SAAS) basis that delivers complete HME business management solutions through an everyday web browser.

“This lets providers manage their businesses, and not have to manage IT,” says Mark Blount, vice president of marketing for Brightree, a provider of a web-based HME system.

Other elements of the homecare landscape are beginning to use the ’Net, as well, such as state Medicaids that are providing online billing via secure online connections, or suppliers that let providers submit POs electronically. As the Internet’s impact on homecare expands, providers must consider how the Internet is currently impacting and improving the way they do business, and how might it evolve to further shape the homecare market in the short term.

Double-Edged Sword?

“I think it has had both a positive and a negative impact,” says Lelia Wilkerson, RN, manager of Heritage Medical Equipment and Supplies.
On the one hand, Wilkerson says the Internet has made it much easier for Heritage to automate processes and work with referral partners, but on the other hand, trends such patients ordering the wrong equipment from online retailers have had a negative impact on the HME industry.

Young and old alike, today’s patients are “very computer savvy,” Wilkerson says, and they are conducting their own online research into medical equipment they might want, which she says is a positive trend. However, when those patients buy from less than thorough (or scrupulous) online sellers that do not take the same precautions that an HME provider typically would to ensure the patient gets the right DME and knows how to use it. Certainly the last thing any responsible HME provider wants to see is a Medicare claim filed for the wrong equipment or HME that a patient doesn’t know how to use.

“The Internet is a good introduction, and a good research tool,” Wilkerson says. “But patients still need that face-to-face education and follow-up from a local provider.”

The key, Wilkerson says, is to strike a balance. A provider might use e-commerce to sell replacement parts, but the core home medical equipment would still require an on-site visit to the provider, for instance.

While e-commerce is obviously not without controversy in the HME industry, “the reality is — as it is in most industries — e-commerce is here to stay,” says Spencer Kay, president of Fastrack Healthcare Systems Inc. “We see a lot of our clients taking advantage of it, and doing quite well.”

Undeniably, buying everything from plane tickets to flowers online is as prosaic as placing a phone call. Plus, as patients get older, ordering HME online makes sense for them, especially those who might not be able to drive or who aren’t close to the nearest provider in their healthcare network. And let’s not forget family members who might want to pay cash to get a faraway parent a piece of needed HME.

“For a provider to ignore that is a mistake,” Kay says. There are definitely providers that have or are developing responsible e-commerce strategies, Kay says, “and the ones that aren’t are probably losing out on some opportunities.”

An Indispensable Tool

Regardless of e-commerce, the use of the Internet in everyday HME operations is becoming more ubiquitous — to the point that providers might not realize how often they rely on it.

“I don’t think providers could do business without the Internet today,” says Edward Kutt, general manager of Diabco Medical Billing Systems. “There are too many things that are needed quickly and that are available over the Internet.”
An example would be electronic billing. “Electronic billing is quickly becoming a must-have, not a nice-to-have,” Blount says. With electronic billing, providers can submit their claims en masse to various funding sources, without having to process them individually.

Moreover, most billing systems provide automated tools for ensuring claims are filled out correctly before they are submitted. For instance, Diabco provides various Medicare eligibility services that are handled over the Internet, Kutt says.

Another benefit of HME systems using the Internet is a sort of “strength in numbers.” Providers of those systems can leverage their user base, if it is large enough, to deliver innovations and tools that providers wouldn’t easily be able to acquire on their own, Blount says. For instance, a provider might have to pay much more for document imaging services on its own in comparison to getting the document imaging as part of an online service.

One software provider that has leveraged this group purchasing strength is Fastrack, which set up its own MSO so that it could function as a purchasing group (see news section, page 8, to read more about the product categories covered by Fastrack MSO).

Likewise, simply using hosted solutions to build online communities among users can confer other benefits says Kutt. For instance, Diabco provides online support systems that not only help providers resolve issues, but also add those solutions to an online knowledgebase that other providers can use. Another support strength of the ‘Net: automatic software updates takes yet another level of IT management out of providers’ hands, Wilkerson says. Now that Heritage uses the automatic update from Computer Applications Unlimited’s Solution/One HME, it no longer has to wait on CD ROMs or run installers.

Another upside to the Internet is that it creates a tremendous tool for communicating with patients, suppliers and referral partners, Kay says. Beyond email, providers can set up web presences that, for instance, let doctors check in to see if patients have received a piece of HME, or patients see if their claim for DME has been covered.

What the Future Holds

One key area where the industry might see some improvement are Medicare/Medicaid billing. As it stands some Medicaids let providers submit claims via secure Internet connections, but Medicare still (frustratingly) requires them to connect via modems in order to bill electronically (read “What’s a Modem?” in the August, 2008 issue of HME Business). This is beginning to see as fix, as Blount notes that Brightree submits Medicare claims via FTP.

Also, increased electronic purchasing is another area that will see development. While the industry has a standardized format for electronic POs to manufacturers, increased usage of online purchasing will drive more functionality, such as order acknowledgements or delivery notifications, Kay says.

Overall, the industry has greatly benefited from the Internet over the years, Wilkerson says, but how the industry uses e-commerce, and how other elements of the homecare industry, such as Medicare, continue to adapt to and adopt the Internet will need to improve. “We’ve come a long way,” she says, “but we still have a ways to go.”

When businesses and consumers began widely using the Internet, it truly changed everything. In fact, it is difficult to recall pre-online life. That use it will continue to evolve — and with it so will the ways providers interact with their patients, partners, payors and the rest of the homecare industry. Consider the ’Net’s impact on homecare a perpetual work in progress, and don’t be surprised if the rules change more than once.

 Points to Take Away
•    As IT has found its way into nearly every corner of HME businesses, so has the Internet.
•    Key ways the Internet is improving the way providers do business include increased efficiency via tools such as electronic billing and better communications with partners and patients.
•    HME systems hosted over the Internet are helping providers leverage their numbers to gain benefits such as cheaper access to services and even form purchasing groups.
•    While e-commerce doesn’t have the best reputation in homecare, its role will grow in importance.
•    Developments providers should push for include improved electronic claims filing to Medicare and widespread usage of electronic purchasing.

Learn more
• – look at our Software Solutions Center, which can be found in the resources portion of our site.

This article originally appeared in the September 2008 issue of Mobility Management.

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on LinkedIn at and on Twitter at @postacutenews.

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