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.
“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
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
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
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
• HME-business.com – look at our
found in the resources portion of our site.