The appeal of information technology to business is undeniable, and in the complicated world of health care, the implications are indeed enticing. For home health care providers, the promise of paper-free inventory management, streamlined data collection, improved usage, and a spectrum of telemedicine applications has some ready to invest in the latest and greatest today.

However, experts in the field say that, from a business perspective, it is best to take a cautious approach. While those at work on the new technology—and those working with it already—are enthusiastic, there are hurdles to overcome.

The first step for many HME companies is to make sure their current systems can handle the influx of new technology. Next, they should consider carefully what will work for their business size as well as their clientele base. Only when providers understand both the trends at hand and what they need to do to react to those trends should they take the giddy plunge into the future of HME.

Laying a Foundation for What Lies Ahead
“At this stage it is about what makes sense for the company, and we need to start with the basics,” says Michael Barish, president of AnCor Healthcare Consulting Inc, in Coral Springs, Fla. “Providers should have something that will take a complete order and produce documentation to get paid for their claims. If they are more sophisticated, they can get into bar coding and document imaging or business-to-business communication, wherein providers send electronic purchase orders to vendors and the vendors automatically send out their order and an electronic receipt.”

But even the basics require the proper infrastructure to support data and technology initiatives—something that Mike Hannah, chief technology officer and vice president of information technology at the home health care provider Gentiva, Overland Park, Kan, says his company is investing in heavily. Luckily, not every provider needs to make a Gentiva-sized investment in computer hardware to prepare for the future.

“The proper technology for home care companies will provide a higher quality of care, but it must also reduce cost in the long run,” Hannah says. That means making sure any technology investments are appropriate for your company’s size and resources.

Technology investments also must address the issue of eventual obsolescence. Devices are no longer good for 10 to 15 years, but good systems allow home health care providers to move to new versions easily, says Tim Buckley, RRT, FAARC, director of respiratory services with Walgreens Health Initiatives, Deerfield, Ill.

And good information technology systems are also appropriate for the company’s size. What works in a company with one to five branches may not in one with 300.

“In 20 years, I have seen larger companies devoting enormous resources and dollars into development of their own systems, which have in some cases crippled or even destroyed them,” Buckley says. “Others have come up with 80% solutions. If your business doesn’t fit into either end of the bell curve, you will be struggling with those systems.”

Because many information technology and telemedicine companies are still focused on developing deals with large hospital groups, home health care providers must be aggressive in finding out for themselves what can be worthwhile from their point of view, advises Frank Lievens, managing director and owner of Lievens Lanckman in Grimbergen, Belgium, and international coordinator for the Telemedicine & Telecare International Trade Fair in Luxembourg. “Some providers already are cooperating with local hospitals on devices that can be interesting for home patients,” he says. “However, if providers just sit and wait until [information technology advances] come to them, they may wait too long.”

Considering “Everyday” Applications
Once HME providers equip themselves to handle new technology and decide what is really necessary for their businesses, there is a wealth of applications to explore. Many of these deal with streamlining basic business elements such as sales, inventory, and data management. Others can make employees more responsible for their productivity.

While health care providers have long collected data, they have not necessarily had the ability to easily output that data. As a result, decisions are sometimes made in a data void.

To solve this problem, Gentiva is examining new information technologies to collect more data more easily. For example, redesigning existing tools, such as handheld computers, can let caregivers collect data electronically in the home and then upload it into a main computer system. “That will give us more accurate, more consistent information,” Hannah says.

Other projects under way at Gentiva are the creation of a portal across all aspects of business that will make timely information available to caregivers, and development of a contact center that handles intakes and admissions. “We are using technology more strategically to make sure that we are more reactive to the needs of the market, and to the demographics and payor mix in that market,” Hannah says. “We want to understand the needs that exist in the markets today, as well as those that are likely to exist in potential markets for the future.”

Walgreen’s Health Initiatives also is investing in technology to measure and document service outcomes and send that information back to the managed care companies. For example, its respiratory therapists now use Palm Pilots for the information that they have traditionally kept on paper. “We had to build our own version of that because there is nothing commercially available out there,” Buckley says. “But this allows us to actually measure what is going on with the patient and provide the payor with a detailed account of which patient has what medical devices and how they qualify for those items.”

The vast field of telemedicine has great potential for health care but HME providers again should err on the side of pragmatism, selecting only the technology that fits appropriately into their businesses as it becomes available.

“Telemedicine is more than just communication—it is e-health,” Lievens says. Though e-health is more in practice between hospitals at this stage, once patients leave the hospital, the same technology will eventually be required. “That technology gives us the possibility to communicate, monitor patients, and establish a diagnosis all from a distance,” he says.

Complicating the telemedicine issue is the question of who will pay for this new approach to monitoring care. “There are two levels for technology—services and devices,” Lievens explains. “As far as devices are concerned, the more they are needed, the more the prices will come down. The devices will then come onto the reimbursement lists. The bigger debate is about services, which have to be sold politically and have legal issues attached,” he continues. “If you are facing a physician, you know who you are dealing with, but if you talk to a center, you never know who is there. If something goes wrong, who are you going to make responsible?”

Though few HME businesses may be ready to implement telemedicine today, it behooves them to get involved with those developing such devices and service options.

“The marriage of medical devices and information technology/telecommunication and service industries is already occurring, and now it is a matter of building the bridges between different industries,” Lievens says. “The larger companies need to be more open to the provider market and make an effort to target dealers and to understand their role—and vice versa. All the players need to play together. That will take some time, but there is the potential for smaller companies to listen to the needs of the market, find the right ideas, and take the initiative to organize proper marketing.”

Overcoming Fears and Embracing Progress
In addition to building bridges, Hannah stresses that manufacturers need to assure providers that the technology they are promoting as a benefit to business and patient care will not also be a liability later on.

“I have not seen the industry get creative enough yet to make providers confident that we are making safe investments,” he says. “Frankly, we are nervous about it—what if we replace our system and the new technology doesn’t work? What happens if telemedicine doesn’t lower visit utilization? If we are paying for the equipment and the attached overhead that goes along with it, and if we are increasing our cost, is there still a benefit? And while there may be a benefit for the patient, can it still be economically feasible for us? We have to be strategic about the cases where this technology really benefits patients. It is incumbent upon the industry to allay our fears a little.”

While realizing the promise of information technology and telemedicine is not something that will be done overnight, it depends on how dealers view this opportunity, Lievens says. “Providers can’t resist an emerging market, and the smart businesspeople will find those things that are most needed by their clientele. Providers have just not yet found the way.”

Elizabeth Finch is a contributing writer for Dealer/Provider.