If there is one thing an HME provider can count on, it is change. New regulations, modified reimbursement criteria, and technological advances each keep the HME provider struggling to stay abreast of it all. The good news is that your company’s software vendor could help you meet at least some of these ongoing challenges thanks to new trends in HME software system upgrades and features.

The Health Insurance Portability and Accountability Act (HIPAA) privacy regulations that went into affect in April may be the most sweeping set of regulatory changes to occur in the health care industry in decades. Indeed, they impact nearly every participant in HME including payors, referral sources, HME employees and business associates, and, most important, patients. As such, the implementation of processes to comply with the mandatory privacy regulations has been the source of more than a little stress for HME providers.

The majority of HME software system vendors have already completed the task of formatting electronic transmissions to be compliant with the current American National Standards Institute (ANSI) standards required by HIPAA. (If you are unsure about your vendor, check the DME Regional Carrier [DMERC] Web site in your region for a list of HIPAA-compliant software vendors.)

With that task concluded, most vendors now have moved on to the development of features to ensure that their products are compliant with the electronic data security portion of the HIPAA regulations in time to meet an April 21, 2005, deadline. Unlike HIPAA’s privacy rules—which apply to protected health information (PHI) in electronic, oral, or written communications—the security regulations apply only to PHI that is communicated electronically. This means that HME providers will need to rely heavily on software upgrades as they move toward compliance with the security standards phase of the HIPAA regulations.

Software companies will likely meet HIPAA’s mandatory requirements through new features, such as:

• Tracking of the user’s log-in name, date, and time, as well as the patient data viewed whenever protected health information is displayed.
• Access controls that manage passwords and permissions to view specific portions of the patient’s electronic data.
• Reports that will alert management when potential breaches in the system security occur.

But software vendors are not stopping at merely the mandatory compliance requirements. To attract your business, many software companies’ programs will also offer features designed to help HME providers manage their compliance with HIPAA regulations.

These features vary in complexity, but nearly all are likely to be appreciated by their users. For example, one software vendor has added a simple checkbox to the patient record in the database that will denote whether the mandatory acknowledgement of privacy notice is on file in the medical record and coupled it with a report that will list those patients missing the required documentation. This feature is sure to expedite the process of making sure that all patients have been notified of their rights under the current law. Other vendors are offering sophisticated security tools, such as user-defined time-out parameters for log-on to prevent security breaches that may occur when employees forget to log out of the system, and system administrator set requirements that force employees to change their passwords periodically in order to enhance log-in security. Yet another vendor offers a comprehensive HIPAA audit module that seeks to make all of its HIPAA-related tools, reports, and logs easily accessible to busy privacy officers charged with maintaining privacy compliance throughout all areas of a company.

Sweetening the Deal
If HIPAA regulations are the medicine, technological advances are the spoonful of sugar that makes that medicine go down. In reality, the warp speed advancements in technology over the past decade are what ushered in HIPAA regulations, but those same advances have also brought the industry the tools needed to automate many labor-intensive HME processes, and with them, the potential to improve profits.

For instance, instead of having an office clerk slog through the process of confirming a large stack of delivery tickets on a daily basis, HME suppliers can provide handheld personal digital assistant (PDA)-type devices to delivery technicians to capture confirmation information at the point of delivery. The PDA is then simply downloaded to the main system with the confirmation process already complete.

A decrease in the cost of computers and peripherals over the past several years has also helped make automation a practical reality. Affordable bar-code readers can maximize the efficiency of inventory management and reordering, making the implementation of “just in time” inventory systems a realistic goal for providers of any size. Wide-area networks can now use relatively cheap high-speed Internet connections to provide reliable access to data from many locations so that multi-branch HME providers can centralize billing and management processes at a single location instead of duplicating employees and processes at many locations.

Does your company drop-ship supply orders to many patients straight from the vendor? If so, you know how much time is spent faxing individual patient orders to your suppliers. Fortunately, some software systems offer the capability to transmit orders directly to the vendor through the HME provider’s software system, and even receive delivery confirmation from the vendor once the shipment is complete.

If your company really strives to be on the cutting edge of automation, document imaging may be the next stop on the technological horizon. Large hard disks and inexpensive, easy-to-use, backup tools and scanners provide the hardware that can reduce the costs of maintaining large paper files—as well as provide easy desktop access to images of paper documents that in the past required a trip to the file room and lengthy searches through medical records by documentation, billing, and audit staff.

Simplifying the Paper Chase
The electronic certificate of medical necessity (eCMN) initiative seeks to simplify the traditional paper CMN process and reduce the transit time of medical necessity documents between physicians and providers through the use of electronic document transmissions, electronic document completion, and digital signatures. This concept has been bandied about for years by those interested in the information management side of the HME business, but several hurdles remain before widespread adoption of the technology is likely to occur.

Without a doubt, the highest hurdle to clear is physician acceptance of eCMNs. According to a study of 1,200 physicians produced by Fulcrum Analytics and Deloitte Research entitled “Taking the Pulse: Physicians and Emerging Information Technologies,” the widespread acceptance of technologies such as the electronic completion and transmission of documents will hinge on whether the software available saves physicians time and improves the operational management of their practices. However, the task of getting physicians and their staff members to recognize the benefits of electronic documentation processing, and therefore garnering acceptance of the technology, will almost surely fall to the HME provider.

Regardless of the challenges ahead, digital signature laws, together with an acceptance of the eCMN concept by the Centers for Medicare and Medicaid Services (CMS), have prompted at least one HME software manufacturer to offer an integrated interface to an eCMN product.

Another software vendor argues that perhaps the best solution for the HME industry is to move away from the whole CMN system altogether and take this opportunity to adopt an electronic payment system similar to that used in the pharmacy industry where approvals and payments are handled electronically in a few seconds at the time the patient picks up the equipment.

However, this idea may take time to gain acceptance and currently even many software companies that do not offer eCMN integration are bullish on the eCMN initiative.

Their arguments are persuasive. Beyond a decreased turnaround time for the exchange of documents between physicians and providers, eCMNs offer an enormous potential to reduce overhead, increase compliance, and decrease documentation error rates—all logical benefits of electronic document processing. As standards emerge and HME providers become willing to offer eCMNs to their patients’ physicians, more HME software vendors may offer eCMN integration in their products.

We have only touched on a few of the newest software features available to HME providers and more are being developed by software vendors every day. Technological advancements and the increasing affordability of computer hardware are sure to keep the revolution rolling. The result is that today’s business owners have more management tools available to them than ever before. The trick is in keeping abreast of what is available and then deciding which tools will offer the most benefit. It is true that HME providers cannot stop change from happening, but they can leverage technology solutions that will help their companies manage change effectively, efficiently, and profitably.

Roberta Domos, RRT, is owner and president of Domos HME Consulting Group, a consulting firm in Louisville, Ky, and Redmond, Wash. For more information, contact her at (425) 882-2035, or visit her Web site at www.hmeconsulting.com.