Not long ago, the software used in the HME industry was simply known as “billing software,” and it is still often referred to as such. But the truth is that the software systems used by today’s HME providers have evolved into much more than programs that just generate claims for reimbursement. Many of the systems can now assist providers in managing their entire businesses from inventory to sales, to delivery operations, and beyond.

Faced with an ever-increasing cost of doing business, coupled with reimbursement that has remained stagnant or even decreased, providers have welcomed software features that automate processes once done manually. Gone from the offices of many HME providers are hand-written certificates of medical necessity (CMNs) and paper tickler files, index-card files to track preventive maintenance due dates, and laborious referral logs.

Ask HME providers what features they most appreciate in their software systems and you will get plenty of responses, few of which have to do with a system’s basic billing capabilities. Competent billing features, though very important, are deemed basic to any HME software system. What providers value most are features that give them the ability to track sales, inventory, preventive maintenance, depreciation, medical-necessity documentation, and a host of other aspects of their businesses. They are also impressed with some of the newer reporting tools that let them mine the data in their systems.

Ask them what they would like to see in future HME software systems and they also are at no loss for words.

For example, keeping new employees trained in the use of the business’s software is a continuing challenge, so Gail Tasch, MD, owner of Medwork of Wisconsin Inc, a DME billing service located in Eau Claire, Wis, would like to see a Windows-style “help” menu that contains context-sensitive instruction on the software’s features added to HME billing programs. From her point of view, “The most important aspect of software selection is to choose a company with excellent software support.” But even with that requirement satisfied, Tasch would like her staff to be able to minimize the need to call the vendor when questions about the operation of the software arise.

High-tech Helping Hand
Software support and training options are becoming more sophisticated and varied, on pace with new technologies that have come of age in the last several years. For instance, several software vendors now offer online help databases or comprehensive multimedia training programs on CD-ROM to supplement the phone support that nearly every system on the market offers.

Terri Thompson, director of HME provider Apex of St Peter’s in Helena, Mont, echoes the request for a more integrated help system but would also like to see built-in features that guide employees through the intake process and “provide a check system that will catch user error.” After all, you can find stand-alone programs and Web sites that offer instant access to coverage requirements for specific Healthcare Common Procedure Coding System (HCPCS) codes and other information that can steer employees through intake and documentation processes. However, it is rare to find these features integrated into HME software systems.

Other providers long for more robust patient-management features than are found in the typical HME software system. For one provider, necessity was indeed the mother of invention. Frank Jett, an owner of Medical Homecare in Birmingham, Ala, saw such a need for these features that his company built its own patient-management program using common database software. The system tracks dispatches in the field, patients’ current prescriptions, equipment rental histories, maintenance details, and a host of other information relevant to the patient care process. In addition, the program can print custom progress-report forms, customer-satisfaction survey letters, and education checklists for each patient entered into the system. All that is missing is integration with Medical Homecare’s commercial HME software—something that would eliminate the redundant data entry inherent in maintaining two different software tools.

But Jett has even more ambitious visions for the future of HME software. He is waiting for the day when physicians can employ wireless personal digital assistants (PDAs) to complete a prescription form and send it over a secure server directly to the HME provider. With electronic CMNs on track to become a reality in the industry, it certainly seems plausible that the day will come when physicians can use PDA software to send orders electronically to HME providers and pharmacies.

Also on the wish list for HME software are features that will help providers go “paperless,” or at least generate less paper than they currently handle now. Imagine having a patient’s entire file, neatly categorized by document type (delivery invoices, CMNs and prescriptions, progress notes, etc), available at the touch of a key. Built-in scanning and computer filing capabilities could render nearly obsolete those multiple trips to the medical records room and large stacks of patient files on the desks of billing staff members.

Companies with multiple service locations and a single location to handle billing duties have already begun to use scanning software and networked servers in place of mailing copies of patient documents to the billing center. However, these features have not yet been integrated into most commercially available HME software products.

Massive hard-drive capacities and simple software tools that can design custom forms raise the tantalizing possibility of recording a customer’s digital signatures on electronic forms, allowing providers to move toward the goal of paperless medical and billing records. However, digital signatures in place of original ink signatures must become more broadly accepted by payors before this dream can be realized.

Present Possibilities
While some desirable HME-software-system features may seem a long way off, the technology and the means to employ it are available now. John Durkee, founder of HME Webnet, an online forum for the HME industry, and a sales representative for American Breathing Care Plus, a respiratory pharmacy in Rainsville, Ala, would like to see beefed-up features designed to track sales activities.

His company purchased a sales-tracking package and has continued to modify and refine it to make it the perfect tool for tracking sales activity. “Any time a contact or action relative to a patient occurs, it is time and date stamped,” he explains. “Shipment dates can be entered by a patient care representative or even an employee in the field via a secure Internet connection. Information can be sorted by physician, by date range, by sales representative—you name it.”

Durkee especially appreciates features that allow him to pull a list of patients who did not order their medicine within a specified date range along with phone notes explaining why, and the fact that the information in the company’s custom database can be synchronized with his PDA.

It is easy to imagine other sales-tracking tools that could be built into HME software. HME sales representatives routinely keep a log of the sales calls that have been made on various referral sources. The ability to log these calls into a company’s HME software and print a report that compares the sales representative’s activities with referral results would help companies to fine-tune their marketing strategies.

Software vendors in the HME industry constantly solicit feedback from their users and add features as technology and budgets permit. Indeed, HME software systems have evolved rapidly over the past decade, and it is likely that vendors will continue to add more and more useful features as technology improves and demand for additional tools becomes more widespread. If you have an idea that would make your HME software the perfect tool to manage your business, let your software vendor know. You may just see it on your desktop someday.

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.