Home respiratory care isn’t what it used to be. In the 1980s, respiratory patients were sent home with equipment as a last resort and to ease the fatal progression of their disease. Oxygen patients were set up on stationary equipment and portables were available as a backup to the stationary, not ambulatory, units.

Typically, oxygen was started so late in the process that complications had multiplied and the patients were so sick that they could not get out of bed. In the ’80s, patients were on oxygen for less than a year.

All that has changed. Now patients are placed on oxygen early in their disease and many patients are young enough to still have jobs. Portable oxygen is the standard of care, and the challenge is to find portable systems that meet the patient’s need to live a normal life while receiving oxygen.

In addition, patients’ relationships with their physicians have changed. Today’s generation of patients asks questions and expects answers from physicians instead of simply trusting the physicians’ judgments. Modern patients want to understand what therapy they are receiving and why. They need to be actively involved in their health care and ask questions if they do not understand why they are receiving a treatment.

For oxygen therapy patients, this means knowing what their options are and how their equipment works. Take the recent introduction of a lightweight liquid-oxygen portable as an example. Many HME providers were uninterested in this new product because it cost more than the larger liquid-oxygen portables. However, when some patients learned of the new product through networks of patient organizations, they actively searched for HMEs that provided the system and switched dealers if necessary to get the equipment they wanted.

In my opinion, this pull-through marketing to home patients was new and has proven to be successful. The information age has allowed patients to search the Internet for products and services that meet their needs and are now informed consumers of home respiratory products. The cat is out of the bag and there is no going back to the old way of providing HME services.

What Do Patients Want?
To get a better understanding of the needs and desires of oxygen patients, my company set up an Internet patient survey with the help of a patient group called Emphysema Foundation For Our Right To Survive (EFFORTS). For the survey, we asked patients to name the top five issues they would like their HME to know regarding their needs and respiratory service. Sixty patients responded with a total of 164 comments collected; 45 responses related to products, 93 responses related to service, and 26 responses covered both products and service. In addition, 19 responses were specifically related to checking equipment and 11 responses specifically requested education related to products and applications.

Analyzing the responses more closely, we found that the patients who replied to the survey would like their HME providers to offer them with a liter meter, an oximeter, a lighter longer-lasting portable oxygen system, more cannula options, and more options for equipment in general.

The patients also wanted more help to determine if their equipment is functioning correctly and if it is oxygenating them properly. After that, they were most concerned about comfort, flexibility, and the ability of their equipment to meet their lifestyle needs.

On the customer service side, the patients said they wanted respect, scheduled on-time deliveries, more frequent equipment checks, knowledgeable billing staff, and more frequent visits from the respiratory therapist. This is not surprising as service is a common expectation from any customer. However, these oxygen patients consider their needs to be a top priority for their home health care provider and they are more than willing to spread the word about the type of service they received from an HME company. Happy customers will tell several people about how pleased they are with their HME providers. Unhappy customers will tell many more people (via a chat room or a list server) about the poor service they received.

More RT Visits, Please
Because 19 responses were specifically related to checking equipment, this is clearly an area of concern. Most of these 19 patients were worried that the equipment they were using was not operating correctly and that the driver did not have the training or skill to understand the problem. This tied back to the comment that the patients would like to see a respiratory therapist more frequently. The clinical skill of a therapist could determine if the patient was not doing well regardless of the equipment’s operation.

Oxygen therapy patients are hungry for information regarding their disease and options for treating it. The Internet has provided a vehicle for patients to search for information and learn of new research and products. Many times the patient learns about new information before the clinician or HME provider since they have more time to surf the Internet. The advantage to this is that the patient can do the research that others do not have time to do. The concern is that a little bit of information can be dangerous and patients may request or demand a new product or procedure that is inappropriate or unsafe for their use.

How individual HME companies respond to these Internet-savvy patients is up to the companies’ management. However, I would keep in mind that patients are the reason the home health care business exists. Now that the patients are becoming motivated, informed, and active, the HME provider that can work with patients to solve problems will likely grow its business and help shape the future of home respiratory care.

Bob McCoy, RRT, is managing director of Valley Inspired Products, Savage, Minn. Contact him at bmccoy@inspiredrc.com.  For more information about EFFORTS, see its Web site at www.emphysema.net.