Proper patient education is one of the keys to sleep therapy compliance says Chris Solitaire, RRT, RCT (right).

Chris Solitaire, rrt, rcT, clinical manager of Med Mart, San Antonio, is amazed every time a CPAP client comes to him with a story about how other HME companies have dealt with their disease.

“They tell me that some other businesses hand them the mask, the machine, and the manual and wish them luck,” Solitaire says. “Other clients say that some companies spend only 10 minutes showing them how to get set up on the system. I just don’t know how that is possible. That can’t be the way to do things, and what bothers me is that these institutions receive referrals from other institutions to place their patients on CPAP.”

With such poor follow-up, it is not surprising that reported CPAP compliance rates can be less than desirable. In a 2001 study in Walla Walla, Wash, for example, researchers reported that as many as a third of obstructive sleep apnea patients may eventually refuse CPAP therapy. And although manufacturers have put much time and effort into making CPAP devices that solve many patient complaints—such as claustrophobia, mask discomfort, nasal congestion, and drying of the airway—Solitaire and providers like him know that one of the ways to improve compliance is simply to spend more time with the new CPAP patient.

“At Med Mart we know we need to take time to properly fit that system,” he says. “Within our institution, it takes 45 to 50 minutes to properly educate and set up a patient on a CPAP or [a bilevel positive airway pressure] system.”

That dedication to thoroughly educating clients about CPAP, as well as other types of HME equipment, is what Solitaire believes sets Med Mart apart from the competition.

“I need to make sure people are well educated in the equipment that I am providing for them,” Solitaire says. “A lot of customers come in having no idea what they are getting and what to do with it. I need to assure my patients and make sure they are at ease, and they are knowledgeable about the equipment they are going to use. By the time they leave my office, they feel comfortable.”

No Rushed Care
The idea of spending extra time with patients may seem antiquated in an era when low insurance reimbursements push physicians and other health care providers to see as many patients as possible in the least amount of time. But it is part of the Med Mart philosophy and, Solitaire says, the key to its success.

Since the company began in 1983, it has been Med Mart’s mission to make sure its clients receive proper and professional care, and that includes making sure they are comfortable with the equipment they are taking home. Further, Med Mart aims to operate the company in a way that improves the quality of life of patients who need medical products or services in an outpatient or homebound setting. As part of that goal, the staff spends considerable time and energy building strong relationships with physicians, home care agencies, and patients.

“Our employees are encouraged to build rapport, confidence, and trust as they attend to the needs of their referrals and patients,” says company president Richard Hernandez. “We have an ongoing process for training and in-service for our staff of 43, and we are dedicated to offering the best customer service we can provide.”

It is a plan that is working so well that Hernandez recently decided to expand the company. Currently, Med Mart’s services are offered at three locations—San Antonio, Laredo, and Jourdanton. He hopes to add two more locations in the next 2 years.

To stand out in an area with stiff competition—Hernandez notes that Med Mart is one of 77 DME companies in San Antonio alone—the company offers nearly every aspect of HME, including wheelchairs, hospital beds, commodes, oxygen, and enteral nutrition. Plus Med Mart sells products in the respiratory, biomedical, and nutrition niches. Clients can access Med Mart’s services 7 days a week, 24 hours a day, and the company offers free delivery within a 100-mile radius of its three locations.

Finally, Med Mart became accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) for the first time 6 years ago.

The highest level of performance has meant making education a pivotal part of service, and led to Med Mart adding staff members like Solitaire, who brought 17 years of experience in the respiratory therapy field when he joined the company in January 2000. While Solitaire’s instruction covers all sorts of products sold at Med Mart, the growing number of clients coming in for CPAP products and the issues of compliance inherent in that niche have made educating sleep apnea patients a unique priority.

“In the past few years, things have changed in terms of people knowing about sleep apnea and being diagnosed with the problem,” Solitaire says. “A lot of organizations are providing education and research, and the [medical] journals are printing more studies.”

Med Mart educates its customers about the three different types of apnea and about what symptoms to look for through an array of printed materials and posters, and offers one-on-one teaching to customers that is tailored to the individual. The process typically starts by focusing on why the doctor picked this equipment for them.

“In some cases the patients don’t know why they are on CPAP,” Solitaire says. “They know they were sent out for a sleep study and now they’re here, but they still don’t understand how not breathing well at night relates to them being sleepy during the day.”

Med Mart’s staff also teaches CPAP clients how to keep their equipment clean and when their insurance will allow them to have another mask or filter. They then follow up with customers in the first week to see how they are doing, if they are sleeping better, and how the mask is working for them.

“If I educate my patients the way they should be educated, there will be fewer issues, fewer problems, and fewer phone calls,” Solitaire says. “It’s not that I don’t want to get phone calls, but getting more calls from patients who are having problems means I have not done my job.”

Elizabeth Finch is a contributing writer for Dealer/Provider.