Patient education can pay off by creating a loyal customer for life.

According to some estimates, as many as 18 million Americans may suffer from sleep apnea, which makes the diagnosis and treatment of this condition an area of home health care with great potential. What is more, providers who are truly

committed to the science and solutions of sleep therapy are earning more than strong profits, they are earning reputations as the best in the business.

We interviewed providers from across the country who have made a strong commitment to serving sleep therapy patients to find out what they think it takes to excel in this still growing niche.

Educate First to Simplify Sales
When it comes to sleep therapy, providing patients with the right products is only part of the success equation. The first challenge lies in educating patients about their sleep disorders.

“If the patient genuinely understands why and how CPAP therapy works, compliance will increase twenty-fold,” says Pattie Wyatt, owner of Phoenix CPAP Service Inc in Orange County, California.

Treatment compliance, of course, is the name of the game. As Andrew Macias, founder, president, and CEO of Breathing Disorders Services Inc in Oklahoma City, puts it, “Education equals compliance equals more referrals.” His company instituted an educational program called the “Sleep Disorders Breathing Rehabilitation Program,” which covers disease-specific topics as well as compliance issues, and it seems to make a big difference. Breathing Disorders Services has experienced a 59% increase in referrals over a 2-year period, he says.

Helen Kent, RRT, and president of Progressive Medical in Vista, Calif, conducts her business according to a similar philosophy. New patients watch a video on sleep apnea and treatment, which helps alleviate their fears. Patients are then encouraged to ask questions, while the staff listens and responds.

There is, of course, a considerable cost to spending time educating patients, but Kent and many other providers believe it is worth it in the long run as educated patients are more likely to continue the therapy and return for replacement masks and other products, such as tubing, headgear, or CPAP humidifiers.

“True, we don’t get paid for our educational efforts,” Kent says. “But in the end, it pays off because compliant patients are patients for life.”

Pattie Wyatt of Phoenix CPAP Service Inc Andrew Macias of Breathing Disord- ers Services Inc

Be Prepared
Carrying the right merchandise mix also is essential to success. Stock too many product lines and the cost of managing such a large inventory will cut into your profit margin. Stock too few, and you may not be able to meet all the needs of your referral sources and patients.

“We believe in a solution-based approach to inventory,” Macias says. Because there is no one-size-fits-all product when it comes to sleep masks, devoting warehouse space toward carrying complete sleep therapy product lines has been the right choice for his company. He estimates that his office receives approximately four additional referrals a week because physicians and sleep laboratories know that traditional HME providers do not carry as many specific brands of CPAP units or mask styles as he does.

From Wyatt’s standpoint, a provider simply cannot succeed in sleep therapy with a small inventory. The more equipment you have on hand, the better able you will be to accommodate every patient situation, she says. Moreover, price is not the only factor in determining her product line. Quality and reliability may be more important in ensuring compliance.

“We invest in good equipment even if it costs more,” she says. “It comes back to feed your business with word-of-mouth, patient-to-patient referrals.”

There are times, however, when a higher price tag does not necessarily mean a better product. Manufacturers have done a good job of promoting their latest products directly to physicians and sleep laboratories, so providers must use diplomacy and rely on strong relationships to negotiate some referral sources’ product selections.

“If I sense I’ll lose profits for something that is not a clinically superior product, I visit the physician and demonstrate the alternative equipment,” says Sherry Fowler, director of patient services at American Home Patient in Wilmington, NC.

Handled correctly, this talking through of the pros and cons of various products can give the provider greater credibility with physicians. “Most physicians are quite flexible because they view us as the expert in these matters,” Kent says.

When a physician is not flexible, Kent, Fowler, Wyatt, and Macias typically acquiesce rather than risk losing the referral source.

Devote Time to Patients
“Time with patients builds trust,” Fowler says. She and the other providers put a heavy emphasis on evaluating, educating, demonstrating products, and following up with every single patient. They may spend anywhere from 1 to 2 hours with a patient during the initial visit.

Next to the education process, the most important factor during the initial setup is the proper fitting of a sleep mask, they say. This involves reviewing the sleep study, getting a sleep history from the patient and spouse (when possible), and asking questions about lifestyle, health issues, and dexterity. Only through this rigorous process can they determine the right type and style of mask for a particular patient.

“In the long run it keeps patients from calling with questions later or having to refit a mask, both of which cost money,” Fowler says.

Demonstrating the system is equally important. This includes showing patients how a mask should fit, how to avoid leaks, and how the CPAP unit works. Most important, providers should allow time for patients to re-enact the setup themselves to ensure they are comfortable with how the system works.

There is an art to the follow-up process as well. Kent, Fowler, Wyatt, and Macias all have a system to troubleshoot patient problems early on. Macias’ company assigns a specific individual to contact a given patient on a weekly basis for the first month, then every other month.

“This allows us to address difficulties and keep the patient compliant,” he says. “But the follow-up care also generates a tremendous amount of sales.” As patients develop a rapport with their provider, they also learn to order a new mask after 3 or 6 months, or about upgrades in technology on new units they may want to consider.

Kent offers an additional tip: Invest time and energy in your own employees as a knowledgeable and courteous staff can make your organization thrive. At Progressive Medical, Kent nurtures internal team building. “We have administrative and billing people here, but they know something about disease states,” she says. “Everyone here contributes to the well-being of the patients.”

Know the Science
Lack of clinical knowledge can be one of the surest routes to failure in the sleep therapy niche. “Only provide equipment and therapy you genuinely understand,” Kent says.

To gain clinical knowledge, visit sleep laboratories to learn how to interpret complex sleep studies. Attending lectures, seminars, and industry events also will enhance your knowledge.

When it comes to products, providers must keep pace with technology as well. “Companies that are not up on new technology are not going to make it in the sleep therapy field,” Kent says.

Fortunately, manufacturers have an incentive to help suppliers stay current on new products, and their salespeople can usually help you stay informed about cutting edge technology.

Make Your Business Visible
Kent, Fowler, Wyatt, and Macias rely less on traditional marketing methods such as advertising and more on taking an active role in the community. Fowler’s organization takes a broad-brush approach, participating in a variety of events sponsored by the American Lung Association, American Heart Association, and Chamber of Commerce to generate publicity.

Breathing Disorders Services is a firm believer in strategic partnerships. “We sponsor outreach programs and educational seminars about sleep disordered breathing so that consumers become aware of the disease and informed about the resources,” Macias says.

According to Macias, it is vital for providers to support sleep laboratories and physicians by educating the public. “The sleep therapeutic market is predicated by the success of sleep labs,” he says. “People are not even aware they have a problem so we need to help drive traffic to the labs.”

Taking an active role in community events and health care initiatives helps turn providers like these into visible, valuable resources to both patients and referral sources. “Relationships first—that’s our greatest secret to success,” Macias says.

Marianne Matthews is a contributing writer for Dealer/Provider.