Jennifer Wyatt of Littleton Respiratory Homecare.

Most HME dealer/providers these days use computers in some or all facets of their operations. However, a computer is actually two separate products—hardware and software. Arguably, the latter is more important than the former. Why? Excellent software gives you a measure of control over competitors, tight-fisted payors, and unyielding regulators. “Can you run a company today and still be successful if the programs on your computer aren’t doing what they are supposed to? No way,” says Jennifer Wyatt, accounts receivable manager at Littleton Respiratory Homecare in Wilmington, Ohio, where the electronic office has been a fact of life for the past 15 years. “Given the challenges home care providers face, you have got to have software that puts every piece of information you could possibly need right at your fingertips.”

Among the challenges for HME enterprises are upcoming deeper cuts in Medicare reimbursement and the nationwide rollout of Medicare’s competitive system in 2007. At Andrew Brown’s Home Healthcare in Scranton, Pa, vice president of operations Robert F. Brown is not too worried because his computer is packed with software he believes is potent enough to help him stay profitable—regardless of what is thrown at him in the years ahead. “Thanks to our software, we are able to keep a sharp eye on costs coming in and on our cash going out,” he says. “It will be hard to catch us by surprise.”

Not Left Wondering
A rule of thumb with software: the more it does, the better off you are. Wyatt says that the software she uses is focused just on accounts receivables (A/R) (the company has a different set of software for other aspects of accounting), but even so, her A/R package handles more than just invoicing. “All our inventory is loaded in to the A/R system,” she indicates. “Each section of our warehouse has a locator code, which is embedded with our inventory record. This lets us go in each morning and run a report that tells us which items we need to reorder, based on pre-established minimum-maximum levels for each item in inventory.

“The software allows us to break down our sales to individual items—how many canes went out compared to how many hospital beds,” she continues. “We can electronically track the lot numbers on our oxygen cylinders, which greatly simplifies our management of those items. And, because of all this, we no longer face the same risk that we might run out of an item or overstock it.”

The software she is using also aids cash flow because it makes it possible to perform decidedly trustworthy purchase projections. “We can very accurately estimate what we are going to need to buy in the week or month ahead,” Wyatt says, adding that this permits better coordination of merchandise ordering in relationship to other spending needs the company might have at the same juncture (as a bonus, this look-forward capability helps the company nimbly time its purchases so as to qualify for the largest possible volume discount).

On a more basic level, the software speeds up the payment cycle, thereby abetting positive cash flow. “Our software has an automated billing feature that submits claims online to payors,” Wyatt offers. “Because there is no paper involved, we receive reimbursement much faster—usually within 14 days, rather than the 6 weeks that was typical in the past. We can also track certificates of medical necessity and physician orders. We can do this by mailing date, for example. We can pull up the patient record and instantly see their A/R balance, equipment purchase history, diagnostic codes, and when the billing took place on items they have received.”

Advantages of Integration
A vital characteristic of good software is ease of use. That should go without saying, but it is especially crucial if your company experiences high rates of employee turnover. Says Brown, “You are going to have to train replacement personnel in the use of your system. The easier the system is to operate, the shorter the learning curve will be for those new employees. If you have a system that is complicated and not easily learned, it is going to take a long time for new employees to become proficient with it.”

In other words, in a high-turnover environment, you will see less productivity from the staff because a sizable part of your team will perpetually be at various stages of learning the ropes of software operation. The learning becomes protracted—and the productivity shortfall exacerbated.

Another key ingredient of good software is reliability. “The data in your system has to be there when you need it,” says Brown. “It should be robust enough that it is very difficult for files to become corrupted.”

Brown thinks it advantageous for software to have an automated backup routine as a safeguard against accidental (or malicious) data purges, file corruptions, and other disasters. In his own circumstances, Brown keeps copies of every bit of stored data. They are on removable discs held in a secure location off site. In the event the computer at Andrew Brown’s goes down, those discs can be loaded onto another computer someplace else so that the company can continue conducting business while the affected system is being repaired, replaced, or otherwise restored.

In recent times, the industry buzz word in software has been “integration.” Roughly, that means programs made by different vendors can fluently exchange and use one another’s data. Integration, obviously, is a good thing in that it makes for efficient and cost-effective operations in a business environment where multiple software packages are used. Alas, integration has yet to find its way into the mix at Littleton where Wyatt works. “Integration would allow data collected and stored in my A/R system to be accessible directly by the general accounting system used in other areas of the company,” she says. “Right now, what we have to do to share data is pull A/R data into a spreadsheet program and from there export to the accounting system. It is a chore.”

A similar situation exists at Andrew Brown’s. The pharmacy side of the business uses a separate system from the HME operation. Brown yearns for integration so there could be a more timely capture of respiratory medication sales figures—data needed by both entities to stay on top of things. “Someone comes in for a nebulizer, we send them next door to the phar-macy for the medication,” he says. “A report is then generated by the pharmacy, but we don’t always remember to pick it up. Having integration between their system and ours would eliminate that possibility, because the report would be automatically and instantly shared.”

Beyond integration, an enhancement Brown would love to see made to his software is electronic signature, a capability by which customers sign their name on a hand-held computer tablet rather than on paper to denote acceptance of products or agreement to receive services. Signatures collected in this way (by delivery drivers, for example) in the field are then uploaded to the office-based system, either in batch mode at the end of the day, or in real time throughout the day via wireless connection between the portable tablet and headquarters.

See For Yourself
Regardless of what features a software package includes, many users can’t help fearing that the programs bought today will be obsolete the moment they are removed from the box. That, says Brown, may be true of hardware because the technology advances so swiftly that equipment is in many instances out of date within 18 to 24 months. However, it is a different matter with software. Software, he explains, is easily updated. “Manufacturers, when they come out with a newer, better version of their software, almost invariably do so by building on the foundation they laid with their original iteration,” he says.

The most helpful piece of advice Brown can offer to those who want good software is to do plenty of due diligence before buying. “Research the software as thoroughly as possible,” he says. “And don’t take the word of the sales team. Ask for the names of three or four users of the software and then pay those users a visit to observe the software in action. That will be your opportunity to really find out how easy the product is to work, how reliable it is, how beneficial it is. You can gather feedback from the top management people, but it is better to get it straight from the people who sit in front of the computer all day and perform the daily routine tasks. Ask them what they like and dislike about the software.”

If you shop wisely, the odds favor your bringing home software that will do most everything you want. There is no such thing as perfect software—at best it is always a work in progress. But a good package of software does not need to be perfect. It just needs to help you do a good job of running your enterprise.

Rich Smith is a contributing writer for Dealer/Provider.