Providers often ask, "Why is it that technology is so expensive?" Technology is actually a tool to help us increase the bottom line. We must strive for efficient use of technology, not merely purchase it. The partnerships you enter into with vendors must be mutually beneficial. Otherwise, what you have spent on technology will be insignificant to what you spend in frustration and lost productivity. Most readers have implemented some form of technology, but is it being used efficiently? Whatever your reason for pursuing a technological solution, think differently and use technology to meet your goals.

ONCE BITTEN, TWICE SHY

After installing your new purchase, did you feel like you were told one thing and received something different? Did the salesman overcommit? This can easily occur without clear expectations. Without a definitive list of expectations and/or requirements, expect disappointment.

Remember the last game you purchased for your child? You brought it home, placed the CD in the drive, and learned that you did not have the appropriate video card. The same is true with technology in our industry. We must be careful to include hardware changes to accommodate the change.

Installing Microsoft Office is possible without training. However, you cannot expect the same for technology that efficiently manages your business. Some vendors may say their software is easy to use, and it will be after months of use.

BAD TECHNOLOGY

"Undocumented features" are also known as "bugs." You know you have one of these when support says, "Hmmm, it's not supposed to do that." The most frustrating of all is when a bug reappears months after it was removed. These relate to quality control and the testing process of the vendor.

The next bit of bad technology is the persistent crash. Crashes impact our ability to operate technology and inconvenience both our customers and us. We must go back to paper while systems are being restored.

The last item on my bad technology list is the proprietary/closed system. These systems are portrayed as a cut above when in reality you end up paying more for features that are standard in other applications. For example, some companies are now offering, for an extra fee, the ability to use their SQL interpreter. Without this optional program, users would not have the ability to query their own data similar to most database programs. The results of bad technology experiences are typically dissatisfaction, a cynical view of technology, and acceptance of the status quo.

GOOD TECHNOLOGY

With good technology, we can now perform tasks that might otherwise require outside help such as payables, payroll, or graphic arts—and this technology does not burn through cash reserves. The adage, "You get what you pay for," must be in the forefront of your mind. Cash-strapped vendors will lure you with unbelievable tactics.

The working definition of efficient technology is "selecting and implementing technological solutions that fit your business model and objectives." As providers search for technology that will be a good fit for their organization, they often have few written expectations and goals. I saw this quite often during consulting situations and in sales.

Clients would say they are looking to "replace their software with one that does inventory control, electronic claim submission, and accounting." Or, "We need a program that is user-friendly." What is "friendly" to one user was "unfriendly" to another.

What does "inventory control" really mean? Some vendors see it as an afterthought to a billing program. Do you know what you mean when you express your desire for inventory control? Will you know it when you see it?

You will encounter various obstacles in your quest to find and implement technology. The first, and probably the most difficult, is the budget. Budgeting for technology is difficult at best and will likely be too low. Recognize that there will be unforeseen issues that will require attention such as additional memory needs or faster network capabilities.

WATCH FOR SMOKE AND MIRRORS

Another potential for "smoke and mirrors" lies in the answer to the question: "How many customers do you have?" Some vendors answer with the number of unique customers. Many will answer with the number of "users." Others will count the same customer more than once based on the number of products they have sold to that customer. And still others will count all customers, even those that are not in the HME industry. The ball is in your court to ask what their definition of "customer" is.

The real benefit of software is not how cheaply you can purchase it. Rather, determine if the vendor is going to be a partner in your success. Complete implementation is more than simply being trained for 1 or 2 days over the phone or on-site. Those offering this type of training are selling software. Their implementation process is installation and showing you how the software works. With the investment you are making in software, you want your software vendor to guide you through the process.

For example, some vendors require that you use HCPCS as item codes if you want to have the allowables updated. This method is a nightmare for good inventory management. A good provider is going to ask questions and recommend the best way to achieve your needs.

What is more expensive?: Implementation from the vendor, or your staff struggling with the software? HMEs will invest in software and expect 2 days of on-site training to give them everything they need to know. Such thinking is a recipe for an unsuccessful software purchase. Vendor response is what matters. The biggest companies can be slow to respond to industry changes and needs. Smaller companies can have too few staff members.

Duane Ridenour

Do you want a vendor with hundreds of unique customers? Or is it important that a vendor has a variety of business sizes and types, including the likes of Cedars-Sinai, Johns Hopkins, and St Jude hospitals? Do you take the word of customers on reference lists who may or may not have a business model that is similar to yours? You will be surprised at how few vendors deal with the entire spectrum of the HME industry. These vendors are better suited than a niche player.

THE INTAKE PROCESS

Many companies continue to use paper as their first step at intake. Some companies are using multiple paper documents that are then used to key the patient information into their computer system. How many pieces of paper do you require? I have heard it all: "We don't have time to get all the info in the system right away"; "Our referral sources will not stay on the phone long enough"; "We have these documents as a paper trail in case an order gets lost."

It may be true that it takes too long to enter patient information into your software. Could it be that your software has merely taken a paper process and migrated it to the computer? It would not be the first time. Today's solution needs to be more than user-friendly; it must be process-friendly—which leads us to logical entry of data.

How many screens are required to enter a patient? Can you easily enter the most critical information so the referral sources can move on to their next task? Papers can easily be misplaced and sometimes never turn up. There is no requirement that you have a paper trail for a new referral. Let the computer handle this task.

Recently, an order was ready to be billed but the physician's written order could not be found. The user checked the scanned documents for that patient and noticed that the original had been scanned into the system. The item that could be billed as the signed physician order had in fact been received. Finding a 4 by 5 script can be even more difficult. Therefore, scan all documents immediately upon receipt. Even if filing of the documents is slow, they are available to all who need access.

Faxing from your software program is a must. Sending the appropriate documentation after entering the order will make your staff more efficient. With a modem and phone line, you are ready to take advantage of this technology that has been around for many years.

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There are many other options for electronic document handling, including electronic remittance notices (ERNs)—such as the ability to create an ANSI 835 electronic file from a paper EOB. Do you have payors that do not send you an 835 file? No problem: Take the document and let the program create an 835, which can then be read and posted just like any other 835 file. The only checks you have to manually post are those that come from a patient for their portion. All others are posted electronically.

Duane Ridenour has provided training and consulting services to providers throughout the United States and Puerto Rico. He is vice chair for the NSCAC executive committee and serves on multiple DME MAC Advisory Committees.