Start your software overhaul by closely examining your current software system. What does it provide that makes your job simpler? What missing components cost you in time, employee productivity, and consistent frustrations? Are you satisfied with the level of support and customer service that you receive when you encounter problems? Is this a problem that could be resolved by simply doing an upgrade with your current system? If you find that the answer to the last question is a resounding NO, then it is wise for you to actively begin shopping for new software.

Information management systems are plentiful in the area of DMEPOS. However, which system is right for your operation? There is no shortage of freeware, or systems that boast compatibility and security capabilities that produce empty promises and deliver little. In today's climate, the number one task of DME CEOs is to create innovative ways of doing business that will not only drive down costs, but also streamline antiquated business processes.

CEOs who successfully do this can create significant productivity gains in an arena that has consistently shrinking margins and rapidly increasing overhead. This requires an in-depth understanding of DMEPOS industry pressures such as competitive bidding, accreditation, and a firm grasp of new technologies—specifically, what is needed to respond effectively to rapidly changing business conditions. Today's information systems must be able to adapt rapidly and keep pace with the evolution of the DMEPOS industry—which is increasingly focused on punishing all to catch the fraudulent and reduce costs.

So where do you begin when trying to identify the right system for your operation? First, consider the impact of competitive bidding and how it may turn current reimbursement methodologies on their ear. For example, are we looking at a world with more lump sum payments versus cap rental payments? If so, what impact will that have on current information systems and their internal architecture? What impact will these changes have on the flow of your business? All DMEPOS operations will require internal changes to adapt to the new standards of business and the imposed quality requirements recently released by CMS; information systems should support those changes.

Traditionally, health care information systems have fallen years behind other industries, such as banking and manufacturing, that use sophisticated data exchange and robust database platforms. These industries produce instant results and access to information, money, or automated business processes. So where does that leave us in the grossly overlooked DMEPOS industry?

With everything always changing, how is it possible for software vendors to keep pace with change—or do they settle for less sophisticated solutions that are less expensive? Other considerations are billing code requirements that may be revamped as a result of bidding—specifically, the modifiers required to properly bill. We should be anticipating the need for new forms to support daily processes, and information systems should manage those forms, eliminating the need for someone to complete them by hand. Automated form generation that meets accreditation requirements, as well as billing requirements, is essential for the future because accreditation requires extensive logging, tracking, and more detailed forms for patient education, quality, performance, and evidence of standards compliance.

Ted Jones, Jr.

If you plan on effectively adapting to competitive bidding, larger service areas, accreditation standards, and rising fuel prices, the correct information management system should be one of your highest priorities. Take into consideration employee benefit costs and decreasing reimbursement.

TOUGH DECISIONS

Many CEOs will be faced with the decision of whether to stay in business or to close shop. Those that decide to stay in business must provide quality service that meets and/or exceeds CMS standards and reduce overhead at the same time. How is that possible, and who has the solution?

There are no solid answers for these issues, but more software vendors are beginning to realize that it is not just about billing and inventory management anymore. Gone are the days of merely billing and collecting. DMEPOS providers of the future know that the wrong system could spell disaster, and choosing the appropriate information management system will be one of the biggest decisions as information systems become the heart of the operation.

Before you purchase an information system, you need to have completed competitive bidding and successfully achieved accreditation so you know what areas of your operation require automation. For most DMEPOS and DME/pharmacy operations, current information systems do not meet today's quality standards. Therefore, CEOs will be faced with an increasing amount of paperwork to get the same results.

Current systems may be responsible for billing, producing necessary forms for daily business transactions such as CMNs, or possibly tracking and controlling inventory. But don't forget tools, forms for patient assessments, equipment recall management, and tracking for infection control.

OUTLINE YOUR NEEDS

Be sure to clearly outline what your needs are, how information flows throughout your operation, the responsibilities of individuals who will be using the software, and how that application should support those functions. In DMEPOS, you can usually grab any medical billing software off the shelf and start using it overnight, but does that make it the right application for your business?

Most medical billing solutions are designed with physician practices in mind, with the most common features being appointment scheduling, claims submission, and perhaps some form-generation capabilities for authorization, claim management, A/R management, electronic remittance management, and, on rare occasions, auto posting of remittance advices. These are great features, but not entirely what you need for your DMEPOS operation.

When I started my DME in Yuma, Ariz, in 2002, I was confused as to what system was right for us despite many years of experience running large coding, billing, and collection agencies for academic teaching facilities throughout California. I had no time for trial and error, and I had tons of questions.

I knew I could not afford, nor did I need, a large and expensive system. I was accustomed to a billing operations administrator like IDX or SMS, but I still had few answers. However, I found quickly that the industry moved fast and some dealers inadvertently commit fraud by putting the wrong date on billing forms and delivery tickets. This was one of the chief reasons my wife Denise and I started TheIBNetwork. We believed there was a need to offer assistance and support to DMEPOS providers, in the same way large consulting firms assist Fortune 500 companies to find answers to common problems.

SO MANY OPTIONS

As you begin your initial inquiries into the numerous software options, do not become alarmed if you find you are overwhelmed. However, you must resolve to purchase a software program that meets your immediate needs but is still capable of handling growth.

Ask questions such as: What is the history of information systems in health care? What are the preferred system architecture and database? What are their connectivity options such as Web integration and remote access? What is the overall capability and functionality of the system? Does the system meet your operational objectives?

Contact other end users for feedback on their experience. What are the reporting capabilities? Test the system to see if it is intuitive. I like systems that will give you 3 to 6 months to try them before you buy. I also like a clear answer as to the platform the system is designed on. Avoid systems built on intermediate databases such as Fox or MS Access, and look for solutions that use robust databases such as Oracle.

Using a system built on the wrong platform can spell disaster as your data storage needs increase. Look into how adaptable to market changes the system is by asking references about their experiences. Finally, find out what you can expect in the area of software support and customer service.

Remember that the system you select may ultimately determine the profitability of your organization. After all, you will be spending money in the hopes of increasing productivity by automating processes and increasing your cash flow while still providing the highest quality of service and care to your patients.

Thedford (Ted) Jones, Jr, is president, CEO, and cofounder of The Intelligent Business Network Inc (TheIBNetwork), Burbank, Calif, a health care consulting firm providing turnkey solutions for Joint Commission accreditation, policy and procedure development, financial management, and information technology. Jones has a degree in health care administration and experience in the areas of accreditation, managed care contracting, accounts receivable management, cash acceleration, and information technology architecture. He can be reached via e-mail: .