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Research we conducted last year shows that 99% of referring providers in acute and ambulatory hospital settings, as well as physician offices, prefer to work with post-acute partners with whom they can interoperate effectively. Unsurprisingly, playing phone tag, tending to fax machines, sending multiple rounds of paperwork and manually keying in data are frustrating processes that most referral partners would rather not deal with.

Acute care referral partners are looking for ways to reduce costly complications and make sure patients are stable in the home after they’ve been discharged. They want their post-acute partners to proactively and securely communicate patient status, and to use automation to move patient data back and forth. In short, they feel that data exchange is an important and fundamental capability in both acute and post-acute care.

While results show that referring providers prefer electronic interactions, only 20% of the HME providers we surveyed receive electronic referral orders or e-prescriptions. So let’s explore what needs to change in our industry to encourage the adoption of interoperable tools.

Why is HME’s adoption rate different?

Difficulty getting accurate and timely information or complete and compliant documentation is not unique to HME and home infusion, but it is more prevalent in our care settings than in most others. Generally, our industry is heavily dependent on paperwork, and there is often a disconnect between who is responsible for providing a compliant order and documents versus who is financially responsible for fulfilling an equipment order or refilling a supply order.

This can lead to situations where you may have an eligible patient, but not necessarily a reimbursable event, which can mean added costs for fixing incomplete orders. And of course, we have to consider financial implications such reimbursement delays caused by orders that you know will be paid but that still need proper documentation.

What interoperability can mean for the HME industry

True interoperability is not just about getting a document. It’s about being able to unlock the power of the data that document contains so, as a provider, you can automate your operation. Interoperability is bi-directional, so all stakeholders have the right data to best serve the patient, including the patients themselves and their family members, no matter where they’re located. And in some segments of HME, there are documents including sleep study chart notes and data from compliance therapy. These responsibilities are outside our control, but need to happen for us to serve our patients and get paid for it.

The more we can bring technological advances to our work, the more we’re going to profit from the work we’re doing, and more importantly, the easier it will be to make sure the patient is getting proper care.

Driving adoption

Historically, it took government mandates and a lot of new technology to increase e-referral adoption. But I think the journey for HMEs will be different. One change over the last few years that has helped increase adoption of interoperable technology is alignment with existing provider workflows. This makes it easier for physicians to send compliant orders and documentation to an HME, helps make sure duplicate data entry is eliminated as much as possible, and brings data up at the right place in the workflow.

Although having everyone use the same platform and workflow would be ideal, without government mandates, it’s on the industry’s shoulder to move toward that goal. But HMEs have to be open to what providers need. Short term, that probably means different solutions, but in the end, I believe we’ll see a trend toward converging on one or two systems.

How e-prescribe can streamline patient resupply and adherence

In our business, it can take a lot of labor time going back and for with physician offices to process annual renewable prescriptions. Solutions that let us do that in an electronic format while still following all the regulations from payors like Medicare can really streamline what is essentially routine maintenance for our patients, but this is critical to reducing friction with referral sources. And again, if more time can be spent with the patient going over any challenges with their therapy and less time spent on routine maintenance and documentation, everyone wins. If the HME’s time is spent getting the patient their supplies, the patient can be thinking more about adherence and checking that supplies are arriving at the right time.

It’s not just large HME providers that benefit from technology tools. E-prescribe is actually a huge advantage for smaller providers because they don’t have the bandwidth larger national HMEs have. They don’t have regional offices all over the country. So this gives smaller agencies a way to stay in front of referral sources, for example in a drop-down menu, without having a brick-and-mortar location or people in the field getting your name out there.

It’s also critical for smaller providers to gain the benefits of automation. They don’t have the economies of scale of larger organization. If I work for a small organization with three people who receive orders and one of those people is out sick one day or on vacation, I’m going to feel that impact because of how labor-intensive the process is of receiving a fax, qualifying the order and manually entering it into the system. But on the flip side, automation has a big impact, too.

It’s also important to remember that today’s opportunities to gain efficiency and differentiate yourself will become tomorrow’s table stakes. As these platforms mature and become more automation-ready for recruiting physicians to adopt e-prescribe, it will become easier for smaller organizations that don’t have large sales forces to encourage physicians to adopt e-prescribe and leverage automation. Even if providers looked at e-prescribe four or five years ago, the technology has changed dramatically. If you’re looking to positively affect your business in the short-term, the time to look at this technology is now.

Other strategic relationships

From a business perspective, we need to be working with health systems and physician groups who refer patients to us and define the agreements we’re forming with them. We should focus on getting a patient out of a facility, delivering their home medical equipment and starting therapy as quickly as possible. When we do that, the health system wins, the provider wins through automation, and ultimately the patient wins

But to make this happen, you need the right people in the room. If a health system is using Epic, they’re going to have an Epic team, and probably several projects they’re working on. How do we get an e-prescribe interoperability project on their list and prioritized? Finding a champion on the health system side, who may not even in part of the technology team, can help prioritize these kinds of projects and get them done. Relationships are a big driver in these projects.

Getting started

The first step toward interoperability is to simply dive in. Sign up on the platforms of various e-prescribe companies. They’ll help educate you and set you up, and will often work with your referral sources if you need help to bring them to the table. Also, look at your existing systems. Many of them have their own platforms, and within those platforms, there may be opportunities to see and share information that can lead to better care.

It’s also important to remember you’ll probably encounter resistance to change. People may wonder about leaving the platform they currently use and going to another system. It’s true that it might take some extra time at the start as people learn new systems and workflows, but what’s important is to paint the picture of the entire process. If you encounter that initial resistance, make sure you’re explaining the entire workflow and all the efficiencies to be gained between the physician, the HME provider and all the other caregivers as you care for your patients together.

The technology and expertise are available to help you be successful with e-prescribing. You can talk to referral sources about these platforms and the opportunities they offer to streamline workflows and improve patient care. You can also talk to technology vendors like Brightree. We love it when people come to us with a challenge they need help navigating. We’re ready to help make life easier and advance conversations about using technology to improve care.

Request a demo today for a closer look at Brightree

Overcoming barriers to adopting interoperable technology - Nick Knowlton

As vice president of business development for Brightree, Nick Knowlton leads the company’s strategic initiatives, including partnership development and healthcare interoperability efforts.Nick has over twenty years of business experience and has held sales, marketing, product, and strategy positions for technology and health information technology businesses. Prior to joining Brightree, Nick ran strategic initiatives for Greenway Health, a market leader in the physician practice EHR space. Nick has a Bachelor of Science degree in biochemistry from the University of Notre Dame​


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