Oxygen Conservation

Conserving devices have been a mainstay modality of portable oxygen therapy for several decades now, yet many providers and clinicians perceive these products to be generic commodities, with little value proposition beyond “they make tanks last longer.” Patients who can’t “tolerate” a pulsed dose conserving device, as determined by a clinician with an exercise protocol and an oximeter, are relegated to using continuous flow regulators with large cylinders that require frequent refills. Clearly a lose-lose for the provider, who incurs high operational expenses, and the patient, who potentially becomes more sedentary.

Conserving devices are not commodities. Treating them as such results in even worse outcomes than high operational costs and dissatisfied patients. By simply being an “order-filler” when a referral source has a patient who needs a portable oxygen system with conserving device, providers are perceived the same way as oxygen conserving devices are… as indistinguishable from one another. At risk is the provider’s very brand, respiratory revenue stream, and perhaps ability to thrive in the brave new world of competitive bidding. With a 45 percent reimbursement cut to many product categories, a 10 percent reduction in DME utilization, substantially increased audit activity and new, confusing documentation requirements, providers must find ways to reduce total cost of equipment ownership, reduce operational costs, and increase sales. Oxygen conserving devices are one way to accomplish all four of these goals.

Most oxygen providers recognize that if compressed gas cylinder delivery is the appropriate modality for a patient, a conserving device will enhance the experience for all stakeholders. Despite costing providers a little more than a continuous flow regulator initially, a conserving device has a far lower total cost of ownership, because it wastes less gas, makes cylinders last longer, and reduces the number of trips a provider needs to make to a patient’s home per month. Patients can use smaller, lighter-weight cylinders to venture out into the community and exercise when using conserving devices, improving their quality of life and health care outcomes. Conserving devices are critical components of virtually every portable oxygen modality, from compressed gas cylinders, to portable oxygen concentrators, to liquid portable systems, to the cylinder systems used with transfill concentrators.

What many providers do not consider is that there are multiple conserver technologies available, some of them brand new, that are changing the way some leading companies are branding themselves in the context of competitive bidding and a competitive oxygen referral landscape. By matching the appropriate technology to an individual patient a provider can:

• Improve patient health-related quality of life and outcomes
• Improve the patient’s perception of the referring clinician
• Improve the referral source’s perception of the DME provider, and
• Reduce COPD exacerbation hospital readmission rates

Advances in oxygen conservation technology come frequently from Drive Medical’s experts in Florida at Chad Therapeutics. Rather than a one-product-fits-all solution, Drive allows for an opportunity to “match the product to the patient.” By communicating to pulmonologists, discharge planners, and other referral sources what technologies they have access to and when to use each product, the provider distinguishes themselves from the “order-fillers” and becomes a consultative expert in the healthcare continuum.

For example, many providers are familiar with pneumatic and electronic conservers. Pneumatics are often used as a “first line of defense against continuous flow” because they are small, lightweight, simple to use and the least-expensive type of pulsed dose device. Electronics are a bit larger, cost slightly more, and run on batteries, but are more sensitive than pneumatics and often detect patient inspirations that pneumatics are unable to. So a simple algorithm would be to use pneumatic conservers, unless the patient is a mouth or shallow breather, who cannot trigger the device. Then move to an electronic. However, it gets much more complex than that. Which pneumatic should be used? The one that delivers the highest volume of oxygen per breath (bolus size)? The one that “gets the pulse in” fastest? The one with the best delivery method (uniform pulse, rather than minute volume)? Furthermore, when should reservoir conservers be used? And finally, what about the ultimate in maximizing both saturations and cylinder durations—the newer auto-adjusting oxygen conservers? These are products that can sense rest or exertion and automatically increase or decrease oxygen dose as appropriate. These smart devices are clearly the future of oxygen conservation therapy. Drive is the only manufacturer making this entire suite of oxygen conserving devices.

Drive Medical has a team of respiratory clinical and sales experts that can provide CEU programs for providers’ referral sources, expertise in matching oxygen conservation technologies to appropriate patient populations, and sales strategies to positively brand and distinguish our partner providers’ companies. Conserving devices are a low acquisition cost portable oxygen modality that when used properly, will not only reduce operational costs, but will give patients the opportunity to be more active, clinicians the opportunity to see better health outcomes in their patient populations, and providers the opportunity to brand their companies and our industry in a positive way.