Use a data exchange to improve business
by Raj Sodhi

Spend time talking with HME providers about leveraging patient data to improve their sleep-related business and there’s one consistent theme: How can I make sure that the investment I make will pay off for my business as well as my patients? That’s a simple question with a complicated answer. Think of a long piece of thread laid out in front of you, with the HME provider right in the middle. To the far left is a patient’s original sleep test that generated a diagnosis of sleep-disordered breathing, and to the far right is the patient’s long-term compliance, with numerous other workflow activities in between. This connecting thread is data: about the patient’s diagnosis and adherence, about the payer who covers the patient, about the patient’s resupply history, other medical conditions, and therapy outcomes. Data is generated at each transactional point of therapy, but needs to be integrated and analyzed to create actionable health and business intelligence. At that point, it can be leveraged to achieve two objectives:

  • To significantly improve the likelihood that your patients will comply with therapy
  • To streamline business processes, from patient intake to reimbursement and resupply, by automating patient management

Compliance technology is getting very sophisticated. It can leverage patient monitoring data to show, at a glance, which patients need intervention or which patients are, for example, consistently showing mask leak. On the patient side, coaching software can automatically generate messages to prompt patients to restart therapy, praise them for a job well done and engage them in their therapy success. These messages work. A recent study presented at the American Thoracic Society meeting (May 2014) showed that automated patient messages improved compliance by 10 percentage points while reducing related labor costs by 59 percent. It’s a win-win for patients and providers.

Leveraging the Power of Patient Data

There are certain obstacles to consider when implementing a system such as this. Patient data usually resides in multiple, disconnected systems and it is easy to lose visibility of patients when trying to manually consult each. Linking them all and getting them to speak the same language may seem daunting. While integrating systems is not simple for most HME providers, it isn’t too difficult for organizations that specialize in creating a data exchange—the unification and structuring of data from disparate systems to ensure that current and accurate data is flowing to each system. If you bring in the right team, your biggest challenge may be defining how you want to shape your use of data to benefit your patients’ care as well as your bottom line.

Three Pillars of Success in Data Exchange

The successful use of data in your practice is dependent upon three things. People: Do you have the right skill set, either on your staff or in your stable of vendors, to generate the blueprint for your system, its implementation and for ongoing monitoring and maintenance? Most HME businesses don’t have a systems engineer to design a plan that will enable the integration of data from multiple sources. You will need good people on both sides of the equation. You will also need to make sure you take into consideration any future systems or applications, such as new billing systems or EMRs, that may need to be incorporated. A data exchange professional with expertise in home care can help anticipate your future needs and design a system that will accommodate those changes as well as future growth. Process: Have you established a reliable, repeatable process for the intake and analysis of data, and have you thought through all of the implications to your business? For example, patient data—from the very first setup—can be leveraged into billing platforms and resupply programs as well as compliance monitoring and management applications. Creating a data exchange within your business can ensure the flow of data to your business systems, but you may need to re-engineer and streamline your business processes to take full advantage of a data exchange. Technology: Have you selected the right software platforms and integration points for your business objectives? A good way to start is to consider what problems you need to solve in your business to identify the corresponding integration points. For example, if you are spending too much time on your billing process because you need to access multiple systems and manually compile data for reimbursement,integration between your compliance platform and billing system could result in significant efficiencies.

A Key Benefit of a Data Exchange

In addition to having better visibility of your patients and automating the management of their compliance and billing, a unified system with a data exchange delivers one additional and very lucrative benefit: the ability to scale. One company recently completed a data exchange for a hybrid HME provider that typically completed around 40 setups per month. Once the provider moved to a fully automated patient management system, it was able to increase capacity to 100 setups per month. Instead of spending valuable staff time poring over patient data to identify which patients needed intervention or trying to marry compliance reports with billing, the provider was able to redirect staff time to more value-added activities, such as increasing referrals and seeing new patients. At a time when reimbursement rates are being squeezed from all sides, increasing capacity for new patient volume is critical; not just for growth, but for survival.

Additional Considerations

Managing Data Integrity: Because most data is manually entered at the initial patient setup, make sure there is a process to monitor data integrity. It only takes one wrong keystroke to impact a patient record. A data exchange can help bring to the surface incorrect data, but it will still need to be monitored and managed on an ongoing basis. A properly designed system also can help enforce data integrity at the time of entry.

Keeping Patient Data Secure: Data security is an important consideration. A proper data exchange will be able to share patient data securely within a closed-system environment and minimize or eliminate any likelihood that patient data is inappropriately shared or accessed by unauthorized individuals. Future Sources of Data: Telemonitoring has opened a new world of patient health information, from blood glucose levels to weight to blood pressure, and of course, sleep apnea. What about new frontiers in health information? Five years ago, no one had ever heard of personal fitness monitors. Now there are hundreds of devices and apps that record everything from heart rate to calories burned, and that data, along with traditional telemonitoring data, may have a future role in caring for your patients by providing holistic views of their health. One final thought: How to answer the question of when to build your data exchange? While it may be tempting to wait it out just a bit longer to see what new technology comes down the pike, there is such a thing as waiting too long. That’s the beauty of a data exchange — it’s more about the data and less about the system. With the right partner, a flexible data exchange platform can future-proof your business as new data-driven services or applications come along. A bit of advice: Get started with automating your patient-compliance and patient-engagement systems, and see where that takes you. You will soon see the power that data has to improve your business efficiencies, your bottom line and, just as importantly, the lives of your patients.