Building skills, increasing productivity
by Russ Willcutt

Most business owners understand the importance of having well-trained employees, but not everyone realizes the many ways in which that can be achieved. Some spend a day or two in conversation with a new hire, describing job responsibilities and how the company is structured. Maybe they provide a copy of the employee handbook and then send them off to start gaining hands-on experience. Smart HME/DME providers, however, educate themselves on the many resources that are available to them—including professional training services, webinars and onsite sessions presented by product manufacturers—and even develop their own innovative internal approaches.

Whether the issue is getting an entry-level employee up to speed quickly, providing continuing education opportunities to seasoned veterans or working toward companywide accreditation, the employee training process begins with identifying the right candidate for the job.

First Steps

Anyone who has handled hiring knows how time consuming it can be. First there’s the flood of résumés to be reviewed, then the phone conversations, then the in-person interviews, the narrowing down of candidates and perhaps even subsequent interviews. Weeks and even months can be consumed by the process, so any means of streamlining it is welcome. As part of its suite of training services, dmetrain has developed a prehiring assessment that is tailored to particular positions and experience levels.

“If you’re hiring a customer service representative, for instance, and they have very little direct experience, you might want to have them complete the level-one assessment for that job,” according to Jon Jasperson, president of dmetrain. “But if they have a decade of experience, the level-three test would be more appropriate. We also have assessments that are specific to other positions such as delivery drivers, respiratory therapists and pharmacy technicians, among others.”

The assessments are sent to dmetrain, which quickly generates a result that is returned to the hiring manager, who can then make a better-informed decision. Once that decision has been made, the new employee receives training that is mandated by the Occupational Safety & Health Administration (OSHA) or the U.S. Food and Drug Administration (FDA). Other training is required by accreditation agencies, such as guidelines on business ethics and fraud prevention. Once these required topics have been covered, job-specific courses are presented according to a suggested template that dmetrain has created. “We offer more than 400 courses, which all of our customers have access to, but we wanted to put together a list of courses that we’ve developed for particular jobs in order to help business owners make their decisions,” Jasperson says. “And they can always drop or add courses as they see fit.”

At the beginning of the relationship with a new client, dmetrain compiles data including which agency the HME/DME provider is accredited by and how many locations the company has and where they’re found, particularly if they are in different Medicare jurisdictions. This information allows the company to provide content that is geared toward the customer’s goals and helps maintain compliance with applicable regulations. As the company’s employees work their way through the courses in their track—dmetrain has identified some 60 separate tracks—they are periodically presented with competency exams to gauge knowledge retention. Clients are also encouraged to take advantage of educational opportunities such as webinars and in-service supplier training; important information that accreditation agencies want to see, and all of which is compiled in the employee’s records using the iTrack feature.

An additional tool dmetrain provides are patient education sheets. “Medicare specifies that you must train a patient on how to use their equipment in a language they can understand,” Jasperson says, “so we’ve created a series of education sheets that can be given to the patient when the equipment is delivered and assembled. We’ve had these sheets translated into seven different languages, so they’re a really nice way of meeting that Medicare requirement while at the same time providing customers with helpful information.”

External Resources

One company that has found dmetrain’s approach to be helpful is Medtech Services, which is located in Reno, Nev. But the company’s president, Rick Graver, also points out that there is a wealth of opportunities for employee education made available online, by manufacturers’ representatives, by agencies such as the Centers for Medicare & Medicaid Services (CMS) and at industry tradeshows. “We always make a point of attending Medtrade,” he says. “In addition to learning about all the new products and technologies that are being presented, we take in as many of the educational sessions as we can. Medtrade was my introduction to the HME/DME market when we first started the company, and it’s a great way for our new employees to learn about it as well.”

Celebrating its 25th anniversary this year, Medtech Services specializes in mobility equipment such as custom manual and power wheelchairs, seating and positioning products and adaptive equipment. It began as a wheelchair repair center, a service that still forms the core of its expertise, and it offers equipment rental and accessible vans as well. Graver attributes the company’s success and longevity to the knowledge possessed by its employees.

“The more knowledgeable about products we are—and even Medicare, Medicaid and third-party reimbursement regulations—the more confident we feel,” he says. “And the more confident we are, the more our customers trust us. They come to see us as an information resource and a friend rather than just an equipment supplier alone.”

In addition to webinars and online training, tradeshows and in-service events, Medtech Services has contracted with industry consultants, seeking an unbiased examination of the company’s operations and needs. “Consulting with a third party who has an independent perspective can really help us identify weaknesses in our knowledge base,” he says. “That allows us to streamline our processes and basically fine-tune our whole way of doing business. A good industry consultant can give us the mile-high view of what’s happening in the market rather than focusing on a specific area or product.”

Grazer is proud of the reputation his company has built over the years, saying that it’s been driven by the desire to be known for its expertise. “We definitely want to be recognized as the experts in our field,” he says. “It doesn’t matter if a person actually makes a purchase with us or not, if we can help answer a question for them they’re going to tell other people, and that’s the best advertising there is.”

Internal Innovations

A conversation with Joe Petrolla, president of Seeley Medical—a full-service HME company with multiple locations in Ohio and outside Pittsburgh—is a bit like speaking with a neuroscientist. His passion is not only for learning, but understanding the mental pathways that make the acquisition of knowledge possible. “When people join the company they bring certain learned behaviors along with them,” he says, “so the first thing we do is identify their strengths, and also the gaps in their knowledge. Then we can begin helping them modify their behavior so they can be more successful in their personal and professional lives.”

Central to this effort is a training program he helped develop that’s called “ASK for Action,” which focuses on action, skill and knowledge. From the first day on the job, every employee is introduced to the concept and assigned certain tasks, beginning with interviewing Petrolla, other members of the executive team and even coworkers. “We first teach them how to conduct a proper interview, and then we encourage them to talk to anyone here,” he says. “Some people are a little shocked by that at first, saying ‘I didn’t even know who the president of the company was in my last job.’ That’s not how we do things here. Everyone has my cell number in case they have an idea to share with me.”

Petrolla is fascinated by brain plasticity, or the extent to which we are capable of learning, modifying our behaviors and excelling at tasks we didn’t know we could perform if we apply ourselves correctly. As an example he describes “learned apathy,” in which employees will establish a point at which they must seek help if they aren’t taught how to reach solutions themselves. “I had an employee come to me in tears, saying she had 5,000 things to do and couldn’t get to them all,” he recalls. “We sat down, made a list and prioritized it, and what we found was that she really only needed to get three things done, and they weren’t even due that day.”

The problem, he discovered, was that the employee—who’d been with the company for 20 years by then—had become the “go-to” person in customer service because of the knowledge she’d accumulated. “She constantly had at least three people at her desk asking questions, so she couldn’t get to any of her own work. I recognized this as a case of learned apathy, and we began providing the other workers with the skills they needed to resolve these issues on their own. Now that employee is our customer service manager, and one of our best ‘ASK for Action’ trainers.”

Seeley Medical’s development program is meant to be approached as continuing education, and it covers a wide range of topics. They include:

  • How people learn
  • Forming successful basic work habits
  • The benefits of planning
  • How to implement planning
  • Developing action plans
  • Time management

The key to success, Petrolla says, is consistency. “I’ve asked some business owners how they handle training, and they’ll say ‘we went to a team-building camp once’ or something along those lines. But we work on our program every day. Studies have shown that within 90 days of learning new information, you lose 80 percent of what you were told if you don’t put it into practice. That’s why we’ve made ‘ASK for Action’ such a major part of our culture.”

Interestingly, many employees have found that the principles embodied in the program have made a positive impact on their personal lives as well. “People have told me they’ve used what they’ve learned in their church groups, or in their homes when dealing with their children, and that it’s helped them immensely,” he says. “And that has a positive effect on how they feel about their work, too.”

People learn in many different ways, of course, and not every personality is amenable to this approach. “We’ve found that those who struggle with the program seem to have problems with accountability,” Petrolla says, “but the ones who embrace it end up doing wonderful things.”

The Ultimate Goal

While the benefits of having a well-trained workforce are clear, for many HME/DME companies the ultimate goal is accreditation. All accrediting agencies require employee training, but one has taken the concept of facility accreditation one step further. The Board of Certification/Accreditation (BOC) has developed the Certified Durable Medical Equipment Specialist (CDME™) credential. According to Jan paul Miller, MA, MEd, director of certification, “The CDME is for anyone who maintains ongoing knowledge in DME/HME devices and their usage,” he says. “Anyone with 500 hours of work experience and a high school diploma can become a CDME. This is someone who is knowledgeable about all aspects of the DME industry, handles basic repairs and troubleshooting of products and ensures home safety.”

Miller says that a CDME is trained on the job, and that BOC recommends training or education in oxygen, transfer systems, enteral supplies, wound care supplies and other DME products. “We are currently working with several providers of preparatory and continuing education courses for the CDME,” he says. “These providers play an important role in helping CDME candidates prepare for the exam and in advancing their knowledge of the DME industry.”

He goes on to explain that the individual benefits of having the CDME credential attached to their name include the fact that it serves as an assurance of professionalism for both the employee and the facility where he or she works. “It is a mark of excellence in the profession,” he says. “In addition, the credential is portable and goes with them wherever they work, increasing their employability.”

As for benefits to the employer, DME facilities with one or more CDMEs on staff report improved customer satisfaction. The certification also serves as an assurance to referral sources, which can increase business. “The CDME credential is a sign of professionalism that differentiates a company in a difficult market,” Miller says. “It offers facilities a competitive advantage.”

Ongoing Education

At a point in time when the HME/DME industry is facing challenges unlike anything it has experienced in the past, every single aspect of a business must be examined, improved and streamlined for ultimate efficiency and professionalism. A company’s employees represent you and your company at the front of store, behind the scenes and on the road. In fact, the U.S. Small Business Administration reports that approximately 70 percent of customers who cease doing business with a company do so because of a negative experience with a single employee. Rick Graver understands this, and is a firm believer in the concept of lifelong learning.

“I think we all understand the importance of education as it relates to the communication of ideas and human interaction, but the ongoing acquisition of knowledge in the professional setting is equally critical,” he says. “Formal education is the foundation upon which extended learning and expertise is based, and the HME/DME providers who embrace continuing education for their employees are the ones who will weather the current storms and find a way to succeed in the new health-care landscape.”

Go Online:

Board of Certification/ Accreditation (BOC)


Medtech Services

Seeley Medical

Sidebar: Certified DME Specialist

A Certified DME (CDME) specialist is a person who is knowledgeable about all aspects of the DME supply industry. This includes prescription verification, intake, product selection, dispensing/setup, regulations, documentation, billing, compliance and performance management in any client environment. This person supports the best DME products and/or supplies considering the prescription order, client’s rights and needs.

General Requirements
To become certified as a DME specialist, a candidate must meet initial experiential requirements and pass a comprehensive written multiple choice exam (MCE) given by the Board of Certification/Accreditation (BOC). Once certified, a BOC DME specialist must meet continuing education and annual renewal requirements to maintain BOC certification. The BOC Certified DME specialist also must adhere to a code of ethics designed to ensure a comprehensive scope of professional competence and deportment. The BOC DME specialist’s activities must reflect his/her certification(s) and education.

Roles of a CDME
Client Interaction: Obtain client/caregiver information, prescription validity and benefits eligibility. Comply with federal, state and local regulations. Educate clients on the operation of equipment/supplies.

Product/Supply Selection: Provide appropriate equipment/supplies that meet applicable standards and guidelines in good working order.

Practice Management: Manage inventory, perform troubleshooting and comply with billing standards. Comply with universal precaution procedures and occupational safety and health rules. Document all patient matters and communicate with other professionals.

Professional Development and Responsibility: Adhere to legal and ethical codes, participate in continuing education, fulfill civic responsibilities, participate in research as appropriate and educate the public and health professionals on available DME services. Refer to allied health care practitioners when patient/customer presents with medical conditions that are outside of this scope of practice. Learn more at