From online therapy to medication prescriptions, the shift to tech-enabled medicine has gained strong traction in numerous areas of health care. Though e-prescribing for home medical equipment (HME) has roughly doubled during the past year, it still lags behind other areas of online health care, despite the clear benefits for suppliers, clinicians, facilities, health plans—and, of course, patients.
Factors Affecting Adoption
Why is this? Many interconnected factors impact the adoption of e-prescribe for HME. First, the clinicians who could benefit most from HME e-prescribing are often the most overwhelmed and under-resourced. They may lack bandwidth or be hesitant to devote their limited time and energy to learning a new system, particularly a system they fear will be complicated or challenging.
The health care sector is also home to numerous tech players who promise to save providers time and money. Many health care workers have taken risks on new technology, only to find that end-user integration challenges or issues with reliability, compatibility and features of the tech itself make full adoption impossible. Understandably, there’s no shortage of skepticism when a new technology makes similar promises.
Another factor impacting adoption for HME e-prescribing is that the medical equipment being prescribed includes simple disposables, complex and sensitive electronics, and everything in between, and traverses a huge range of diagnosis and treatment categories, with a seemingly endless list of ICD-10 codes, current procedural terminology (CPT) codes and health plan requirements to match. This means complete order documentation on the clinician side and qualified orders eligible for fast reimbursement on the vendor side are both challenging to ensure. All these factors mean it is hard for HME e-prescribing platforms to get a seat at the table, and rightly so.
Some of Parachute Health's most important insights come from being good listeners. From listening to our stakeholders, we've learned that to earn users’ trust, the makers of health care tech have a responsibility to understand their needs, then make sure the tech they build adequately addresses those needs. We also came to believe that ethical tech entrepreneurship must involve efforts to support exhausted health care workers and repair stressed health care infrastructure, including effective training and education to ease transitions to new tools and systems, both at the point of signup and after onboarding. Finally, we learned from our friends in public health that the healthcare sector benefits greatly from transparency and open exchange of information, so we strive to act as a source of unbiased data about HME e-prescribing and how it compares to conventional ordering.
What does health care gain from a move to e-prescribing for HME? Before the advent of online ordering, the chaos and complexity of conventional HME ordering was a known source of dread and frustration for clinicians, health care administrators and home health care providers—not to mention vendors awaiting payment and health plans fielding substantiated grievances from plan members. These are still major pain points for the roughly 80% of orders completed by fax and phone—with many relying on inferior systems of sticky notes, handwritten cheat sheets and long lists of phone or fax numbers as workarounds.
Orders sent by fax are often rejected due to incomplete documentation or illegibility. If forms don’t get lost or thrown away before making it to the next phase, there’s often a round of phone calls between providers, suppliers and health plans to add missing documentation and CPT or ICD-10 codes and coordinate delivery. Each order can take hours, spread across days or even weeks.
This can cause pain on a deeply personal level. For example, Parachute Health was born when CEO David Gelbard’s father suffered a dangerous fall at home because a walker that he needed was ordered, but never arrived. In fact, most of the people who work for the company have loved ones who have had similar experiences or rely on HME themselves.
Data our company collected from large health systems and facilities across the country, as well as smaller datasets and individual case studies, show that HME e-prescribing on a full-service platform can slash order times from hours to under three minutes, decrease discharge delays and readmissions, and improve patient-reported satisfaction ratings. This translates to thousands in daily savings for health systems and plans and allows health care workers to be reassigned from administrative busywork to direct patient care.
Especially for care transitions and home health care, quick and reliable HME orders mean shorter lengths of stay, fewer demands on health care workers’ time and lower costs for health plans. Patients also experience a soft landing as they return home, confident that the equipment they need to stay safe and have their best quality of life will be there when they arrive.
What to Look For
Data is one piece of the puzzle, but it’s also important to be transparent, reliable and accountable at every opportunity. Here are some recommended features to look for in a good HME e-prescribing platform:
- Eligibility and benefits checks at the point of ordering, including complete, integrated coding options across ICD-10, CPT and other systems where relevant
- Bi-directional integration from the electronic health record to vendor enterprise resource planning system to connect and track orders end-to-end
- Complete order documentation features that go beyond just the prescription or written order before delivery to include face-to-face notes and checks for all required documentation and forms
- Multiple e-signature methods across devices and modalities—at a minimum, these should include mobile, email, in-electronic health record and on-screen
Technology leaders and health care trailblazers have an obligation to provide clear, actionable data and recommendations while facilitating transparency, accountability and empathy. In no area is this more apparent than HME.
A sector-wide transition to HME e-prescribing could usher in a new era of less burnout, improved cost efficiency and better patient outcomes. With such improvements well within reach, we should all collaborate to make them a reality.
Want more about e-prescribing? Take a look at Parachute Health recent report, "The State of DME E-Prescribing" available here.