Channel George Custer's spirit

Tuesday, October 31, 2006

In Ken Burns' landmark Civil War documentary, the late historian Shelby Foote tells a wonderful anecdote about the young George Armstrong Custer when he was serving as an officer during the Civil War. While the generals muddled over the best way to cross a stream, Custer plunged forward on his horse and showed the generals that, indeed, they could simply ford the shallow river.
In the HME industry today, we could use a little bit of Custer's spirit, especially with regard to doing something so obvious, and so obviously beneficial, that we as an industry should be chagrined by our failure to implement this to date.
I am talking about...Well, I'm not going to say the word because your eyes will glaze over. So let me put it this way: Every HME provider should, starting tomorrow, begin to track how many of their respiratory patients check into hospital emergency rooms on a regular basis.
I choose my words carefully here. I say provider because if you are a provider, and not merely an equipment jockey, then presumably, you're doing more than simply delivering equipment.
Now, at the risk of rubbing my good friends at AAHomecare, the MED Group and VGM the wrong way, I'm going to suggest that these organizations need to coordinate these efforts for members. For more than a decade, I've listened to HME suppliers talk about how they save payers money. This is easy to believe. But I've never seen any hard evidence that the provision of home respiratory services actually does save payers money. Until the HME Business Summit. That's when Susan Riley at Airlogix threw up the single most powerful slide I've ever seen in the HME industry.
In this slide, she showed data from a West Coast managed care organization, tracking ER room visits and hospitalization for some 13,000 patients. One column showed the number of ER visits and hospitalizations in the year before Airlogix implemented its COPD respiratory program; the other showed how many ER visits and hospitalizations there were after the program went into effect.
The hospitalizations dropped by more than half. Consequently, that payer was saving gazillions and sharing those savings with Airlogix.
No doubt, there are legions of HME providers who provide respiratory care and impact healthcare savings on the same order. But we don't know who they are. As Vernon Pertelle says (See page 24): In healthcare, if you don't document it, you didn't do it. There are no plans at large in the industry to start tracking ER visits and hospitalizations in any kind of coordinated fashion. This is a shame and needs to be rectified. At the risk of sounding callow, why not open an Excel spreadsheet tomorrow? List patients in one column and ER visits in another. Hospitalizations in another. Start tracking, and at the same time start clamoring for some organization to participate in the collection and aggregation.
It's a gesture that's long overdue and so obviously necessary.