Credibility: An industry begins to state its case

Tuesday, February 28, 2006

LAKE FOREST, Calif. - With the recent publication of Vernon Pertelle's article in the peer-review journal Chest, the medical profession has its first official glimpse at the intense clinical research going on in the HME industry.
Now it is up to like-minded respiratory providers to keep the momentum going, said Pertelle, Apria's former national respiratory manager. (See story page 23.)
"Hopefully it's the first step toward getting more of these submissions," he said. "A lot of people didn't know this type of research is being done in home care. The more of these programs that are submitted, the better chance we have to publicize it and get home care on the map."
Pertelle's paper demonstrates how home respiratory therapists intervene with COPD patients to help prevent hospital readmissions. Chest is a monthly clinical journal published by the American College of Chest Physicians.
The article's November publication is noteworthy for a couple of reasons: It's the first time an HME provider has appeared in a periodical of this type, and it opens the door for others to do the same. It also dramatically underscores the message Pertelle has promoted at seminars across the country: The HME industry needs to demonstrate home care's effectiveness through evidence-based data if it wants to build alliances with the medical profession and elevate its status as a legitimate member of the healthcare spectrum.
Pertelle's paper used data compiled from one of Apria's recent evaluations of COPD patients.
"What we found was that home respiratory therapists had a very positive impact on patients and were sorely needed," he said. "Because of the way the system is set up, most COPD patients don't realize they have access to an RT and as a result don't know anything about why they're on oxygen. But once patients interact with an RT, they really appreciate the educational experience and that results in greater satisfaction levels."
Pertelle speculates that the systemic problems leading to the patient's "knowledge deficit" are due to a communication breakdown that starts with the prescribing physician and continues through to the respiratory provider.
"It was consistent across the board that the majority of patients didn't know they could use an RT to help them understand their condition," he said. "The physician didn't communicate it to them, but neither did the provider."
Jim Dudley, division clinical manager for Apria, assisted with the article and deserves a lot of credit for his role, Pertelle said.
"Jim's our resident expert on the Excel program and served as analyst, pulling all the information out of the system," he said.
While the publication of Pertelle's article is significant, he asserts that many other respiratory providers are capable of doing the same thing--and should.
"This was an Apria study, but it's easily duplicated because most other respiratory providers are engaged in similar activities," Pertelle said. "I would encourage others to publish their abstracts because they result in manuscripts. These are defensible documents that we can present to Congress and policy-makers to show why we need more RTs in the home."