e-CMNs still looking for traction

SCHENECTADY, N.Y. -- Nearly three years after the first e-CMN went back and forth between a doctor's office and an HME supplier, just 44 HME suppliers are working with Trac Medical's CareCert e-CMN, the industry's current frontrunner in the fight against paper. Those 44 companies represent three of the largest in the industry -- Apria, American HomePatient and Rotech -- and some of the most widely respected, such as Advanced Home Care in Greensboro, N.C., but Trac's lack of traction is a curious contradiction when you remember that not very long ago people were hailing e-CMNs as one of the greatest opportunities for savings in the business. But there's no contradiction for people like Michael McDonald, president of Clincal 1 Home Medical in Weymouth, Mass. "Call me old-fashioned, but we're still doing it internally," said McDonald. "What we do is working, so we don't see any reason to change." The disparity between the cost of processing was supposed to create a groundswell of movement toward e-CMNs. The best estimate in the business, formulated some years ago by Advanced Home Care in an activity-based costing exercise, says it costs $20-$25 to process a paper CMN. Jeff Frankel, president and CEO of Trac Medical, says it costs about $1.80 to process an eCMN. McDonald doesn't believe it costs his business $20-$25 to process a paper CMN. "We have a full time document manager, and whether we are doing e-CMNs or not, we still need a full time document manager because we're handling so much other paper," he said. At Advanced Home Care, the bloom is still on the rose of the new e-CMN and blossoming more brightly every week. Currently, about 15-20% of the company's CMNs are processed electronically. Of approximately 150 doctors who've registered through Advanced to do e-CMNs, about 100 of them are active users. "We had one doctor who came back from medical leave and did 55 documents (e-CMNs) in a single day," said Kim Brummet, director of reimbursement at Advanced Home Care. Brummet credits her company's e-CMN success with a strategy that leverages both operations and marketing. It's not only the sales reps who are trying to get doctors to get on board with e-CMNs; it's the revenue team who are pushing the initiative as well. If other HMEs aren't crowding the gates at Trac Medical and other e-CMN vendors, it may be due to a lack of IT savvy, said Brummet. "When I go into different companies, quite often their e-CMN processes are a mess," she said. "When you have a messy problem and you try to automate a messy problems, it can be a disaster."