Embrace the benefits of interoperability

It’s no longer an interesting approach, but a must for long-term survival
Friday, September 25, 2015

In our professional life, most of us have been exposed to the definition of insanity. As the home and durable medical equipment industry manages multiple challenges within the sector, one constant remains true: we chase paper. This workflow is simply unsustainable and no longer a viable option to managing physician orders, documentation, audits and additional payer requirements. By manually managing paper, faxes and phone calls, our industry produces insufficient insight and data related to patient care and outcomes. In contrast, employing electronic intelligence allows suppliers and manufactures alike to best demonstrate to key stakeholders the life changing and affordable care that can be provided from within the sector. Moreover, electronic health information can proactively address market trends and even offer an appropriate response to natural disaster preparedness as further examples. Certainly we can all agree to the breadth and depth of electronic health information. Alternatively though, we continue to be time constrained and financially hampered with a paper-based delivery model that allows for unprecedented denial rates and, unfortunately, they are too often categorized with fraud and abuse concerns versus the quality of patient care.

The Office of the National Coordinator for Health Information Technology is at the forefront of health IT efforts, including the adoption of health information technology. According to the ONC, 94% of non-federal acute care hospitals and 78% of office-based physicians now use an electronic health record (EHR) system as a result of the health IT initiative. Now the ONC is driving toward “interoperability” or the standards that make it possible to electronically share patient information from the EHR with other healthcare providers. Interoperability is delivering better patient care for pharmacy and laboratory providers, and now is on the cusp to include the home and durable medical equipment sector. Interoperability delivers efficient care, improved outcomes and is supported by patients, providers, physicians and payers alike. That said, according to HealthIT.gov website, the ONC recognizes the many speed bumps to interoperability and the time required to tackle such issues.

On May 29, 2015, the American Association for Homecare submitted a detailed response to the ONC on behalf of suppliers and manufacturers stating, “AAHomecare believes that the failure to encompass standards for DMEPOS items used by patients in their homes has posed a significant hurdle to achieving full functionality for the EHR and permitting the health care system and patients to garner the benefits and efficiency of the EHR.” By virtue of suppliers and manufacturers not being part of the interoperability conversation, AAHomecare recognizes the “challenges in submitting EHR records to Medicare contractors to document medical necessity.”

Although early in adoption, suppliers and manufacturers are beginning to embrace the benefits of interoperability. At this junction of our business life cycle, it’s no longer an interesting approach, but a must for long-term survival. Our industry continues to weather the impact of extreme margin compression, intense regulatory pressures and any number of competitive threats. A forward looking approach toward shared electronic health information can ease the burden of such obstacles, and create a more integrated, financially viable delivery model, while providing better patient care and outcomes.

The industry must embrace interoperability not in unique silos, but in a way that all parties participate, including suppliers, manufacturers, trade associations, group purchasing organizations, payers and service providers, as well as appropriate governmental involvement.

As a reference point, we should look no further than the pharmacy sector of healthcare. In the late ’90s, pharmacies were challenged with a paper-based prescribing platform. Patients recall how physicians carried prescription pads to handwrite and prescribe medications. With the involvement of many stakeholders and the leadership of RxHub and Surescripts (since their 2008 merger, now known as Surescripts), e-prescribing for medications is now a standard of care. E-prescribing changed the delivery of care for pharmacies with a compliant, efficient workflow process. Its favorable impact is well documented with Surescripts’ annual industry report that showcases e-prescribing benefits, now based on billions of transactions each year. Earlier this year, a study by The American Health Information Management Association (AHIMA) states, “e-prescribing meets with approval from more than 80% of adults over 50.” The study goes on to state, “e-prescribing is generally perceived by patients as safer, more convenient, and more efficient than paper-based prescriptions, and fosters improved communication with healthcare providers.”

E-prescribing for home and durable medical equipment will take time to fully mature. We know this. As such, we can all participate and change the delivery of healthcare as well as our definition of insanity, by embracing interoperability.

John Brady is CEO of Stratice Healthcare, developer of eDMEplus, an EHR integrated e-prescribing platform connecting medical professionals with their suppliers. He can be reached at jbrady@stratice.com.