Pertelle's book underscores need for oxygen outcomes

Tuesday, October 31, 2006

SAN DIEGO - Spurred by the frustrations of an industry that talks the talk but can't seem to walk the walk, that knows what it should do but doesn't, and that has now been brought to its knees by a crippling blow to the home oxygen benefit, Vernon Pertelle has authored a 200-page blueprint that challenges HME suppliers to start documenting outcomes.
The book--"Outcomes: A Comprehensive Guide for Home Care & HME Providers"--spells out a four-step process designed to shepherd an HME supplier from the basement (re: no program) to the front porch (re: something to crow about.)
The four steps skip from problem identification to activity identification to data compilation to marketing.
"In healthcare, if you don't document it, you didn't do it," said Pertelle, who was the corporate director of respiratory care at Apria Healthcare until early this year and now works as a senior director at Tri-City Hospital, which serves 1 million in five cities in North San Diego County.
Published by Global Healthcare Solutions, the 200-page soft cover book was three years in the making and went through multiple drafts. The end-product, said Pertelle, is simple yet comprehensive.
"It's concise and easy to follow," he said. "That was the goal. We didn't want to create something so complex that people wouldn't read it."
Though there's industry-wide consensus about the need for suppliers to measure outcomes, there has not been any coordinated effort to track outcomes. AAHomecare is currently developing outcomes and pay-for-performance criteria for the home health industry and recognizes a similar need for HME.
"I think we agree that it's important to collect more data in a number of areas--not just outcomes," said Michael Reinemer, AAHomecare's vice president of communications and policy. "Studies from OIG, GAO or MedPAC are often requested and used as fodder to attack home care, which is why we often commission our own studies to drill deeper and more thoroughly into a given issue."
Some believe the industry's failure to substantiate its credibility as a network of suppliers, not equipment jockeys, is why HMEs now face an oxygen cap and other reimbursement reductions.
"If we had been doing this 10 years ago, it's likely we wouldn't be facing what we're facing in oxygen therapy today," said Roberta Domos, president of the Domos HME Consulting Group in Redmond, Wash.
Domos, whose business sets up COPD management programs for HME providers, said none of her customers currently track outcomes.
Not surprisingly, Pertelle also blames the industry's failure to adopt outcome measurements as a part of its day-to-day business processes for ongoing reimbursement woes.
The industry does produce data to counter accusations from the OIG, GAO and Congress, but Pertelle labels such efforts "one-hit wonders."
"Rather than invest hundreds of thousands of dollars in the lobbying groups, why not invest that in providing HRQOL (health-related quality of life) measures, measurements specific to the industry," said Pertelle. "Use those dollars to create a grant at the NIH or to develop a valid measurement tool for the industry, that allows us to consistently report the same type of information. It doesn't take that much to do that."
"Outcomes: A Comprehensive Guide for Home Care & HME Providers" will be available at or write directly to the publisher at