The standard bearer: Bob McCoy on conservers

When it comes to oxygen conserving devices, Bob McCoy supports setting standards. That's because there are no standards, he says. In the new second edition of his "A Guide to Understanding Oxygen Conserving Devices," almost all of the 30 conservers he analyzed deliver different oxygen doses when calibrated on the same numerical setting--in one instance more than two times as much. That's not good, McCoy said. It means unless a provider matches a patient's clinical needs with the appropriate conserver--and they often don't--desaturation frequently occurs. In fact, while many providers attribute desaturation to a patient's condition getting worse, the real culprit is an inappropriate conserver, he said. The conservers McCoy studied--pneumatic, electronic, liquid portable and portable oxygen concentrators--"all work pretty well" and have their place. He designed his 100-page guide ($89.95) to help providers compare products, make buying decisions and understand conserving terminology, concepts and history. He does not recommend one device over another. McCoy is managing director of Valley Inspired Products, an independent company that tests respiratory products. HME News talked to him in late March about conservers. HME News: Without standards, you say, providers can't make an apples-to-apples comparison when evaluating conservers. Why don't manufacturers push for standards? Bob McCoy: It is vulnerability for them. If standards come out and say that this one technique is the way to do it and one manufacturer owns the patent on that, then everyone else will have to license it. That would be a nightmare. And if someone claims a 7-to-1 savings ratio and that has been their marketing edge, and the standard moves away from that, they lose some of their marketing advantage. HME: Given the lack of standards, what should providers do to best serve their patients' therapeutic needs? McCoy: I'd go with a high-dosing system and a low-dosing system. For patients who don't need much, they can go on the low-dosing systems--but they have to be tested. Then I would have a high-end one--a unit that can dose the most--for the most challenging patients. HME Do manufacturers currently make it clear in product literature what the maximum dose is on their conservers? McCoy: No. If they do, it is usually not prominent. HME How do providers navigate around the lack of standards? Stick with the conserver they understand and set it to match the prescription? McCoy: Some do that. There are a lot who buy based on features, and probably the biggest feature is cost. Whichever is cheapest, they'll buy that. HME Just because a provider gets a good deal on a conserver, then, doesn't mean they should put it on all their patients? McCoy: Right. And because the knob is big and easy to read doesn't mean the device is the best out there. That's where I'm beginning to blame some of this on consumers. They've been asking for something pretty that has nice aesthetics and mandating that the provider use it or they will go elsewhere. They are part of the problem."