How HME Adapts to a Telehealth World

Posted on in Growth Strategies, HME Government Issues, Process Improvements, Legislation, Government and Advocacy, Business Operations

One of the only constants in life is change. Though change can be difficult, as Charles Darwin said, “It is not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.”

Currently, the healthcare community is in the process of making big changes to improving care for rural areas. The Center for Medicare and Medicaid Services (CMS) recently launched a Rural Health Strategy that focuses on improving access to high quality, affordable healthcare in rural communities. “For the first time, CMS is organizing and focusing our efforts to apply a rural lens to the vision and work of the agency,” CMS Administrator Seema Verma said. “The Rural Health Strategy supports CMS’ goal of putting patients first. Through its implementation and our continued stakeholder engagement, this strategy will enhance the positive impacts CMS policies have on beneficiaries who live in rural areas.”

VGM members and other HME providers serving rural areas know this topic all too well, as declining reimbursement rates have affected businesses and quality patient care across the country. Changes like this and many others in the industry have forced us all to think differently about the entire HME service model. Part of the new CMS rural health strategy focuses on advancing telehealth and telemedicine which allows patients to receive care when and where they want it. Ideally, patients in rural communities will have better access to quality care from the comfort of their own home with telehealth developments. The CMS strategy looks to reduce barriers to stakeholders, such as reimbursement, cross-state licensure issues, and the administrative and financial burden to implement telemedicine.

About one in five people, or 60 million, live in rural communities across the country, according to CMS. CMS is hoping that telehealth and telemedicine will bridge this gap between quality care and rural America. As reimbursements continue to drop, there is a demand for HME providers to offer an alternative care model for certain segments of patients that embraces emerging technology and creates efficiencies in order to advance business and patient care.

By bringing the appropriate technology and care to the patient, telehealth cuts costs drastically for providers and patients. Telehealth visits cost 60 to 70 percent less than in-person visits and save the patient around $100 per visit.  Recent studies also show that telehealth decreases hospital readmissions and saves health systems millions. When patients who live in rural areas are discharged from the hospital with a chronic condition or needing rehabilitation after surgery, they are at a much higher risk for readmission due to lack of compliance or proper in-home care.

As patients take more control over their care, we’ll see fast growth in home-based self-care, as well as self-monitoring technologies. Driven by the rise of new technologies, experts anticipate that, over the next decade, as much as 50 percent of healthcare will move from hospitals and clinics to homes and communities. Technology now allows health systems to communicate with, and also manage, patients remotely. From smartphones to social media to sensors, new tools are empowering consumers with more information and control over their healthcare decisions—and providers with more options for where and how they treat their patients.

Technology we have seen in the marketplace ranges from patient wearable technology, patient monitoring programs, two-way video communication, wireless tablet devices and text messaging, to workflow software and other systems that support a remote process for both care providers and business owners. As the variety of telemedicine models continue to increase, companies have started to develop home monitoring equipment that will allow clinicians to remotely track their patient’s progress and vital signs.

Some models will primarily rely on home monitoring services linked to a nurse or other clinician to track physiological parameters. Many companies are developing or already offer this type of equipment; some also include remote clinical management in their offering. Other programs might provide patients with secure video conferencing equipment and possibly diagnostic tools, and request that they link to their physicians for scheduled appointments. There will be a demand for equipment required to support true medical visits rather than a simple videoconference. Another model sends a non-physician into the patient’s home and links to a remote primary care provider (PCP) using telemedicine equipment.

There are some keys to success for HME providers who are looking at their service models. The telehealth/telemedicine models may not be appropriate for every patient. Selecting the right patient segments is crucial. For example, patients needing consistent care through the traditional service system are not ideal candidates. Communication with patients and caregivers is also vital and this outreach must center around the patient’s needs and via channels that connect with even the most hard to reach patients and caregivers. Staff training, developing metrics and reporting regularly, as well as how care is coordinated (think logistics, equipment and shared systems) are additional keys to success when building a tele-program.

Telehealth has made a major step forward in New York with the Visiting Nurse Service of New York (VNSNY) working to offer a virtual rehabilitation program to their patients. The FDA recently cleared a program called VERA  that engages patients in virtual rehab and physical therapy. Likewise, California hospitals have been exploring the possibility of robots such as RP-VITA, a 1.7 meter tall telepresence robot, entering the medical field. RP-VITA will allow specialist to reach those rural areas that have a shortage of expert care. VERA and RP-VITA are great examples of where in-home care is headed and it will be up to the HME providers to stay ahead of the curve with relevant products and services.

As the need for quality care around the nation continues to grow, so will the demand for quality telehealth and telemedicine products; and, it is up to the HME providers to keep up with the fast paced progression of the telehealth world. Those with the ability to embrace change and adapt quickly will not only contribute to the improvement of patient care, but the healthcare system as a whole.