Page 12 - HME Business, May 2018

By Joshua Bolkan
Problem Solvers
Making an Oxygen Therapy Match
How can providers ensure oxygen patients get the right device for their care?
Stationary or portable? Tanks or concentrators? Liquid or gaseous? When trying to set a patient up with the oxygen services that are best for them, the options can feel a little overwhelming.
And it’s not just you. There is a lot to consider, according to Andrew Brown, director of global hospital sales at Precision Medical.
“I talked to a patient yesterday and my phone conversation lasted 45 minutes,” Brown said.
But it can be more straightforward if you just keep a few things in mind. First, there’s the simple matter of when they need oxygen and how much.
“What is their oxygen requirement and liter flow,” Brown asks. “When
do they require their oxygen? Is it when being active? Stationary? Sleeping?
If it were to be just stationary when sleeping it would lead me to choose a stationary device versus if they need it to be mobile it might lead me to the portable oxygen devices. And then I would ask if they have been tested on any devices, so if they’ve done a six-minute walk test, have they been tested on any device and has that device been used to correct their low oxygen saturations?”
Physical Activity
Brown stressed that oxygen solutions should help a patient continue in their daily activities and maintain their physical activity as much as possible.
“That should be really one of the most paramount things,” Brown said.
“As healthcare providers we should be able to assist and enable the patient to maintain their activities of daily living while being the most compliant on their oxygen delivery device.”
Physical activity doesn’t necessarily have to refer to training for marathons or climbing mountains. Some patients might be quite active carrying out regular activities, and a more mobile solution may be right for them, too.
“Portable devices are not just for leaving the home,” Brown explained. “Portable devices can be used to enable a patient to walk about their home and not drag along feet and feet of oxygen supply tubing which leads to tripping and safety hazards. So if the patient is active outside the home or very active inside the home, \[a portable device\] may be a good choice rather than trying to feed oxygen tubing out and bring it back in as they move further or closer to their stationary unit. It may be beneficial from a safety aspect to give them a portable device to avoid safety and tripping hazard.”
Disease Progression
Why not, then, give every patient the most portable device available? You would, theoretically, and it’s still generally a good idea to give them the most portable device you can, provided it meets their current and future needs.
“There are certain disease processes that continue to get worse and there’s no steady-state or reversal to that,” Brown said. “So if their initial order is two liters per minute, which is the most common setting for home oxygen, and they’re given a device that only does 2 liters or 3 liters pulse, within the period of a year or so — depending upon their severity — their disease process
may outgrow that device, requiring them to get a bigger device to give larger amounts of oxygen. Or they may get weak enough that they can’t trigger a pulsing device and then they have to transfer over to continuous flow. Rather than switching a patient out after two years I’m just going to give them the largest heaviest device that gives the most oxygen so that I don’t have to try
to redeliver something if they outgrow their disease process... Rather than
switching a patient out after two years I’m just going to give them the largest, heaviest device that gives the most oxygen so that I don’t have to try to rede- liver something if they outgrow their disease process.”
Referral Coordination
Making sure you understand the patient’s prognosis and whether their disease process is likely to progress should begin right up front through coordination with the referral partner.
“The coordination of devices should start right from the referral with
the appropriate team members, which should be patient care coordina- tors, discharge planners or those type of people that facilitate patients being discharged from the hospital,” Brown said.
If the patient is referred by a family physician or similar source, there should still be communication between those same team members and whatever care provider is referring them to make sure the patient is receiving the device that meets their oxygen needs while keeping them as active as they can possibly be.
Common Pitfalls
Lack of knowledge about what’s on the market in terms of functionality and usability is one of the most common pitfalls in pairing patients with the right oxygen solution, according to Brown. He suggested trying to develop a broad and general knowledge of the oxygen services market, rather than mastering one option or even a few.
“Another pitfall is you could just get tied up with one company because that’s the service you’ve always offered and their pricing is okay, Brown said, but then you are less likely to “look at new things coming down the pike that would increase the level of care to the patient.”
Ask the Patient
Patients are increasingly aware of what’s available, and that suggests the best starting point is to simply ask your patients what they want.
“I think more and more home oxygen patients are becoming smarter about the choices that are out on the market and they’re able to go out and do their shopping and due diligence about what they might need,” Brown said. “And that choice may not match what a provider is giving them. And I believe it could be up to the providers, all things being the same, to try to get the device that the patient has educated themselves on and that they feel is the best use of their therapy.”
What’s Missing?
In that vein, Brown said that he would like to see more focus on helping patients take more control of their own therapy. He pointed to diabetes treat- ment as an example of technology empowering patients to manage their care.
Diabetes patients are “given all the tools to manage their disease. They’re given the ability to connect with a lot of education and resources...,” he said. “They get their glucometer. They get their insulin on their mobile applications and can watch trends. Unfortunately, oxygen patients are not afforded that same thing. They’re not allowed to manage their disease process.” n
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Joshua Bolkan is a freelance writer specializing in various markets including education and healthcare. He can be reached at jbolkan@gmail.com.