Page 8 - HME Business, August/September 2018

By Leila McNeill
Problem Solvers
E-Prescribe Is Coming to HME
What should providers know and how should they prepare before transitioning to an e-prescription system?
Since the late 1970s, physicians and pharmacies have been utilizing some form of electronic prescribing system. As computing technology has evolved and become more widely available over the decades, the number of healthcare providers and suppliers using e-prescribe has significantly increased. Today, an estimated 70 percent of physicians have transitioned to using an e-prescribe system. Despite its popularity in various segments of healthcare, the HME industry has been slow to transition to e-prescribing, but its adoption is becoming inevitable.
From suppliers to patients, e-prescribing has the potential to transform the industry through streamlining the referral cycle, eliminating the prevalence
of incorrect documentation and driving efficiency. Still, transitioning to an e-prescribe system can feel like an unnecessary disruption to your current business model, or even a looming unknown. To help ease the coming transi- tion, it’s important to know how e-prescribing works and what steps to take in preparing your business for an e-prescribing platform.
Understanding E-Prescribing
E-prescribe is an electronic delivery system that allows physicians and other medical practitioners to securely send prescriptions and other patient informa- tion to a pharmacy or another healthcare provider directly from the patient’s point-of-care. These systems can stand on their own or tie into integrated electronic medical record systems. More than just phasing out the pen and prescription pad, sophisticated e-prescribing systems can manage medical history for individual patients.
Nick Knowlton, vice president of business development at Brightree
LLC., believes that HME providers will see numerous benefits by adopting e-prescription. “Providers can automate what once were manual processes, allowing them to focus on more value-added tasks.” He added, “They can
also bring in the right data and documentation to correctly fill an order and ensure reimbursement, which eliminates costly rework and time spent chasing physicians.”
Benefits of e-prescribing are perhaps most evident is in the lengthy referral process. Typically, the referral cycle kicks off when a physician sends the HME a prescription or order by phone, fax and sometimes EMR. After the HME processes and generates documentation, they send it back to referral to complete the documentation on a varying timetable.
“If you think about the way that we do things in the industry, everything is done by way of fax, phone and hand delivery of documentation,” said Bill Guidetti, executive vice president for Apria Healthcare’s East Zone. “It’s really archaic and it’s rife with mistakes.” Overall, clerical errors are responsible for over 80 percent of fax orders being initially denied.
This is where e-prescribing comes in. Electronic forms, unlike paper, ensure that all necessary fields are filled in, which prevents denials resulting from incomplete or incorrect paperwork. In 2017, Medicare reported that 64.1 percent of improper payments were the result of insufficient documentation; for DME alone, the error rate was more than 46 percent.
With real-time error notifications, faulty or incomplete data is flagged before documentation is submitted while call back and fax back communication
with physicians the referral time is drastically reduced. “You can go from what would take days to get an order right and take it down to hours,” Guidetti said. “I think we can do better as an industry and healthcare system to use this technology to communicate with each other and make it faster and easier.”
Making the Industry Transition
In other segments of healthcare, e-prescribe with referral management has been proven to work. Knowlton, who first worked in the EHR industry, said “I...remember the emergence of ePrescribe for medications and the evolu-
tion of capabilities to support lab orders and other post-encounter activities.” The technology, however, is not yet as mature in HME. “Key in that evolution will be the role that government agencies, payers, technology vendors and providers play. I believe this will mature rapidly, but we as an industry need to make sure that it’s done correctly.”
AAHomecare is currently undertaking a project to ensure that this transi- tion to and integration of e-prescribing will be done correctly. Part of their project includes working with the four leading HME e-prescribing plat- forms: Stratice Healthcare, GoScripts, DMEhub, and Parachute Health. Kim Brummett, vice president of regulatory affairs at AAHomecare, explained, “We’re setting up demos [with the platforms] and having conversations with them to get a feel for their platforms – how they work, their differences, their similarities.”
As of yet, there is not an industry standard for e-prescribing interoper- ability with other current HME billing and management systems. Unlike other segments of healthcare, Knowlton explained, “Our sector of care delivery was not considered when interoperability standards were developed for the rest
of the healthcare industry.” This means that HME e-prescribe platforms must provide a robust system that can support multiple existing standards from various vendors.
CMS will have a hand in setting standards for interoperability best practices. As such, the other part of AAHomecare’s research involves working closely with CMS to ensure that e-prescription standards and functionality are what works best for the industry.
Brummett says that there is not a strict timeline for transitioning the industry to e-prescribing en masse. Though she does have some suggestions for how suppliers can start to prepare their business for adoption. Suppliers can begin by educating themselves about the e-prescription platforms available to them and thinking about how it would fit into their current systems. “[The
“I think we can do better as an industry and healthcare system to use this technology to communicate with each other and make it faster and easier.”
— Bill Guidetti, Apria Healthcare
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