Page 13 - HME Business, April 2020

“The benefits for most e-Rx platforms is you are accepting the order in the same way as you did before with the fax method, the difference is that you have the data in front of you,” says David Gelbard, founder and CEO or Parachute Health. “It is not much of a change for the workflow, just you are looking at the informa- tion digitally.”
The benefits of using e-prescriptions are measured in minimizing chances for errors, streamlining documentation and workflow, potential faster payments and new business opportunities.
“This is an emerging trend and has an op- portunity to solve a lot of pain points,” says Nick Knowlton, Vice President of Business Develop- ment at Brightree and Vice Chairman of the CommonWell Alliance interoperability group. “We talk a lot in the industry about interoper- ability, and this is one of the easiest concepts for folks to grasp.”
So why hasn’t there been a stampede to switch to e-prescribing DME? There are a few reasons: no pressure from payers or incentives from CMS; a multitude of closed systems with fragmented adoption among prescribers; and perhaps most importantly, DMEs alone bear the cost.
None of that should put you off of using e-prescriptions entirely. It makes sense for some businesses today, and industry experts say the day will come when e-prescribing dominates the DME landscape the way it does in medical prescribing. It’s just not there yet.
“In general, hesitancy by providers to par- ticipate in adoption of e-prescribing for DME creates a growing risk of loss of patient refer- rals and orders from adopting prescriber and referral sources,” says Jason Farmer, CEO of Stratice Health.
DON’T LOOK FOR
OUTSIDE INCENTIVES
If you are a DME pharmacy, chances are you are already using e-prescriptions for medications. As part of its ongoing efforts to digitize health records, CMS used some carrots and sticks to get pharmacists on board. “They used to be able to do incentive payments to those hospi- tals and physician practices for using a certain parts of an EHR. It was called ‘meaningful use’...I’m not sure if meaningful use even exists anymore,” says Kim Brummett, Vice President of Regulatory Affairs at AAHomecare.
There’s a chance your pharmacy e-prescrip- tion vendor has an add-on module for DME, but don’t count on it. As Knowlton explains, the e-prescription systems for meds and for DME evolved separately and often aren’t compatible.
“The e-prescribing for medications by and large flow through a couple of large national networks that have been around and been large enough to be relevant for more than a decade,” he says. The largest, Surescripts, handles about 80 percent of medication prescribing. “That is not the same thing we see in the HME world. There is some capability for HME \\\\\\\[in pharmacy systems\\\\\\\], but by and large they are separate technology platforms.”
Hence the rise of competing independent DME e-prescribe platforms. “Those are systems that were designed from the needs of the HME provider perspective, and a little bit less from what the EHRs are capable of doing perspec- tive,” Knowlton explains. “We kind of have a convergence out there between those two concepts, where some of the EHRs can produce and transmit electronic orders, and where there are now several reputable platforms for provid- ers to choose from.”
Therein lies the rub. The market for DME e-prescribe is young and the number of com- peting platforms can make shopping for the right fit a challenge. “The whole e-initiative that CMS had to get physicians, hospitals and practices to adopt EHRs, it had all this stan- dardized programming and interfaces,” Brum- mett notes, while there’s a lot of variation DME e-prescribe platforms.
In the absence of incentives, your refer-
rers may not have made the switch. There’s no empirical research on e-prescription use among DMEs; there are no set standards or payer incentives. To some extent the DME part of the industry is playing catch-up, so the cost/benefit analysis rests solely with the individual business.
TOO MANY CHOICES?
Remember when you (or your parents) went out to buy the family’s first video player? Back at the
beginning, you had a choice between VHS and Betamax. Even with just two choices, it took a couple of years of parallel marketing before the VHS format won out.
One reason DMEs have been slow to adopt e-prescriptions is that there are several plat- forms, and – like VHS and Betamax – they don’t talk to each other. Some are geared more to use in a physician office environment, while others are more suited to hospital and institutional use. They offer different features to support differ- ent markets.
“Providers typically select one primary e-prescribing solution and persuade their prescribers and referrals to both initiate and receive new and resupply orders for faster, more reliable fulfillment,” Farmer says. “To a lesser degree, some providers participate in additional e-prescribing solutions to ensure they are an available fulfillment option for those prescribers and referrals using other e-prescribing solutions.”
That’s definitely not a selling point for DMEs. Staff having to learn each individual system
and then switch among them can outweigh the value of the change, Brummett says. “Some of them are using two or more of the applications, and they’re so different. You’ve got practices and hospitals that are using Parachute and you’ve got other ones using GoScripts and others on DMEHub. Your poor staff.”
FOLLOW THE FEATURES
The number of players in the space can both complicate and simplify your choice. At first glance, the field looks so crowded it’s intimidat- ing. But the vendors have focused on different capabilities and, in some cases, geography, that will make it easier to rule some out.
A good e-prescription system should reduce claim rejections up front by ensuring documen- tation is complete. Most have a dashboard user interface that’s simple to navigate. If a question should arise, all of a patient’s information should be in one cyber-place, easy to find and pull up for review. Many systems can pre-check claims to make sure the patient is covered. Some sys- tems interface with physician EHR systems, but many of the stand-alones don’t. Some can allow for nonphysicians to place orders – think facility ordering and hospital discharge management. “There is even connectivity available to inven- tory closets and the like to help drive electronic orders,” Knowlton says.
An e-prescribing system that offers a cata- log-like interface will let the prescriber choose and order a specific item from your business. “It is almost a storefront. The DME company has to figure out how to stock the shelves and what
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DME Pharmacy | April 2020
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“In general,
hesitancy by
providers to
participate in
adoption of
e-prescribing
for DME
creates a growing risk of loss of patient referrals and orders from adopting prescriber and referral sources,”
— Jason Farmer, Stratice Health