Page 12 - HME Business, January/February 2022

Business Solutions
HEALTHCARE’S LAST MILE
HME filled critical gaps in care & fortified referral
bonds during Covid-19. Now what?
By David Kopf
Some might consider it an exaggeration, but HME providers helped save American healthcare during the worst days of the Covid-19 public health emergency (PHE). The reach of hospitals only extends so far, but almost at the outset, HME providers showed they could close that “last mile” gap between the hospital and the homecare setting. If they hadn’t, one shudders to think how hospitals would be faring at this moment.
Even before the public health emergency and the pandemic really made itself felt in March 2020, many HME providers — and partic- ularly respiratory providers — were implementing telehealth solu- tions and transitioning their back-office personnel to work-from- home arrangements. So, by the time the pandemic was hitting its first bump up to 20,000 new daily cases in late March/early April, many HME providers had already laid the groundwork to help miti- gate the pandemic’s impact.
When Covid-19 diagnoses started ramping up to more than 65,000 daily new cases in summer 2020 and then 170,000 in winter, ICUs, CCUs and even entire units that were dedicated to Covid-19 patients were quickly overwhelmed. Hospitals were resorting to providing emergency services in military hospital-style
tents erected in parking lots. The question being asked across the entirety of U.S. healthcare was how were beds in hospitals going to get freed up, even if that meant providing more acute care in the home?
“The primary part of healthcare that created that release valve and opened up bed capacity is DME,” Marx says Josh Marx, managing director sleep and vice president of business develop- ment for Medical Service Company (medicalserviceco.com) in Cleveland, Ohio. Marx adds that if a patient wasn’t going to spend a long time (and perhaps their final days) in the hospital, then “they were being discharged rapidly and put on oxygen.”
REINVENTING RESPIRATORY
Early into the PHE, respiratory providers were working with hospital discharge staff to accomplish a smooth transition.
“That’s where the DME space lives,” Marx notes, explaining that providers are already adept at identifying how to support facilities- based care. In the case of the Covid-19 PHE, they took it to the next level.
“It’s about allocating your inventory and your personnel to be in lockstep with the health system and understanding where the points of patient buildup are,” he explains. “Is it in an emergency department? Is it in the acute care setting? Where in the hospital is the buildup, and what are the timelines that trigger those discharges? Then how quickly can we be feet on the street to help get that patient to the home safely so they can move another fragile patient into the hospital?”
And, of course, there was the need to help hospitals continue provisioning oxygen in the facility. There was certainly an increased use of oxygen concentrators in the hospital setting. In the case of Hometown Healthcare (hometownhealthrx.com) in Clifton Park, N.Y., local hospitals weren’t reaching the point where they felt a pressing need to get patients into a homecare setting, but they did need additional equipment on site.
“One of the things the hospitals were asking from us was, do we have equipment for the inpatient setting?” recalls Casey Toomajian, CEO of Hometown Healthcare. “Because they just didn’t know if they were going to have enough to cover the demand. So, we were providing oxygen concentrators direct to the facility, and then home vents directly to the facility as well.”
Getting back to the homecare model, Covid patients were being sent home by their physicians with oxygen equipment or were being prescribed oxygen devices even before getting to the hospital. In either case, once patients were in the homecare setting, the pandemic forced providers to reinvent delivering virtual care.
“Whether that’s educating patients on how to use their oxygen equipment or doing a full CPAP setup on Zoom, up to the point of troubleshooting equipment,” Marx says. “We perform more trou- bleshooting virtually now than we ever did before, and part of that is the safety factor of we don’t want to our technicians necessarily in harm’s way.
“But the other opportunity is the ability for one technician to take care of more patients and caregivers that need support in a virtual environment versus driving 30 miles each way,” he adds. “It’s just a little bit of a scalability game where we can take care of the surge of demand that we’ve received.”
12 HMEBusiness | January/February 2022 | hme-business.com
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