Editorial note: This article includes highlights from an HME leadership discussion.
As we all continue to prioritize health and safety in our personal and professional lives, the importance of accurate and immediate information has become quickly apparent. This changing environment in light of COVID-19 means the industry must adapt quickly, and we’re here to support you. As we shared with you last week, our business continuity plan is in full swing, and we’re already working on product enhancements as a result of COVID-19.
For example, we’ve enabled the new COVID-19 diagnosis code in Brightree and GoScripts effective April 1. We’ve also added three CDC-recommended forms on COVID-19 to Mobile Delivery, MyForms and our standard delivery ticket.
Another way we’re working to support you is by providing a forum for HME providers to share the impact of COVID-19 on their businesses. In what has typically been a competitive HME landscape, most companies are now operating in the spirit that one provider shared: “Don’t be afraid to ask your neighbor.”
Read on for best practices from your peers in the areas of referral trends, hospital discharges, patient care models and frontline employees.
While some HME providers are reporting a decline in CPAP setups, others have experienced upticks in the last two weeks as they prepared for a more extended shut-down period. They’ve also had to anticipate sleep labs shutting down and are trying to determine what they can predict 30, 60 and 90 days out to make spending plan adjustments.
This uptick in CPAP referrals also stems from rolling out telehealth, which requires the same documentation as traditional face-to-face. There has also been an increased demand for diabetic and CPAP supplies, bracing and compression hose as some patients are taking an “I need one of everything” approach to the pandemic.
Outside of sleep, the trends are showing that hospital referrals have been scrambling to obtain PPE for staff to prepare for the surge. Some providers are busy selling ventilators and beds to their referral hospitals and furnishing CPAPs and BIPAPs as the hospitals prepare their emergency disaster lists.
With some hospitals wanting 10-liter oxygen concentrators in addition to ventilators, providers must determine how to preserve these so they can be ready when patients are transitioned to homecare versus the immediate need in the critical-care setting. By talking to manufacturers and distributors on a daily basis, providers can make sure they have buffer stock for the next few months to ensure patients can be released from the hospital to open up beds when the surge moves from acute to post-acute. However, the reality is that nobody can know county to county where the breakout will be, making it difficult for providers to make promises in reserving specific equipment for specific hospitals.
Some skilled nursing facilities have seen families requesting their loved ones be discharged because they’re concerned about the new COVID-19 visitor policies. In these skilled nursing and hospital discharges, HME providers are seeing additional requests for oxygen for pneumonia patients. Additionally, there has been a high sales volume for stairway lifts and C-lift chairs due to the bed shortage.
Bringing in and prepping the entire team that will be going to the patient’s home is another discharge best practice.
Patient care models
Virtual setups have been the main shift in patient-care models. Providers are using the healthcare version of Zoom to conduct a telehealth setup for CPAP and DocuSign for all documentation signatures. DocSeeMe is another platform that is reported to work reasonably well.
Another change is that there’s a validation rule in Brightree that instructs the order to be sent to a manager if there is a COVID-19 diagnosis. This notification allows the manager to alert the operations team to make sure they understand the necessary PPE and other safety precautions needed to see the patient.
Providers report that they’re expediting pickups with whole teams assigned exclusively to pickups and that they’re placing additional orders but seeing costs going up.
A big concern is making sure they’re able to maintain their current ventilation patient census. Providers must protect needed inventory if any life-sustaining equipment goes down, which restricts the ability to take on new ventilator patients.
And instead of disposing of nonfunctioning oxygen concentrators, they are now sending them out to be repaired.
Providers report various policies and concerns to consider for their employees. Since employee safety is first and foremost, providers said how they’ve quickly moved everyone they can to a remote status. Providers are monitoring the health of every employee daily by logging symptoms, tests and quarantines to avoid any spreading of COVID-19.
To avoid attrition, some are considering hazard pay for frontline, ED, clinical nurses, home care staff, respiratory therapists and nurses who collect the specimen for COVID-19 testing in the community.
Reduction in workforce is also a real scenario for some. Without initial face-to-face consults, providers are 60 days out from receiving new DME referrals. In looking at the data, they plan to make decisions about how they need to adjust labor.
Others are going on the offense by building a playbook for their referral partners on how they can leverage telehealth to continue to drive patient visits for Home Sleep Testing (HST) and CPAP referrals. By going to the physician practices in their communities with the playbook, providers can give them ideas on how to continue to create volume. Instead of sitting back, they want to be creative in building these relationships and teaching referral doctors how to streamline their referral processes during the crisis.
Whether it’s referral trends and hospital discharges or patient-care models and frontline employees, HME providers are willing to help their peers with the best practices that are developing across the country.
As we continue to provide resources to aid you during this crisis, let us know if there’s a question or topic you’d like to explore further by chatting it on the Brightree Community COVID resource page.