BRIGHT Ideas
THE WORLD OF TECHNOLOGY IS full of promises and innovative ideas. For many, it symbolizes get-rich-quick opportunities and a never-ending stream of electronic gadgets. In the medical community, high-tech often translates into new ways of treating chronic conditions. And in the home medical equipment industry, the promises of new processes and delivery models bring expectations of improved, more independent lives.
“When we look at technology, we really try to focus on the application in terms of people’s lives and their functionality in their environment,” says Dan Easley, senior vice president of product management, Sunrise Medical, Carlsbad, Calif.
In other words, technology for the sake of technology has little value, says Lou Slangen, senior vice president of sales and marketing for Elyria, Ohio-based Invacare. “We get enamored with microprocessors, software and all those things that promise the world, but the challenge we face is coming up with technology that really addresses a need.”
Safety, compliance, convenience and improved clinical outcomes are the drivers for new technology, manufacturers say. Any one of these factors can propel a product idea through the research and development stage.
But the idea and consequent product must also address the needs and expectations of at least one of the customers that manufacturers target – the consumer, provider, clinician, caregiver or payer.
THE CONSUMER
Consumer needs often translate into convenience, a strong indicator for compliance. Diabetes care, one of the fastest-growing segments of the industry, continues to focus on convenience and comfort.
That’s what drove MediSense Products, a division of Abbott Laboratories located in Bedford, Mass., to develop the Sof-Tact, a blood glucose meter designed for virtually painless testing. Since users can test on parts of the body other than the fingertips that have fewer nerve endings, they are inclined to test more often, says Glenn Magnuson, the company’s marketing manager for diabetes new products.
Comfort is also a concern for sleep therapy product manufacturers. Comfort has been shown to increase compliance and recent technology is hitting its mark by improving the comfort of both flow generators and masks. That was the impetus for the design of ResMed’s AutoSet technology, which “adjusts the pressure according to the needs of the patient throughout the entire night,” says Ron Richard, vice president of marketing for the Poway, Calif.-based company. “What it does is lower the overall airway pressure, which reduces a lot of the unwanted side effects of CPAP (continuous positive airway pressure) therapy and increases compliance dramatically.”
The other component of sleep therapy compliance, says Richard, is mask comfort. Since 1993, the company has worked to perfect its mask. In that time, technology has improved, allowing ResMed to create the Ultra Mirage mask, which was designed to reduce the incidence of skin breakdown on the nasal bridge, a common complaint, and sensitive parts of the face. It incorporates a double-layer cushion technology, an adjustable forehead piece, and cupping style headgear anchored to the frame of the mask, according to Richard.
Sunrise Medical is using Internet technology to enhance the performance of its sleep therapy systems. “We are using the Internet with our new compliance system to deliver sleep therapy compliance information quickly and more effectively,” says Easley.
Sometimes innovation comes without breakthrough technology. When you combine existing products to meet a previously unrecognized need, you create excitement, according to Neal Curran, Invacare’s vice president of engineering. For example, Invacare’s new Rollite rollator was designed to feature the functions of a rollator and the transportability of a folding walker.
Who Needs It?
Is there a need for the product and is it accessible? Manufacturers spend considerable time answering those questions.
“Products must have an application to either improving someone’s life, improving the functionality of the equipment in their environment or providing a better cost solution to those in the provider chain,” says Easley.
The latest mobility products on the market promise to do just that. Easley says the new Quickie P-222, which is a high-performance power wheelchair, uses velocity electronic feedback control. “This means it senses what the consumer is trying to do as he or she presses the joystick and makes directional corrections through the motors,” he says. “The result is the chair drives exactly as the consumer intends it to.”
Invacare’s TrueTrack technology, which is comprised of gearless-brushless motors and MKIV A electronics, is designed to offer improved safety for power wheelchair users. “TrueTrack delivers on the promise that users can drive this chair even with very limited dexterity,” says Slangen, noting that its intent is to answer the need of users to be mobile without an attendant.
The latest wheelchair technology from Invacare focuses on drivability. “Sure Step is a combination of mechanics, electronics and motor technology that allows us to provide a chair that is intuitive, has a small turning radius, and goes over transitions and obstacles,” says Curran.
Sure Step technology is intended to address the consumer’s need for aesthetics and performance, says Curran, as well as an important issue for providers: reliability and functionality.
THE PROVIDER
Conducting business in the home care market is difficult these days, making providers less receptive to technology that has a high cost associated with it. When manufacturers analyze new technology, one sure sign of success is a product that decreases HME provider service time and operational costs and increases profit opportunities.
“What distinguishes us from other industries is that we are not only driven by coming up with a product that meets consumers’ needs in a better manner, but the technology is also driven by the reimbursement component,” says Slangen. “Manufacturers are using technology to come up with more cost-effective delivery models to service the needs of the consumer.”
One example of product development that directly addresses service and delivery barriers is Invacare’s Venture HomeFill II, which enables users to fill their own high-pressure cylinders from a concentrator and thus decreases costly service calls.
Pittsburgh-based Respironics recently incorporated sophisticated technology – the Encore SmartCard – into its Virtuoso LX auto-CPAP system. The idea was to create a product that would be less costly and which would also consume less of a clinician’s time. “We have SmartCards in our units that allow compliance data to be delivered to home care providers and physicians for downloading into a software package,” says Elias Diacopoulos, director of sleep engineering. “The information that is stored on these smart cards allows physicians to monitor patients’ compliance.”
Most importantly for providers, this is accomplished through the mail. “Previously, patients would have to visit sleep labs in order to gather this information on the units,” says Diacopoulos.
ResMed’s latest efforts have also considered provider expectations. The Ultra Mirage mask’s adjustability and modularity are designed to reduce a provider’s inventory – an attractive incentive in today’s unstable reimbursement environment. “The system is modular so the provider can actually sell independent parts rather than whole systems,” says Richard. “It reduces the cost to the patient and to the health care system.”
THE CAREGIVER
More than 54 million people provided care for an elderly, disabled or chronically ill friend or relative during the past year, according to the National Family Caregivers Association. NFCA and other organizations estimate the average caregiver is female and approximately 60 years old.
For these unpaid home care providers, technology is often their only assistance. One product that is designed to help caregivers is the new Voyager Portable System Lift from Sunrise Medical. Easley says it is intended to improve safety for both the user and caregiver.
An issue that is gaining momentum in the industry is how reimbursement for caregivers can be implemented. “We have in many ways been held back as an industry because there is no reimbursement component for products that can really help the people who help people,” says Slangen. “You need to have some [financial] relief for the caregiver to be able to afford these products.”
CLINICIANS
When a product can produce positive clinical outcomes, health care providers take notice. And it certainly helps when it decreases the length or cost of treatment.
Kinetic Concepts Inc.’s V.A.C. (Vacuum Assisted Closure) device is designed to do both, says Brian Murphy, vice president of home care for the San Antonio- based company. In developing the V.A.C., KCI tried to answer concerns about the cost of healing wounds, as well as the time it took to do so. “People want to be cared for in the home,” Murphy says, adding that the company’s device allows that. “Patients whose wounds have not healed in three or four years are having their wounds closed in 45 days,” he says. “The worst wound we have treated had been open for 47 years and by using this therapy, it was closed in 199 days.”
The V.A.C. assists in wound closure by applying localized sub-atmospheric pressure that promotes wound healing, Murphy says. The V.A.C. therapy is applied to a special dressing that is positioned in the wound cavity or over a flap or graft.
Wound prevention is a benefit of the latest technology offered by the Roho Group, Belleville, Ill. The company’s Therapoint pressure measurement device offers three mode options that allow for measurement during specified intervals, rolling averages and weighted averages. “The Therapoint displays pressures dynamically so it displays in real time an LED reading in millimeters of mercury as the patient is moving,” says Cynthia Fleck, director of global training and education. The device is portable, another feature attractive to home care providers.
One challenge manufacturers face when introducing a new technology is clinician acceptance – and sometimes, that can hinge on reimbursement. The V.A.C., for example, is covered by Medicare – it received a reimbursement code less than a year ago after a six-year battle – and it is paid separately from nursing services under the Medicare prospective payment system. Murphy says that has helped clinicians accept it.
Sizing Up Technology
One of the first approaches many manufacturers utilize to judge provider response to new technology is the use of focus groups. The next consideration typically involves education since so often manufacturers are asking users to make a change in their behavior.
“One of the things that it comes down to is if the technology is radically different and is a paradigm shift from what they are doing – for example, if there is a huge educational component to it – you have to determine if there is a large enough market to educate people,” says Curran.
“People do not beat a path to your door when you build a better mousetrap,” says Slangen. “You need a strong educational component and [effective] training.”
Most new products require some type of training. Murphy says home care nurses must go through a certification process to use the V.A.C. device and KCI offers two levels of certification. Fleck uses hands-on training to teach clinicians how to use the Therapoint measuring device. She says it takes about five minutes to train someone.
Technical training is not the only educational need. Clinicians and other referral sources must understand the value of technology. “With new technology, there can be a very large challenge to get people to look at it in a new light as to how it provides better care or lower cost in the long term,” says Easley.
Acceptance challenges are not limited to clinicians and end-users, however. Payers must also see the value in new technology.
PAYERS
Regardless of the clinical benefits of emerging technologies, if they are not reimbursable, they will not likely succeed in the HME industry.
“We redesign and develop products to fit within a (Medicare) code,” says Slangen. “We have to look at two things: How can we better meet the consumer’s need and how can we create a better profit opportunity for the provider? There are products that require the process of having a whole new code assigned to them, which is much more difficult.”
The reimbursement process is daunting, says Richard, whose primary focus is on managed care rather than Medicare. “Managed care follows the guidelines of national policy that is dictated by CMS [Centers for Medicare and Medicaid Services], so it’s a double-edged sword,” he says. “We are working on both sides of the fence now trying to create a strategy to get reimbursement in place for new technologies even before we release them because we are finding that often times the pace at which we as a manufacturer develop and design new techniques and technology is not kept up with in terms of reimbursement.”
“What you want to continue to focus on is how well the products meet the requirements of the end-users,” says Easley. “You look at where the inefficiencies are in the system that delivers these products and you grab technology and apply it to these gaps.”
THE NEXT GENERATION
What gaps are still open? Where is technology taking the industry? Towards a generation of products that are streamlined, efficient and valuable to consumers and providers.
“You learn through good design and manufacturing practices how to consolidate different aspects of the design,” says Diacopoulos. “We are doing this and we are becoming more effective.”
Manufacturers are also seeing the benefits of exploring how technology can be used in multiple disciplines. ResMed is entering one of its products currently used in Europe into U.S. Food and Drug Administration trials. The product, the Auto CS, is an automated bi-level device that has shown promise in treating cardiovascular disease and hypertension. “We have been able to normalize very difficult breathing patterns and improve the patient’s quality of sleep,” says Richard. “I think that is going to be a key innovation going forward.”
Another goal for respiratory care, says Richard, is to get patients more involved in their own therapy. “I think developing technology that helps them interact with their treatment is going to be one of the paramount things we need to consider,” he says. “I also think reimbursement for telemedicine needs to come into play so physicians can look at reports and get reimbursed for transmitted information.”
Manufacturers, it seems, are indeed geared up for the next phase of innovation.
Computer Software for Home Care Companies
3M Health Care
Building 275-4E-01, 3M Center, St. Paul, MN 55144; 800/367-2447
Web site: www.3m.com/healthcare
Product Name: 3M Coding and Reimbursement System
Designed For: Home Health
Alpha Site
11844 Dublin Blvd., Suite C, Dublin, CA 94568
925/828-9500; fax: 925/828-4251
Web site: www.alphasiteinc.com
Product Names: AlphaTemp, AlphaCare
Designed For: HME, Home Health
Artsco, Inc.
9535 Route 30, Irwin, PA 15642; 724/863-1160, 800/798-3858; fax: 724/863-3559
Web site: www.artscoinc.com
Product Name: Rehab Anywhere
Designed For: Home Health, Rehab
CareCentric
2625 Cumberland Parkway, Suite 310, Atlanta, GA 30339; 678/264-4400, 800/254-9872; fax: 770/384-1603
Web site: www.carecentric.com
Product Names: CareCentric Agency, HMExpress, DME VI, MSS, MestaMed
Designed For: HME, Home Health, Infusion
CareKeeper Software Development
One Dunwoody Park, Suite 240, Dunwoody, GA 30381; 770/392-1542, 800/233-1542 fax: 770/392-1805
Web site: www.carekeeper.com
Product Name: CareKeeper Software
Designed For: HME, Home Health
CogniMed LLC
100 Tower Office Park, Suite P, Woburn, MA 01801; 781/932-5300, 888/264-6463 fax: 781/932-5329;
Web site: www.cognimed.com
Product Name: CareSystems
Designed For: HME, Managed Care
Computer Support Systems Inc.
1265 Mid Broadwell Road, Alpharetta, GA 30004 770/667-9976; E-mail: css4000@bellsouth.net
Product Names: Medical Control System, Nurse Scheduling Payroll Billing System
Designed For: Home Health, Infusion, Respiratory
Computers Unlimited
2407 Montana Ave., Billings, MT 59101; 406/255-9500; fax: 406/255-9595; Web site: www.cu.net
Product Names: TIMS (Total Information Management System), TIMS Pharmacy
Designed For: HME, Home Health, Infusion, Respiratory
Curtis Software
520 S. Main St., Suite 2442, Akron, OH 44311 330/376-7665, 800/648-2377; fax: 330/376-9812
Product Names: PRM (Proclaim Reimbursement Manager), Proclaim ZAP
Designed For: HME, Home Health, Infusion, Respiratory
DataLogic
220 Brandon Blvd., Suite 209, Brandon, FL 33511 813/654-2422, 800/766-6931; fax: 813/653-2370
Web site: www.dmerc.com
Product Name: Sentracare
Designed For: HME, Respiratory
Definitive Homecare Solutions
4150 Indianola, Columbus, OH 43214; 614/261-6761 fax: 614/268-2843; Web site: www.cprplus.com
Product Name: CPR Plus
Designed For: HME, Home Health, Infusion, Respiratory
Dynamic Energy Systems Inc.
1500 South Central Expressway, Suite 200, McKinney, TX 75070; 972/548-0444, 800/326-0314
fax: 972/548-0395
Product Name: Med-Act Designed For: HME
Electronic Marketing Systems
100 E Street, Suite 304, Santa Rosa, CA 95404 707/523-2002, 800/789-8034; fax: 707/523-1608
Web site: www.emssurveys.com
Product Names: QS1000 Electronic Survey System, QS2000 Electronic Survey System
esigned For: Home Health
Fastrack Healthcare Systems
255 Executive Drive, Plainview, NY 11803 516/349-9136, 800/520-2325; fax: 516/349-8875
Web site: www.onlyfastrack.com
Product Names: Fastrack HME, Fastrack Infusion, Acclaim for Windows
Designed For: Hme, Home Health, Infusion, Respiratory
FGA Software Solutions
44 Stelton Road, Suite 315, Piscataway, NJ 08854
732/752-7052, 800/682-5749; fax: 732/424-0084
Product Name: FGA Sotware Solutions
Designed For: Home Health
Futura International
22051 U.S. Highway 19 N., Clearwater, FL 33765 727/791-3332; fax: 727/726-7164
Web site: www.futuraintl.com
Product Name: H.O.M.E.
Designed For: HME, Home Health, Respiratory, Infusion
Hann’s On Software
3550 Round Barn Blvd., Suite 302, Santa Rosa, CA 95403; 707/547-1711; fax: 707/547-1710
Web site: www.hannsonsoftware.com
Product Name: Ascend-I.V.
Designed For: Home Health
HealthCare Computer Corp.
2601 Scott Ave., Suite 600, Fort Worth, TX 76103 817/531-8992, 888/727-5422; fax: 817/531-8999
Web site: www.hcc-care.com
Product Names: Alpha-PC, Alpha-POS, Alpha-CARE, Basic-RX, HCC:HME, Synercom
Designed For: Home Health, HME, Infusion, Respiratory
Health Care Data
515 Encinitas Blvd., Suite 200, Encinitas, CA 92023 760/943-8087; fax: 760/943-8072
Web site: www.hcdinc.com
Product Names: Health Care Data Systems, Health Care Data Systems II
Designed For: HME, Home Health, Infusion, Respiratory and other therapies
Health Com Services
2058 S. Logan, Denver, CO 80210; 303/722-5076, 800/536-1972; fax: 303/722-5257
Web site: www.healthcomservices.com
Product Names: P*O*P Accreditation Program, DocuCare Patient Instruction Software
Designed For: HME
Health Objects
2400 Boston St., Suite 201, Baltimore, MD 21224 410/659-3900; fax: 410/659-3901
Web site: www.healthobjects.com
Product Name: inFusion 2000
Designed For: HME, Home Health, Infusion
Home Care Resources
7900 SW 24th St., Davie, FL 33324 954/472-2333; fax: 954/472-2353
Product Name: Home Care 2000 Millennium
Designed For: HME, Home Health
Home Healthcare Systems
10601-A Tierrasanta Blvd., Suite 329, San Diego, CA 92124; 858/337-9909; fax: 858/292-0569
Product Name: HHS
Designed For: Home Health, Infusion
InfoSys
1821 Walden Office Square, Suite 350, Schaumburg, IL 60173; 888/463-6797
fax: 847/925-9421
Web site: www.infosysusa.com
Product Name: Homesys
Designed For: Home Health, Rehab
Integrated Software Inc.
2060 Palm Bay Road N.E., Palm Bay, FL 32905 321/984-1986; fax: 321/951-4291
Web site: www.isiusa.com
Product Name: ISI Health Care Management
Designed For: HME, Home Health
Lewis Computer Services
9522 Brookline Ave., Suite 100, Baton Rouge, LA 70809; 229/709-2000, 800/955-3947
fax: 225/709-2010; Web site: www.lewis.com
Product Names: Prompt PPS, Prompt-Link, Patron
Designed For: Home Health
Management by Information
2224 Cottondale Lane, Suite 102, Little Rock, AR 72202; 501/661-0105, 888/661-2230
fax: 501/661-0057; Web site: www.mbimbi.com
Product Name: MBI HomeCare
Designed For: HME, Infusion
McKesson Information Solutions
5995 Windward Parkway, Alpharetta, GA 30005 404/338-6000, 800/981-8601
Web site: www.mckesson.com
Product Name: Pathways Homecare
Designed For: Home Health
MCN Group Inc.
2500 First Ave. N., St. Petersburg, FL 33713 727/321-6783, 800/579-4651; fax: 727/321-6834
Product Names: The Purchasing System, Custom Software Applications
Designed For: HME, Home Health
Medical Data Institute
1170 Wheeler Way, Langhorne, PA 19047 215/752-2100, 800/542-1119; fax: 215/752-9454
Web site: www.mdinet.com
Product Names: EpicPlus, ProfitBuilder Suite
Designed For: HME, Home Health
Medi-Care Data Systems
425 Sand Shore Road, Hackettstown, NJ 07840 908/852-4500, 800/995-4637; fax: 908/852-2255
Web site: www.dmeasy.net
Product Name: DMEasy 2000
Designed For: HME, Home Health, Respiratory, Rehab
Meditech
1 Meditech Circle, Westwood, MA 02090 781/821-3000; fax: 781/821-2199
Web site: www.meditech.com
Product Name: Home Health Information Systems
Designed For: HME, Home Health
OmniSYS
2824 Terrell Road, Suite 602, Greenville, TX 75404 903/455-0461, 800/448-6891; fax: 903/455-7910
Web site: www.omnisysinc.com
Product Names: TeleCare, CareClaim
Designed For: HME
Patient Care Technologies
2 Executive Park West N.E., Suite 220, Atlanta, GA 30329; 404/235-7828
fax: 404/235-7839
Web site: www.ptct.com
Product Names: The Home Care Manager
Designed For: Home Health, Infusion, Respiratory and other therapies
P.C. Solutions
33 Town Farm Road, Woodstock, CT 06281 860/974-1156, 800/441-5473; fax: 860/974-1886
Web site: www.dmefree.com
Product Name: DMEFree
Designed For: HME
QS/1 Data Systems
P.O. Box 6052, Spartanburg, SC 29304 864/503-9455, 800/845-7558; fax: 800/231-7783
Web site: www.qs1.com
Product Name: SystemOne
Designed For: HME, Home Health
Rollins Healthcare Data Systems
1920 Opdyke Court, Suite 100, Auburn Hills, MI 48326; 248/475-5500, 800/530-9004
fax: 248/475-5526
Web site: www.rollinsmedical.com
Product Name: Rollins Software
Designed For: HME, Home Health
Sandata
26 Harbor Park Drive, Port Washington, NY 11050 516/484-4400, 800/544-7263; fax: 516/484-6084
Web site: www.sandata.com
Product Name: Santrax
Designed For: Home Health
Siemens Health Services
400 Lakemont Park Blvd., Altoona, PA 16602 814/944-1651; fax: 814/942-0125
Web site: www.deltahealth.com
Product Names: Home Care System, Total Clinical Link System, Novius Home Care System
Designed For: HME, Home Health, Respiratory, Infusion
Sleep Multimedia Inc.
P.O. Box 329-H, Scarsdale, NY 10583 914/722-9291; fax: 914/722-4490
Web site: www.sleepmultimedia.com
Product Name: Sleep Multimedia
Designed For: Home Health, Sleep Therapy
Strategic HealthCare Programs
222 E. Canon Perdido, Suite 304, Santa Barbara, CA 93101; 805/963-9446, 800/542-5125 fax: 805/963-2102;
Web site: www.strategichp.com
Product Name: SHP Online
Designed For: HME, Home Health, Infusion, Respiratory
Team DME!
1321 Murfreesboro Road, Suite 655, Nashville, TN 37217 615/333-1900, 888/832-6363; fax: 615/333-0234
Web site: www.teamdme.com
Product Name: Team DME!
Designed For: HME, Home Health, Infusion, Respiratory
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