Products & Technology

Eprescription for HME

Other healthcare industries have made incredible efficiency gains thanks to eprescription. Now this game-changing technology is making strides in postacute care, and that includes HME. How do providers leverage its benefits?

• By David Kopf
• Apr 01, 2022

Say hello to eprescription, the electronic healthcare handshake that is rapidly gaining momentum in HME. For years, HME has sat on the sidelines of healthcare’s adoption of eprescription, but several factors are changing that.

So, what is eprescription? It’s simple: rather than a referral source sending a faxed prescription to an HME provider, the referring physician or other healthcare professional can send the prescription electronically. Eprescription acts as the secure, HIPAA-compliant mechanism for sending prescription and patient data from the referral source to the HME provider. This leaves nothing up to interpretation; the prescription is accurate, error-free, and includes all the necessary information for a clean claim.

While eprescription has been a regular component of healthcare IT systems for years, its adoption in the home medical equipment industry has taken some time, but recently that development has gained traction. HME software companies such as Brightree LLC (Brightree.com) have been working to drive eprescription for the industry, and eprescribe companies such as Parachute Health (parachutehealth.com) and GoScripts (goscripts.com) have been offering eprescription solutions specifically for HME providers and their referrals.

The biggest recent development in eprescription for HME happened last September when a collection of HME industry leaders formed DMEScripts LLC, an eprescription company for HME that was driven by providers and industry groups. The alliance of investors forming DMEScripts includes the American Association for Homecare, VGM & Associates, AdaptHealth LLC, Apria Healthcare Group LLC, Lincare Inc. and Rotech Healthcare Inc.

Suffice it to say, eprescribe for HME is starting to make big strides. That’s due to several factors.

MARKET MOMENTUM

“We’re starting to see a lot of the solutions out in the space come of age, and we’re seeing a greater uptake amongst referral sources and HMEs alike for moving forward with technology-based solutions to enable eprescribe,” says Nick Knowlton, vice president of business development for Brightree.

Knowlton has been heavily involved in health data system interoperability and eprescription for HME. In fact, Knowlton chairs the CommonWell Health Alliance board of directors and has been involved in the Alliance since it was founded roughly nine years ago. CommonWell is a group of various healthcare technology stakeholders that aim to create links between disparate healthcare data systems to securely connect patient records and data services across those systems.

Also, the Covid-19 public health emergency helped accelerate the adoption eprescribe for HME.

“I’d say since we formed, we’re seeing an uptick, and I think the rest of the eprescribe platforms are as well,” says Dan Starck, CEO of Apria and chair of DMEScripts’ board of directors.

Starck adds that the number of platforms out there and the expanding range of claims they support is also helping drive adoption. This helps providers continue to specialize.

“Not only DME but also medical supplies, and diabetes supplies,” he says. “As those product lines continue to be built out and are facilitated through the eprescribe platforms, the more advantageous it becomes or easier to send the referrals to multiple providers or suppliers.”

Another factor that is helping to drive the uptake of eprescription for home medical equipment is the fact that referral partners are seeing eprescription spread across postacute care in general, Knowlton says. That creates an expectation on the part of referring physicians.

“Once referrals experience the ease of electronic referrals and electronic orders, they start to expect it elsewhere,” he explains. “So we’ve seen a great increase in other home-based care settings, such as home health and hospice.

“And we are seeing very large upticks now appearing in the HME and equipment space,” he adds. “I think the progression that we’ve seen in the past year has been tremendous in terms of the number of physicians enrolled in various networks. Be they ordering from a standalone platform, such as Parachute, GoScripts, or DMEScripts, or leveraging specialty platforms or direct from EHR integrations.

PROVIDER BENEFITS

Eprescription offers a lot to providers. For starters, it’s a massive efficiency gain in the way that providers work with referral and their patients.

“There’s a huge opportunity that still exists out there around adoption and the ability for the industry to move off of the old fax paperbased system and adopt it at a much higher level and a faster rate,” Starck says.

“Ultimately, it’s a shorter time allotment for somebody sending a referral,” he continues. “And it’s a shorter timeframe for the supplier to process and qualify a patient. Both of those things mean the patient gets their equipment faster, and there’s less rework. So, all those things align and begin, I think, to build that business case.”

And that efficiency helps considerably in terms of providing care. Increased care and service make a big difference in an increasingly outcomes-oriented reimbursement environment.

“When we talk about eprescribe, we’re talking about getting any type of order or documentation over from the referral sources that is going to help the HME take care of a patient or obtain reimbursement,” Knowlton explains. “And in our industry, a lot of times taking care of the patient and being able to obtain reimbursement go hand in hand.”

Since the data coming from the referral source has to be entered properly, eprescription helps on the claims processing and audit mitigation fronts as well. There, too, care is improved.

“All the eprescribe platforms basically have edits around requirements for orders to be processed, which largely meets all the compliance needs,” Starck explains. “So, when a DME supplier receives a complete and accurate order, they can move as quickly as they possibly can to make sure that the patient gets what they need as soon as they can.”

“Being able to collect all the information, being able to have rules-driven workflows, and being able to get the right documentation upfront is tremendously powerful for HMEs dealing with reimbursement challenges,” Knowlton says.

“And that has, I think, a direct impact also on patient care,” he adds. “If an HME isn’t sure whether they’re going to get reimbursed, patients can very quickly fall through the cracks. So, it’s the right thing to do on a lot of different fronts for an HME.”

PREPARING FOR EPRESCRIBE

Implementing eprescription starts with thinking strategically. Brightree’s Knowlton suggests providers think a little strategically at the outset of the process to determine how far they want to take the implementation.

Providers should start by assessing their business lines, their geography, and what their referral sources are already doing with eprescription, Knowlton advises.

“A good first recommendation is always talking with your referral sources, in terms of where eprescribe for HME is on their radar,” he says. “Do they understand the benefits? Do they know that they have the ability to move forward with eprescribe now?

“I’d also ask if they have the right technology underpinnings to take advantage of eprescribe,” he continues. “Depending on business lines and geographies, you could be dealing with many different referral sources with different choices and technology. So, making sure that you as an HME are first and foremost, ready to deal with that, that would be a quick checkbox for beginning the journey of how to implement an eprescribe strategy.”

The next step in the process depends on how deeply the HME provider wants to implement eprescribe into their business and their software systems. So, let’s look at that.

FLIPPING THE SWITCH

In the most basic terms, HME providers can implement eprescription in essentially a day, assuming they are using the eprescription company’s web portal.

“Basically, they only need to contact the eprescribe company, whether it’s DMEScripts or any of the other eprescribe companies, and get in their network,” Starck says. “And as soon as [a provider] joins the network, it is available on the menu for the prescriber.

“There’s an onboarding process we have both for a supplier as well for a prescriber, both of which are pretty easy and can be done really in one day,” he adds.

Again, that’s for a basic implementation using the eprescription company’s web portal.

If providers want a more systemic eprescription integration where eprescriptions are handled through their HME software system, such as those from Brightree, Universal Software Systems, or Computers Unlimited, then there will need to be more integration work on the back end.

“Based on the billing system the HME provider is on, there may be some further integration needed,” Starck says. “But at a minimum, if a prescriber and a supplier both enrolled in the same day, they could at least send them an electronic order to start. It might not be fully automated from beginning to end, but they could send the electronic order in one day.”

GOING DEEPER

Before talking about integration with software, it’s important to understand that interoperability between healthcare systems uses a variety of technology approaches as well as standards. Making all that interoperability happen in a seamless way is why organizations like the CommonWell Alliance and eprescription companies such as DMEScripts, GoScrips and Parachute exist.

“The physician ideally gets to do things in their native workflow or as close to their native workflow as possible, and the HME providers receive orders in their electronic systems as well,” Knowlton explains. “If interoperability is done right, HME providers and physicians don’t have to deal with any of the complexity. The vendors that they leverage can handle it for them.”

So, for a provider that might not have a lot of on-staff IT muscle to do their own implementation but wants to integrate eprescription into their software systems, they want to consult with their software company and eprescription company.

“While there are some big HMEs out there that might be able to do their own plumbing for this sort of thing, we at Brightree and I know a whole bunch of other technology vendors in the HME space and the eprescribe vendors themselves, want to support their customers and have them lean on them for the technical journey,” Knowlton explains. “So, we and others stand by, ready to talk to anybody that wants to understand how to prepare for their journey.

“Once you’ve talked to your referral sources and taken stock of your situation, talk to your technology vendors about how they can support you on your journey,” he continues.

Then the provider wants to put a strategy in place that will keep the business moving, Knowlton adds. For instance, it needs to map out how it will continue working with referral sources. Does the provider want to drive adoption of a particular eprescribe approach, or does it want to work with referrals regardless of eprescribe system and hook into whatever platforms or approaches they might already be using?

From an organizational standpoint, the provider needs to consider how it implements eprescription with its staff during the integration. They need to determine what they can do from a personnel standpoint to be able to take advantage of these opportunities now.

“It’s getting easier and easier [to implement eprescription] every day,” Knowlton explains. “However, depending on how aggressive an HME wants to pursue driving eprescribe solutions upstream into their referral networks, there can be an investment of time from sales and marketing reps. And there can certainly be an investment of time and internal operations folks and aligning workflows with new and easier ways of doing business.”

MAINTAINING MOMENTUM

From Starck’s perspective, as both a national HME provider and the chairman of an eprescribe industry backed by multiple large providers, VGM and AAHomecare, eprescription is an industry initiative; its adoption will benefit the industry.

“I think that the number one thing everyone can do from a DME supplier community is to get involved,” he says. “The more the DME community in total rallies around eprescribe and helps move it with the referral partners, that will drive adoption. And it will drive connections and connectivity across EHRs and backend billing systems.”

Essentially, uptake increases uptake. The more providers make referral sources aware and champion eprescribe as a “priority” within the industry, the more referrals will want it, and that will help eprescribe achieve ubiquity. The goal is to make what seems like a new innovation at this moment seem commonplace in the future.

“The more providers that get involved and actively participate and champion, the better,” Starck says. “We have a number of providers that do that today, but you think about the fact that we still have roughly 6,000 DME providers in the United States. We don’t have 6,000 people actively moving eprescribe and adopting and driving eprescribe.

“The capability is there,” he continues. “So, this is not a technology issue; this is really an adoption issue. And there are multiple platforms available, and the industry and the prescribers, and the patients, really all benefit from much higher adoption of eprescribe. And the way to make it happen is for the entire industry to engage in it and really champion it.”

This article originally appeared in the Mar/Apr 2022 issue of HME Business.