VGM Playbook: Growing Your
Business With Data and Technology
Table of Contents Letter From the President.......................................................................... page 4
Clint Geffert, President, VGM & Associates
TRENDS AND TECHNOLOGY
Emerging Technologies for 2022 ........................................................... page 5
Jeremy Kauten, CIO, Senior VP, Information Technology, VGM Group, Inc.
Focus on Patient Experience.................................................................... page 8 Curt Graff, VP, Technology, VGM Fulfillment
Emerging Opportunities in Wearable Technologies......................... page 11 Kyle J. Walker, MHA, ATP, VP, Rehabilitation Program Development, VGM HOMELINK
Best Practices for Implementing New Technology........................... page 13
Leah Homeister, Technical Project Manager, VGM Group, Inc.
Keeping Up With the Times: Integrating E-Prescribe in Your Business Operations....................................................................page 16
Kayla Mahler, Brand Manager, VGM & Associates and Ken Hodel, VP, Development, DMEscripts
DATA AND SECURITY
Making Your Data Work for You............................................................. page 20 Jim Nygren, CFO, VGM Group, Inc.
Know Before You Go: Evaluating and Quantifying DME Market Expansion Opportunities................................................. page 23 Ryan Ball, Director, VGM Market Data
VGM Playbook: Growing Your Business With Data and Technology
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Table of Contents continued... Reach Goals and Increase Profits With Data-Driven Decision Making....................................................... page 25
Nupura Kolwalkar, Chief Product Officer, Brightree
The Internet of Medical Things: Detecting and Preventing Crises for New Value Creation......................................... page 28
Audra Bares Watt, VP, Marketing, Permobil Americas
Cybersecurity in 2022: What to Watch For........................................ page 30 Jay Bracken, CISSP, Information Security Officer, VGM Group, Inc
OUTCOMES-BASED HEALTHCARE
Beyond Measure: The Patient-Driven Model in Wound Care....... page 32 Heather Trumm, Director, VGM Wound Care
Distinguishing Your O&P Practice......................................................... page 34
Todd Eagen, President, OPGA
Complex Rehab Technology and Outcomes-Based Healthcare.................................................................. page 36 Greg Packer, President, U.S. Rehab
Outcomes Driven by Clinical Respiratory Software and Analytics ..................................................... page 38
Zach Gantt, RRT, FAARC, CEO, Encore Healthcare
COVID-19 Pandemic Opened the Door for Decentralized Clinical Trials ................................................................... page 40
Andy Maloy, Senior VP, Technology and Clinical Trials, Verustat
VGM Playbook: Growing Your Business With Data and Technology
Table of Contents | 3
Letter From the President In the last edition of the VGM Playbook, we touched on several areas all of us in the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) space should consider and analyze to better understand how we as an industry can continue to raise the bar. Our ability to adapt has been proven, but there are always ways we can improve. There are many opportunities out there to enhance our way of doing business and positively impact consumer and clinician relationships, including the implementation of data and technology in our business operations. “VGM Playbook: Growing Your Business With Data and Technology” focuses on best practices for data and technology in the DMEPOS space. Topics include expanding and applying new technology in your business, cybersecurity trends, making data part of your daily routine, remote patient monitoring, utilizing real-time data to optimize positive outcomes and grow your business, and so much more. VGM’s goal is to provide you with insight on how to maintain your business operations while integrating new technology and data practices to positively impact the patient experience and improve your bottom line. Thank you for being part of the VGM family that helps, supports, and strives to be better together. Together, we are part of something bigger. Kindest regards,
Clint Geffert, President VGM & Associates
Clint.Geffert@vgm.com 319.874.6990 office 281.734.3391 cell Follow me on LinkedIn.
VGM Playbook: Growing Your Business With Data and Technology
Letter From the President | 4
Emerging Technologies for 2022 By Jeremy Kauten, CIO, Senior VP of Information Technology, VGM Group, Inc.
T
he onset of the pandemic in 2020 disrupted “business as usual” regarding technology. Technical teams across the globe released technology overnight to allow for changes in the environment. Work-fromhome capacity increased. Virtual meetings became regular. And customer service was digitized. All this has changed technology expectations forever.
Where do we go from here, and what does 2022 look like for your company’s technology? Each organization is unique, but based the current trends there are four key areas to focus on first.
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If businesses don’t meet employee expectations, they may take their skills elsewhere.
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1. Hybrid Remote Workforce Technology Employee expectations have changed. Technology follows people and allows them to work from, well, anywhere. If businesses don’t meet employee expectations, they may take their skills elsewhere. Companies should prioritize mobility to retain and maximize talent. Giving employees a choice to work remotely, both in and out of the office, will generate new technology challenges that are different from a meeting where all employees are remote or in the office.
other, but those remote will experience less of the conversation and not be as connected to the team, group, or conversation. One item of note is that many referral sources, as well as HIPAA rules and regulators, allowed for various remote technologies such as Zoom, Microsoft Teams, GoTo Meetings, Google Meet, and even Apple’s FaceTime during the pandemic. Recently, many of these same entities are limiting the systems they support and may cause your company to use different virtual tools based on the customer’s selection and security requirements. FaceTime and Google Meet are getting the negative attention of auditors and will likely not be considered acceptable for PHI transmissions going forward.
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When investing in new technology, prioritizing mobility and hybrid work will help you find diverse and untapped talent.
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When investing in new technology, prioritizing mobility and hybrid work will help organizations find diverse and untapped talent through accessibility and accommodations.
Hybrid work will take additional technology investments. Conference rooms and workstations installed before the pandemic are likely near obsolete. Most, if not all, were not set up with hybrid work as a priority. Those in-room attendees are able to hear and see each
VGM Playbook: Growing Your Business With Data and Technology
Emerging Technologies for 2022 | 5
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Emerging Technologies for 2022 By Jeremy Kauten, CIO, Senior VP of Information Technology, VGM Group, Inc. authentication) is a must. Locking down access to your VPN or approved IP addresses is also very important. Don’t assume that security is built natively into the application. Review what is available and use it.
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Don’t assume that security is built natively into the application. Review what is available and use it.
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3. Robotic Process Automation (RPA) 2. Cloud Applications Throughout 2020 and 2021, many organizations adopted cloud storage to access files remotely. Many of these tools were not used widely due to concerns of HIPAA or referral sources restricting such usage for patient data. During the pandemic, HIPAA auditors and referrals sources lowered requirements temporarily for use of these platforms. Examples are DropBox, Box.com, Microsoft OneDrive, and Google Drive to name a few.
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Health systems and payers are now starting to dictate which cloud platforms are acceptable to transmit their data.
With the continued shortage of workers across healthcare and other industries, the use of RPA will continue to increase. A digital worker, or “bot,” is a software tool that can multitask and perform work within your systems that is mundane or tedious for staff, such as copying and pasting data from one system or spreadsheet into another system. Bots can also check email, review messages, and trigger other functions such as procuring products from vendor websites, creating billing documents, and even executing tasks in operations processes such as scheduling patient deliveries or appointments.
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Health systems and payers are now starting to dictate which cloud platforms are acceptable to transmit their data. Some approve Box.com; others require Microsoft OneDrive. Anticipate needing to react to your larger clients based on their specifications. The entire Google Suite (Google Drive, Google Meet) is getting greater scrutiny from referral sources, while Box.com and Microsoft OneDrive are becoming acceptable by many security assessments conducted by referral sources and payers. When using such tools, be sure to enable as many, if not all, security controls that are native to the platform. MFA (multi-factor
RPA can run 24/7 and increase employee satisfaction by reducing tasks that don’t accentuate employees’ skillsets.
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Consider adding automation to your company’s IT strategy. Digital workers don’t call in sick, don’t need to be quarantined, and do not consume expensive company benefits. RPA can run 24/7 and increase employee satisfaction by reducing tasks that don’t accentuate employees’ skillsets, working together with humans to advance the speed of business processes. There are many RPA tools on the market. Market leaders include Blue Prism, Automation Anywhere, UiPath, and Kofax.
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Emerging Technologies for 2022 By Jeremy Kauten, CIO, Senior VP of Information Technology, VGM Group, Inc.
The ability to “try before you buy” will enhance customer experiences and boost collaboration among team members.
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4. Augmented Reality (AR) and Virtual Reality (VR) Nothing can replace the real thing, but many are reporting that we can be reasonably close. The software applications developed for VR are growing at a lightning pace. Facebook’s Oculus Quest 2 has exceeded 10 million users and continues to grow. The use of VR to purchase a home, vehicle, or even medical equipment will have exponential growth in 2022. The ability to “try before you buy” will enhance customer experiences and boost collaboration among team members.
Embrace new technologies in 2022. Put them to use to retain and recruit employees, referral sources, and patients.
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The Value of Technology Technology spending can seem like a never-ending black hole. Security and infrastructure investments do not have a direct value to the business. Embrace new technologies in 2022. Put them to use to retain and recruit employees, referral sources, and patients.
High-tech companies are issuing VR machines to employees and requiring them to meet in virtual spaces instead of traditional virtual team meetings, advancing their knowledge and adoptions of VR environments. As customers adopt new technologies such as VR, it will become more and more common in the shopping experience, similar to how mobile ordering for restaurants took off during the pandemic’s peak. Restaurants now must be in the “mobile experience game” for online ordering and table reservation because customers expect it. Likewise, VR will become an expectation in the retail world.
VGM Playbook: Growing Your Business With Data and Technology
ABOUT THE AUTHOR Jeremy Kauten, CIO, Senior VP of Information Technology, VGM Group, Inc. Jeremy Kauten is the CIO and senior vice president of information technology at VGM Group, Inc. He’s spent his entire career in the cyberworld, and currently focuses on protecting computers, networks, programs, and data from unauthorized access, change, or destruction while coordinating and optimizing the use of technology throughout VGM. He earned a bachelor’s degree in marketing and business management from Upper Iowa University, with additional credits from the computer information systems program from the University of Northern Iowa. He also holds an A.A.S. in law enforcement and an M.B.A. from the University of Iowa Executive Master of Business Administration Program. Connect with him on LinkedIn or email him at Jeremy.Kauten@vgm.com.
Emerging Technologies for 2022 | 7
Focus on Patient Experience By Curt Graff, VP, Technology, VGM Fulfillment
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ver the past couple of years, technology has been a key area of development for companies in almost every industry, including healthcare. It likely won’t come as a surprise to anyone that this trend isn’t going anywhere. Expectations have been forever altered. And the experience patients expect requires DMEs to become increasingly digital and more streamlined.
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Whether it be scheduling an appointment or paying a bill online, patients don’t just appreciate these items—they demand them.
The Status Quo Is Changing You cannot afford to ignore the patient experience. The patient will begin to lean toward the easier path. Over the past year, there has been a 40% jump in patients who switched providers due to a poor digital experience.1
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Over the past year, there has been a
40%
jump in patients who switched providers due to a poor digital experience.
Patients Are Consumers Thanks to the internet, Amazon in particular, consumers are accustomed to real-time, self-service experiences at their fingertips. Being a patient doesn’t eliminate them from this expectation. Whether it be scheduling an appointment, real-time chat, proactive communications on their shipment, or paying their bill online, patients do not just appreciate these items—they are beginning to demand them.
One might think that older patients are not tech-savvy, but adoption of technology has been gaining steadily in the last decade. A 2021 study by the Pew Research Center captured the following about those age 65 and older2:
49%
of patients wish for a digital healthcare experience resembling experiences from major consumer brands
49% of patients wish for a digital healthcare experience resembling experiences from major consumer brands.1 This shift in patient behavior is not going away and is only intensifying.
VGM Playbook: Growing Your Business With Data and Technology
In 2012, 13% of those 65 and older owned smartphones compared to 61% in 2021, a increase
48%
The percent of those 65+ who use the internet has climbed
32%
in this timespan
The increase of social media adoption has grown from in 2012 to
16% 45% in 2021
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Focus on Patient Experience By Curt Graff, VP, Technology, VGM Fulfillment
Many times, it is thought that the technology will do everything. This is why many initiatives fail.
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Where to Start Like anything, it begins with people, then process, then finally technology. Many times, it is thought that the technology will do everything. The technology is plug-and-play. The technology will save the day. This is why many initiatives fail. In order to create a great patient experience, you need to start with the patient. What is the current experience? What is good about that current experience? What is bad? Once you identify that, it’s time to focus on the future state experience. The future state is where you get to keep the good, eliminate the bad, and add what is missing.
Once the future state patient experience is defined, you can begin to identify solutions. As you look to fill those gaps, ask yourself: Questions to Help You Identify Gaps • Do I need a new business system? • Do I need to update how we schedule our patients? • Do I need to update how we communicate with patients? • Do I need a different process or technology? • Am I spending too much time on other tasks— managing inventory, billing, customer service, answering phone calls and emails, performing refurb or repairs—that I can’t focus on the patient experience? Making Choices This stage is where it gets tough. This is where choices must be made. The first thing to do is prioritize the gaps according to impact to the experience and the business. This may be a direct or indirect change. For example, a direct change would be to procure a selfservice scheduling system. An indirect change would be a new business system. A new business system may have the greatest impact because you spend less time billing and more time focusing on the patient.
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Focus on Patient Experience By Curt Graff, VP, Technology, VGM Fulfillment
No matter the change, there are going to be time, budget, and people constraints.
References
If you do not have the expertise on your staff to navigate the current and future state process, or the resources to implement the changes, you will need to find partners that can guide you along the way. It may be a specific partner to implement a new technology, a partner that can outsource your fulfillment or provide managed IT services. Seek out assistance. Don’t go it alone.
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New technology has never been more accessible than it is right now.
1. Pearson D. Patients dissatisfied with providers’ digital prowess voting with their (actual or virtual) feet. Health Exec. https:// healthexec.com/topics/precision-medicine/healthcareconsumers-digital-health-survey. Published Dec. 07, 2020. 2. Faverio M. Share of those 65 and older who are tech users has grown in the past decade. Pew Research Center. https:// www.pewresearch.org/fact-tank/2022/01/13/share-of-those-65and-older-who-are-tech-users-has-grown-in-the-past-decade/. Published Jan. 13, 2022.
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New technology has never been more accessible than it is right now. Leveraging existing integrations to your business systems and flexible platforms can significantly decrease the effort and time it takes to bring the changes you require. Embracing the Challenge The patient experience will be ever evolving, but if you embrace the challenge of improving the patient experience, you may start to see:
ABOUT THE AUTHOR Curt Graff, VP, Technology, VGM Fulfillment Curt Graff is the vice president of technology at VGM Fulfilment and is charged with creation of strategic technology initiatives that align with both VGM Group’s and VGM Fulfillment’s longterm goals. He works closely with internal and external partners to deliver innovative programs and services that enhance VGM’s offering to customers. Connect with him on LinkedIn or email him at Curt.Graff@vgm.com.
• Improved patient adherence • Improved patient retention • Increased use of self-service • Decreased customer service issues • Higher overall patient satisfaction Remember, a happy patient means happy referral sources and payers. And while offering the best possible patient experience is an ongoing challenge, all you have to do is keep doing what you do best— caring for your patients.
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Emerging Opportunities in Wearable Technologies By Kyle J. Walker, MHA, ATP, VP, Rehabilitation Program Development, VGM HOMELINK
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echnology continues to advance at rates faster than we’ve ever seen, especially in healthcare where the boundaries between these two booming markets continue to blur.
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Wearables span more than just exoskeletons in healthcare, including applications in remote patient monitoring and accessibility.
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But wearables span much more than just exoskeletons in healthcare, including applications in remote patient monitoring (RPM), risk management, accessibility, and fitness. With our growing, virtually connected world and the ability to amass large amounts of data to then analyze and create predictive modeling, the opportunities are, in my opinion, limitless. The Payer Perspective
Last year, I wrote “Wearable Robotics: From Cinema to Reality” for CMSAtoday™. In it, I explored wearables in the form of exoskeletons that continue to become more prevalent in markets from rehabilitation and manufacturing to a military application, and it’s quite exciting to see the impacts and development.
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More and more clinics across the world are adopting exoskeletons as an early interventive ambulation approach.
More and more commercial and private health insurers are offering premium discounts and rebates in different forms, as well as on fitness trackers themselves as part of “movement” campaigns. The aim is to encourage their members to become more active with simple awareness and some shared data.
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In the rehabilitation realm, more and more clinics across the world are adopting this early interventive ambulation approach on both the inpatient and outpatient sides. And the results are very encouraging for those with neurological conditions. In manufacturing and risk management, stakeholders continue to explore robotic automation of processes. But where a human needs to be present, there is a growing emergence of supportive exoskeletons aimed at reducing the stressors of high-risk, injury-prone job functions.
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VGM Playbook: Growing Your Business With Data and Technology
To the insurer, fitness trackers mean a decreased risk and expenditures for pennies on the dollar.
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Emerging Opportunities in Wearable Technologies By Kyle J. Walker, MHA, ATP, VP, Rehabilitation Program Development, VGM HOMELINK
We are all aware of the massive amounts of data and research that correlate human movement to decreased health risks. To the insurer, this means a decreased risk and expenditures for, one could argue, pennies on the dollar if you compare the cost to medical expenses for obesity, diabetes, and heart disease.
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Wearables now come in the form of RPM devices for medical conditions like high blood pressure and diabetes.
Where You Fit In
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Remote Patient Monitoring Another exciting form of wearables comes in the form of RPM for a patient’s medical condition like high blood pressure and diabetes. A newer product called FreeStyle Libre by Abbott allows the user to live monitor their blood glucose levels through a subcutaneous sensor and an app on their smartphone.
The opportunities are limitless when it comes to wearables in the post-acute market—from prosthetic and orthotic providers to your retail DME. The goal is to figure out where you fit in the picture. Are you a part of a growing ACO (accountable care organization)? Do you participate in any risk mitigation or value-based agreements? At the end of the day, you have to ask yourself, what can I bring to the table with all the lives I touch on a daily basis? Given the direct access DMEs have to patients, I encourage you to consider adding wearable technologies to your current solutions. It’s a market with growing opportunities both for your DME business and the patients you serve.
Recently, I came across a company called Sensoria Health which manufactures and distributes products to remotely assist in the care and prevention of several health conditions, from patients with diabetic foot ulcers, to infants with sleep irregularities. With current pending legislation in the works, which could expand RPM to more providers, the opportunities continue to grow. At the most recent ISS (International Seating Symposium) in 2022, researchers including Karin Leire, VP of research and innovation at Permobil, shared exciting developments in the analysis of data collected from users in their “connected” chairs and users who use a SmartDrive power assist with a push tracker (wearable). I believe that with this data, along with claims data, there could be opportunities for predictive modeling, which may someday affect health policy.
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The opportunities are limitless when it comes to wearables in the postacute market—from O&P providers to retail DMEs.
ABOUT THE AUTHOR Kyle J. Walker, MHA, ATP, VP, Rehabilitation Program Development, VGM HOMELINK Kyle Walker MHA, ATP, is the VP of rehabilitation program development with VGM HOMELINK. The majority of his professional career has been in the field of assistive technology. He is active on several RESNA boards, educational advisory committees, a participant in scientific peer reviews, and an advocate for consumers and providers alike. Connect with him on LinkedIn or email him at Kyle.Walker@vgm.com.
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Best Practices for Implementing New Technology By Leah Homeister, Technical Project Manager, VGM Group, Inc.
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hange is inevitable, especially in the technology space. Adoption of technology doesn’t always happen as quickly as we would like. Whether it is incorporating new technology, such as e-prescribe, into your business or upgrading an existing system, full adoption is critical to get the full benefits of your investment.
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To get buy-in early, create and communicate a compelling vision so all employees understand what the future looks like.
to the audience. For example, have one-on-one weekly touch bases, use Microsoft Teams or Slack chat, or provide a shared document where questions, comments, and concerns can be listed anonymously. Build trust by providing responses to their feedback. It is important for employees to feel heard.
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Create a Compelling Vision Even before the project kick-off, start planning for adoption. To get buy-in early, create and communicate a compelling vision so all employees understand what the future looks like. They need to know how the new technology supports the company vision, mission, and strategy. New technology causes disruption, and inevitable process changes create employee anxiety. Acknowledge and address their anxiety from the very start with honesty and empathy. Reassure employees by communicating regularly throughout the project.
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The goal is to have a consistent, well-crafted message that drives priorities, creates urgency, and inspires employees at all levels of the organization to embrace the change that comes with implementing new technology. Keep the vision front and center by sharing it throughout the project and celebrate successes along the way. Get the Right People Involved Get the right people involved in the project from start to finish. Identify stakeholders from all levels of the company for the project team. Promote and encourage sharing ideas. Flatten traditional hierarchies within the team to inspire diverse thoughts, identify potential issues quickly, and improve buy-in especially for those directly impacted by the new technology.
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Be intentional about transparency and sharing the vision. Have a feedback loop for employees to provide input and get access to information. Offer various communication channels and tailor responses
The goal is to have a consistent message that drives priorities, creates urgency, and inspires employees to embrace change.
When selecting the project team, understand how individuals adopt technology at different rates.
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When selecting the project team, understand how individuals adopt technology at different rates based on the Diffusion of Innovation Theory. Identify individuals and determine what role they play on the project by understanding key traits of the five groups across the innovation adoption spectrum.
VGM Playbook: Growing Your Business With Data and Technology
Best Practices for Implementing New Technology | 13
Best Practices for Implementing New Technology
continued...
By Leah Homeister, Technical Project Manager, VGM Group, Inc. Early Market The Chasm
Pragmatics Conservatives
Visionaries Tech Enthusiasts
Skeptics
2.5% 13.5% Innovators
Every project will have challenges. Innovators and early adopters make good testers because they don’t expect perfection with a new release. Include them from the start and plan for opportunities to celebrate successes early and often. Seeing quick results will keep them enthusiastic and energized. The objective is to have an agile mindset: Fail fast and adjust as needed to keep moving forward to build and keep momentum throughout the project.
Mainstream Market
Early Adopters
34%
34%
16%
Early Majority
Late Majority
Laggards
Include innovators and early adopters. These “tech enthusiasts” are curious and adopt new technology quickly. For example, innovators will camp out overnight to get the newest iPhone on day one. While early adopters won’t necessarily wait in line, they are influential leaders that will pay a premium to have the latest version of the iPhone. Diffusion of Innovation Theory Group Reactions Innovator
Camp out in line and pay a premium
Early Adopter
Pay a premium, but not wait in line
Early Majority
Purchase the latest version once the kinks are worked out
Late Majority Purchase older version once it goes on sale
Laggard
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Continue to use long after contract expires
Have an agile mindset: Fail fast and adjust as needed to keep moving forward.
Getting full benefits requires “mainstream” groups (see graph) to also buy in, starting with the early majority. Continuing the iPhone analogy, this group will purchase the latest version once kinks are worked out. Win over this practical group with logic by showing them advantages of new technology. The early majority may not be leaders in the organization like early adopters, but they have strong social networks and will champion new technology to subsequent groups. Persuading this group is a key step toward full adoption. Identify influencers from this group and include them early in the journey. Help them visualize what the new technology can do for them. To win over the last two mainstream groups, late majority and laggard, seek their input as they will likely identify issues others may overlook. It will be key to have a fully functional and bug-free minimum viable product (MVP) at implementation. Otherwise, you risk fueling these skeptics and elongating the technology adoption window. The late majority group is cautious and skeptical. They are persuaded by economics and peer pressure. They will purchase an iPhone that is a few versions removed once they go on sale based on recommendation from a friend. Use the influencers in the previous groups to help pull them along the adoption journey.
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VGM Playbook: Growing Your Business With Data and Technology
Duality of systems (maintaining the old and new system in parallel) is costly and disruptive.
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Best Practices for Implementing New Technology By Leah Homeister, Technical Project Manager, VGM Group, Inc.
Laggards are an important group, so consider their viewpoints when designing and implementing new technology. (Recommended read: Forbes, July 23, 2020: “Technology Laggards:” 14 Important Lessons They Can Teach Tech Leaders). They are opposed to change and will continue to use an old iPhone long after contract expiration. Create urgency for laggards to adopt. Duality of systems (maintaining the old and new system in parallel) is costly and disruptive due to extra licensing, hardware, and maintenance costs, as well as employee frustration. When replacing an existing system, limit the adoption window by having a plan to retire the old system.
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Don’t let off the gas too soon. Fully integrate the new technology into your culture.
Finally, don’t let off the gas too soon. Fully integrate the new technology into your culture. Monitor adoption rates, report on value realization, and adjust as needed based on feedback from stakeholders.
Empower and Engage Employees
ABOUT THE AUTHOR
Once you have all seats on the bus filled, empower and engage employees by verifying that all project members understand their role. For example, senior management champions the initiative across the organization. By removing barriers, they allow those closest to the processes, customers, and technology to focus on how to implement changes.
Leah Homeister, Technical Project Manager, VGM Group, Inc.
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Set aggressive, yet realistic target dates for implementing new technology.
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Clearly define and articulate the project priority. Set aggressive, yet realistic target dates for implementing new technology. Have others take on extra responsibilities to free project members’ time. Incentivize, recognize, and celebrate the teamwork required by all who support the project whether directly or indirectly.
Leah Homeister joined VGM Group, Inc. in 2019. Her career spans over 20 years in IT, primarily in financial services, including investments, finance, and mortgage servicing. She has studied Prince2 and Project Management Institutes (PMI) project management methodologies. Leah is certified as a project management professional (PMP) with the PMI since 2010 and earned Scrum Master certification in 2021. She has managed numerous technology implementation projects over more than 15 years as a project management professional and completed her M.B.A. with the University of Iowa in 2021. Connect with her on LinkedIn or email her at Leah.Homeister@vgm.com.
Seek input to define the MVP with enough functionality to be relevant and without frills that create complexity, keeping focus on what is most important. Keep a parking lot list of requested enhancements to prioritize later.
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Keeping Up with the Times: Integrating E-Prescribe in Your Business Operations By Kayla Mahler, Brand Manager, VGM & Associates and Ken Hodel, VP, Development, DMEscripts
O
rders written on paper. Fax machines. Dial up connections. Using Netscape Navigator or Internet Explorer. These are all methods of transmitting data in business that have changed over the past 30 years. The DME industry is fairly new, and providers have traditionally been slower to adopt technology. But technology impacts everything we do in our personal lives as well as in our businesses. Technological advancements happen frequently and will continue for years to come.
Eric Schmidt, Google’s CEO in 2010, once stated, “There was 5 Exabytes of information created between the dawn of civilization through 2003, but that much information is now created every 2 days, and the pace is increasing.” Whether or not we can truly quantify all data ever created, Schmidt raises a good point. Technology and systems to capture and analyze data are rapidly changing. Technology and software companies in the DME industry continue to make advancements to help automate and speed up otherwise manual processes that could take hours or days.
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Since the pandemic, acceptance and utilization of technology in the DME space has accelerated.
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E-prescribe is one area where we have seen advancements and acceptance from physicians and providers. Electronic prescribing of medications and lab tests has been a part of the healthcare ecosystem for almost 20 years. E-prescribe has been proven to improve quality of care, reduce errors, and lower administrative costs. In the past, e-prescribe for DME was largely focused on electronic transmission of data and documentation with little concern for the accuracy or qualification of the order. The result was simply a well formatted electronic fax that still needed to go back and forth multiple times before the DME provider could get paid. However, in the past few years, a new crop of true DME e-prescribe platforms has emerged. The DME e-prescribe platforms are centered around producing complete and accurate DME orders. Unlike the e-faxed orders that come out of an electronic health record (EHR) or referral management platform, a high percentage of DME e-prescribe orders come with a billable and refillable prescription in addition to the accompanying documentation to prove medical necessity for the item being ordered. The orders produced by these platforms reduce, and many times remove, the rework that is inherent in the current fax and phone-based DME ordering process.
Acceptance of E-Prescribe in DME Since the pandemic, acceptance and utilization of technology in the DME space has accelerated. Exacerbated by workforce strains, technology is propelling innovation toward cost-management solutions.
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E-prescribe has been proven to improve quality of care, reduce errors, and lower administrative costs.
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Keeping Up with the Times: Integrating E-Prescribe in Your Business Operations By Kayla Mahler, Brand Manager, VGM & Associates and Ken Hodel, VP, Development, DMEscripts
Without the friction point of rework, orders can sail smoothly from intake to delivery, resulting in real benefits for DME providers like faster delivery of orders, higher patient and healthcare provider satisfaction, reduced inbound calls, and increased patient starts on service. So why hasn’t e-prescribe for durable medical equipment taken off?
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Whether it’s uncertainty, loss of control or any number of other reasons, people are inherently resistant to change.
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Obstacles in Adoption Whether it’s uncertainty, loss of control or any number of other reasons, people are inherently resistant to change. That dynamic is amplified in healthcare, where the general perception of technology is that it is an inhibitor that slows clinicians down and creates more work for them. DME providers also require more than just a signed prescription to get paid for their services. Payer qualification guidelines and the need for documentation that supports medical necessity add a layer of complexity that results in more “clicks” for the healthcare provider user entering the order. In addition to those “clicks,” the user must enter the required prescription elements, like patient name, date of birth, delivery and phone number, and they often come away with the perception that continuing to fax orders is easier than using a DME e-prescribe platform.
[
]
Business operations managers likely wonder how they can provide better service with less cost. E-prescribe platforms can help you do this by helping improve your business’s efficiencies. Instead of relying on your employees to manually input orders into your system, getting the doctor or prescriber approval, and checking that all documentation is complete, e-prescribe systems automate the pre-qualification process. One of your main goals in business is likely to increase revenue. With the current reimbursement rates, one of the ways to increase revenue is to decrease your overall operational costs by being more efficient. According to a survey of over 200 DME providers and referral sources, on average, a provider would go back and forth with a referral source on one order three times before all required information for a SWO or CMN was collected for just one patient. A provider would go back and forth with a referral source on one order three times before all required information for a SWO or CMN was collected for just one patient
How will it improve my efficiency? It is easier than ever to start to utilize e-prescribe platforms but integrating a new e-prescribe platform into your already existing technologies and processes needs to be addressed first. There are a few things to consider when researching and determining which e-prescribe platform would work best for your business’s needs.
E-prescribe platforms can help you provide better service with less cost by helping improve your business’s efficiencies.
By reducing the back and forth and helping prequalify orders, delivery of orders is sped up, patients receive their equipment more quickly—which increases satisfaction with patients and referral sources— inbound calls are reduced, patient starts on service are increased, and there is a quicker order-to-cash timeframe.
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Keeping Up with the Times: Integrating E-Prescribe in Your Business Operations By Kayla Mahler, Brand Manager, VGM & Associates and Ken Hodel, VP, Development, DMEscripts
According to DMEscripts, over 90% of orders received through their e-prescribe system are accepted the first time. By speeding up one part of the DME process you can increase efficiencies and productivity in many areas of your business. According to DMEscripts,
over
90%
of orders received through their e-prescribe system are accepted the first time Will this system work with my processes or existing software? Will it work with my referral sources’ software or processes? Before implementing a new process or software, you need to consider if it will work with your current processes and systems you have in place or if additional changes will need to be implemented. Interoperability of systems depends on your business’s software systems and the e-prescribe system. Interoperability would allow for systems to “talk” or have a bridge between them, reducing duplicate data entry and data entry errors. Here are 10 considerations to think about when researching what system is best for your business: 10 Questions to Help You Find the Right System for Your Business 1.
How easy are both systems to navigate? If a system is hard to navigate, your employees may have a hard time adopting the new technology. The more intuitive it is, the better.
2. Will it cause your team more work to enter information into a separate e-prescribe system and back into your main operations system? Ideally, the implementation of a new system should not cause additional work, but save them time. If the system requires dual entry, it increases the risk of errors and additional delays.
3. Do both (or all) of your systems need to communicate to automate processes or reduce duplicate data entry? 4. How secure is the platform and does the platform ensure cybersecurity? 5. Does the platform meet HIPAA Security Rule guidelines? The HIPAA Security Rule requires Covered Entities and Business Associates to perform a comprehensive risk assessment. 6. Do your referral sources already use an e-prescribe system that they would recommend or prefer? 7. What is the e-prescribe’s onboarding process? How will they train your employees? How often are they available for questions? Do they offer any training tutorials or FAQs for your employees? What type of information do they need to be able to setup your files in their system? 8. What is the ongoing technical support? Do you have an assigned contact or phone number for a team who can continue to assist you after onboarding? 9. Is the e-prescribe system available for all types of medical equipment that you provide? 10. How long will it take to implement and onboard the system? How much time do they need to upload your files? What is the typical timeline for training, implementation, and follow-up? In many cases, software systems need APIs to connect to each other for data to flow from one to another. Some systems are easier to connect than others. If you are already in the process of discussing workflows and processes, you may want to have your IT team involved to discuss logistics to determine how the e-prescribe software will integrate with your system.
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Keeping Up with the Times: Integrating E-Prescribe in Your Business Operations By Kayla Mahler, Brand Manager, VGM & Associates and Ken Hodel, VP, Development, DMEscripts
Whatever your why is, know that the rapid pace of technological advancement is not going to slow down.
]
What Is Your Why? Ultimately, what is your why? Why do you want to shift to e-prescribe? This may be a major shift, but think about your overall goal, whether it be to improve the healthcare quality for your patients, to submit cleaner claims, to get paid more quickly, or to free up time for your employees to have more time for more meaningful work. Whatever your why is, know that the rapid pace of technological advancement is not going to slow down. It will only speed up. It’s time to make the leap to better efficiencies. This list of questions is only the beginning. As you proceed with implementing a new technology, also consider implementing a clear project management strategy to keep your team on board and up to date with the process. Leah Homeister’s article, “Best Practices for Implementing New Technology,” describes how to implement change adoption in your business. VGM members do have access to several e-prescribe services including Brightree e-prescribe solutions, DMEscripts, and Parachute Health. If you have questions regarding any of these services, contact your account manager.
VGM Playbook: Growing Your Business With Data and Technology
ABOUT KAYLA MAHLER Kayla Mahler is the brand manager for VGM & Associates. Prior to joining VGM & Associates, Kayla worked as the operations manager for Essentially Women for one and a half years and as the operations manager for U.S. Rehab for four and a half years. Kayla earned her bachelor’s degree in communication studies from Central College in 2009 and her master’s in communication studies from the University of Northern Iowa in 2017. Follow Kayla on LinkedIn.
ABOUT KEN HODEL Ken Hodel is vice president of development at DMEscripts and held the same role at its predecessor company, DMEhub. You can connect with Ken via email at ken.hodel@dmescripts.com or follow him on LinkedIn.
Keeping Up with the Times... | 19
Making Your Data Work for You By Jim Nygren, CFO, VGM Group, Inc.
Through the internet of things, data sources can collect and aggregate all the data that is recording people’s behaviors and showing the patterns and correlations between those behaviors. Websites track and store your activity and behaviors and feed you content based on your actions. Businesses collect everything from job titles and company affiliations to your favorite color and beverage. (Arnold Palmer is mine for the record.)
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Data is in the eye of the beholder. Asking a CFO which data is important will get you a very different answer than if you ask a CMO. This is critical to remember as your company identifies key performance indicators (KPIs) and data collection goals. Each company and department will likely have a different set of KPIs.
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Make sure your KPIs are simple—don’t have too much packed into them.
There are a couple of points to remember when building out KPIs, which is not an easy task. First, make sure they are simple—don’t have too much packed into them. You need to really boil them down to what truly means the most to your company or
W
5W Why ?
Define Which Dataset Is Important
[
Why?
? Why
Wh
[
Data is in the eye of the beholder. Asking a CFO which data is important gets you a very different answer than if you ask a CMO.
VGM’s finance department looks at KPIs more focused on financial performance or financial trends. Our KPIs are built from a combination of retrospective and real-time datasets. Retrospective data helps determine historic performance that can be used to build predictive modeling. Real-time data helps us immediately see emerging trends, allowing us to pivot quickly if needed. I think these are the types of KPIs everyone wants, but it is very difficult to achieve.
? hy
Data has always been important in driving business decisions, and today’s world of Big Data has enhanced businesses’ ability to gain additional insight. But you’ll need to put in some work to truly make your data work for you.
department’s strategic objectives. I’d recommend finding the top five most meaningful indicators for your business.
y?
N
ow, more than ever, data is in abundance. Everywhere you look, someone is collecting data on you, and you might not even realize it. The impact technology has on data is immense.
We also spend considerable time looking at variances and use the “Five Why” technique to identify the reason for the variance. The Five Why means simply asking “why” until you find the root cause of a variance. We find this very impactful, and it helps us improve how we manage our operations. One of the areas we continue to improve here at VGM is separating out financial KPIs from operational KPIs. Operational looks at more input indicators whereas financial looks at output indicators. Input indicators could be the number of referrals we do in a day, the number of communications being sent out to members, or how many shipments of CPAP supplies are going out. These are typically our realtime datasets. Those inputs are going to drive the output. We are really trying to look at input and output indicators across our businesses, knowing that each business unit will have specific objectives they are trying to accomplish.
VGM Playbook: Growing Your Business With Data and Technology
Making Your Data Work for You | 20
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Making Your Data Work for You By Jim Nygren, CFO, VGM Group, Inc.
Look at your KPIs and data frequently. If it’s not something you’re looking at daily, then it’s probably not a KPI.
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say that your data is accurate, I would argue this is one of the most challenging parts. Every single business struggles with how to aggregate the vast amounts of data they are collecting.
Look at Your Data Frequently Second, you need to look at your KPIs and data frequently. Reviewing your data should be part of your daily routine, multiple times a day. Then monthly, take a deeper dive into some of the questions that may have come up during your daily review of the data. If it’s not something you’re looking at daily, then it’s probably not a KPI.
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Data and discipline go hand in hand.
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Evaluate and Re-Evaluate Lastly, re-evaluate or audit your KPIs to see if they need to be adjusted. You need to make sure the data you are collecting is meaningful and that it is measuring the proper objectives. Data and discipline go hand in hand here. You must have the discipline to set them up, review them, stick with them, and then adjust if needed to achieve the full benefit of datadriven decision making. Financial KPIs need to be audited every monthend, and they should tie to your financials. I would recommend making the review and audit of your financial KPIs part of your monthly closing process. You can be a little more lenient with your operational KPIs. You could do monthly or quarterly. Source Accurate Data It can be difficult to source all the data you need because it will need to be aggregated, validated, and validated again. If the data isn’t accurate, you simply cannot make smart decisions based on what the sources are telling you. While it might seem easy to
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It isn’t that simple, and no program can account for human intuition and the discretion of the decision maker.
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Now, there might be some people out there who wish there were a system or algorithm that could just aggregate data and decide for them. But this is a false reality. It isn’t that simple, and no program can account for human intuition and the discretion of the decision maker. It’s a similar expectation to when people put up an e-commerce page without any marketing, or someone dedicated to managing it, and expecting the site to be hugely profitable. It just doesn’t work that way. Data is the same. It won’t tell you anything without digging into it, analyzing it, and putting time and effort into it. Avoid Common Mistakes There are a few common mistakes or missteps businesses tend to make when collecting data. The first common mistake is undervaluing the amount of effort needed to produce meaningful outcomes. It isn’t
VGM Playbook: Growing Your Business With Data and Technology
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Making Your Data Work for You By Jim Nygren, CFO, VGM Group, Inc.
a one-hour strategy session with your team or a tenminute conversation with a buddy at the water cooler. This is a critical business function, and you need to put the same amount of effort into it as you do your other business functions. The second common mistake is not validating or using the right data. Due diligence needs to be done upfront and a consistent audit trail through the process should be implemented to make sure you are producing accurate results.
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Don’t expect the data to tell you something magical. You must analyze and come up with the answer as a team.
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Lastly, you expect the data to tell you something magical. As mentioned before, this doesn’t happen. You must analyze and come up with the answer as a team. Ideally the data will show you the proper narrative and facts, but then it is up to the decision makers and team to implement the strategy.
At the end of the day, effort has a compounding effect. The more effort you put into your objectives, KPIs, data analytics, and data sourcing upfront, the better results you’ll get on the backend.
See the Right Narrative While data analysis takes work, it is worth it. Data has really helped our company by providing more accurate narratives. For example, we might hear that a project, product, or department is just knocking it out of the park, and everything is perfect, but that might not be supported by data. Or maybe it’s a strategy we’ve implemented that we think is doing amazing, but again it isn’t supported by the data. It can work the other way too. We could feel like something isn’t working great, but the data tells us it is. Data allows us to step back, listen, and see the right narrative on a situation, providing us the ability to pivot as needed.
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Effort has a compounding effect. The more effort you put into your objectives upfront, the better the results on the backend.
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VGM Playbook: Growing Your Business With Data and Technology
ABOUT THE AUTHOR Jim Nygren, CFO, VGM Group, Inc. Jim Nygren is the chief financial officer of VGM Group, Inc., and steward of accounting and treasury operation. He’s the lead financial voice of the company and provides vital strategic, analytical, and financial perspectives for the VGM family of businesses. Jim joined VGM in 2014 and has held positions in VGM’s internal marketing agency and most recently as the vice president of business development and marketing at VGM HOMELINK where he oversaw the expansion of solutions and network development for workers’ compensation and group health payers. Jim holds a B.A.A. in finance from the University of Northern Iowa and an M.B.A. with an emphasis in finance from Iowa State University. Connect with him on LinkedIn or email him at Jim.Nygren@vgm.com.
Making Your Data Work for You | 22
Know Before You Go: Evaluating and Quantifying DME Market Expansion Opportunities By Ryan Ball, Director, VGM Market Data
T
he DME market is changing, and current market dynamics have further incentivized providers to explore new areas for growth and expansion. Planning for growth and selecting new markets to invest in frequently becomes a guessing game, done without solid data backing up your decision-making process. What is my market share in my current markets? How much business is in that new market and how does that compare to my current markets? Who are my competitors and which payers do they work with? What is the reimbursement for the new product focus with private payers? Too often, DME providers move into a new market without having the answers they need.
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Whether expanding into a new geographic market or product line, data should be at the heart of your business development strategy.
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Whether entering a new geographic market or expanding into a new product line, data should be at the heart of your business development strategy. Rather than flying blind into a new venture and hoping your projections will take hold, analyzing available market intelligence data can provide greater certainty to your strategic planning and jump start efforts to grow your business.
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Defining market expansion opportunity is the name of the game in 2022.
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Defining market expansion opportunity is the name of the game in 2022. Data will enhance your planning efforts to ensure you’re selecting the right markets and setting your growth plan up for success. Profiling Volumetric Market Opportunity Once you’ve settled on a growth strategy, understanding market volume potential is the first step
in planning a market expansion. The first step is to simply identify how much relevant claim volume exists by geographic and DME product market area. Quantifying the market size to determine where the largest potential opportunity exists allows you to shrink your initial expansion plans to areas where the greatest payoff exists. Rather than spending time and money on multiple markets, focusing your resources in a more targeted, profitable area will provide your sales and marketing team with the information they need to act quickly and efficiently. Once you’ve determined key volumetric opportunities, the next step is to get a better sense of the competitive dynamic that exists in those potential new markets.
Understanding Competitive Dynamics Competitive dynamics in a potential expansion area can have a significant impact on your strategic planning decisions. Do you have a specific competitor where you have a strategic advantage when approaching referral sources? Was there a recent local acquisition that may cause market disruption that could be of benefit to you? Is there a high volume of business being sent to non-local providers? Each of these potential market dynamics should be considered when selecting a new market to enter.
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VGM Playbook: Growing Your Business With Data and Technology
Identifying and engaging a list of high-value referral sources currently operating in the new market can jump start your efforts.
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Know Before You Go... | 23
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Know Before You Go: Evaluating and Quantifying DME Market Expansion Opportunities By Ryan Ball, Director, VGM Market Data
In addition to understanding overall market share dynamics, identifying and engaging a list of highvalue referral sources currently operating in the new market can jump start your efforts and move you to profitability more quickly. Engaging top referral sources will also help define messaging tactics and further define your niche within the market. Evaluating Payer Dynamics and Potential Reimbursement Levels
VGM Market Data provides market intelligence solutions for DME providers that spans all major product categories and markets across the country. By harnessing and using the power of market intelligence data in your business planning and market development strategies, your team can significantly increase your ability to capture market share and expedite your timeline to becoming a more profitable business.
Market volume and the competitive landscape are important factors to consider when evaluating an expansion opportunity, but can you actually go get the business? Understanding the prominent payers in new potential expansion areas, which competitors work with specific payers, and how the reimbursement rates compare to what you are currently accepting in adjacent markets are additional key factors in determining market potential, as well as profitability. Consider the following: Key Factors to Consider When Evaluating Market Payer Dynamics • Covered lives by payer/geography • Network size/availability of key payers • Payment amounts by payer/HCPCS • Competitors working with key payers • Payment rate variance by payer Network viability and negotiating quality reimbursement rates could be the differentiator between a successful and unsuccessful expansion plan. Data can provide a window into current market reimbursement dynamics, giving you the ability to better understand potential market profitability before investing in entering the market.
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Harnessing the power of market intelligence data can expedite your timeline to becoming a more profitable business.
ABOUT THE AUTHOR Ryan Ball, Director, VGM Market Data Ryan Ball has worked in the healthcare industry for VGM Group, Inc., for over a decade, as director of VGM Market Data and various analyst roles within the VGM Government & Regulatory department. Prior to working as a regulatory analyst, Ryan worked as a political campaign consultant, focusing primarily on developing and analyzing data to identify statistically significant market trends and make recommendations on efficient resource allocation. For the past eight years, Ryan has been the director of VGM Market Data and works with VGM members to provide market intelligence data to identify key referral source opportunities, profile market share for current and prospective markets, reimbursement intelligence, and provides tools to provide actionable intelligence to post-acute healthcare sales/marketing teams. Connect with him on LinkedIn or email him at Ryan.Ball@vgm.com.
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VGM Playbook: Growing Your Business With Data and Technology
Know Before You Go... | 24
Reach Goals and Increase Profits With Data-Driven Decision Making By Nupura Kolwalkar, Chief Product Officer, Brightree
W
hat if I told you that you were making decisions the wrong way? Or, that you were leaving money on the table?
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Providers that implement DDDM move from analyzing an occurrence to predicting it and intentionally moving toward a desired result.
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You aren’t the only ones. In today’s business environment, gut instinct is not enough to remain competitive. Enter data-driven decision making (DDDM). Simply put, it’s “the process of using data to inform your decision-making process and validate a course of action before committing to it.”1 Providers that implement DDDM move from analyzing why an outcome occurred to predicting its occurrence and, instead, intentionally moving toward a desired result. Invalidating the Rearview Mirror Approach Throughout the DME sphere, organizations are looking retroactively at their business results and wondering why something happened the way it did. But today’s business environment requires a sharp pivot from this rearview approach. Decision-making shouldn’t be about when, but how. Let’s take an example. If a goal is never set, DMEs may wonder why their teams only conducted outreach to half of their patients. But with a data-driven goal, providers can take a proactive instead of reactive approach. This is what a data-driven goal sounds like: My DME can drive $5 million in additional revenue while keeping patients adherent on their therapy. For that to happen, we must reach out to at least 80% of our patient population on a monthly basis to ensure they use their products, order on time, and continue to stay on therapy. In this scenario, providers identify an objective and a strategy that is proven to achieve it, based on data from their own past, as well as from outside of their organization and in other industries. Bearing this in mind, those providers know how to meet their
revenue goal and can focus their most important resources where they will have the biggest impact, thereby maximizing profits with limited resources. By actively analyzing and implementing data, the rearview mirror approach is invalidated. Breaking Down Data-Driven Decision Making Data-driven decision making is a five-step process— strategy, identification of key areas, data targeting, collection and analysis, and finally, action items. Let’s take a closer look and understand how DDDM can work in DME from start to finish. Data Targeting
Strategy
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Identification of Key Areas
Action Items
Collection and Analysis
First, evaluate and prioritize organizational objectives. Any action taken needs to have those goals at its core.
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1. Strategy When considering strategy, you need to first evaluate and prioritize organizational objectives. Any action taken needs to have those goals at its core. Once you understand what the goals are, it’s quite simple to break them down into actionable steps. For example, if you want to serve more patients, you’ll need more physicians to prescribe more patients to your organization. 2. Identification of Key Areas For key areas, let’s consider three in line with our objective: the number of physicians converted into referral sources, the number of referrals converted into patients, and the number of existing patients due for resupply.
VGM Playbook: Growing Your Business With Data and Technology
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Reach Goals and Increase Profits With Data-Driven Decision Making By Nupura Kolwalkar, Chief Product Officer, Brightree
3. Data Targeting
4. Collection and Analysis
By taking the results gleaned from each of the key areas and having your team focus on them, data targeting becomes a hinge point for this process, moving into examination and action.
After accumulating this data through collection and analysis, your team can track month-over-month data points and determine whether you are most efficiently working toward the set goal or if recalibration is necessary. 5. Action Items With that consideration of next steps, you’ve entered into the final phase of DDDM—action items. The insights derived from this analysis then inform each manager’s quarterly goal. If a team doesn’t reach its set goal, there’s an opportunity to consider how technology or other solutions may be implemented to automate and/or augment existing efforts. For example, if the intake team only converted 40% of patients, short of a 50% goal, perhaps technology can be used to automate messages to the entire patient base to reach more patients at once from the outset. Data-Driven Decision Making in Action Let’s take a look at three examples of companies that have centered DDDM. They might seem familiar:
By targeting a certain number of physicians, you can determine how many are not in your current database or are not recurring physicians that can be converted. As a result, your team can focus on physicians with these data points in mind. When considering patient conversion, ask yourself the same questions. For example, if you want to convert 50% of referrals to intake, consider what steps your referral team needs to take to address that increase. Whether or not that happens, you want to keep your eye on the number of intakes vs. referrals. In terms of resupply, you want to know how many patients are coming up for resupply and what percent of that population has had an interactive confirmed outreach. This is imperative and must go beyond just sending an email; it requires placing an order. Once again, there’s a takeaway formula. With resupply, the number of orders divided by the amount of outreach equals a response rate.
Amazon Amazon analyzes data to decide which products customers see on their page, based on previous purchases and searches. McKinsey estimated that, in 2017, a whopping 35% of Amazon’s consumer purchases could be tied back to this recommendation system.
35%
of Amazon’s
consumer purchases come from its recommendation system created with
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DDDM
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Reach Goals and Increase Profits With Data-Driven Decision Making By Nupura Kolwalkar, Chief Product Officer, Brightree
Driving Your DME Forward
Instead of looking for the perfect unicorn people manager, Google’s Project Oxygen, centered in people analytics, mined data from more than 10,000 performance reviews and compared the data against employee retention rates. Google used the information to identify common behaviors of high-performing managers and created training programs to develop these competencies. These efforts boosted median favorability scores for managers from 83% to 88%2 by instilling the right people management training.3
Across industries, we have seen a greater reliance on DDDM. Yet, healthcare has not leveraged the approach as readily. However, a number of challenges impacting DME operations, from regulatory changes affecting reimbursement to a general decreasing of margins, make it more important than ever for DMEs to drive their business forward with DDDM. Those that have are more likely to outperform their peers and benefit from greater revenue and profit growth, ensuring they’re able to meet shifting market trends with ease. References
Google boosted median favorability scores for managers from
83% 88% to
through management training discovered through DDDM
1. Stobierski T. The advantages of data-driven decision-making: HBS Online. Business Insights Blog. https://online.hbs.edu/blog/ post/data-driven-decision-making. Published Aug. 26, 2019. 2. Garvin DA. How google sold its engineers on management. Harvard Business Review. https://hbr.org/2013/12/how-googlesold-its-engineers-on-management. Published Sept. 10, 2019. 3. McElheran K, Brynjolfsson E. The rise of data-driven decision making is real but uneven. Harvard Business Review. https://hbr. org/2016/02/the-rise-of-data-driven-decision-making-is-real-butuneven. Published Aug. 31, 2021.
Starbucks After hundreds of Starbucks locations closed in 2008, Starbucks now pinpoints ideal store locations using data like demographics and traffic patterns. Starbucks uses this data to determine the likelihood of success for a particular location before taking on a new investment.3
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It is more important than ever for DMEs to drive their business forward with DDDM.
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VGM Playbook: Growing Your Business With Data and Technology
ABOUT THE AUTHOR Nupura Kolwalkar, Chief Product Officer, Brightree Nupura Kolwalkar, chief product officer at Brightree, has almost two decades of experience developing and managing healthcare technologies in the pharmaceutical industry. With previous leadership roles at Purdue, Pfizer, and McKesson, Kolwalkar brings a wide range of strategic backgrounds to her role at Brightree.
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The Internet of Medical Things: Detecting and Preventing Crises for New Value Creation By Audra Bares Watt, VP, Marketing, Permobil Americas
“
An ounce of prevention is worth a pound of cure,” stated Benjamin Franklin in 1736. This sound advice has been used across a variety of settings from healthcare to natural disaster recovery. But what about in the complex rehab technology (CRT) industry for individuals utilizing seated and mobility devices?
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The value in a fully integrated IoMT world would be through the switch from crisis management to crisis prevention.
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Opportunities in CRT The internet of medical things (IoMT) has been discussed in academic and technology circles as the answer to reducing the ballooning healthcare costs in developed countries. This combination of networked data, systems, and software intersected with smart devices such as wearable monitors, is ideally supposed to help healthcare providers deliver the right interventions, at the right time, to the right people. The value in a fully integrated IoMT world would be through the switch from crisis management to crisis prevention. The application of IoMT to seated and mobility devices shows tremendous promise to link real-time data with on-time interventions to optimize clinical and functional outcomes. For example, the LUCI system for power wheelchairs has linked inputs from cameras and sensors into the drive unit to enable collision avoidance and drop-off protection.
Or, consider Permobil’s real-time wheelchair insights and connected technology available through the MyPermobil app. It shares key operational data to equipment providers through the Fleet Management web portal, and helps wheelchair users easily check their battery status and track their power seating usage for improved health. While the technology and commercial availability of these solutions is still maturing and changing, the goal is the same—utilize real-time data to support behaviors and activities that optimize positive outcomes, and to help avoid behaviors and activities that can lead to either immediate or future crises.
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One of the challenges facing technology pioneers in the IoMT era is the limitation of the current U.S. healthcare system.
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Challenges to Innovation One of the challenges facing technology pioneers in the IoMT era is the limitation of the current U.S. healthcare system which is set up as a fee-for-service model, where the provision of treatment or equipment is assigned a set fee schedule, regardless of context. The incentives are set up to compensate for the treatment of symptoms, but not necessarily for the underlying condition or the factors that contribute to symptoms. Prescription pills are paid for to manage pain versus paying for preventative exercise and therapies. Type 2 diabetes is managed with insulin instead of possible prevention by funding professional nutritional services. Treatments and antibiotics are used to manage pressure injuries versus preventing them in the first place. These are just a few examples. Our opportunity in the CRT industry, particularly in seated and mobility devices, is to illustrate and define the value associated with driving optimal behaviors which help to avoid costly medical interventions and risks to individuals’ health.
VGM Playbook: Growing Your Business With Data and Technology
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The Internet of Medical Things: Detecting and Preventing Crises for New Value Creation By Audra Bares Watt, VP, Marketing, Permobil Americas
One ongoing challenge for manual wheelchair users is maintaining their shoulder health. This is both a short- and long-term problem. The anatomy of the human shoulder is not designed to sustain the same stresses and forces as the human hip, and yet that is what is required for their independent mobility. This is exacerbated by a world where wheelchair ramps and elevators are often tucked far away from foot traffic pathways and built at inclines greater than what is recommended by the ADA. Researchers found that the average manual wheelchair user propels approximately 1,800 times per day,1 and we know that ISO defines any repetition greater than 1,500 to be potentially harmful. This can be higher or lower depending on the individual, but certainly this level of activity puts strain on the rotator cuff and can contribute to pain and injury over time.
Real-Time Data and the Value of Prevention While we do not have data that connects total pushes saved to the development of rotator cuff injury or the subsequent application of shoulder arthroplasty, the opportunity certainly exists to do so through the IoMT. By embracing the collection and analysis of real-time data, we can together find new business models and ways of extracting value through prevention. Our end users’ health and well-being depend on it. References Mozingo JD, Akbari-Shandiz M, Murthy NS, et al. Shoulder mechanical impingement risk associated with manual wheelchair tasks in individuals with spinal cord injury. Clin Biomech (Bristol, Avon). 2020; 71:221-229. doi:10.1016/j.clinbiomech. 2019.10.017
ABOUT THE AUTHOR The application of a SmartDrive power assist during trials reduces the number of propulsions by about
Audra Bares Watt, VP, Marketing, Permobil Americas
81%
Data from Permobil’s Smart Evaluation app demonstrates that, on average, the application of a SmartDrive power assist during trials reduces the number of propulsions by about 81%. Given this data point and calculating against the Monzingo data, it is reasonable to predict that a SmartDrive user could be saving approximately 1,458 propulsions every single day. At an individual level, this could add up to over a half a million pushes saved per year—ultimately saving over 2.6 million pushes over the five-year useful life of the product.
[
By embracing real-time data, we can find new business models and ways of extracting value through prevention.
]
VGM Playbook: Growing Your Business With Data and Technology
Audra Bares Watt joined Permobil in 2020 as vice president of marketing for the Americas region. In her role, she oversees upstream marketing, product management, portfolio strategy, marketing communications, digital marketing, and funding strategy. She is passionate about applying the scientific method to product and brand marketing strategies and is proud to lead a hybrid in-person/remote team of incredibly talented marketing professionals from all over the U.S. and Canada. Audra has a broad educational background with degrees in chemistry, economics, and also business administration. Prior to Permobil, she spent 10 years in surgical medical device development including a focus on the application of robotics to minimally invasive spinal fusion surgery.
The Internet of Medical Things... | 29
Cybersecurity in 2022: What to Watch For By Jay Bracken, CISSP, Information Security Officer, VGM Group, Inc.
T
he landscape of cybersecurity is always evolving as new technologies come along and attackers become savvier. Going forward, we will continue to see some common cybersecurity trends from the last few years. However, there are some new threats on the horizon as well that we all need to be prepared for. With that in mind, let’s take a look at some of the biggest trends in cybersecurity for 2022.
[
We’ve seen whole hospitals shut down for days, even weeks, with no ability to access vital patient records.
]
Ransomware: Quantity and Severity Increase Anyone who follows the news will have heard reports of large ransomware attacks on all types of businesses. When it come to the healthcare industry, these attacks can really hit home. We’ve seen whole hospitals shut down for days, even weeks, with no ability to access vital patient records. Obviously, that can lead to severe impacts to patient outcomes. In 2021, there was a 150% rise in ransomware, and we can expect a similar rise in 2022. The big trend in ransomware is an increase in carefully targeted attacks. Hackers learn about your business through publicly available resources like LinkedIn, Facebook, Twitter, even your own website—then weaponize this knowledge to trick users into clicking phishing emails or downloading malicious applications.
In 2021, there was a
150% rise in ransomware, and we can expect a similar rise in 2022
This doesn’t just apply to large, global companies— the FBI observed some threat actors directing their ransomware attacks at small to medium businesses over the course of 2021, as these companies often have fewer resources devoted to security. Use of next-generation antivirus and endpoint protection software, along with thorough user training on security awareness, are needed to fend off these cunning attacks. Supply Chain Attacks With all that has happened during the COVID-19 pandemic, one of the largest impacts has been on the global supply chain. We’ve all had our eyes opened to just how fragile supply chains can be, from chip shortages and increased prices to shipping delays. Even with the increased attention to the supply chain, there are still many blind spots out there.
[
Attackers are now attacking the supply chain to disrupt business even further.
]
Attackers have noticed this too and are now attacking the supply chain to disrupt business even further. Attacks to the supply chain provide a lot of bang-forthe-buck to threat actors, as one attack can impact hundreds or even thousands of companies. Careful planning to eliminate single points of failure among your suppliers is needed to mitigate this vulnerability and ensure your business has the resiliency it needs.
[
VGM Playbook: Growing Your Business With Data and Technology
State-sponsored attackers have far more resources than the old “hacker in mom’s basement” stereotype.
]
Cybersecurity in 2022: What to Watch For | 30
continued...
Cybersecurity in 2022: What to Watch For By Jay Bracken, CISSP, Information Security Officer, VGM Group, Inc.
Nation-State Threats The largest and scariest threats can come from statesponsored attackers. These attackers have far more resources and access to highly sensitive intelligence than the old “hacker in mom’s basement” stereotype. Many countries are looking to expand their global influence by using cyberattacks to obtain top secret government data, and to fill their financial coffers with valuable information such as technology patents and stolen identities. You may be thinking, “Well I don’t have any government secrets for anyone to steal,” and you may not. However, as we saw in 2021, once attackers find vulnerabilities in commonly used systems or software, it’s open season on anyone who uses those systems. State-sponsored attackers have the manpower and resources to chase down every last dollar.
Additionally, many remote workers log in at unusual hours when fewer security staff may be on-hand to monitor systems. Careful assessment of what type of data is accessible remotely, and what additional controls can be put in place to monitor for remote attacks, should be performed ASAP to make sure you are doing everything you can to mitigate this risk. Keeping Data Safe It’s inevitable that cybercriminals will become more and more proficient at extracting valuable data from insecure systems. It’s our job as business professionals to do all we can to keep pace with them and keep our data secure. Staying on top of cybersecurity trends and making honest assessments of your organization’s risk exposure are the first steps toward keeping your data safe and preventing your company from becoming a target. If you use thirdparty vendors to provide systems or security, make sure they are performing their due diligence to ensure your data is protected on their systems. ABOUT THE AUTHOR Jay Bracken, CISSP, Information Security Officer, VGM Group, Inc.
Remote Work Attacks Any list of increasing trends in cybersecurity would be incomplete without mentioning attacks on the remote workforce. Fully remote or hybrid work arrangements are here to stay, and while many employees love it, unfortunately, so do the hackers. Remote workers are often the first targets of attackers, as by definition they have remote access to sensitive systems. The holes poked in the network perimeter to let these users work remotely can also be exploited by cybercriminals.
VGM Playbook: Growing Your Business With Data and Technology
Jay Bracken, CISSP, is the information security officer for the VGM Group, where he continues to evolve a comprehensive information security program. With over 13 years of cybersecurity experience, Jay has leveraged his extensive technical and business operation experience to apply sound IT security practices while supporting the complex, highly regulated business requirements of the healthcare industry. He is also responsible for the development and coordination of VGM’s strategic IT security planning and business continuity initiatives to reduce risks, respond to incidents, and limit exposure to liability that may result in financial and image loss to the organization. You can connect with Jay on LinkedIn or email him at Jay.Bracken@vgm.com. Cybersecurity in 2022: What to Watch For | 31
Beyond Measure: The Patient-Driven Model in Wound Care By Heather Trumm, BSN, RN, CWOCN, Director, VGM Wound Care
W
hen we hear the word “outcomes” in the wound care category, the first thought that generally enters our minds is healing rates. But another—equally important—factor in positive outcomes is the patient experience.
[
When we hear the word “outcomes” in wound care, the first thought that generally enters our minds is healing rates.
]
In my tenure with VGM, I’ve had many conversations about outcomes, how we should define them, and what an effective outcomes program would look like for a DME. One of those conversations stands out in particular—because the DME used data and put a plan into action.
pressure wound therapy (NPWT) pumps. To do this, he looked over the data and recorded the following information: Data to Capture From Your Wound Care Population • Patient Placement • Wound Type • Gender • Wound Location • Patient Age • Readmission Rate • Average Length of Therapy
[
Data without some type of analysis isn’t very useful.
]
Making Data Mean Something
A Case Study in Positive Patient Outcomes In 2018, one of our VGM members contacted me with an idea about outcomes. He had come across a white paper, “Wound healing outcomes: Using big data and a modified intent-to-treat method as a metric for reporting healing rates.” Essentially, what the researchers in this study analyzed were the electronic medical records of chronic wound patients. The VGM member didn’t just read the paper, though. He mimicked the methodology and applied it to the population base he was supplying with negative
Data without some type of analysis isn’t very useful. So, he and his team collected the data and converted it into meaningful information. They connected therapy outcomes and patient experiences to build a more precise NPWT value proposition that would allow them to market to referral sources. Some data points focused on included: Metrics Referral Sources Find Meaningful • Our 30 day hospital readmission rate is X. • We have an X wound healing rate. • Our average length of therapy is X days. • Our surgical wounds have an X healing rate with an average of X days on service. • A diabetic foot pressure injury has an X healing rate with an average of X days on service.
VGM Playbook: Growing Your Business With Data and Technology
Beyond Measure: The Patient-Driven Model... | 32
continued...
Beyond Measure: The Patient-Driven Model in Wound Care By Heather Trumm, BSN, RN, CWOCN, Director, VGM Wound Care
By taking the white paper’s methodology, the DME was able to use patient demographics, add in outcomes data elements, and ultimately create a more accurate picture of the typical patient they serve. And by marketing their results to various referral sources, they were able to gain trust, as well as additional referrals.
[
Whether you are looking at physiological endpoints or patient satisfaction endpoints, the power of data is beyond measure.
]
The Power of Data Whether you are looking at physiological endpoints or patient satisfaction endpoints, the power of data and outcomes is beyond measure.
[
If facilities and agencies can lean on ancillary services to offset treatment costs or heal the patient sooner, they will do it.
]
If facilities and agencies can lean on other ancillary services to help offset the cost of treatment or heal the patient sooner, they will do it. It’s financially motivating to them, and working with a local DME company puts an extra set of eyes on the patient to ensure they are receiving the best care possible. DMEs are invaluable to patient care. Sometimes, referral sources—and even patients—need just a reminder. Dig into your data to help show your value and tell your story.
ABOUT THE AUTHOR
Qual it
Ou
st Co
y
$
Patient
tc o m es
With the new payment structures in long-term care facilities and home health agencies, both entities are looking to collaborate and partner with providers to decrease costs and increase value-based care. [For reference, the new systems are called PDPM (Medicare patient-driven payment model) and PDGM (Medicare patient-driven grouping model.)]
VGM Playbook: Growing Your Business With Data and Technology
Heather Trumm, BSN, RN, CWOCN, Director, VGM Wound Care As director of VGM Wound Care, Heather educates VGM members about the importance of diversifying product selection and incorporating aspects of wound care into their product mix. Heather’s past nursing experience encompasses medical/surgical nursing, community and public health nursing, and home healthcare nursing. She has also worked in sales for major healthcare corporations. Heather has lectured at conferences, trade shows, and seminars across the country. She is a member of the National WOCN Society, president of the Iowa Affiliate of the WOCN Society, and a supporter of the National Nurses Association. Connect with Heather via email at Heather.Trumm@vgm.com or follow her on LinkedIn.
Beyond Measure: The Patient-Driven Model... | 33
Distinguishing Your O&P Practice By Todd Eagen, President, OPGA
H
ealthcare is increasingly moving to outcomesbased care models which require O&P clinicians to effectively communicate patient outcomes. Tomorrow’s clinicians should prepare for refined and repeatable articulation of their impact on patient outcomes with referral sources, patients, and payers.
[
Tomorrow’s clinicians should prepare for refined and repeatable articulation of their impact on patient outcomes.
]
Current Discussions on Outcomes O&P patient outcomes have been talked about a lot. But what has actually been done that is meaningful to the individual clinic, patient, healthcare system, and payer? Recent articles relating to the profession’s data
gaps have all suggested we need to do something, but what? Much of the discussion has centered on deciding what should be measured, only to resign to the idea that we should simply measure anything as a start. This haphazard approach wastes precious time and energy—especially when a game plan has already been laid out for us. Solutions Already Exist A patient outcomes management tool, like Össur’s PRO App (Prosthetic Rehabilitation Outcomes Application), that supports clinicians and O&P organizations in the administration, storing, and analysis of patient outcomes, is ideal. It benefits your practice in patient management, clinical decision making, and communication with referral sources.
VGM Playbook: Growing Your Business With Data and Technology
Distinguishing Your O&P Practice | 34
continued...
Distinguishing Your O&P Practice By Todd Eagen, President, OPGA
A functional mobility outcomes tool that relies on both clinical and patient-reported measures can provide the following: Benefits of a Functional Mobility Outcomes Tool • Advance patient engagement, resulting in better individual outcomes and overall retention while maximizing medical justification through an automated reporting structure. • Expedite patient prosthetic knowledge and effective communication through reporting that demonstrates changes in mobility, shows patient progression/digression, and provides objective patient documentation. • Make more informed decisions to improve clinical protocols with data to understand what clinical care pathways are working better than others, resulting in better outcomes, while improving clinical operations and efficiencies. • Enhance referral source communications and increase value to other healthcare professionals by focusing the narrative on positive patient outcomes, as opposed to product or price.
[
Utilization of a validated outcomes tool allows you to improve the patient’s experience and clinical practice performance.
]
ABOUT THE AUTHOR Todd Eagen, President, OPGA Todd Eagen is president of Orthotic Prosthetic Group of America (OPGA), a membership organization that provides comprehensive business services to more than 1,200 independent O&P practitioners nationwide. He has a great understanding of the healthcare system including patient care, practice management, and the complexities of reimbursement and regulatory guidelines. Through his leadership, OPGA has excelled at connecting its membership and supplier partners to programs that improve productivity, proficiency, and profits. Prior to joining OPGA, Todd was a senior sales representative for GlaxoSmithKline Pharmaceuticals, where he worked with both primary care and specialty physicians to connect them to an extensive portfolio of medications. Todd earned his Master of Arts degree in physical education with an emphasis in anatomy and kinesiology from the University of Northern Iowa, after which he served as an assistant football coach for 12 years. Connect with him on LinkedIn or email him at Todd.Eagen@vgm.com.
Improving the Patient Experience and Clinic Performance Utilization of a validated outcomes tool allows you to easily collect patient outcome measures to monitor and improve the patient’s experience and clinical practice performance. In addition, the rich data provides the opportunity to distinguish your business and provide greater value to key stakeholders and referral sources.
VGM Playbook: Growing Your Business With Data and Technology
Distinguishing Your O&P Practice | 35
Complex Rehab Technology and Outcomes-Based Healthcare By Greg Packer, President, U.S. Rehab
T
he Complex Rehab Technology (CRT) industry, along with many others in the DME space, is moving to an outcomes-based or performance-based system versus the fee-for-service system we have been in for decades. We have seen that the fee-forservice system does not work, and it has failed the patients and the providers, as well as stymied the development manufacturers are capable of.
[
We have seen that the fee-forservice system does not work, and it has failed the patients and the providers.
]
Collecting the Data U.S. Rehab collaborates with the University of Pittsburgh Department of Rehabilitation Science and Technology, and we use the FMA with our members to collect data and measure the performance of interventions. We now have over 12,000 datasets in our active registry. The paper presenting our findings has been published in the official journal of RESNA.
We now have
over 12,000 datasets in our active registry
This new system will enhance the patient experience and help those who provide service and delivery of CRT equipment create an accurate picture of their performance. Determining Outcomes Objectives Before we can shift to an outcomes-based system, we need to examine: What are the objectives of CRT outcomes? At U.S. Rehab, we believe we should aim to develop a patient registry related to wheeled mobility and seating device interventions and accumulate large datasets for clinical quality assurance. That said, there should also be guidelines for the registry development to apply and anchor the data with a uniform tool. U.S. Rehab has put its support and dollars behind the Functional Mobility Assessment (FMA). About the FMA: The FMA is a validated, 10-question patient-centered outcomes measurement tool that investigates satisfaction in performing common mobility-related activities of daily living (MRADLs). It was developed under a corporate research agreement between clinical researchers and commercial providers. Questionnaires are administered in rehabilitation clinics to patients at the time of assessment for new device interventions (baseline) and readministered by telephone or other remote strategies periodically thereafter (follow-up).
[
Quality equipment—appropriately provided by certified professionals— increases positive outcomes and higher patient satisfaction.
]
Data drawn from the FMA also provides evidence that quality equipment—appropriately provided by certified ATPs, PTs, and OTs— increases positive outcomes and higher patient satisfaction in their ability to perform MRADLs. This quality assurance project systematically describes the population of people with disabilities who need and use mobility assistive equipment (MAE). It also assesses the outcomes post-provision of properly provided equipment. All of this is made possible through the FMA and uniform dataset (UDS).
VGM Playbook: Growing Your Business With Data and Technology
Complex Rehab Technology... | 36
continued...
Complex Rehab Technology and Outcomes-Based Healthcare By Greg Packer, President, U.S. Rehab
Measuring Performance By analyzing the 12,000 cases of people with disabilities who use MAE, we now see a clear picture of the positive role quality equipment and well-trained professionals play in patients’ lives. Through this analysis, we have seen:
[
Outcomes-based care is here to stay in CRT.
]
Getting Started An increase of
128.31% in patient satisfaction in performing MRADLs
It is through this scientific analysis that the university has, through de-identified data, been able to determine with high correlation that outcomesbased care is here to stay in CRT. Please ask your VGM/U.S. Rehab representative how to get involved. The train is leaving the station—make sure you have your ticket, and you are on it.
64.32% decrease in reported falls
71.3%
reduction in readmissions due to a seating and mobility incident
57.38%
reduction in skin breakdown
VGM Playbook: Growing Your Business With Data and Technology
ABOUT THE AUTHOR Greg Packer, President, U.S. Rehab Greg Packer is president of U.S. Rehab. Greg’s background, which includes sales management for Pride Mobility Products Corp. and Biocore Medical Technologies, Inc., provides him with an understanding of both the sales and product areas of rehabilitation technology. Greg served three terms in the Kansas House of Representatives and is familiar with the regulatory and governmental issues facing the rehab/HME industries. He currently serves on five industry boards and committees to help make the industry a better environment for the independent provider. A graduate of Iowa State University, Greg received his master’s degree from Baker University. Connect with him on LinkedIn or email him at Greg.Packer@usrehab.com.
Complex Rehab Technology... | 37
Outcomes Driven by Clinical Respiratory Software and Analytics By Zach Gantt, RRT, FAARC, CEO, Encore Healthcare
P
atient outcomes are rapidly emerging as a powerful growth strategy. In fact, with large referrals and payers, they’re becoming a requirement. Collecting patient-focused measures and transforming that data into clinical metrics is the key to success in the respiratory DME model going forward. Elite DMEs combine compliance information with Nexus Clinical Respiratory Software to go “beyond the box” and become high-value strategic partners with their referral base.
[
Patient outcomes are emerging as a powerful growth strategy. With large referrals and payers, they’re becoming a requirement.
]
Healthcare delivery in the U.S. is evolving with emerging managed care chronic disease initiatives, accountable care organizations, and other valuedriven care models. Hospitals want to act like a complete system to maintain every penny of the healthcare dollar spent. Physician groups can drive quality and revenue with aligned home providers. And payers are struggling to understand how to effectively manage patients in the home, especially the 12% that drive 60% of the spending.
[
Elite DMEs go “beyond the box” and become high-value strategic partners with their referral base.
]
The intersection of these trends for chronic respiratory disease patients is in the home. Implementing Nexus Clinical Respiratory software and Encore TeleRespiratory Services transitions the DME from being known as the equipment supplier to a full home-based pulmonary service partner. Nexus creates unique opportunities for the provider to succeed in outcomes-based models by keeping patients out of the hospital, tracking symptoms and physician interventions, and demonstrating improvement in key
metrics. The question comes down to: How do you “own the home” and execute before your competition beats you to the strategy?
Nexus Clinical Respiratory Management Software Respiratory management software is the new model the industry is moving toward. The key to a successful transition to these models is adding sophisticated clinical metrics on top of excellent compliance results. These clinical metrics measure goal performance, objective data, and—sometimes most importantly— subjective data like self-management skills or symptom management.
[
Asking “how do you feel” questions at the point of care isn’t enough.
]
These goals and metrics need to be translated into patient language and need to communicate progress in an overall plan of care. For respiratory therapists, asking “how do you feel” questions at the point of care isn’t enough. They must collect scaled answers via software to standardize them and to understand the changes from initial visits to ongoing visits. Software also enables patient answers to be tied to actions and instructions and to prompt physician interventions. Additionally, a database can be used to analyze results and identify hidden relationships that drive better outcomes.
VGM Playbook: Growing Your Business With Data and Technology
Outcomes Driven by Clinical Respiratory... | 38
continued...
Outcomes Driven by Clinical Respiratory Software and Analytics By Zach Gantt, RRT, FAARC, CEO, Encore Healthcare DMEs now have cost-effective and standardized means to identify risk, manage symptoms in partnership with their physicians, and document the progression to advanced therapies. Data shows that up to 20% of COPD patients will become hypercapnic and need some form of ventilation and up to 30% of stage 3 or 4 COPD patients have undiagnosed bronchiectasis needing airway clearance devices like HFCWO.
Oxygen TeleRespiratory Program DME providers have an existing population of oxygen and nebulizer patients who will eventually need advanced therapies like noninvasive ventilation (NIV) and airway clearance devices. Due to reimbursement cuts over the years, these oxygen and nebulizer patients are just provided with equipment and never clinically managed.
Summary Traditional expectations of DME services are focused on therapy compliance and basic equipment education—that’s the starting point. Value-based models demand a provider move from productcentered care to patient-centered care.
Encore’s TeleRespiratory Services combine the support of a respiratory navigator-staffed call center that assesses patients with the integration of sophisticated Nexus outcome algorithms to manage the disease progression. The data algorithms from these brief and continual clinical calls measure patient engagement, identify gaps in care for physician followup, and detect increased clinical impairments that lead to advanced therapies such as NIV and high frequency chest wall oscillation (HFCWO). The patient experience includes training instructions and educational videos, and suggests appropriate physician interventions. Advanced therapy identification is based upon: • Hospitalization history • Current or prior lab testing • Ongoing dyspnea and other symptoms • Continual respiratory infections • Airway clearance issues These key criteria support a higher level of outcomes that are documented, trended, and compiled into objective physician reports. VGM Playbook: Growing Your Business With Data and Technology
ABOUT THE AUTHOR Zach Gantt, RRT, FAARC, CEO, Encore Healthcare Zach is a healthcare executive with two decades of experience in post-acute respiratory care services and outcomes-based care models. Zach grew up in the home care/respiratory industry, as well as a family of successful respiratory therapists and entrepreneurs. After becoming a respiratory therapist himself, Zach worked in acute care for three years before transitioning back into post-acute care. Zach served as special projects manager and national clinical educator for Linde-RSS and served as VP of health management and chief clinical officer at Alana Healthcare developing the CROM program that transitioned the company from a DME provider in Tennessee into a national disease management organization. Zach started Encore with the vision of radically improving post-acute respiratory care delivery through clinical excellence, innovative technologies, and the Nexus software.
Outcomes Driven by Clinical Respiratory... | 39
COVID-19 Pandemic Opened the Door for Decentralized Clinical Trials By Andy Maloy, Senior VP, Technology and Clinical Trials, Verustat
D
ecentralized clinical trial (DCT) is not a new term to the life sciences industry. But it is an approach that many contract research organizations (CROs) and pharmaceutical companies did not utilize until the COVID-19 pandemic began. In 2020, remote and virtual studies were suddenly essential to continue care for patients and conduct research for clinical trials. The pandemic woke up many companies, forced the adoption of DCTs, and shook the clinical research industry into action.
[
In 2020, remote and virtual studies were suddenly essential to continue care for patients and conduct clinical trials.
]
A New Standard At the beginning of the pandemic, hospitals and clinics prepared for record-breaking patient volumes and equipment shortages, while many non-essential clinical care and non-COVID-related clinical trials were forced to pause all in-person studies. According to NPR, 440 clinical trials were suspended since March 1, 2020, due to the outbreak. The study reveals about a quarter of the trials put on hold were for cancer treatment, involving as many as 200,000 subjects. Pre-COVID, DCTs were being discussed but not part of standard service offerings.
440
clinical trials
were suspended since March 1, 2020, due to the outbreak. The study reveals about a quarter of the trials put on hold were for cancer treatment, involving as many as
200,000 subjects
[
Adopting DCT services is no longer optional—it is necessary in order to keep pace with the needs of patients and providers.
]
At SCOPE Clinical Operations Conference 2022, I noticed most exhibiting companies had added some form of DCT service offering. Many speakers addressed the challenges of DCTs and how to promote better patient care, focusing on ease of the patient experience. Thus, adopting DCT services is no longer optional—it is necessary in order to keep pace with the rapidly evolving decentralized healthcare and clinical research needs of patients and providers. A Challenge Leads to Opportunity The abrupt change in healthcare systems’ operations challenged researchers to transition into a virtual, decentralized process that offered more protection and increased adherence and compliance in the patients’ homes. With DCTs, clinical trial sponsors and participants were given another opportunity to find cures for diseases, bring products to the market, and have an overall peace of mind in an uncertain world. If solely remote research is not attainable, hybrid clinical trials can be used to combine virtual and in-clinic workflows. According to MD Group, nearly 30% of patients drop out of clinical trials due to time and schedule conflicts. Losing a patient also means a loss of valuable data. Once they drop out of the trial, the data collected from that patient is no longer usable, and the process will need to begin again with a new patient. The average cost to recruit a new patient if one is lost due to noncompliance is almost $20,000.
Nearly 30%
of patients drop out of clinical trials due to time and schedule conflicts
VGM Playbook: Growing Your Business With Data and Technology
COVID-19 Pandemic Opened the Door... | 40
continued...
[
COVID-19 Pandemic Opened the Door for Decentralized Clinical Trials By Andy Maloy, Senior VP, Technology and Clinical Trials, Verustat
DCTs offer a more inclusive, patientcentric approach by allowing patients to participate in clinical trials from their homes.
A More Inclusive Approach
][
DCTs offer a more inclusive, patient-centric approach by allowing patients to participate in remote clinical trials from their homes. This is especially helpful for patients with mobility issues or those who do not reside near a clinical trial site. Because these trials reduce patients’ time and financial burden, they can expedite patient recruitment and reduce dropout rates. DCT services that handle all the logistics involved in getting equipment to and from patients—from inventory to delivery tracking, return management, and cellular and mobile device management—help keep these trials on the right course.
In contrast to traditional clinical trials, DCTs are trials carried out by telemedicine and mobile healthcare providers that can incorporate a range of solutions. For example, services such as Verustat DCT offerings enable remote patient care. Verustat’s services can be customized to the patient’s requirements. This platform’s specific offerings include remote patient monitoring (RPM), telemedicine visits, medical peripheral hardware sourcing, multiple communication methods, global customs management, tier 2 technical support, and equipment leasing.
access the patient’s STAT-Phone and update their password in real time.
With remote, decentralized capabilities, researchers can recruit larger, more diverse trial groups.
]
Password reset has been a hurdle previously for older patients, and this remote capability can alleviate various technological issues. With remote, decentralized capabilities, researchers can recruit larger, more diverse trial groups while increasing the study’s reach to under-represented communities. These same capabilities can be expanded to international clinical studies with the various requirements and challenges that researchers and patients must be aware of. Patients First and Foremost Ultimately, the focus of decentralized trials should, first and foremost, be on the patient while addressing the researcher’s need to manage data and protocol delivery within a compliant, patient-first environment. Providing tools and services to increase patient satisfaction should be the primary goal of every DCT.
A Better Way to Communicate DCT platforms can leverage remote technologies, like Verustat’s STAT-Phone communications hub, to offer appointment reminders, smartphones, data collection, and effective communication between patients and trained support to help increase participant engagement and retention. Call center teams can also promote trust between patients and providers, alleviating the clinical study staff of time-consuming tasks while housing all information in an all-in-one solution. With the patient’s permission, the care coordinator team can virtually VGM Playbook: Growing Your Business With Data and Technology
ABOUT THE AUTHOR Andy Maloy, Senior VP, Technology and Clinical Trials, Verustat Andy Maloy, senior vice president of technology and clinical trials at Verustat, has supported hundreds of clinical trials with technology services throughout his career. He has seen where DCTs have started before the pandemic to where they have evolved now. This has helped him design Verustat’s multiple levels of support for DCTs. To learn more about Verustat’s customizable SELECT DCT offering, visit verustat.com/clinical-trials. COVID-19 Pandemic Opened the Door... | 41
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