Solving the DME ordering puzzle: Leading health systems share how ePrescribing improves DME ordering processes, increases clinician satisfaction, and accelerates discharges

When patients need durable medical equipment (DME) such as wheelchairs or oxygen, the required documentation can be immense.

Busy clinicians and case management teams must have all the right forms on hand, collaborate on gathering product-specific clinical information to meet individual health plan requirements, and then follow up to make sure the order get to the patient. For healthcare providers still using manual DME ordering, the administrative burden can negatively affect patient care.

In a Becker's Hospital Review webinar, sponsored by Parachute Health, Catie Moser, senior vice president of enterprise client success at Parachute Health, moderated a discussion among three care management executives about their organizations' DME ordering challenges and how Parachute's solution has helped them solve their DME puzzle. The panelists were:

• Joanna Lucas, RN, BSN, vice president, care management, St. Luke's University Health Network in Pennsylvania and New Jersey
• Joseph Vina, RN, BSN, manager of surgery and transplant services, department of care coordination and social work, UCLA Health System in Los Angeles
• Dina Walker, RN, MSN, national director of case management, Encompass Health

Four key takeaways were:

1. An inefficient DME order system results in a heavy administrative burden and delayed patient care. Many health systems are sending DME orders through a referral management system or even by fax. "If a provider sends over a request for oxygen for a patient, a supplier often needs 20 to 40 pages of documentation to get reimbursed," Ms. Moser said. "There's often this back-and-forth exchange that could take an hour. If you have five patients you're trying to discharge and each one needs two pieces of DME, your day is entirely gone just ordering DME."
   
   In addition, the Case Management Association reported that more than 23 percent of all discharges are delayed solely due to DME. Hospitals have to choose between absorbing the DME costs or “holding beds for walkers or nebulizers that cost a lot less than keeping that patient in that bed for an additional day," she said. Switching to ePrescribing is the solution.
   
   
2. Encompass Health integrated the Parachute Platform into their workflows starting 5 years ago, which streamlined its DME ordering process by improving EMR documentation. "About 80 percent of our discharges require [DME] equipment," Ms. Walker said. "We didn't have good documentation in our EMR, so we built a form for our therapists to complete prior to patient discharge with equipment recommendations. Now our case managers have one or two places to go to complete the [DME] order and our physicians receive a secure text link to electronically sign. The whole process takes about eight minutes. Parachute Health support has been phenomenal." The ePrescribing workflow decreases discharge delays, and gets patients out of the hospital sooner to recover. 
   
   

3. After switching to DME ePrescribing on Parachute, UCLA Healthcare reduced patient discharge delays with visibility into readiness of the next site of care. "We identify patients who are clinically ready to be discharged, but this has to match what is needed in the post-acute setting," Mr. Vina said. "We are now able to see the progression of discharge planning, including DME challenges. The auto-generation of clinical documents gives us guidance on why specific equipment may have been denied and how we can get an alternative to take care of our patients." Today, about 83 percent of UCLA Health's orders are accepted, and the median time to acceptance is 30 minutes.
   
   
4. St. Luke's University Health Network (SLUHN) improved operational efficiencies and successfully directs more orders to its joint venture DME supplier. "We moved from a manual paper process that lacked specificity, required a lot of faxing and involved chasing doctors down for approvals," Ms. Lucas said. With Parachute, SLUHN has improved documentation, implemented single sign-on, and drastically lowered time to sign orders from a day or more to just minutes across the entire health system. "We also have a joint venture with a DME company, and we wanted to make sure that, for the most part, our business went to them," she added.

These successes are a testament to the leadership of these healthcare systems in transitioning to ePrescribing. Because the DME ordering problem is real and many health systems are still struggling: In an audience poll, 55% of webinar attendees shared that it takes a day or more to gather documentation for a DME order at their health system. Another 34 percent said the ordering is fast but requires many time-consuming follow-ups that take focus away from patient care. Ordering on Parachute takes an average of 3 minutes, and the platform ensures clean, complete orders every time, with no follow-ups needed. 

Visibility into order status enables efficient discharge and follow-up planning. And direct access to data empowers health systems with visibility into supplier or DME business performance, to take steps to control costs, hold suppliers to SLAs, and optimize patient care. 

By integrating DME ePrescribing on the Parachute Platform, health systems are successfully streamlining their DME ordering. With Parachute Health, they significantly reduce administrative burden, eliminate paperwork getting lost in the shuffle of faxes, reduce frustration of clinicians dealing with endless paperwork and back-and-forth with DME companies, and get patients the life-saving products they need fast and reliably.

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