How To Integrate DME Into Treatment Protocols

By Josh White, DPM, CPed

   4. Learn from everyday care. Continually monitor the results of the practice’s approach and integrate the lessons learned from cases when the standardized approach is not successful.

   The structure and processes of the clinic must allow learning from the everyday work. The people designing the practice protocols must learn from every member performing the various tasks. The people designing the protocols must understand the demands for every service as well as how one performs the task. Such an approach will enable allocation of resources to best meet expected demand. Office managers should do ongoing reviews of charts to ensure that the practice is following treatment protocols and documentation is in order.

Incorporating DME Into Treatment Protocols: Can This Transform Your Practice?

While streamlining care is designed to improve patient outcomes and reduce overall health care costs, there is also an opportunity to increase practice revenue. Incorporating durable medical equipment (DME) into our treatment protocols for conditions of biomechanical etiology requiring stabilization may be beneficial in several respects.

   Durable medical equipment provides readily available modalities when the patient presents. Utilizing DME enables you to get immediate patient feedback on the comfort and benefits of the given modality. Additionally, the availability and demonstration of DME products in the office can help facilitate both patient adherence and patient satisfaction.

   One of the fundamental concepts for integration of DME into practice is to identify the frequency of the most common podiatric biomechanical diagnoses you see in practice. These are the conditions that offer the greatest benefit of integrating a streamlined approach to care. If you recommend a prefabricated ankle-foot orthotic (AFO) as a part of the treatment protocol, there should be a direct correlation between the incidence of the condition and the number of DME items dispensed.

   After identifying the most common diagnoses you see, determine the DME items to use with each. Create treatment protocols for each visit and vary these by severity. Create protocols for follow-up visits depending on how well the condition is improving.

   The DME recommendations should be based on the concept of providing items that are therapeutically appropriate and the least expensive. Recognize that some conditions are best treated by an orthotist who has more experience in the range of customized orthoses and related products.

   There are a number of factors to consider when selecting DME products. For ease of ordering, seek out products from as few distributors as possible in order to obtain the best pricing and streamline ordering and bill paying. Look for distributors to match manufacturer direct pricing.

   Favor products from companies that support podiatry through the American Podiatric Medical Association (APMA), American Academy of Podiatric Practice Management (AAPPM), American Academy of Podiatric Sports Medicine (AAPSM) and young practitioners associations. Work with distributors that offer ready technical assistance.

Maximizing Efficiency With DME Protocols

For every patient, the front office should determine, in advance of the doctor seeing the patient, if the insurance plan covers DME and whether the podiatrist is allowed to provide the specific DME product. If the plan includes coverage and the podiatrist can dispense it, determine whether the plan has an annual deductible or lifetime coverage amount. If the patient has coverage and the podiatrist is not allowed to dispense the product, the patient needs a referral.

   The medical assistant can do the initial intake. Based on an understanding of treatment protocols, the assistant can then make the DME products readily available for the physician to recommend. The physician should review the initial intake and perform an evaluation. The physician describes the plan of treatment and therapeutic objectives of DME. The medical assistant reviews the application of DME with the patient.

   When a patient’s therapeutic needs are beyond the ability of the provider, make a referral for consultation or further treatment. Consider pedorthists, orthotists and other podiatrists for possible referral. If appropriate, the medical assistant issues instructions on referral.

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