As computer applications for home medical equipment providers play a wider role in billing, inventory management and other areas, these potentially costly investments become increasingly critical to your operations. And knowing how to use them effectively requires training.

The learning process that gets users up and running and then proceeds to teach them how to expertly mine the system's depths is the link between what is-and what can be better.

For some providers, software purchases hinge on how well training leverages the strengths of the software. "The training package was one of our main criteria," recalls Gary Burgess, who, as manager of the HME department at Westmont Medical, Helena, Mont. "Some vendors had very little training. Some had a lot. But any package is only as good as the people who are using it and making it function. A good car needs a good driver, so we put a lot of emphasis on training."

A Technical Assist Vendors can be true partners in the training process. Donna Serratore is vice president of finance and administration at Philadelphia-based Philcare Home Medical Equipment, which has 10 people on its software program. "If I could not train them or somebody else here couldn't, I needed to know that I could fall back on the manufacturer's training," she says.

Training assistance on new software can be scheduled throughout all phases of planning, testing and going live. Even setup meetings or times when vendors come to check data systems or do conversion testing are ripe opportunities to start pre-installation training. Sparrow Regional Medical, a full-line HME provider in Lansing, Mich., with more than 40 users on its software system, started the training process shortly after buying the program in December 1998.

"Initially, the director and supervisors of billing and customer service and I had a strategic meeting at the vendor's facility. That was three days in February," says Sparrow's assistant director of operations Matt Beno. "They came out and did some more training in the middle of April. That was where we trained customer service people on how to enter orders; purchasing people on how to develop purchase orders; accounts payable on how their process flows; and billing people on how the billing system works." The company went live the next month.

Who and How Much In a small company, it may be the president or just the billing person who receives training. In a larger organization, a couple of key department heads typically take the lead. Still, everyone who is touched by the software should have some understanding of what's relevant to his or her department. These key people then sometimes become ad hoc trainers themselves.

"We did bring in people who don't live here in the home office area," says Burgess. "Then, I would travel out to the different areas and assist them in the training at their particular location."

Just how much training varies by product complexity, vendor and provider-somewhere between a few hours and several weeks per employee. Westmont trained for 16 days on its system. "That may seem like a lot," remarks Burgess, "but wait until you have a wide variety of skills in employees that you're trying to bring together in a large geographical area to use one comprehensive system. I don't think it's overkill."

Training needs last the life span of the software. Particularly in the HME industry, high turnover creates a continual need for training and retraining, experts say. "In the last couple of years," says Lynne Crowley of St. Albans, W.Va.-based Premier Medical, an HME provider, "we had almost a complete turnover in administration. All the people who set up the program and used it and who had been trained initially were gone except for one lone person in the billing office. Now, we have 12 people on it."

Many vendors offer ongoing training contracts that can be used as needed. Additionally, many provide audits to evaluate how well users are applying the technology and to make suggestions for improvement. This, of course, implies a learning curve. At first, "you learn the most important things that you're going to do on a daily basis," explains Tina Penzel, Colonial Health Care in Pompano Beach, Fla. "And then the vendor likes to give you three to six months on your own using the software with tech support, after which you go to them for an additional two days' training."

Specialization and Cross-training Whether specialized training or cross-training on various aspects of a system is best depends on the size and management style of the provider. In smaller organizations, cross-training is usually required since there are typically few users on a system. Penzel's company is an example. "There are just two of us here that do this," she says, "so we're both trained pretty comprehensively."

By contrast, Healthscripts, an HME provider in Englewood, Colo., has 14 people trained as software specialists. "One group is our collection unit whose responsibilities are from billing through collections," says Sharon Tarnowsky, accounts receivable manager. "Then there is a clerical group that will be responsible for claims, electronically pulling our reports and posting our cash. They will probably be trained specific to what they're doing. That is, the collectors won't be trained on how to post cash."

Sometimes cross-training isn't relevant. "Inventory tracking and equipment maintenance are different animals from [certificates of medical necessity]status and accounts receivable," says Burgess. "Therefore, I didn't want to spen d time teaching technicians the duties of accounts receivable and vice versa."

Cross-training should be considered, however, as Serratore indicates. "We started with one person from customer service, one CMN specialist and one billing person," she says. "Their jobs were separate. Now we're starting to think about cross-training. It would be advantageous when people are out so that everybody understands what everybody else does. Everything I do affects somebody else. Cross-training makes us more aware of that."

On-Site and Off Whether an HME provider sends people out for training or has trainers come on-site depends largely on the economics of its size and goals. Simply, it is uneconomical for large providers to fly each user to the vendor for training. Still, others might prefer this option. "We decided to go to the vendor for its one-week program to get us away from the work environment, avoid interruptions and able to concentrate on just its software," explains Tarnowsky.

Group training sessions and user conferences also offer other benefits. "Those are opportunities to meet other people who are using the system, find out what they're doing well or how they're working around an issue, whether it be a CMN issue or a Medicare billing issue," notes Beno.

The downside to group training is that each provider's business may be unique, and sometimes general software training is too general or irrelevant. Premier Medical used to send three or four people at a time to such classes. "Typically what would happen is we would end up using the people there on the break time to ask questions specific to us, things that we wanted to know that had to do with only our environment," says Crowley. "While I thought it was a good experience to go there, I didn't feel it was the best bang for the buck, because there's so much more that we needed to know. I had been there twice and decided what we really needed to do was have them come here for three days and work with problem-specific issues that we were dealing with."

That's what they did, and the return, Crowley says, was fantastic. "It probably works out to be about dollar for dollar, but the return was about a hundred to one. There's no comparison."

On-site training assumes that you have suitable facilities to do it. Beno says Sparrow's in-house training involved two training rooms. "One was a room where we could use a projection screen and were able to train people using that. We had groups of 10 to 15 people. We also had five PCs set up where they could practice. Then we had a small training room with PCs where smaller teams like accounts payable could learn that process."

Taking the Advantage For that three-day meeting Crowley scheduled for Premier Medical, the team went all out. "We decorated folders and hung them in all of the offices for about six months where people would drop notes as they would think of questions they had about the system: 'Why is it doing this?' 'Is it possible to make it do this?'"

She says two days were spent answering those questions; the third day featured an accountant and computer people talking about hardware. "It was the best money we have ever spent as far as any kind of computer training," Crowley says. "I would say that probably within three months, we're going to be utilizing a great deal more than we're using now."

Training can be the key to not only handling the exigencies of everyday operation but also to learning how to leverage automation's more complex capabilities. Many providers express the desire to train and get the most from their systems but lack the time. "If you're going to train for it," warns Serratore, "you have to be prepared to follow up and do it, and right now, we don't have time to do something else. We're still trying to streamline."

Burgess notes the same challenge. "The system has opportunities for us to grow that I don't believe we'll be using for six months to a year. Within the basic implementation, there's a lot to learn to get up and running and keep the customer satisfied," he says, "but there's also a huge growth potential by learning the depth of the system."

Effective training implies having the right class at the right location, at the right time with the right tools. And that means checking a vendor's training options is an important step when considering soft-ware. HC

Richard Bash National sales director

Noble House, Deerfield Beach, Fla.

A higher level of training is required just based on the fact that [HME providers who submit claims] are not required to have the same information on paper [as] on electronic claims. The training becomes more than just how to use the program; it's also training to adapt the program into their environment, and make sure that their forms collect the information that they need so that the claim doesn't reject.

Jim Highsmith Chief executive officer

Softcare Software, Griffin, Ga.

It's important that the person who is the trainer has had a lot of experience with the software. It's also important for the trainer to have a background in the industry. You get people who knows how to use computers, but they don't know anything about the intricacies of what the billing clerk goes through every day. The billing clerk will gobble them up in a heartbeat.

Spencer Kaye President and chief executive officer

Fastrack Healthcare Systems, Plainview, N.Y.

We find that the biggest plight people have with a lot of systems [is that] the management people feel they can't get the information out of the system. A lot of times the information is there, they just don't know how to get it.

Rick Long President

Spectrum Software, Nashville, Tenn.

If they're not willing to make the investment in training, we don't want them as a customer.

Terry McCoy Marketing director

MCS Inc., Pittsburgh

In software today, you live or die by support. It's the main issue. Having real-time access or the ability to actually call into a person who can attempt to solve the problem then and there, that's really quite a bonus for our customers.

Heidi Tometz Director of Sales and Marketing

Computers Unlimited, Billings, Mont.

We firmly believe in ongoing education. We really have a partnership with our customers. We are only as good as they are and vice versa. So, if we can go out and help them use the system better, they like us better, our support department works better, their company runs better, and it's a real benefit to everybody for them to be able to take advantage of the things we can give them.