In wound care, explains Dave McCausland, senior vice president of planning and government affairs for The Roho Group, support surfaces must address one or more of four things: reducing/eliminating peak pressures and evenly distributing pressures, resulting in envelopment of the soft tissue without deformation; reducing/eliminating shear; reducing/eliminating friction; and addressing micro-climate issues like excess moisture and temperature.
But, questions McCausland, how do you test for all of those things?
“And do you perhaps test in tandem? And how do you test for those things after a product has aged for a year or two? And then how do you ensure that you've got a standardized test that's repeatable from one place to another?”
Plus, he points out, it's very difficult to use human subjects in testing support surfaces because of individual differences in weight and build, for example. “Not one of us would pressure map exactly the same,” he says.
Because of these factors, McCausland says, coming up with standardized testing for support surfaces is a challenge. “But,” he continues, “as an industry we'd better do it, because if we don't, the regulators are going to create it for us — and we've seen what that almost caused with powered mobility.”
What's more, McCausland says, support may be on the “hot list” of products targeted for competitive bidding. “If I were a betting man, then I would have to believe support systems are going to go into competitive bidding — not because there's been any fraud or abuse there, but this is a high-ticket item and it has already been identified under [the FEHBP cuts].”
With Medicare's bidding program set to begin in 2007, that means a lot of work for the industry in a very short time, he advises. “Support surfaces can't be bid effectively unless the codes are fleshed out,” he says, which includes looking at the diagnoses, re-evaluating the coverage criteria — and coming up with standard test methods to validate products.
An ISO (International Organization for Standardization) group met for the first time last month to identify what work is currently going on relative to support surface standards, and may in the future begin work on some testing methods to propose. “But,” cautions McCausland, “standards work is not very fast.”
