COVID-19 impact on respiratory is vast

Because COVID-19 is a virus that attacks the body’s respiratory system, it has put home medical equipment providers on the front line for fighting the pandemic.

Manufacturers from across the respiratory spectrum are responding to this crisis by furnishing the equipment needed to assist those afflicted with the virulent pathogen, contributing to a joint effort with HME providers.

“COVID has caused an uptick in home oxygen equipment overall,” said Doug Francis, president and CEO of St. Petersburg, Fla.-based Lifestyle Mobility Aids. “We are seeing huge growth in the utilization of oxygen equipment as it is being used to treat certain COVID patients. Specifically, the focus has been on stationary products and more specifically, oxygen concentrators.”

To be sure, the most significant area of growth has been in stationary oxygen concentrators – especially 5- and 10-liter units, added Joseph Lewarski, senior vice president of global business for Port Washington, N.Y.-based Drive DeVilbiss Healthcare.

“Since the first wave of COVID-19 infections and hospitalizations in the spring, global demand for oxygen concentrators has grown significantly,” Lewarski said. “Key drivers include the emergency use for hospital overflow, which was more significant at the start of the pandemic, along with the increased volume of patients discharged to home still requiring supplemental oxygen."

The virus has also increased the use of home oxygen therapy for patients without underlying lung disease who are still experiencing some level of hypoxemia at the time of discharge, Lewarski said.

“With hospitalizations now at the highest point in the U.S. since the start of the pandemic, we expect strong demand to continue through the winter,” he said. “COVID, in conjunction with influenza, may deliver one of the worst respiratory seasons ever recorded.”

But demand during the pandemic has not been limited to oxygen conentrators. Chris Southerland, general manager of commercial operations for North Billerica, Mass.-based Breas Medical, said “the home life support ventilation business has remained strong, especially as it relates to COVID-19 patients transitioning from hospital to home care.”

Embracing technology

David C. Lyman, vice president of sales and VGM Respiratory for Waterloo, Iowa-based VGM & Associates, says COVID is impacting the industry in another way: by forcing HME providers to embrace technology – most notably telehealth and telecommunications technology.

“Providers had to turn to HIPAA-compliant software and virtual communication tools, such as Microsoft Teams or Zoom,” he said. “Use of this technology will continue in the future, whether it is virtual setups or using cloud-based data from CPAP machines or ventilators.”

Telehealth has shown a great leap forward, and while “it is not a technology that will work for everybody, it does have the potential to help limit exposure of the high-risk pulmonary patients to hospital and clinic visits,” said Neal Smith, director of marketing and education for Austin, Texas-based International Biophysics. “One area we’ve been working on is an airway clearance program that provides clinicians a structured tool set to use around the education of all different types of airway clearance techniques.”

The growth in telehealth has been borne out of necessity, especially in protecting the vulnerable elderly, said Curt Merriman, chief sales officer for Frankenmuth, Mich.-based rtNOW.

“Prior to this pandemic many seniors were not willing to use telehealth options,” he said. “However, necessity of mitigating exposure to COVID-19 has motivated those same patients to have their children and grandchildren assist them with the technology challenges.”

At Coral Springs, Fla.-based VirtuOx, there has been a huge increase in demand of the company’s sleep telemedicine solution DocViaWeb, a platform that allows sleep specialists to order home sleep apnea testing and prescribe CPAP equipment in coordination with HME providers, said Kyle Miko, vice president and chief marketing officer.

“We have also seen a huge increase in the need for disposable HSAT devices to help reduce the possible spread of COVID-19,” he said.

Evolved thinking

Scott Wilkinson, CEO of Goleta, Calif.-based Inogen, contends that the medical community has “learned a lot about how to properly treat COVID patients” since the pandemic began.

“The prevailing thought in the first quarter was that the majority of patients would be treated with a ventilator and we all know that early on there was a big stockpile of ventilators at hospitals at that time,” he said. “But as we moved through the second quarter, we quickly learned that treating COVID patients with a ventilator could do more harm than good for most patients – only a relatively small fraction of COVID patients that progressed to a state of respiratory failure truly needed a ventilator. As a result, most home care companies and hospitals have more ventilators than they need today, and many have been put in storage.”

Oxygen therapy emerged as a primary treatment for COVID patients, Wilkinson said, pointing out that home care companies began to purchase stationary oxygen concentrators “at a much higher rate than historical levels.” Manufacturers increased production to meet the incremental demand, he said, adding that most vendors “have either a backorder or extended lead times for stationary oxygen concentrators.”

In examining how COVID-19 has impacted the type of respiratory equipment used by providers, Tom Bannon, president of St. Louis-based Responsive Respiratory, said there is a transition from standard-flow to high-flow devices.

“Specifically, this applies to the increased usage of high-flow regulators and cannulas, as patients are requiring higher flow and prolonged oxygen usage due to the illness,” he said.

As hospitals reach capacity status, HME providers need to support discharged patients increases exponentially, Bannon said. 

“As such, there should be reimbursement increases to reflect the rising service levels and the value of the home health care provider to provide the support to hospitals,” he said. “It is important that the home care providers and lobbying groups remind decision-makers of the support and rapid adaptation home care has provided.”

Because they are on the front line, HME providers are serving a critical role in patients’ transition from hospital to home, said Elliot Campbell, executive vice president and chief commercial officer for Whitmore Lake, Mich.-based Trace Medical. Therefore, he said it is imperative for HME providers to tout their value to referral sources.

“Not only do providers incur the costs, such as additional PPE and labor, they prevent readmissions into hospitals,” Campbell said. “Under no circumstances is it cost-effective for a patient to be in an inpatient setting vs. a home setting. To collectively show our referral sources how partnering reduces readmissions, providers need to show them the data. It is all about the data.”

Category: Respiratory

COVID IMPACT #1

Vent demand sags: Manufacturers created a glut of hospital ventilators based on early projections, but home-based ventilator demand has been steady for patients transitioning out of the hospital.

COVID IMPACT #2

Stationary O2 swells: The most significant area of growth has been in stationary oxygen concentrators – especially 5- and 10-liter units.

COVID IMPACT #3

Technology boost: As person-to-person contact is discouraged, both providers and patients are embracing connectivity and telehealth solutions.