Wound care providers need to market expertise

Home care providers serving the wound care population can't just treat it as a sideline if they expect to get referrals from the clinical community. They have to immerse themselves in the business, demonstrating expertise in the latest therapies and products and supporting it by carrying all the supplies a wound care patient needs, vendors in this underserved market contend. That means being knowledgeable about the prevention and treatment of decubitus pressure ulcers, determining which products are most appropriate for each patient and serving as a peer with the clinicians who want a comprehensive wound care provider for their patients. Dealing with a referral source base that includes wound care nurses (WOCNs), VNA nurses, endocrinologists and geriatric practitioners means the provider must have more than a perfunctory grasp of treating the wounds that often beleaguer bed- and chair-bound patients, said Maxine Rankin, RN, clinical training and reimbursement specialist for Holliston, Mass.-based Invacare Supply Group. “They are the ones who make the recommendations on how to treat the wound and are careful to watch how their patients get what they need,” she said. “They want to know that the provider has a full range of products to serve their patients.” The HME industry appears to be fragmented when it comes to wound care, with some providers handling dressings, others carrying support surfaces, but few carrying both. Those who are serious about boosting their referrals need to be in it all the way, Rankin said. “Referral sources don't want to go to two places for wound care products - they want a single source,” she said. Furthermore, referral sources are usually well-versed in wound care products and tend to have specific preferences, said Susan Wilson, director of research and development for San Jose, Calif.-based Supracor. “They know what they want for their patients and are usually adamant about the products they prescribe,” she said. “They're not looking for alternatives and don't appreciate it when providers try to persuade them otherwise. They want the provider to fill their order.” If anything, that fact underscores the importance of providers educating themselves about the application and efficacy of every product, said Abbey Daniels, CEO of Fort Lauderdale, Fla.-based SenTech Medical Systems. “Providers need to understand the real differences of one product and one type of therapy from another,” said Daniels, whose company manufactures 20 different kinds of support surfaces. “Once they have a full understanding and knowledge, it is much easier for them to show conviction when they promote a product. Focus on the therapy it provides and why that therapy is a benefit to that patient. Don't just list the features, but the therapeutic benefits of the product.” Wound care expertise is a priority at Medline Industries, and the Mundelein, Ill.-based manufacturer has programs aimed at both providers and clinicians, said Jonathon Primer, president of Medline's dermal management system division. To help providers determine treatment protocols for wound care patients, the company offers a hotline staffed by nurse specialists. In addition, Medline has put together a CEU seminar series for referral sources called Educare that covers such wound care topics as product selection, wound assessment, compression therapy and pain relief. Specialty dressings are an essential part of the wound care inventory, and Rankin said collagen and ionic silver are in highest demand from nurses. “Those two are the most sought after,” she said. “When prospective payment first started, agencies were quick to go back to gauze because they were less expensive. But they soon found that they don't save money with gauze because nurses spend more time treating the wound.” Ionic silver's primary value is its antimicrobial properties and because it now has a half-life of up to three days, greatly reduces the number of dressing changes, Rankin said. Medline introduced the ionic silver treatment concept seven years ago and has seen impressive sales growth for the product line, Primer said. “We've seen a huge push and enormous response to silver products in chronic wounds because it works extremely well,” he said. “The market likes the product very much and sales have doubled every year as a result.” Familiarity with support surfaces is paramount when it comes to offering the most advanced technology available for wound prevention and treatment, whether it be mattresses or cushions. For instance, Volkner Technology has pioneered a patient turning system that uses an electronic control to automatically shift a patient's position on a dual-chambered air mattress. Among the advantages of the unit is that it can be used with an existing bed and it relieves stress on caregivers, said Brian James, president of the Walnut Creek, Calif.-based manufacturer. “Nurses have told us over the years that they have bad backs from turning patients every two hours,” he said. “This system is fully automatic and eliminates the need for physical exertion.” Lift chairs can also be included as a support surface with therapeutic benefit for wounds, such as Old Forge, Pa.-based Golden Technolgies' new MaxiComfort system for its Golden Relaxer lift chair. The mechanism allows users to position the chair in the extended Trandelenberg position, a zero-gravity-like posture that elevates the hips with armrests while in fully and slightly reclined positions. “The mechanism positions the body in a way that minimizes pressure, so it fits well into the support surfaces category,” said C.J. Copley, vice president of marketing. “Because the seat actually lifts, if you're in the recline position, the seat will pitch back for additional pressure relief.” Another area of wound care that providers need to study hard is reimbursement, sources said. While coverage policies are often vague and stringent, funding options are available under the right circumstances, Rankin said. “Not much is paid for by Medicaid, but there are Medicare Part B codes for some specialty dressings,” she said. “Providers can find decent coverage for these products.” Likewise, support surfaces such as the Volkner system are covered as a Medicare rental for the more severe stage three and four-level wounds, James said. HME By J. Andrews, contributing editor Home care providers serv- ing the wound care population can't just treat it as a sideline if they expect to get referrals from the clinical community. They have to immerse themselves in the business, demonstrating expertise in the latest therapies and products and supporting it by carrying all the supplies a wound care patient needs, vendors in this underserved market contend. That means being knowledgeable about the prevention and treatment of decubitus pressure ulcers, determining which products are most appropriate for each patient and serving as a peer with the clinicians who want a comprehensive wound care provider for their patients. Dealing with a referral source base that includes wound care nurses (WOCNs), VNA nurses, endocrinologists and geriatric practitioners means the provider must have more than a perfunctory grasp of treating the wounds that often beleaguer bed- and chair-bound patients, said Maxine Rankin, RN, clinical training and reimbursement specialist for Holliston, Mass.-based Invacare Supply Group. “They are the ones who make the recommendations on how to treat the wound and are careful to watch how their patients get what they need,” she said. “They want to know that the provider has a full range of products to serve their patients.” The HME industry appears to be fragmented when it comes to wound care, with some providers handling dressings, others carrying support surfaces, but few carrying both. Those who are serious about boosting their referrals need to be in it all the way, Rankin said. “Referral sources don't want to go to two places for wound care products - they want a single source,” she said. Furthermore, referral sources are usually well-versed in wound care products and tend to have specific preferences, said Susan Wilson, director of research and development for San Jose, Calif.-based Supracor. “They know what they want for their patients and are usually adamant about the products they prescribe,” she said. “They're not looking for alternatives and don't appreciate it when providers try to persuade them otherwise. They want the provider to fill their order.” If anything, that fact underscores the importance of providers educating themselves about the application and efficacy of every product, said Abbey Daniels, CEO of Fort Lauderdale, Fla.-based SenTech Medical Systems. “Providers need to understand the real differences of one product and one type of therapy from another,” said Daniels, whose company manufactures 20 different kinds of support surfaces. “Once they have a full understanding and knowledge, it is much easier for them to show conviction when they promote a product. Focus on the therapy it provides and why that therapy is a benefit to that patient. Don't just list the features, but the therapeutic benefits of the product.” Wound care expertise is a priority at Medline Industries, and the Mundelein, Ill.-based manufacturer has programs aimed at both providers and clinicians, said Jonathon Primer, president of Medline's dermal management system division. To help providers determine treatment protocols for wound care patients, the company offers a hotline staffed by nurse specialists. In addition, Medline has put together a CEU seminar series for referral sources called Educare that covers such wound care topics as product selection, wound assessment, compression therapy and pain relief. Specialty dressings are an essential part of the wound care inventory, and Rankin said collagen and ionic silver are in highest demand from nurses. “Those two are the most sought after,” she said. “When prospective payment first started, agencies were quick to go back to gauze because they were less expensive. But they soon found that they don't save money with gauze because nurses spend more time treating the wound.” Ionic silver's primary value is its antimicrobial properties and because it now has a half-life of up to three days, greatly reduces the number of dressing changes, Rankin said. Medline introduced the ionic silver treatment concept seven years ago and has seen impressive sales growth for the product line, Primer said. “We've seen a huge push and enormous response to silver products in chronic wounds because it works extremely well,” he said. “The market likes the product very much and sales have doubled every year as a result.” Familiarity with support surfaces is paramount when it comes to offering the most advanced technology available for wound prevention and treatment, whether it be mattresses or cushions. For instance, Volkner Technology has pioneered a patient turning system that uses an electronic control to automatically shift a patient's position on a dual-chambered air mattress. Among the advantages of the unit is that it can be used with an existing bed and it relieves stress on caregivers, said Brian James, president of the Walnut Creek, Calif.-based manufacturer. “Nurses have told us over the years that they have bad backs from turning patients every two hours,” he said. “This system is fully automatic and eliminates the need for physical exertion.” Lift chairs can also be included as a support surface with therapeutic benefit for wounds, such as Old Forge, Pa.-based Golden Technolgies' new MaxiComfort system for its Golden Relaxer lift chair. The mechanism allows users to position the chair in the extended Trandelenberg position, a zero-gravity-like posture that elevates the hips with armrests while in fully and slightly reclined positions. “The mechanism positions the body in a way that minimizes pressure, so it fits well into the support surfaces category,” said C.J. Copley, vice president of marketing. “Because the seat actually lifts, if you're in the recline position, the seat will pitch back for additional pressure relief.” Another area of wound care that providers need to study hard is reimbursement, sources said. While coverage policies are often vague and stringent, funding options are available under the right circumstances, Rankin said. “Not much is paid for by Medicaid, but there are Medicare Part B codes for some specialty dressings,” she said. “Providers can find decent coverage for these products.” Likewise, support surfaces such as the Volkner system are covered as a Medicare rental for the more severe stage three and four-level wounds, James said. Pressure ulcer prevention & wound care Key Referral Sources: WOCNs (wound care nurses), VNA nurses, endocrinologists, geriatric practitioners, hospital discharge planners, case managers, social service agencies, dermatologists, internal medicine practitioners, general practitioners, rehab therapists, physical and occupational therapists, foot care specialists, home care nurses, patient advocacy groups (such as the MS and ALS societies), neurology clinics. Effective Marketing Techniques: - Be a full-service wound care provider, offering everything from silver and collagen dressings to support surfaces. - Become an expert in the science of wounds, the intrinsic and extrinsic conditions that cause them and treatment modalities. Demonstrate wound care solutions, not just products. - Respect the referral source's choice of products; don't offer alternatives unsolicited.