Gaps in the delivery of rehabilitation medical equipment in the digital age

An Important Tool to Understand Durable Medical Equipment and Supply Use in Children

“…General pediatricians commonly feel unprepared to manage DMES and delegate DMES responsibilities to other service teams and support staff . Patients and families report substantial distress from DMES use and barriers to reliable access . While researchers recognize that DMES use can both positively and negatively affect health and health services, the lack of standardization in measuring DMES use prevents addressing important knowledge gaps.…”

“…Additionally, needed DMES are sometimes obtained through means not captured in claims, eg, lending agencies, out-of-pocket purchases, or do-it-yourself (or build-it-yourself) workarounds. At times, DME is obtained through home and community-based waiver programs, including for items that may not yet have HCPCS codes . Many of these limitations illustrate the value and potential utility of the authors’ system.…”

“…Clinicians, payers, and/or policy makers might use similar approaches to guide improvement initiatives. The value of this direction is underscored by recent work illustrating how families create extensive workarounds to overcome DMES gaps, which pose unknown risks to their children . Researchers might apply the authors’ classification system to determine expected patterns and profiles of concomitant DMES use.…”

“…1 Patients and families report substantial distress from DMES use and barriers to reliable access. [2][3][4] While researchers recognize that DMES use can both positively and negatively affect health and health services, the lack of standardization in measuring DMES use prevents addressing important knowledge gaps. For example, population estimates of overall DMES use are not well known, and research suggests that complications of assistive technology, one form of DMES, can contribute to overall hospital and ED use.…”

“…At times, DME is obtained through home and community-based waiver programs, including for items that may not yet have HCPCS codes. 3,8 Many of these limitations illustrate the value and potential utility of the authors' system.…”