Apria Healthcare taps its learning content management system
(LCMS) to rapidly create, reuse, and track training in order to
meet the challenges created by a new bidding structure mandated by
the Centers for Medicare & Medicaid Services.
Lake Forest, California-based Apria Healthcare provides customers
with home healthcare products and services, including respiratory
therapy, diabetic supplies, medications, and home medical equipment
services. The company employs approximately 11,000 healthcare
professionals in more than 500 branch offices across the United
States, serving over one million patients annually. Each year,
healthcare companies such as Apria receive payments from the
Centers for Medicare & Medicaid Services - part of the U.S.
federal government - for supplying items like wheelchairs, oxygen
equipment, and respiratory services to millions of Medicare
beneficiaries. Apria continuously trains its employees, ranging
from managers and administrative staff to nurse clinicians and
pharmacists, about the company's products and services, as well as
an array of government regulations.
In 2008, the U.S. Congress directed the Centers for Medicare &
Medicaid Services (CMS) to put in place a new competitive bidding
structure for physicians and durable medical equipment providers,
such as Apria. The new structure was to begin on July 1, 2008, as a
pilot in selected metropolitan areas. "The new CMS structure stated
that durable medical equipment providers would have to bid for the
right to supply products to Medicare beneficiaries," says Gaylene
Galliford, manager for Training, Design & Development at Apria
Healthcare. "Whoever won the bid for each product would earn the
right to supply those healthcare items."
This new structure promised some complexity for Apria's sales,
marketing, and customer service teams. The company had long billed
itself as a one-stop shop for home healthcare products and
services. But the new regulations meant Apria couldn't always
market itself as a single source for Medicare beneficiaries' needs.
Galliford's team had to put together a training program for 500
Apria employees in 54 branches who worked in the metropolitan areas
that CMS selected in the first round of bidding. The program would
teach Apria employees the new procedures for selling selected
products and services as well as helping customers. Apria decided
it had to create content for employees, based on role and market.
According to Galliford, the training content was complex and
nuanced. Sales staff, customer service representatives, and
logistics personnel would each need to focus on different
ramifications of the new bidding structure. Apria faced a training
challenge in which it needed to rapidly disseminate a core set of
training, yet personalize the training to meet the needs of
employees with different jobs. Because Congress mandated the new
bidding structure, Apria would also have to prove its workforce was
complying. And that meant reporting on each employee's level of
proficiency once they had been trained.
CMS began awarding bids to providers of home healthcare products in
the middle of June 2008. Apria had to work quickly to meet the July
1 CMS rollout and highlight the products and services that had
received a winning bid.
"We turned to our learning content management system," adds
Galliford. Apria's learning content management system (LCMS), made
by OutStart, enabled rapid authoring and reuse of content, while
supporting assessments and personalized training.
"Our regulatory affairs group asked our instructional designers to
make last-minute changes to 20 pages of course content. We could've
never accomplished that by our deadline without an LCMS," says
Galliford. "We had to not only create a course instructing all
employees on the new regulations, but also teach disparate groups
of workers about the nuances affecting their specific roles. We
used the LCMS to build two modules for our course, which we then
reused for all groups; the last modules we built were specific to
each person's job."
Apria delivered its first online CMS course on June 29, in time to
train employees for the July 1 rollout of the CMS program.
Augmenting the online training were conference calls in which
Apria's trainers reinforced messages with employees. To ensure all
employees were grasping the new regulations, Apria used its LCMS to
embed a test at the end of each module. The assessment required
employees to determine what products or services qualified for
Medicare's new bidding structure and answer potential questions
from customers. With the LCMS, Apria could see which employees
within a given location were not only completing the training but
also how well they grasped the material.
Apria's LCMS also includes a content model for employers to develop
and reuse any learning object no matter where it was created. The
software provides training departments with an advanced taxonomy
and metadata tags to easily categorize and retrieve content, which
simplifies reuse and reduces maintenance of the bits and bytes that
make up training. These features made it easy for Apria to take
content for one audience and reuse it for another.
While Apria trained its employees, a lobbying effort by durable
medical equipment providers and physicians regarding the new
bidding structure convinced Congress to delay the implementation of
the CMS program for 18 months. So, Apria had to roll out another
training program in early July to advise its employees about the
delay by Congress and the details of an intermediate plan to be
followed until the new CMS launch date. "The LCMS helped us mirror
the frequent changes related to the CMS competitive bidding
program," says Galliford. "It's a testament to the LCMS's power
that we could create and reuse content easily and get that
information to employees quickly."
In all, Apria developed five courses in two weeks for the CMS
competitive bidding process. Apria's Training, Design &
Development team delivered the first of the five online courses two
days prior to the Centers for Medicare & Medicaid Services'
July 1, 2008, deadline. Within 24 hours, approximately 500
employees scattered across 54 branches had completed the course.
Apria's training team says it saved more than 50 hours of design
work because they were able to reuse modules from the initial CMS
course for follow-on content. "The assessment capabilities of the
LCMS verified that staff in each metropolitan area had taken and,
most importantly, understood our training," says Galliford.
Without its LCMS, Apria says it probably would have conducted the
CMS training via a conference call with slides. Instead, Apria used
its LCMS to create interactive training filled with tests that
reinforced concepts, which made a complex issue easier for all
employees to understand. And the LCMS enabled employees to take
training where and when it suited them. "Our LCMS includes internal
tracking and reporting that we can easily generate any time," says
Galliford. "These customized reporting capabilities suit our needs
as well as compliance requirements, so we're never in doubt as to
what training has been delivered and who's taken it."
For example, The Joint Commission (formerly known as The Joint
Commission on the Accreditation of Healthcare Organizations) audits
companies like Apria to assess if these employers are following
proper industry procedures and training accurately. If The Joint
Commission finds an employer has failed to comply with regulations,
that organization's accreditation can be taken away. Adds
Galliford, "Our LCMS plays a critical part in accounting for