By David Henry
Like many of you who are reading this, I am a Warfarin “lifer.” Also, like many of you, I have experienced the frequent delays and inconvenience of waiting at busy lab sites for the brief procedure resulting in my PT-INR ratios. As a busy professional, I felt a growing need to challenge this “traditional” approach. I found my answer in taking ownership of my coagulation health management through patient self-testing.
Patient self-testing involves using a device similar to those used for testing blood glucose levels. I learned that I could do my PT-INR testing at home, on my schedule and with highly accurate results. Knowing this, I turned to the Internet to research how I could make this work. I learned about coagulation monitors on manufacturer web sites. When I could not locate a local ‘in-network’ DME (Durable Medical Equipment) provider, I chose one via the Web. This DME provider became a one-stop source for the coagulation monitor, supplies, physician coordination, 3rd party insurance reimbursement and training.
Initially, I experienced some reimbursement delays due to lost files and a time-consuming approval process. Eventually, however, my insurance plan agreed to cover all of my DME equipment and supplies and processes it as ‘in-network’. I have also developed my own Excel spreadsheet with charts to log and manage my coagulation levels. I coordinate my testing results and dosage adjustments with my specialist by phone. Patient self-testing may not be appropriate for everyone. However, I like the flexibility and satisfaction that I now have from owning my coagulation health management. The key is in making the patient self-testing process easier for all who desire the benefits of this approach. I challenge NBCA to lead the advocacy charge in overcoming obstacles with public and private 3rd party payers and in documenting the health and economic benefits.