Problem Solvers

Keeping a Close Watch

Remote sleep patient monitoring makes sense in more ways than one.

• By David Kopf
• Aug 01, 2011

The crux of successful sleep therapies is ensuring compliance, but how providers help ensure that compliance is an ever-evolving set of responsibilitiesand capabilities to respond to patient compliance challenges.

This is totally understandable. While patients might be suffering from obstructive sleep apnea, they’ve learned to live with it. Now, instead of simply laying their heads on a pillow and trying to go to sleep (however futile that exercise might be), now they have to strap on a mask that is hooked up to a device that now occupies their night stand. If copping some “Z”s wasn’t hard enough, now they have a device trying to force air into their nose. That’s a tough transition to make.

But somehow those patients must comply with therapy, and providers are depended upon to help foster and ensure that compliance.

One of the main ways to do that is through the mask itself. The goal is to provide a mask that fits the patient’s head shape and facial features so well that they can truly ignore the mask and get some rest. But ensuring good mask fit is a multi-faceted undertaking. Beyond the general discomfort of the mask’s fit, small air leaks can lead to dry eyes, nasal passages and skin; the air leaks can make noise; and humidity and heat can build up.

And even if those issues are addressed, there are other factors as well, such as the severity of the patient’s condition, how strongly the patient experiences his or her symptoms, the patient’s other health habits, and the general mindset of the patient. Because of all these varying factors, ensuring therapy compliance goes well beyond just making a good mask fit.

And therein lies a key issue for providers and other caregivers responsible for the successful outcome of the patient’s therapy: How can they stay on top of patients when those patients are undergoing their treatment in the privacy oftheir bedrooms?

Fortunately, there is a solution. Many manufacturers of PAP devices offer various systems for monitoring the patient sleep data their devices generate in the course of a night. As the old saying goes, “what gets measured, gets managed,” and these devices offer a variety of ways for collecting that data and getting it to caregivers so that they can stay on top of how patients are doing. There are three main ways this is done:

• The device has wireless capabilities and can transmit the data in real-time or in a store-and-forward fashion to providers and physicians.
• The device is connected to a wireline modem that can transmit the data.
• Data is collected via a memory storage card that is picked up or sent to caregivers, who can download the data from the card.

From there, the data can be inspected to see where patients are doing well, where they are having trouble, and why. It could be the patient is regularly experiencing an event in their sleep that needs to be addressed through changing settings on their PAP device, or he or she might be taking off their mask or unsuccessfully readjusting it for a poor fit. No matter what the situation, the data collected and viewed through reporting tools conveys a clear picture of how the patient is performing in terms of compliance and how all parties involved in that patient’s care can help bolster or improve their compliance.

But being able to collect this patient data not only represents a major step forward in compliance, but also a business opportunity for sleep providers. Since they are providing the CPAPs, etc. to the patients they can use remote monitoring capabilities as a key business differentiator for their referral partners. The provider can tell its physicians and other caregivers that it can help ensure that their patients will experience better compliance and thusly better therapy outcomes. That’s a key selling point that is hard to ignore.

Many sleep equipment manufacturers offer remote monitoring functionality with their devices. Let’s take a look at a couple examples:

EncoreAnywhere, collects data via modem or smart card and offers a Web-based compliance monitoring and management system from Philips Respironics designed for its PAP devices. The system manages patient records, develops patient reports and tracks overall treatment progress of patients. It even provides physicians with the capability to change patient pressure settings, and prescription changes also can be automatically communicated back to the patient’s device.

A key feature of EncoreAnywhere is its reporting. Caregivers can access standard and create custom reports on patient therapy data, scores on Functional Outcomes of Sleep Questionnaires, along with any past problems reported by the patient to obtain a more complete picture of the patient’s treatment history and office interactions. This data can be used to schedule reminders to alert staff when it’s time to replace a mask, schedule a home visit or take whatever action you find most helpful.

Bearing that in mind, the therapy team can retrieve detailed information about patients’ devices, masks and accessories, as well as monitor the age of every mask in the field to help determine which patients might need a new mask. And to help support the entire continuum of care, the entire care team—including RTs, physicians and clinicians—has access to the same patient information and can communicate via notification messages.

ResTraxx from ResMed is a system that collects data wirelessly and delivers it to physicians and providers via a Web-based system. The wireless device collects data and then transmit it each day to the system, where care providers can logo on to get up-to-date patient information.

Patients can be checked at a glance via a Exception Summary Report that provides a simple summary of the last 10 days for actively monitored patients. The display is color coded to help quickly identify areas of compliance and instances where patients were experiencing trouble. Also, physicians can drill down for additional compliance and efficacy data when needed. View monthly trends in usage, efficacy and leak data.

Like the EncoreAnywhere, ResTraxx lets physicians change settings to finetune therapy and streamline patient management. Also, providers and physicians can access the same patient data and add notes for efficient communication with homecare providers.

This article originally appeared in the August 2011 issue of HME Business.