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[Equipment] Purpose of WiFi on Resmed S9 Autoset
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ImRichard Offline

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Post: #41
RE: Purpose of WiFi on Resmed S9 Autoset
robysue, in a word -

Bravo.

Thanks!
Richard
05-14-2014 08:46 PM
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SuperSleeper Offline

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Post: #42
RE: Purpose of WiFi on Resmed S9 Autoset
Holy cow, Robysue... excellent post, excellent questions... patient empowerment to the max, gotta love it.

Well-done

SuperSleeper
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

05-14-2014 09:07 PM
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PaulaO2 Offline
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Post: #43
RE: Purpose of WiFi on Resmed S9 Autoset
(05-13-2014 12:19 PM)jaycee Wrote:  I work for a DME and can't wait for the next generation machines that are all WiFi capable.

And what about users who do not have wifi at home? Or live in an area where cellular reception is pert near nil? I have wifi and I'm not paying for my DME to have free access to my secured network. And good luck getting cellular reception here. I can't.

Quote:Your DME does not get paid to instruct you on how to use your CPAP. They don't get paid to show you various masks. They don't get paid when they do a download. They don't get paid when you walk in with a mask/machine problems.

Those are all expenses that need to get paid for via equipment/supplies.

Yes, it's called overhead. It's common in a lot of businesses. The clerk at the post office doesn't get paid when she handed over my package but she does it anyway. My pharmacist doesn't get paid when he explains a new medication to me but he did it anyway.

Quote: There was a time when DME's were making money hand over fist. Those days are long gone.

Until so many of them got caught. No one was regulating them. Or not regulating them enough. Take The Scooter Store for example. "Hand over fist" is a good description of what they were doing. Big bucks from all sorts of insurance companies, primarily Medicare. But they got caught. Too many DMEs were overcharging and now it has caught up with them. I've been seeing a lot of them start to close in this area and I'm not surprised with the ones I see going down. It's the ones that pushed products and not service. You know, the ones who thought it easier to have wifi CPAPs since they didn't get paid to help the users anyway.

Quote:Having a wireless capable machine means that I can get your compliance data for insurance or DoT purposes without you having to come into the office. Without me having to schedule you to come into the office. I can pull you up on the computer, print out the report and fax it where it it needs to be fax'd. If you provider wants your pressure changed, I can do it via the wi-fi. You don't have to make an appt to come into the office.

And what of us who don't need to keep track of compliance data? Are DMEs to then just ignore us by giving us non-wifi Escapes and PRS1 SE or Plus?

Seems to me that it would make DMEs jobs easier if they handed everyone APAPs right from the start. Even if they were set to run as CPAP. The patient calls, says has problems. You, from the comfort of your chair, can then wifi in their data. You can let the doc know the AHI is high. The doc can okay an increase in pressure or, better yet, open the Auto function of the APAP and do a two week titration study. Done. Then you wifi that command to the user's machine and you've not had to move except to perhaps get up to go to the fax machine.

Quote:If you call me with a problem, I can pull up your information on the computer and use that data to help me figure out what your problem is (all without you having to make an appt or walk in and wait to see a therapist).

But without a data capable machine, the DME can't do that. Far too many of them hand out the Escapes because the profit is bigger. Because, as you say, they don't get paid to do more so why do more?

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
05-14-2014 11:02 PM
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jaycee Offline

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Post: #44
RE: Purpose of WiFi on Resmed S9 Autoset
"I ask because, quite frankly, your credibility with me, as a PAP user, depends strongly on your answer to that question."

I guess you confused me with a DME CEO that makes purchase decisons on what equipment is used.

I said I was an RT that sets people up on equipment. In a perfect world I would set everyone up on brand new S-9 Autosets with SD cards & wifi adapters (unless the patient objected). The reality is that in a competitive bid area, a company doing this would lose money. Maybe they can offset this with their profits in other areas of DME, maybe they can't. Either way, operating at a loss is not a good way to stay in business.

The future of CPAP is your machine/mask (ordered by your doctor) being shipped to you along with a DVD that explains how to use it. If you are lucky, the call center would be open all night but likely you will be leaving a message for the 1 RT handling thousands of CPAP patients.
05-16-2014 11:14 AM
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robysue Online
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Post: #45
RE: Purpose of WiFi on Resmed S9 Autoset
(05-16-2014 11:14 AM)jaycee Wrote:  The future of CPAP is your machine/mask (ordered by your doctor) being shipped to you along with a DVD that explains how to use it. If you are lucky, the call center would be open all night but likely you will be leaving a message for the 1 RT handling thousands of CPAP patients.
Gee. I can only imagine what this kind of treatment will do for compliance issues.

As it is, fewer than 50% of new PAPers make it to long term CPAP compliance. And of all the things that have been studied, only one of them seems to improve that rate: High quality patient education and support during the first 3 months of therapy with appropriate medical follow-up when needed because the PAP therapy is not working well during the first few weeks.

You know, the DMEs would fare better financially if they figured out a way to drastically increase CPAP compliance. Then, instead of having a constant stream of needy newbies coming in the door and half of those newbies returning the machine before the rental is up, the DME would have a large community of loyal customers who keep purchasing supplies (masks, hoses, filters, and extras like batteries, hose cozies, mask pads, hose hangers, etc) for many years to come and who need little or NO follow up after the initial three months of intensive support and education.

Heck a good DME would even be able to recruit some of those successful long term PAPers as volunteer CPAP "coaches" for helping with the patient education for the newbies. Imagine the good that a DME could accomplish by sponsoring a CPAP patient support group run by their long term successful PAP customers ....
05-16-2014 03:15 PM
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robysue Online
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Post: #46
RE: Purpose of WiFi on Resmed S9 Autoset
(05-16-2014 11:14 AM)jaycee Wrote:  "I ask because, quite frankly, your credibility with me, as a PAP user, depends strongly on your answer to that question."

I guess you confused me with a DME CEO that makes purchase decisons on what equipment is used.

I said I was an RT that sets people up on equipment. In a perfect world I would set everyone up on brand new S-9 Autosets with SD cards & wifi adapters (unless the patient objected).
As an RT you are in a position that an OSA patient (particularly a newly diagnosed OSA patient) is not: You can and SHOULD inform your bosses of why full efficacy data machines are important. In other words, if you really want to be an advocate for your patients, you would speak up---relentlessly if necessary---about why full efficacy data machines are important.

If I as a mere patient say to your boss that I want a full data machine, guess what? He blows me off and says that his trained staff (meaning you---the RTs) have never expressed that there's a problem with setting people up with S9 Escapes and System One SEs or Pluses.

But you are NOT willing to fight for all your patients since you go on to say
Quote:The reality is that in a competitive bid area, a company doing this would lose money. Maybe they can offset this with their profits in other areas of DME, maybe they can't. Either way, operating at a loss is not a good way to stay in business.
So it's fine in your opinion to set your new patients with bricks. Just so the business makes more profit.

I'm curious: What do you do when a patient whom you've set up with a CPAP brick calls you about a month into therapy and says, "Something's not working. I feel worse now than I did before I started this crazy therapy. My sleep is worse now than it was before I started using this damn machine and I'm ready to give up. Can you help me figure out what's wrong?? Can you check the data to see if this damn machine is even working???"

And, for your information, there ARE DMEs that do set up all their patients with full efficacy data machines. The small DME that specializes in PAP equipment that I use sets all their new patients up with the patient's choice of an S9 AutoSet or a System One Auto CPAP. And they're doing fine financially. And if a new PAPer has problems, they work with you in helping you trouble shoot the problems. And they look at the efficacy data before making suggestions about what to try to address a problem. And if they see the AHI is too high, they'll tell you that you really need to get in touch with your sleep doc.

My guess is that this DME "makes it up" by having a much higher than average number of new patients become fully compliant long term patients who return year after year for masks, hoses, filters, and (eventually) new PAP machines. And, of course, these long term happy PAPers need little or no additional assistance in "making" it work.
05-16-2014 03:26 PM
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robysue Online
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Post: #47
RE: Purpose of WiFi on Resmed S9 Autoset
jaycee,

Overall, the picture you paint of what you see as the future is frightening to me:
Quote:The future of CPAP is your machine/mask (ordered by your doctor) being shipped to you along with a DVD that explains how to use it. If you are lucky, the call center would be open all night but likely you will be leaving a message for the 1 RT handling thousands of CPAP patients.

If you are correct, its clear that we're going backwards and not forwards in terms of making it possible for an OSA sufferer be an active, knowledgeable partner in their own healthcare and CPAP therapy.

You see a future where it is considered PERFECTLY ACCEPTABLE that I, the patient who is using CPAP equipment night after night in the privacy of my own bedroom, can be kept totally in the dark when it comes to some very important decisions concerning my medical care.

In particular: In this future I, the OSA patient,:
  • have no right to be involved in making the choice of the brand or model PAP equipment that I will use night after night in my own bedroom;
  • am not allowed the privilege of trying on a mask to see if it fits my face if my doc orders the mask I am to use from a centralized warehouse;
  • have no right to a hard copy of my own prescription and no right to determine what that script actually reads once I get the machine. (I can beg the doc for a copy I suppose);
  • have no right to see data that is collected about my sleep habits in my bedroom in my house night after night, and have no right to know who has access to that data without my specific permission;
  • have no right to know whether there is any efficacy data being collected to verify that my therapy is actually working as intended;
  • have no right to see any of the efficacy data that is gathered by my machine (if it gathers efficacy data at all);
  • do not need to be informed if the doc decides to fax instructions to have my machine's settings changed without my knowledge;
  • do not need to be informed that my machine's settings have been changed without my knowledge or permission; and
  • have no way to directly verify that my machine has been set according to the actual script I was given.

The scenario you paint not only leaves me--the patient--with no choice about my equipment, but it also leaves me--the patient--with no knowledge of my settings and with no knowledge of the data being recorded by my equipment in my own bedroom night after night. And that is just plain WRONG.

To draw an analogy: If diabetics were treated the way you seem to think that OSA patients can (should?) be treated, then type II diabetics would not be told the dose of each of the medications prescribed for their condition. (Heck they might not even be told what the name of the prescribed meds are.) And the daily results of their blood glucose monitoring would be sent directly to the doc or pharmacy via the "cloud", but the glucose monitor would not tell the diabetic a damn thing about their blood sugar level; all the glucose monitor would tell the diabetic is that they've been "compliant" in taking samples of their blood 3 times a day for the last 7 days in a row.
05-16-2014 03:41 PM
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Bama Rambler Offline

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Post: #48
RE: Purpose of WiFi on Resmed S9 Autoset
RobySue is on a roll! Banana You go girl!

Just to bring home some of Roby's points. I will add that my DME has taken good care of me and the DW. Given us full efficacy data machines and let us try as many masks as it takes to find the right one.

Whenever I call, the RT either answers the phone immediately, or calls back very soon. So whenever we need a new item, I always call them and get a price, and if they're within reason of the online prices I am more than happy to give them my business, and will for years to come.

While they may not have made as much money up front as they would have if they'd given me a brick. They will wind up making much more in the long run by treating me right. Also, if they had tried to give me a brick they would have lost my business and would have never gotten a chance at providing the DW anything.

And to add. If we ever need any other type DME equipment, they will be the first place I contact. That's how you make a business successful.
05-16-2014 03:44 PM
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