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[Equipment] Purpose of WiFi on Resmed S9 Autoset
#31
RE: Purpose of WiFi on Resmed S9 Autoset
(04-30-2014, 08:06 AM)lafsa Wrote: thank you robysue for the visual... thank god i don't have one of those... i would have a major issue with it..
my new machine came with a data card and a mailer... the dme said that my insurance may request the card.

imrichard thank you for this thread...

Thank you for taking the time to respond.

Best,
Richard








Thanks!
Richard


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#32
RE: Purpose of WiFi on Resmed S9 Autoset
So looking at all these responses, I'm confused on several fronts.

1.) Why would anyone care when or whether their doctor, DME or insurance company had the data? Bottom line, they're going to get it and as a general rule, it's a helpful matter. Why would you want a healthcare provider to have less information? If I had such little trust in my doctor, I'd be finding a new one.

2.) This data is already sitting on an unencrypted card that people are mailing, handing over to random techs at a DME company, and then getting submitted in a million forms. Why the pretense that any of it is relatively private when it's being transmitted in such an insecure manner to begin with?

3.) Why the belief the doctor wouldn't hand you your data if you wanted it? I've never had a doctor refuse me my data. And I've never had a doctor charge me any large fee for copies of my data I did not already have. This is not to mention in the current state of things, my data goes directly from the office to my cloud account. I have every single lab result and number waiting for me any moment I want it. Problems with access don't exist the way they used to, unless your doctor isn't involved in modern practices.

4.) If there's a software dev problem, hijacking WiFi or cellular data is a pretty easy matter, so there's no huge hurdle, even if they did take away the SD option.

5.) Why in the Hell would they take away the SD option in the first place? This is a medical device, what would they do in a no service area? Or with someone who had no WiFi? In the US, Internet and Broadband coverage lags so far behind the rest of the world it's not even feasible to remove hard access on a device you're handing out to patients who quite easily might not have access for a number of reasons. There will be an internal storage solution of some sort regardless. Maybe you end up with a USB adapter, but either way, on-site storage isn't going to disappear. But also see, above. If your doctor won't readily give you your data, find a different one. Healthcare is a competitive market and you speak with your words first, your requests second and your dollars and patronage last.

So those are my thoughts on the matter, and I'm interested to see some response as I just don't get the objections.
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#33
RE: Purpose of WiFi on Resmed S9 Autoset
Again the UK there are areas that dont have a good broadband connect so you would still need the sd card.

I am one of these people that love data and i download my data on a daily basis so that I can save the wave pattern everyday as you cant download the whole weeks wave pattern report so this is why i am do this. I use encore and sleepy head software to look at the data. Dont sure if I would want my data in a secure data cloud as it could be hacked. It could be used against you if you are trying to say that one of the problems you arent sleeping well.

Currently my Data looks like I'm having a great night but in reality I'm not sleeping as well as they think. My numbers are good but I am still totally knackered even if I havent done anything that day.
Dee
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#34
RE: Purpose of WiFi on Resmed S9 Autoset
(05-11-2014, 04:16 AM)CKJ411 Wrote: So looking at all these responses, I'm confused on several fronts.

1.) Why would anyone care when or whether their doctor, DME or insurance company had the data? Bottom line, they're going to get it and as a general rule, it's a helpful matter. Why would you want a healthcare provider to have less information? If I had such little trust in my doctor, I'd be finding a new one.

"Mr. Smith, we're denying your insurance claim because you didn't use your CPAP for the required amount of time 3 months ago."

"Mr. Smith, we're cancelling your driver's licence because you aren't using your CPAP enough."

"Mr. Smith, we're going to introduce your CPAP records as evidence in the trial about your auto accident."

(05-11-2014, 04:16 AM)CKJ411 Wrote: 2.) This data is already sitting on an unencrypted card that people are mailing, handing over to random techs at a DME company, and then getting submitted in a million forms. Why the pretense that any of it is relatively private when it's being transmitted in such an insecure manner to begin with?

One person's CPAP data on one SD card, or on the computers at one DME is one thing. Data on thousands of people, conveniently gathered in one place, "in the cloud," where you can potentially steal it remotely, is a more attractive target.

"Mr. Smith, please pay the attached bill for CPAP analysis services to Nigerian prince respiratory service."
"Hey, Jimmy, watch me change the settings on all these old geezers' CPAP machines. "
"OK, we have his sleep schedule, now we know the best time to break into his house. "
"Mr. Smith, send me $2000, or I'll send your records to the DMV, pretending to be your doctor and they'll probably take your driver's license away."

(05-11-2014, 04:16 AM)CKJ411 Wrote: 3.) Why the belief the doctor wouldn't hand you your data if you wanted it? I've never had a doctor refuse me my data. And I've never had a doctor charge me any large fee for copies of my data I did not already have. This is not to mention in the current state of things, my data goes directly from the office to my cloud account. I have every single lab result and number waiting for me any moment I want it. Problems with access don't exist the way they used to, unless your doctor isn't involved in modern practices.

Many people have had problems getting their data, or getting charged for it.

Many doctors offices are in the stone age in terms of data access and CPAP treatment.

(05-11-2014, 04:16 AM)CKJ411 Wrote: 4.) If there's a software dev problem, hijacking WiFi or cellular data is a pretty easy matter, so there's no huge hurdle, even if they did take away the SD option.

You're simply wrong here. Not everyone has the skilz.

(05-11-2014, 04:16 AM)CKJ411 Wrote: 5.) Why in the Hell would they take away the SD option in the first place? This is a medical device, what would they do in a no service area? Or with someone who had no WiFi? In the US, Internet and Broadband coverage lags so far behind the rest of the world it's not even feasible to remove hard access on a device you're handing out to patients who quite easily might not have access for a number of reasons. There will be an internal storage solution of some sort regardless. Maybe you end up with a USB adapter, but either way, on-site storage isn't going to disappear. But also see, above. If your doctor won't readily give you your data, find a different one. Healthcare is a competitive market and you speak with your words first, your requests second and your dollars and patronage last.

A wireless only data collection scheme gives them another item they can charge for. It gives them another way to keep their hooks in you.

The medical mafia hates empowered patients. They don't want patients or other people intruding on their highly profitable turf.

It's like how most prescriptions now have 1 year or shorter limits. "Let's bring him in for an unnecessary but highly profitable office visit or cut off his drug supply. We won't actually do any useful tests, or even actually think about it, but it's an easy ring on the cash register."

Get the free OSCAR CPAP software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#35
RE: Purpose of WiFi on Resmed S9 Autoset
A great post/response. Thank you!







Thanks!
Richard


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#36
RE: Purpose of WiFi on Resmed S9 Autoset
I work for a DME and can't wait for the next generation machines that are all WiFi capable.

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

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.

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).

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#37
RE: Purpose of WiFi on Resmed S9 Autoset
It is so comforting to think of a day when a highly skilled DME techie can take charge of my machine, yea even my life, anytime they choose. No longer shall I need to be concerned about my own health. There will be a technician somewhere twisting dials to make my life complete. Just think: "retired_guy's heart is a little slow this morning, let's crank it up a bit."

What a comfort that day will be.

I do empathize with DME's not getting paid for the services they are expected to provide. It will indeed be a lovely day when you can be paid without having to provide those services.
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#38
RE: Purpose of WiFi on Resmed S9 Autoset
Jaycee,

You may not be one of these but my first DME's RTs did not respond to any of the problems that I had during the first year of my CPAP use. None of the RTs were ever available when I called-ever-not once. I left messages but very seldom got any call back and on the very few occasions that I did the call would come in when I was in a meeting. I would call back and the whole process would start over again.

When I got my first full face mask, the RT that fitted it for me put it on, hooked me up, and started my CPAP. It was leaking so bad that it was playing several tunes simultaneously. She said, "its not leaking is it?". Being stupid, I figured that I could get adjusted at home and get the leaks fixed. I fought with that mask for months and never did get it to quit leaking. So you why some of us may harbor negative feelings toward DMEs in general.

This is said with my apologies to the good DMEs out there and there are some.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#39
RE: Purpose of WiFi on Resmed S9 Autoset
(05-11-2014, 04:16 AM)CKJ411 Wrote: 1.) Why would anyone care when or whether their doctor, DME or insurance company had the data? Bottom line, they're going to get it and as a general rule, it's a helpful matter. Why would you want a healthcare provider to have less information? If I had such little trust in my doctor, I'd be finding a new one.
I want to know what data my doctor has on me. I do not want them gathering data that I know nothing about. Worst case scenarios were posted by archangle earlier in the thread.

Quote:2.) This data is already sitting on an unencrypted card that people are mailing, handing over to random techs at a DME company, and then getting submitted in a million forms. Why the pretense that any of it is relatively private when it's being transmitted in such an insecure manner to begin with?
My own biggest fear is that the unencrypted SD card will disappear and I will have no access to my own data. Unless I'm willing to try to hack into the DME's computers, the doc's computers, or the manufacturer's cloud hosting computers, all of which is a crime since I am NOT an authorized user of those systems.

And, again, archangle wrote an excellent post about the worst case scenario if the cloud site is hacked by people intent on causing mischief (at best) or out right harm (at worst).

Quote:3.) Why the belief the doctor wouldn't hand you your data if you wanted it? I've never had a doctor refuse me my data. And I've never had a doctor charge me any large fee for copies of my data I did not already have. This is not to mention in the current state of things, my data goes directly from the office to my cloud account. I have every single lab result and number waiting for me any moment I want it. Problems with access don't exist the way they used to, unless your doctor isn't involved in modern practices.
I have had doctors (including my first sleep doc) refuse to give me any copies of the results of medical tests. I have also had to go through the trouble of filing HIPAA requests for medical records and paying a buck or more a page just to gain access to data that was gathered from my body.

And here again---if my doc is enlighted and has a patient portal site with unrestricted patient access to their own medical records, it's great. I have some docs like that. But I also have some docs where the information available on the patient portal is significantly less than complete. On one site, I can see results of things like blood tests, but not the results of sleep tests or DNA tests that have been run at the request of the docs in the practice.

Quote:4.) If there's a software dev problem, hijacking WiFi or cellular data is a pretty easy matter, so there's no huge hurdle, even if they did take away the SD option.
Says you. But I sure don't have the skills to hack into WiFi or cellular data.

And if the breach is detected by the owner of the WiFi or the cellular network, it's going to be investigated and the hole(s) will continually be patched. Especially if the data is regarded as confidential.

Quote:5.) Why in the Hell would they take away the SD option in the first place?
Because they can. That's my fear.

Quote:This is a medical device, what would they do in a no service area? Or with someone who had no WiFi? In the US, Internet and Broadband coverage lags so far behind the rest of the world it's not even feasible to remove hard access on a device you're handing out to patients who quite easily might not have access for a number of reasons.
I can see a day when the SD card module becomes the "extra" non-standard piece of equipment that is only given to patients living in remote areas where the machine's built-in modem cannot reach a wireless network of some sort.

Quote:There will be an internal storage solution of some sort regardless. Maybe you end up with a USB adapter, but either way, on-site storage isn't going to disappear.
The S9 does NOT store any of the interesting data on board; everything except for the summary data is stored on the SD card, which is overwritten every 7 days (for wave flow) and every 30 days (for the rest of the data) because Resmed in its infinite wisdom has decided that nobody could possibly be interested in data that is any older than that. It won't surprise me at all if they decide that the data available from the cloud doesn't need to be any older than that---except for summary data and usage data. And since most docs have no interest in even looking at the wave flow data, why bother to record it at all? Docs weren't exactly screaming about the lack of wave flow data on the old S8s after all.

And a USB adapter presumes that the default machine for the masses has some kind of a USB port.

Quote:But also see, above. If your doctor won't readily give you your data, find a different one. Healthcare is a competitive market and you speak with your words first, your requests second and your dollars and patronage last.
My point is that I do NOT want to have to keep bugging my doc on a daily basis just to see my nightly data. It would be like expecting diabetics to do their blood testing on machines that reported the blood glucose levels directly to the doc's office via the cloud, but failed to let the diabetic see the number at the time they did the blood test.

Why should I have to contact my doc just to see how many events I had, what kind they were, when they occurred when I get up in the morning?

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#40
RE: Purpose of WiFi on Resmed S9 Autoset
(05-13-2014, 12:19 PM)jaycee Wrote: I work for a DME
I have to ask: What's the default CPAP machine that you set your new patients up with when the script says nothing except "CPAP at 9 cm"?

I ask because, quite frankly, your credibility with me, as a PAP user, depends strongly on your answer to that question.

Do you routinely your new patients up with the more expensive Resmed S9 Elite or AutoSet or the PR System One Pro or Auto, all of which record full efficacy data?

Or do you routinely set your new PAPers with a Resmed S9 Escape or a PR System One SE or a System one Plus, none of which record anything except usage data?

Or does the machine sold to a particular new patient strongly depend on how knowledgeable and stubborn the patient is about getting a machine that records full efficacy data?


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.
Pardon me for saying it, but I really don't give a damn about the compliance data. I know how long I use the machine each night and I don't need you telling me that I'm doing a Good Job because my usage is roughly 6.5 hours every single night.

Yes, I can understand why its easier for you to process the paper work to convince my insurance company to pay you for my equipment if you don't need to make me come in or mail my card in. But on the other hand, that also means that I get even less meaningful face to face (or telephone) contact with an important part of the "health care team" that is supposed to help me make this crazy therapy work when I'm running into some bizarre problems during my first few days or weeks of PAPing.

Quote: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.
Pardon my saying it: But I do NOT want you making any changes to my pressure behind my back. Seriously. That's one of my BIGGEST worries about this whole wireless data transmission stuff:

You and the sleep doc can communicate about my data without ever asking me a single question about how things are going each night in MY bedroom when I am trying to use this crazy machine. And then you can make a change to my machine and never tell me about it. And that's just plain WRONG.

I want to be a central participant in any discussion about whether my pressure setting should be changed. I don't want my sleep doc looking at my data (without me being there), deciding my pressure needs to be change (without informing me or asking me any questions about how things are going), and faxing or emailing a request to you to change the pressure on my machine without telling me about it. And I also don't want you sending my machine the instructions through the cloud, but NOT bothering to call me or email me about the fact that it has been done.

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).
In my humble experience, phone conversations to discuss problems even when both parties have the same data sitting in front of them usually are much less effective at actually solving the problem than a decent face-to-face meeting. And if only ONE of the parties on the phone can see the data? It's not going to be a very effective conversation.

Besides---what data are you going to pull up on your data screen when I call you? If your company sold me a machine that records nothing but usage data (as MOST DMEs do), you're not going to be able to tell me anything I don't already know.

And if you do have real efficacy data, I won't be able to see it because I don't have it on my computer because I have no way to download it because there is no SD card in my machine. So I'm flying blind: I have no idea what you're talking about. I can't see the data. And I can't ask you any intelligent questions about your particular interpretation about the data.

And for me, that kind of a conversation will NOT be satisfactory: For every change you (or my doc) insists that I should make in my therapy, I want to SEE the data that justifies the change. I'm aware that most patients are not like this, but I am not "most patients". I am ME and I want my need to fully understand what's going on to NOT be treated as "silly" or "stupid" or "difficult" or "unwarranted." (And through the years, I have been made to feel that way on numerous occasions both by DMEs and sleep docs and their minions.)

As a specific example: If I meet with you (face to face) about problems I'm having with aerophagia and you tell me I need to use a chin strap because I have leaks that are too large, I want you to show me the leak line and point out exactly where the large leaks are occurring. Because if you can't do that, then leaks are probably NOT my problem (if efficacy data exists) and there's no point ADDING something that's going to increase my discomfort when it's not likely to solve a problem that does not exist.

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