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Replacement options - new machine soon
#11
RE: Replacement options - new machine soon
A few more comparison points:

Warranty: Both 2 years.

Bluetooth transceiver: Dreamstation yes; A10 no.

Cellular transceiver: Dreamstation optional (removable module); A10 yes (built-in, not removable but can be disconnected after opening the case [thereby voiding the warranty] or can be temporarily disabled softwarily by using "Airplane Mode", which is not a long-term fix).

Disguises itself as a clock radio: Dreamstation yes; A10 no.

Those are just minor things, of course. The most important point is how the algorithms in the firmware compare ... response to breathing events, APAP subtleties, EPR vs. Flex, etc.
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#12
RE: Replacement options - new machine soon
(12-07-2018, 07:59 AM)Fats Drywaller Wrote: A few more comparison points:


Cellular transceiver:  Dreamstation optional (removable module); A10 yes (built-in, not removable but can be disconnected after opening the case [thereby voiding the warranty] or can be temporarily disabled softwarily by using "Airplane Mode", which is not a long-term fix).

Can you expand on this? I am leaning towards the A10 as the form factor seems a little better but the Cellular transceiver bothers me. I hate the idea of this for privacy reasons and wonder about how this works when traveling out of the country?
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#13
RE: Replacement options - new machine soon
Well, it's just that some <sarcasm>clever</sarcasm> person at Resmed thought it would be a great idea to take the S9's optional external plug-in cellular modem, shrink it, and make it a non-optional internal component of the Air10 series. Sad So if you want to switch it off, you have to open the machine (instructions are here and photos here thanks to Sleep87) and disconnect it (there's a tiny plug-and-socket arrangement on the circuit board, rather delicate, "no user-serviceable components inside" as they say), which of course voids the warranty. Sad Sad The software alternative, using the machine's "Airplane Mode", is not a complete solution because as soon as that is switched off, the machine calls the nearest cell site and spills its guts as usual. A workaround is to do "Erase all data" from the clinician's menus before switching Airplane Mode off. So in any case you need to continually mess with all that stuff, switching Airplane Mode on & off and erasing data, as long as you use the machine. Or else you have to keep it in a Faraday cage, which is sort of impractical for most folks.

That happens even outside the USA. There isn't a phone number that is called; the cellular transceiver makes a connection with whatever cell site it can reach and identifies itself by its IMSI, and the packets that it transmits are forwarded to a server at Resmed, where the data are made available in that company's database for the use of DMEs, patients using Myair, and whatever or whomever else (including marketeers, of course). The machine is identified by its Resmed serial number, and when a DME is involved, the DME establishes the association in the database between the machine's serial number and the patient's name and/or chart number. That last part might be private to the DME and not known by Resmed; I don't know. However, Resmed does want your e-mail address and wants to associate that with the machine's serial number, so it can spam you.

Because of that, IMO anyone who is seriously opposed to that unapproved use of the cellular modem by the machine and who, for whatever reason, can't do that surgery to disable it should not get an Air10, I'm sorry to say, even though it's the best machine around in other ways. The S9 series is a good alternative.

The percentage of Resmed users who care about this stuff seems to be very small. If you don't get the machine from a DME and you don't have insurance compliance requirements, so that your transmitted data will never be retrieved by anyone, and if you don't object to having a cellular transceiver next to your bed for any other reason, then you can ignore the thing and just live with it.
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#14
RE: Replacement options - new machine soon
There's more about the privacy implications in this thread, featuring a link to an interesting news article at the Pro Publica web site.
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#15
RE: Replacement options - new machine soon
I forgot to say that if you do get the machine from a DME and you do have insurance compliance requirements, then the DME will want to get the summary data via the modem and will object strenuously to your disabling the modem. The workaround there, as was mentioned in that Pro Publica article, is to use a different model of machine without a modem and to deliver the compliance data periodically on an SD card instead.
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#16
RE: Replacement options - new machine soon
Thanks for the link. The privacy concerns are enough to drive me to the Dreamstation even though the I actually prefer the Resmed machine.
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#17
RE: Replacement options - new machine soon
Here's a video that compares the Respironics algorithm vs. ResMed in a simulated environment.

Be aware that the comparison is on an S9 and RemStar, neither the latest machines. I believe the ResMed AS 10 still uses the same or similar algorithm. I'm unsure about the RemStar.
https://www.youtube.com/watch?v=Cdmqn9JIuzc
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#18
RE: Replacement options - new machine soon
(12-10-2018, 05:00 PM)sansnap Wrote: Thanks for the link.  The privacy concerns are enough to drive me to the Dreamstation even though the I actually prefer the Resmed machine.

You are buying a machine for your health and comfort for quite a few years.  I have never seen anything that suggests these "privacy" concerns amount to anything at all.  You can opt out of MyAir with Resmed, or Dreammapper with Philips, but you can't change the therapy either machine produces.  You can physically disable communications if those concerns are overwhelming.  I challenge you to find one single instance where that data has been abused, or used in any way that the end user is identified.

I'll get off my soapbox and put my tin-foil hat back on now.
Sleeprider
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#19
A right to privacy? Not much. (RE: Replacement options - new machine soon)
(12-10-2018, 06:40 PM)Sleeprider Wrote: You are buying a machine for your health and comfort for quite a few years. I have never seen anything that suggests these "privacy" concerns amount to anything at all. You can opt out of MyAir with Resmed, or Dreammapper with Philips, but you can't change the therapy either machine produces. You can physically disable communications if those concerns are overwhelming. I challenge you to find one single instance where that data has been abused, or used in any way that the end user is identified.

As the most outspoken critic here of Resmed's practices, I'm slightly annoyed at myself for making a big deal of it and very annoyed in general that it's necessary to make a big deal of it and to be a loudmouth. The more patients who ignore this stuff and assume that Big Brother knows best and would never harm us, the easier it is for the corporations to continue to stomp all over our few remaining privacy rights.

You make some good points, except that I don't know what you mean by "physically disable communications" with an Air10 machine other than voiding the warranty by doing surgery on the thing.

Also, when you say "in any way that the end user is identified", if you mean identified in public, I believe you're right that there's nothing to worry about practically, so far. But Resmed and Philips do use the data for their own purposes, and they can decide at any time what those purposes are without consulting the patients (who, after all, are not their customers), and at the very least they associate each machine's ID with a patient's e-mail address in their databases whenever possible. If you think that accidental or malicious public disclosure of corporate databases of customers/victims is a rare or unlikely occurrence, then you haven't been following the news about that over the last decade or two. (BTW, a useful first point of contact is Bruce Schneier's blog, "Schneier on Security", which has early reports of those occurrences and expert opinions on each one.)

The main thing is that it should be up to each patient to decide beforehand, preferably before he or she is given a machine, whether he or she wants to use the cellular data link. The problem with the Air10 series is that Resmed hasn't provided that option, so the DMEs are pretty much forced by the circumstances to go along with Resmed's program. With the S9 series and the PR Dreamstations, the modem module is optional and that is exactly as it should be.

I doubt that either side in this debate is ever going to persuade the other side of anything. It's not about tinfoil hats or black helicopters (or black hats or tinfoil helicopters either). It's all about the megacorporations doing whatever they want for whatever reasons they want, unchecked and unmonitored and unregulated. As a random consumerdroid I can't do anything about that, so I take the simple step of nuking the modem in my machine and then I stop being concerned about it on my own behalf. I'm glad to say that I don't lose any sleep over it. (Har!) However, what about the patients/victims who have no idea what the situation is to begin with? That's what the Pro Publica article was about, and those are the real victims of the corporate arrogance and the entire corporate attitude of "We know what is best for you, and you don't, so just shut up and play our game."

Edited to add: All that Resmed had to do was to provide an on/off switch for the modem module! "But nooooooooooo ..."
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#20
RE: A right to privacy? Not much. (RE: Replacement options - new machine soon)
(12-10-2018, 07:15 PM)Fats Drywaller Wrote: As the most outspoken critic here of Resmed's practices, I'm slightly annoyed at myself for making a big deal of it and very annoyed in general that it's necessary to make a big deal of it and to be a loudmouth.  The more patients who ignore this stuff and assume that Big Brother knows best and would never harm us, the easier it is for the corporations to continue to stomp all over our few remaining privacy rights.

I fundamentally agree with this and am in the IT biz.  Where data is stored on a server it is vulnerable to breach.  Just because it hasn't happened yet doesn't mean it won't in the future. 

Googles (Verily) recent partnership with resmed will raise flags for hackers and it's clear that the data analysis they intend to undertake will involve looking at patient data.. That data can be leveraged for all sorts of purposes and I won't willingly offer mine up.   All sorts of consumer items have been subject to hacks.  Smart thermostats, refrigerators, automobile nav systems, cameras the list is long.  I don't think it's reasonable to share my personal medical info with anyone other than my doctor nor do I desire to delegate decisions about what is prudent security to others.

Those who suggest that stripping out personal info should be sufficient are being short sighted imo.  IP and location info are enough to determine who a patient might be and as each modem is uniquely trackable to a specific machine, the data payload is large.
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