.

[lars4life]

.

[Otter]

Should I worry about what the Dr. might say? Do they
get upset when one self manages?

Some do. But why worry about it? Your doctor works for you. This your therapy, your sleep, your body, and your health we're talking about. If he doesn't like it, he can fire you as a patient, and you can find a doctor who has enough experience to realize that it's actually preferable if you manage your own therapy. If your doctor has an unrealistic sense of the dangers of CPAP, then he's not much of a sleep doc anyway.

[PtownKev]

I doubt the doc will give it more than a cursory glance, if he even sees it at all. The DME wants the card because they have to report the compliance data to the insurer in order to get paid. They will probably make sure that the numbers look like the treatment is reasonably effective but I doubt they'll give it much thought beyond that.

[DocWeezy]

Ditto what Otter said. I would run away from any doctor that did not want me to be involved in my own therapy and health care. If a doctor is so insecure or has such a fragile ego that he/she wants to keep patients passive and in the dark, then I don't want to go that doctor for a number of different reasons. My sleep doc was a bit surprised at first, but was happy I was so involved and has been very supportive. Those kind are out there!

Weezy

[Wulfman...]

My DME wants my SD card to download data for the Dr. The clinician setup was locked out, but I
found how to access it. I use Encore 2 Pro and with monitoring my data, I have made pressure
changes that are now on my SD card. Should I worry about what the Dr. might say? Do they
get upset when one self manages?

Dittos to what Otter said (which is essentially what I've been saying for years).
The only thing I would add is to NOT yield your card to the doctor (or DME or anyone else). It's YOUR card, too. You indicate that you have the software. Either print a hard copy to give to him or save a copy of the report to a .pdf file (using something like "CutePDF") and give/transmit it to him somehow. All too often, people have reported that they don't get their card back or it's been corrupted when they do get it back.


Den

[JDS74]

My DME wants my SD card to download data for the Dr. The clinician setup was locked out, but I
found how to access it. I use Encore 2 Pro and with monitoring my data, I have made pressure
changes that are now on my SD card. Should I worry about what the Dr. might say? Do they
get upset when one self manages?

It's simple to protect the SD card contents. Just hop over to the nearest store that sells them and get a 2 GB SD card. Then copy all the data from the original card to the new one. That way you'll be able to reload it if the DME erases 'your' card befre giving it back.

Since you are using a Respironics machine, that's all there is to it.

If you have any problems, PM to me and I'll walk you through it.

[lars4life]

.

[rested gal]

I doubt the doc will give it more than a cursory glance, if he even sees it at all. The DME wants the card because they have to report the compliance data to the insurer in order to get paid. They will probably make sure that the numbers look like the treatment is reasonably effective but I doubt they'll give it much thought beyond that.

I think you're absolutely right, Kev.

The one and only thing most of them would look at is the compliance. All they really want to know is... is the person using the machine enough hours to qualify for continued insurance reimbursement on the machine.

I doubt they'd look for, or even notice, anything else unless the machine had been ordered for a temporary autotitrating trial at home. But if it was intended to be the permanent treatment machine, I don't think most would notice, or care, about anything other than "hours of use." They're busy, in a hurry, and downloading the cards are just a necessary boring part of the job. I'd imagine it goes something like this:
"Let's see here...using it enough?"
"YES! Good, we'll keep getting paid on that one."
"Moving on...next one (wonder if I can get all these done before lunch)...."

It's equally boring to most of the doctors who receive a copy of the Summary report from the DME. It's just a formality to be glanced at (if that, since he'll take the DME's word for it that the patient is "using" the machine) and placed in the patient's file in case Medicare or insurance wants proof that the person is using the machine at least a minimum required amount of time.

[builta]

Hi,

First, I agree with everyone. All they want to see is that you are using the machine at least 4 hours per night and that the therapy is basically working for you (that way everybody gets paid--The FBI got one thing right, to find the crooks all you have to do is follow the money!)

Second, as far as a PRS1 xPAP and the request to give the "SD card" to the DME/DOC, I think that it is actually easier, and much less stressful, then what you've been told so far.

1. Copy the contents of your card to a folder on your computer's desk top - then you can just copy the contents back to the card or to another blank 2 GB SD card.-then you definitely have your data!
2. Stick a different or blank (formatted) 2GB SD card into your PRS1 xPAP machine and it will make a copy of your data onto the new card (yes it is that easy). Watch the display and you will see it warning you not to remove the card while it transfers the data (from the xPAP to the blank card). It does not transfer "Wave Form Data" but you do get all of your summary information (including the daily summaries) and you can review the detail pages.
3. The PRS1 units store up to a year's worth of data (minus the Wave Form Data) in the machine. If you insert a card into the machine, it will copy all the data back to the card again. You will not have all the individual daily files because they are compressed into a single summary file. This file contains all the previous daily and detail data. This is different then what happened with the previous "Smart Card" systems (Like the "Old tanks" and "M-series"). For the older units no detail data was ever stored on the machine--it was all sent to the smart card. Therefore, if the smart card was erased (by that darn DME/DOC) or you forgot to installed in the machine on any given night, the detail data was lost. So, with the PRS1 xPAPs this appears to have been corrected and ultimately I don't think that you loose the data.

Note: I've verified this for you by running a small experiment using two different cards (one with a month worth of data and one blank card) I plugged the blank SD card into the xPAP and the data was transferred to the blank card (process can take a minute or more). I then loaded both cards to Encore Pro, to different patient files, and all the data is there (minus the wave form files). I don't have Encore Viewer so, cannot say how the "dumbed down" software reads the compressed files. Maybe one of the other forum members can try the same thing with Encore Viewer?

Relax, you are in the company of friends! We all protect our data. The Philips Respironics System 1 xPAPs appear to have been set up to save the data.

Cheers!

[DennisG]

Note: I've verified this for you by running a small experiment using two different cards (one with a month worth of data and one blank card) I plugged the blank SD card into the xPAP and the data was transferred to the blank card (process can take a minute or more). I then loaded both cards to Encore Pro, to different patient files, and all the data is there (minus the wave form files). I don't have Encore Viewer so, cannot say how the "dumbed down" software reads the compressed files. Maybe one of the other forum members can try the same thing with Encore Viewer?

I tried the same experiment with a formatted blank card inserted into the machine and set up a test patient in Encore Pro. I found that it loaded the summary data from when I started using the machine in January but it only loads the detailed daily graph info from the last seven days and no wave-form data.

If you download your data regularly, it should stay in Encore Pro. I think it is still best to copy the card you use regularly in your machine (the Respironics card for most people I would guess) onto your computer before you go to see your DME or Sleep Doc.

My Sleep Doc did some strange things to my card last time I went in for an appointment. New directories and files were added by him when he changed my prescription on the machine. Another really strange thing he did was to turn off my ability to see my data on my machine's screen. I turned the data display back on. Maybe he did something else to my machine so that it does not keep as much data?!?

I did not tell him that I have the software and am reading my own data. I think he wants to keep me in the dark.

I now copy the data from my Respironics card to my computer and the onto my own SD card. I then use my card to transfer the data into Encore Pro.

It would be great to get a copy of the user manual for Encore Pro to better understand how it works.

Dennis

[builta]

Note: I've verified this for you by running a small experiment using two different cards (one with a month worth of data and one blank card) I plugged the blank SD card into the xPAP and the data was transferred to the blank card (process can take a minute or more). I then loaded both cards to Encore Pro, to different patient files, and all the data is there (minus the wave form files). I don't have Encore Viewer so, cannot say how the "dumbed down" software reads the compressed files. Maybe one of the other forum members can try the same thing with Encore Viewer?

I tried the same experiment with a formatted blank card inserted into the machine and set up a test patient in Encore Pro. I found that it loaded the summary data from when I started using the machine in January but it only loads the detailed daily graph info from the last seven days and no wave-form data.

If you download your data regularly, it should stay in Encore Pro. I think it is still best to copy the card you use regularly in your machine (the Respironics card for most people I would guess) onto your computer before you go to see your DME or Sleep Doc.

My Sleep Doc did some strange things to my card last time I went in for an appointment. New directories and files were added by him when he changed my prescription on the machine. Another really strange thing he did was to turn off my ability to see my data on my machine's screen. I turned the data display back on. Maybe he did something else to my machine so that it does not keep as much data?!?

I did not tell him that I have the software and am reading my own data. I think he wants to keep me in the dark.

I now copy the data from my Respironics card to my computer and the onto my own SD card. I then use my card to transfer the data into Encore Pro.

It would be great to get a copy of the user manual for Encore Pro to better understand how it works.

Dennis

Hi Dennis,

If you want to see the details from a different date range then the "last seven days" then all that you need to do is set up a custom date range of seven days that does not include the most recent seven days. This is done under the patient ”history tab” –the same place where you generate any patient detail report. For example if April 1-7 2011 are the most recent seven days then in "patient history" set up a different "custom" date range where the last seven days, of the custom range, are the days that you are interested in reviewing (e.g.: a custom date range of March 1st 2011 to March 31 2011). This would produce a detail report with March 25th through Match 31st, 2011, with daily detail information. All of that information is in that "compressed file" that I previously described. You just have to go and look for it. It isn’t any different with the compressed single file or the multiple single day files.

No matter how you store the data, you have to use something like the procedure I described to review the detail data that is differs from the most recent seven nights (which is more accurately described as the last seven distinct sleeping periods). If you sleep each night and take a nap in the middle of the day and you use your xPAP for both then the "last seven" days will include the night and nap periods of the "last" 3.5 days (the last seven distinct sleep periods).

With regards to your “My Doc did something,” your Doc changed your prescription on your data card. That is how your settings and access changed. The information is automatically updated when you insert the card into your machine (it’s a little sneaky if Doc doesn’t tell you up front.) It is a way to update the prescription without having to require you to actually bring the blower to you appointment. You have to admit that bringing the little SD card is more convent then bringing in the whole machine.

You have already figured out how to get round that.

Note that Doc (or the DME) can kind of "lock the machine down." This is done by turning off patient access to the data in the "providers menu" as part of the prescription that they wrote to your card. They can really lock it down by checking the check box for "Keep prescription on card" during the process of loading a new prescription to the card. This will keep you from having any access the “Provider’s Setup Menu.” If you try to access it you will get an error message and the machine will beep at you. To fix this you have to go in and write a new prescription to the card (with something changed like - un-checking that check box that prevents you from seeing AHI) and un-checking the “keep prescription on card” check box. Or you can edit the card directly and just remove the prescription file. Either way, you now have access to the “Provider’s Setup menu.”

Cheers

[Starlette]

DennisG - Had my doctor done that to me without my consent, I'd be looking for a new doctor.

Starlette

[builta]

DennisG - Had my doctor done that to me without my consent, I'd be looking for a new doctor.

Starlette

Hi Starlette,

You know the Dr. might have discussed changing some things with Dennis and then changed the card to reflect the changes. Dennis would know about that. The Dr., according to the AMA , is responsible for the therapy (you know that you need a Dr's prescription for all of this stuff). (Remember--"Follow the money trail to find the crooks!." )

Let's hope that the Doc was trying to do their job and not being sneaky. It is likely that an office assistant is the one who made the changes. Who knows how well they actually understand the Encore Pro Software and what the ramifications of checking a little box for "keep the prescription on the card after it is delivered to the machine" will be . It actually might "seem" like a good thing to do . In my opinion, the "sneakiness" is on the part of Respironics and how the software and machines respond to that check box.

Cheers

[archangle]

Either print a hard copy to give to him or save a copy of the report to a .pdf file (using something like "CutePDF") and give/transmit it to him somehow.

Just click on "save" instead of "print." It creates a PDF file without having to mess with CutePDF.

However, CutePDF is a must have tool for any Windoze PC user anyway.

[archangle]

If the doctor gets cute and locks you out, what happens if you simply take his card out and then try to access the clinician menu though the buttons? (On the PR System One REMstar BiPAP Pro with Bi-Flex.)

Then just put in a new SD card.