New PR S1 Pro Auto IQ

Received this from a Philips Respironcis Rep after I read about its introduction at cpap.com and inquired about it:

First off, I would like to make it clear that our CPAP Pro with Auto IQ is NOT a low end Auto CPAP, It's #1) a better CPAP (in lab titrated pressure with Auto-Check) and #2) a product that fills the rapidly growing need of short term auto and switch to low end CPAP (Auto-Trial then Auto-Check).

If the Home Care Provider or physician want to use it for #2 above, they DON'T have to use all 30 days. Over 80% of all patients are on CPAP which means they get only ONE day titration in the lab and they're on CPAP for the rest of their life. With this product, 10 patients could use Auto-Trial for 3 days on one device.

If they want unlimited Auto on a bunch of patients, we've got a product for that need --- the RemStar Auto CPAP. Again, the Auto IQ product is for #1) a better CPAP (in lab titrated pressure with Auto-Check) and #2) a product that fills the rapidly growing need of short term auto and switch to low end CPAP (Auto-Trial then Auto-Check).

The Auto-Trial is only good for 30 days of use (regardless of the number of patients using the device). The Auto-Check is available forever and never goes away. Auto-Check allows the device to change CPAP level over a 30 hour period, while evaluating the patients flow pattern. The device will increase or decrease only 1cmH20 in that 30hour period and compare the patients flow to the previous 30hour evaluation. The pressure range will never exceed 3cmH2O above or below the determined “best pressure” from the Auto Trial period. For example if the best pressure from the Auto Trial period was 10cmH20, during the Auto-Check phase the device can go between 7-13cmH20.

If for some reason the physician/Homecare Provider NEEDs to have our breath-by-breath Auto Algorithm, that means they value the capabilities of the RemStar Auto and should use this device (even if that means paying more for it).

I hope this answers your questions as to the advantage of our the Auto IQ over a regular CPAP. And when it is beneficial to remain with our advanced breath-by-breath technology that has always been available in our RemStar Auto CPAP.

There is advantages to both Homecare Provider/physician and patient using our RemStar Auto CPAP, as well as advantages to using our CPAP Pro with Auto IQ, instead of the Regular CPAP Pro( without Auto IQ).

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I was glad to see the admittance that low-end CPAPs exist. What a nice term for the compliance data only leaf flowers!

However, this is the one thing that did strike me as a good feature w/the IQ:

The Auto-Check is available forever and never goes away. Auto-Check allows the device to change CPAP level over a 30 hour period, while evaluating the patients flow pattern. The device will increase or decrease only 1cmH20 in that 30hour period and compare the patients flow to the previous 30hour evaluation. The pressure range will never exceed 3cmH2O above or below the determined “best pressure” from the Auto Trial period. For example if the best pressure from the Auto Trial period was 10cmH20, during the Auto-Check phase the device can go between 7-13cmH20.

From the response "Over 80% of all patients are on CPAP which means they get only ONE day titration in the lab and they're on CPAP for the rest of their life." This is true and it is a potential concern. However, the statistic is warped by the vast majority of DMEs who will provide patients a CPAP and nothing else (typically a data incapable one at that!). If all patients were given an informed choice of machine (CPAP or Auto), I wonder if it would still be 80% who chose a CPAP. As well, given the business model of most DMEs I wonder if they would offer an Auto IQ to patients when there will be greater profits for them to continue providing data-dumb, straight-CPAP machines!

For the probable small difference in cost of manufacture, Philips-Respironics would do better to just increase the cost of their base machine, and make it a fully data capable auto, and include the Auto-IQ circuitry in it for those who want to use it!

Considering the price difference in APAP and CPAP, especially with machines like the Intellipap becoming available, I'm wondering if the industry isn't headed for a all-auto standard. I would guess that most people have a sleep study, get assigned a number, feel better and continue on their way. It's expensive to have sleep studies done over and over and so is the constant monitoring where you bring your machine into the office and get charged for a visit.

With medical costs rising and pressure on insurance companies to help control medical costs, APAP just might be a cost effective way to ensure that patients get the therapy they need. Patients could drop a smartcard in an envelope and mail it in for evaluation. The doctor can read it, charge a consultation fee, and the patient stays home. Titration range changes can already be made on the smartcard and they take affect when the patient puts it back in their machine.

Well, I'm extremely underwhelmed by the justification from Philips Respironics.

I thought he contradicted himself right off.

First off, I would like to make it clear that our CPAP Pro with Auto IQ is NOT a low end Auto CPAP, It's #1) a better CPAP (in lab titrated pressure with Auto-Check) and #2) a product that fills the rapidly growing need of short term auto and switch to low end CPAP (Auto-Trial then Auto-Check).

So it starts out in auto (but only for 30 days) then switches to what it's not - a "LOW-End CPAP".

The Auto-Trial is only good for 30 days of use (regardless of the number of patients using the device).

Do I have that right?

I am sure I will have NO use for this device.

Slinky wrote:Received this from a Philips Respironcis Rep after I read about its introduction at cpap.com and inquired about it:

First off, I would like to make it clear that our CPAP Pro with Auto IQ is NOT a low end Auto CPAP, It's #1) a better CPAP (in lab titrated pressure with Auto-Check) and #2) a product that fills the rapidly growing need of short term auto and switch to low end CPAP (Auto-Trial then Auto-Check).

If the Home Care Provider or physician want to use it for #2 above, they DON'T have to use all 30 days. Over 80% of all patients are on CPAP which means they get only ONE day titration in the lab and they're on CPAP for the rest of their life. With this product, 10 patients could use Auto-Trial for 3 days on one device.

If they want unlimited Auto on a bunch of patients, we've got a product for that need --- the RemStar Auto CPAP. Again, the Auto IQ product is for #1) a better CPAP (in lab titrated pressure with Auto-Check) and #2) a product that fills the rapidly growing need of short term auto and switch to low end CPAP (Auto-Trial then Auto-Check).

The Auto-Trial is only good for 30 days of use (regardless of the number of patients using the device). The Auto-Check is available forever and never goes away. Auto-Check allows the device to change CPAP level over a 30 hour period, while evaluating the patients flow pattern. The device will increase or decrease only 1cmH20 in that 30hour period and compare the patients flow to the previous 30hour evaluation. The pressure range will never exceed 3cmH2O above or below the determined “best pressure” from the Auto Trial period. For example if the best pressure from the Auto Trial period was 10cmH20, during the Auto-Check phase the device can go between 7-13cmH20.

If for some reason the physician/Homecare Provider NEEDs to have our breath-by-breath Auto Algorithm, that means they value the capabilities of the RemStar Auto and should use this device (even if that means paying more for it).

I hope this answers your questions as to the advantage of our the Auto IQ over a regular CPAP. And when it is beneficial to remain with our advanced breath-by-breath technology that has always been available in our RemStar Auto CPAP.

There is advantages to both Homecare Provider/physician and patient using our RemStar Auto CPAP, as well as advantages to using our CPAP Pro with Auto IQ, instead of the Regular CPAP Pro( without Auto IQ).

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I was glad to see the admittance that low-end CPAPs exist. What a nice term for the compliance data only leaf flowers!

However, this is the one thing that did strike me as a good feature w/the IQ:

The Auto-Check is available forever and never goes away. Auto-Check allows the device to change CPAP level over a 30 hour period, while evaluating the patients flow pattern. The device will increase or decrease only 1cmH20 in that 30hour period and compare the patients flow to the previous 30hour evaluation. The pressure range will never exceed 3cmH2O above or below the determined “best pressure” from the Auto Trial period. For example if the best pressure from the Auto Trial period was 10cmH20, during the Auto-Check phase the device can go between 7-13cmH20.

I thought he contradicted himself right off.

"First off, I would like to make it clear that our CPAP Pro with Auto IQ is NOT a low end Auto CPAP, It's #1) a better CPAP (in lab titrated pressure with Auto-Check) and #2) a product that fills the rapidly growing need of short term auto and switch to low end CPAP (Auto-Trial then Auto-Check)."

So it starts out in auto (but only for 30 days) then switches to what it's not - a "LOW-End CPAP".

I don't think they contradicted themselves, they're just splitting hairs. The Auto IQ is not a low end AUTO CPAP, it's a high-end straight CPAP. They are categorizing it not as an auto CPAP at all, but a straight CPAP that has special auto powers. I think it is their auto-adjust feature that they are pointing to that makes it a high-end CPAP.

cowlypso wrote: I think it is their auto-adjust feature that they are pointing to that makes it a high-end CPAP.

No where in the OP post did I see "high-end" written.

No, it's implied. As in, "this is not a low-end auto cpap" and "it's a better cpap".

And even if you want to argue that it's a low-end CPAP, they still haven't contradicted themselves... They said that it isn't a "low-end auto CPAP", not that it isn't a "low-end CPAP". Like I said, they're splitting hairs somewhere in there.

cowlypso wrote:No, it's implied. As in, "this is not a low-end auto cpap" and "it's a better cpap".

And even if you want to argue that it's a low-end CPAP, they still haven't contradicted themselves... They said that it isn't a "low-end auto CPAP", not that it isn't a "low-end CPAP". Like I said, they're splitting hairs somewhere in there.

Not here to argue, you are certainly entitled to your opinion but that also entitles me to mine.

He did say switch to low end CPAP did he not? But does he also imply it is an auto and that makes this device unique? I'm just pointing out what was said.

Maybe marketing is not their strong point but why would anyone defend it then?

So in summary it is a low-end cpap that does auto but it is NOT an auto cpap. Well not after 30 days anyway. So the advantage of this new, unique device is? That no one else makes one? Or that there is NO billing code for this yet?

The control and revenue portion of the Doctor and DME part of the spectrum would dictate that they keep you coming back for more. Education by the DME and the Doctor would be beneficial to the patient in using the machine and the software. OTOH, not all people are savvy enough to use the software or the extended menus of the machines. There would be a segment of the patient population who screwed things up and didn't realize that they weren't getting the correct therapy. I agree that this could be dangerous for the patient and create liability for the Doctor and DME.

Some type of monitoring system has to come about to settle the monitoring part without having the patient spend more money to come back to the office. A telephone line jack on every machine might be the key. Dial it up and read the numbers ...

The only reason I see an issue here is that national health care will eventually be the norm. Fees for medical care will have to drop to make this work. I can't see a HC plan paying for the care that some patients get under their private insurance. But then, maybe I'm wrong about that. It all will hinge on costs.

The rep doesn't know what he is talking about. The following is an excerpt from the machine description from our host (https://www.cpap.com):
Auto-Trial Phase

Auto-Trial Phase monitors and adjusts pressure on a breath by breath basis for up to 30 nights. The goal of the Auto-Trial Phase is to use breathing pattern data to identify the ideal pressure needed. At the end of the trial, the machine is automatically set to a pressure that the patient was at or below 90% of the time.

All 30 nights do not need to be used at one time. A minimum of 3 nights can be used to complete an Auto-Trial Phase. The remaining nights can be used at any time in the future.

Every time the Auto-Trial Phase is used, the machine will use the most recent Auto-Trial Phase data to set the ideal pressure.

Auto-Check Phase

Once the Auto-Trial Phase is complete, the AutoIQ mode transitions to Auto-Check Phase. Every 30 hours, the machine checks if a pressure adjustment is needed based on breathing events.

If a pressure adjustment is needed, the machine will automatically adjust by 1 cm/H2O up or down. Every 30 hours the machine will continue to track and adapt pressure as needed in 1 cm/H20 increments, staying within an upper and lower limit of 3 cm/H2O of the original set pressure. If a pressure change is not needed, the machine will stay at the current pressure.

Here is an example of how the Auto-Check Phase works:

If the ideal pressure after the Auto-Trial Phase was 10 cm/H2O and after 30 hours of use Auto-Check Phase data indicated the pressure needed to be raised, the machine would automatically change the pressure to 11 cm/H2O. If the pressure needed to be lowered, the machine would automatically change to 9 cm/H2O. If no pressure adjustment was needed, the pressure would stay at 10 cm/H2O. The Auto-Check Phase would continue every 30 hours to monitor and adjust the pressure as needed. However, the pressure would not be raised or lowered more than 3 cm/H2O of the original pressure. Using the original pressure of 10cm/H2O, the machine would not be lowered past 7 cm/H2O and would not be raised past 13 cm/H2O.

If the machine is placed back into Auto-Trial Phase mode to determine a new ideal pressure, the Auto-Check Phase would monitor and change pressure as needed every 30 hours, staying within 3 cm/H2O of the new ideal pressure.

The machine does not need to be set on Auto-Check Phase. It can be placed on straight CPAP mode, where no pressure checks or adjustments are made.


Notice in blue it indicates that he machine can be placed back into Auto Trial Phase mode to determine a new ideal pressure.

The rep should know his product line better.

Well, let me recant a bit. You may need to know the Clinician's control code to "reset" the machine back into Auto Test mode.

The rep may just assume that a pt would never be able to get into the mode to reset it.

PAJerry wrote:Well, let me recant a bit. You may need to know the Clinician's control code to "reset" the machine back into Auto Test mode.

The rep may just assume that a pt would never be able to get into the mode to reset it.

From what I've read, it sounds to me like you get 30 days worth of Autotrail mode and then it permanently disables autotrial mode. You can use it 3 days at a time, but once it's gone, it's gone.

The documentation makes it pretty clear that the clinician is the only one who can put it in "autotest" mode and select how many days to begin with. It makes no sense to tell the clinician is limited to 30 days if he can reset it in the clinician menu.

I can see the AutoCheck as being an inexpensive but valuable feature - but I sure do NOT see the advantage to the DME provider OR the patient(s) for a 30 day limit on the autotrial feature at all. Once those 30 days of autotrial are used up what does the DME provider do w/the device? He can't sell a used device as new .... How many patients take more than 30 days to get acclimated to and comfortable w/PAP therapy? Especially the mask, the RIGHT mask.

My apologies to all. From the PR S1 Pro with Auto IQ information page on the Philip's web site:

"Clinicians can opt to use all 30 Auto-Trial days up front or choose to use fewer trial days and save the balance for a later date if the patient’s condition changes. For example, if you choose to use only seven days of the Auto-Trial phase at the start of a patient’s treatment, you will still have 23 available days remaining should an important change in your patient’s condition occur, such as a significant weight loss or gain."

So it does appear that it is 30 days over the life of the device. What a dumb idea.