Resmed and Patient Health

[VA3AEQ]

In another thread, someone posted a link to Resmed's product list in .pdf

http://www.resmed.com/us/documents/product-list-usa.pdf

I read through the sections on xPAP machines starting around pg 28. The interesting thing that I noticed was that Resmed did not mention the Efficacy Data that any of their machines collect but rather focused on the Compliance Data.

Just an interesting insight into Resmed and how they function.

[tschultz]

I've found so far that in far too many cases compliance is the major concern. I am troubled by this without at least also taking effectiveness into consideration as well. One can comply with 4 hours of in-effective treatment but as a patient I want to know that I'm not just wasting my time wearing the mask and everything else. I do want to know the effectiveness of my treatment each and every night.

I had said to my RRT that if a CPAP machine only logged the hours used that I could simply wear it for 4 hours each night while using the computer and then sleep without it and no one would know the difference.
I asked how could this then be considered adequate compliance monitoring under any circumstances?

I do not think that the focus on compliance monitoring is limited to ResMed and that particular document is simply a full listing of their product offerings related to xPAP. If you look at the document(s) for a given machine, such as the S9 Autoset you will see much more detail and there is then not simply a focus on compliance only.

[Slinky]

REsmed has been THE leader in the ease of access to and amount of efficacy data available via the LCD screen. Only recently has Fisher & Paykel and DeVilbiss begun providing fully data capable CPAPs. And whilst Respironics (now Philips Respironics, PS) has been providing access to some efficacy data via their LCD screen, it has been quite limited data and not as easily accessible as the Resmed models.

No, the CPAP companies don't produce ONLY fully data capable CPAPs;, yes, they do provide compliance data only CPAPs. That is due to the local DME providers calling the shots and taking advantage of unsuspecting patients.

Whilst still in the vast minority, we patients in these apnea support forums screaming for data and access to their data are making a difference. The manufacturers are listening - not as well and as carefully as we would wish that they would but .... DeVilbiss and Fisher & Paykel recognize the trend and they are causing Resmed and PR to wake up and smell the roses and lose their complacency or lose their "edge" in the CPAP field.

[tschultz]

I really don't see any difference between xPAP being used to treat OSA and other related issues than I do insulin to treat diabetes. I don't think any diabetic would be happy with a glucose monitor that only recorded the number of times used or had a light to show good/bad. In the same manner a diabetic patient reads their glucose levels and makes adjustments to their insulin is how I think xPAP should be used to treat OSA. This requires full data logging and visibility to that data. I think it should be mandatory that all machines be data capable, then at any time that data can be used or ignored as a choice, but if and when needed it is there.

Sure there are going to be some that don't want to, or shouldn't, go through all the trouble and if things are OK for them then that's great. For me with severe OSA I do look an each and every night's data and have made changes based on this to further optimize my treatment.

I don't understand why the insurance companies, medical establishment, and government agencies don't stop, read the information that shows OSA has impacts on our overall health which they are so happy to quote when it suits their needs, and actually realize that in many cases with optimized treatment that efforts and costs related to many other health conditions could be further reduced. This then would be a win not only for the patient, but also the companies involved as well. But in this scenario pharmaceuticals and such may suffer and they too play a big role in pressuring the system.

[rested gal]

The interesting thing that I noticed was that Resmed did not mention the Efficacy Data that any of their machines collect but rather focused on the Compliance Data.

Yep.

That emphasis is true of all the CPAP manufacturers, I think.

The manufacturers' real customers are the DMEs... the home health care equipment stores. Not the end users (us.)

The DME's interest is in getting receiving payments each month from insurance companies/Medicare.

Insurance companies are interested only in "Is the machine being used enough to justify our continuing to pay for it?"

Hmmm. I left the doctor out, didn't I?

The doctor diagnoses OSA, prescribes a CPAP pressure -- probably most often simply signing off on both things per the sleep tech's findings -- in effect leaving even that up to the sleep tech. The doctor then usually leaves all the rest of the therapy stuff to the DME.

CPAP users who are interested in any details about what's going on while we're sleeping with a CPAP machine are a drop in the bucket compared to the vast majority of "patients" who couldn't care less about the details. I don't think that will ever change.

[Wulfman...]

In another thread, someone posted a link to Resmed's product list in .pdf

I read through the sections on xPAP machines starting around pg 28. The interesting thing that I noticed was that Resmed did not mention the Efficacy Data that any of their machines collect but rather focused on the Compliance Data.

Just an interesting insight into Resmed and how they function.

HUH??? The list of flow generators starts on page 24.

36005 S9 AutoSet™
Features include the new Enhanced AutoSet algorithm with central sleep apnea detection.
Superior APAP comfort with whisper quiet operation and dramatically reduced conducted
noise levels. Also includes EPR with Easy-Breathe technology; available in AutoSet mode as
well as CPAP mode. Includes usage-based compliance and efficacy downloads for accurate
patient monitoring and a standard data card for easy two-way data transfer. Optional accessories
support wired and wireless compliance data transfer and integrated pulse oximetry
monitoring.

36003 S9 Elite™
Features include new central sleep apnea detection, whisper quiet operation and dramatically
reduced conducted noise levels. Also includes EPR with Easy-Breathe technology;
Includes usage-based compliance and efficacy downloads for accurate patient monitoring
and a standard data card for easy two-way data transfer. Optional accessories support wired
and wireless compliance data transfer and integrated pulse oximetry monitoring.


It's true that they didn't emphasize the "efficacy" information on the previous generations of machines, so I imagine that they're trying to "push" the newer S9 series. The fact that they've dried up the S8 card reader and card supply seems to be further evidence of that.


Den

[mbkjad]

Bottom line.....money drives everything in just about all subjects. Insurance companies pay the monthly bills (and just like diabetes, the real money is in the supplies and not the up front sale of the cpap (i.e., meter). So the compliance data is the factory settings and the doc's can get there information with a little more work. I personally don't care as long as when I put that mask on the machine works and I get a good night's sleep.

Mike

[Janknitz]

CPAP users who are interested in any details about what's going on while we're sleeping with a CPAP machine are a drop in the bucket compared to the vast majority of "patients" who couldn't care less about the details.

And I would venture the vast majority of those patients who can't care less about the details have their machines gathering dust in a closet or the garage.

Seems like insurers would get smart and understand that EFFECTIVE treatment will save them money in the long run, but so far that bit of logic has escaped them.

[rested gal]

And I would venture the vast majority of those patients who can't care less about the details have their machines gathering dust in a closet or the garage.

I agree. I think that's mostly from mask issues. The mask is, imho, the most difficult thing to deal with in CPAP therapy, and the single reason most users drop out.

The people who care about finding out details about their own treatment and educating themselves about it are often ones who end up here on this forum. Their eyes are opened to a whole new world of machine efficacy data and mask comfort issues that they'd never find out from most DMEs or doctors. Heck, most of the DMEs and doctors themselves don't even know about those things.

Seems like insurers would get smart and understand that EFFECTIVE treatment will save them money in the long run, but so far that bit of logic has escaped them.

You're right, Jan. I don't think the long run matters to them at all. Or at least not anywhere near as much as keeping shareholders (and the CEO!) happy from one earnings announcement to the next.