I have a couple questions for you guys that track data

[Mike@TibroMedical]

I've noticed that there are ALLOT of you guys that have there own card readers and the encorepro or resscan programs, my question is, do you guys keep track of this stuff for any certain reason? like personally? I have thousands and thousands of pt's with company's i work for and not one of them has there own reader's. cause we do all that for them when the Dr or ins need it for compliance.... also I've read ALLOT of you guys are having issue's with the encore pro working well, and I was wondering how many have heard of encoreanywhere which is a card less system for the M series machines now. instead of a card slot it's a modem that is wired into your home phone and automatically uploads every morning to the web based queue they set up, for DME providers. found at encoreanywhere.com that way we get daily updates on issue's s we can tackle any compliance problems right off hand and the pt don't have to do anything... which brings me to my next question, the more I read the more i see where DME companys basically toss the machine at you and thats it. doesn't seem to be ALLOT of good customer service or anything from what I've read, which is surprising to me. I have teams of people that do nothing but call existing pt's every 3 months to make sure everything is going ok and to make sure there's no question's and these are pt's that have had PAPs with us for years they all get calls. I've heard from hospital's that call us the "Cadillac"of DME providers.... I just honestly had no Idea other companys were THAT bad, please correct me if Im wrong that just seems to be what ALLOT of people on here say.

Either way The names Mike and Im glad I registered I like hearing different issue's that people have and how they work through them cause I feel I can learn and apply it to my job so Im always wanting to learn more. I've been in the PAP business for almost 3 yrs now and I picked it up very quick and have a good amount of knowledge that Im hoping I can share with others to help them out and get the treatment they need. GLAD TO BE HEAR THOUGH!!!


Mike

[bdp522]

My insurance only works with Apria. I've been at this for 3 yrs and Apria hasn't gotten an order right yet. They don't return phone calls. I can send them my card, but they only read compliance data and send that to the MD, then of course they keep the card.
I got the software and reader and read my own card now. I keep an eye on leaks, and AHI info. I was titrated at 7 at a lab and have since changed my pressure to 10.5 with an AHI of under 1.0. I have solved my mouth leaks. All done with info from the machine. I am 100% compliant in fact I don't think I could sleep without the mask and machine now, it's like my security blanket. If I have a bad night I can check my info and see what was going on and when. I also print out reports for my MD who shows them to other MDs. He says I am his most successful xpap patient.
I must say that without the info provided by members of this forum I would NOT be so successful!
You do sound like a wonderful DME, too bad I'm stuck with Apria. Apria did say they would call at least every 3 months to see how I was doing...still waiting for that first call!

Brenda

[ozij]

, my question is, do you guys keep track of this stuff for any certain reason? like personally? I have thousands apon thousands of pt's with company's i work for and not one of them has there own reader's. cause we do all that for them when the Dr or ins need it for compliance....

Mike,
I case you missed the point: we track our data for efficacy; not for compliace.

O.

[Muffy]

I've noticed that there are ALOT of you guys that have there own card readers and the encorepro or resscan programs, my question is, do you guys keep track of this stuff for any certain reason? like personally? I have thousands apon thousands of pt's with company's i work for and not one of them has there own reader's. cause we do all that for them when the Dr or ins need it for compliance.... also I've read alot of you guys are having issue's with the encore pro working well, and I was wondering how many have heard of encoreanywhere which is a card less system for the M series machines now. instead of a card slot it's a modem that is wired into your home phone and automatically uploads every morning to the web based queue they set up, for DME providers. found at encoreanywhere.com that way we get daily updates on issue's s we can tackle any compliance problems right off hand and the pt dont have to do anything... which brings me to my next question, the more I read the more i see where DME companys basically toss the machine at you and thats it. doesnt seem to be alot of good customer service or anything from what I've read, which is suprising to me. I have teams of people that do nothing but call existing pt's every 3 months to make sure everything is going ok and to make sure there's no question's and these are pt's that have had PAPs with us for years they all get calls. I've heard from hospital's that call us the "Cadillac"of DME providers.... I just honestly had no Idea other companys were THAT bad, please correct me if I'm wrong that just seems to be what alot of people on here say.

Either way The names Mike and I'm glad I registered I like hearing different issue's that people have and how they work through them cause I feel I can learn and apply it to my job so I'm always wanting to learn more. I've been in the PAP business for almost 3 yrs now and I picked it up very quick and have a good amount of knowledge that I'm hoping I can share with others to help them out and get the treatment they need. GLAD TO BE HEAR THOUGH!!!


Mike

Welcome to the forum Mike!

I have to admit I just joined, too, and being a part of this group has helped me immensely in overcoming my shyness (part of my meekness is probably due to the fact that I'm only 5'2" and 93 pounds, so I tend to get a little intimidated by just about everything).

If I'm not being too forward (and please forgive me if I am, because I'm still new to this forum discussion thing), may I suggest that you take a #*%$!*&^# English grammar course or at least hit the *%#!$%*^ spellchecker before you post? If one of my children came home from school with a *%*@#%^ paper written that #*^&%!*^# poorly I'd hit them upside the head with a shovel for being that %*&!#*! stupid. That would certainly make a good "impression"!

At any rate, thanks very much for posting, and have a Muffy Day!

Muffy

[Wulfman]

I've noticed that there are ALOT of you guys that have there own card readers and the encorepro or resscan programs, my question is, do you guys keep track of this stuff for any certain reason? like personally? I have thousands apon thousands of pt's with company's i work for and not one of them has there own reader's. cause we do all that for them when the Dr or ins need it for compliance.... also I've read alot of you guys are having issue's with the encore pro working well, and I was wondering how many have heard of encoreanywhere which is a card less system for the M series machines now. instead of a card slot it's a modem that is wired into your home phone and automatically uploads every morning to the web based queue they set up, for DME providers. found at encoreanywhere.com that way we get daily updates on issue's s we can tackle any compliance problems right off hand and the pt dont have to do anything... which brings me to my next question, the more I read the more i see where DME companys basically toss the machine at you and thats it. doesnt seem to be alot of good customer service or anything from what I've read, which is suprising to me. I have teams of people that do nothing but call existing pt's every 3 months to make sure everything is going ok and to make sure there's no question's and these are pt's that have had PAPs with us for years they all get calls. I've heard from hospital's that call us the "Cadillac"of DME providers.... I just honestly had no Idea other companys were THAT bad, please correct me if I'm wrong that just seems to be what alot of people on here say.

Either way The names Mike and I'm glad I registered I like hearing different issue's that people have and how they work through them cause I feel I can learn and apply it to my job so I'm always wanting to learn more. I've been in the PAP business for almost 3 yrs now and I picked it up very quick and have a good amount of knowledge that I'm hoping I can share with others to help them out and get the treatment they need. GLAD TO BE HEAR THOUGH!!!


Mike

Hi Mike.

Welcome to the forum.
I started my therapy four years ago. I purchased all of my equipment from CPAP.COM (including the software and card reader) and bypassed the local brick & mortar DMEs, but my insurance provider did reimburse me for 80% of my costs. So, I have had no issues with having to prove ongoing "compliance" with my insurance provider or sleep doctor (I dumped his sorry ass immediately after starting therapy). The reason I've continued to monitor my own therapy is for my own peace of mind that my therapy is as good as it can be. Part of my initial interest in doing so was because the pressure my sleep doctor prescribed was almost twice as high as what I started out with (I changed it) and through monitoring my own data, I discovered that my sleep study was probably flawed and my sleep doctor (pulmonologist) was either a moron or didn't know $%&@ about sleep medicine......because I was doing fine with alot less pressure.

Why is it that people with diabetes are taught or encouraged to monitor their own glucose levels but people with sleep apnea are treated like idiots and told that it's "illegal" to or they shouldn't be monitoring or tweaking their own therapy. You can't have it both ways.

After being here and reading this forum for four years, I'm convinced there are far too many money-grubbing idiots in the sleep medicine business. They're giving the good ones a bad name. If it's not true, how do you explain so many people flocking to the apnea/cpap forums for help? I've never really had any "problems" with my therapy, but I think that's partly because I DID bypass the medical/insurance money-grab in the beginning and started monitoring my own therapy from day one with Encore Pro. (which, by the way, I've never had that many problems with)


Den

[Sleepy Boy]

Hi Mike,and welcome. I just had an experience with my DME. I'm due for a new mask on May 10th. I'm using the Quattro now, it leaks, and it leaks worse if I don't wear my dentures to bed. I called the lady I usually talk to and told her this. She said I probably would want to try a different set up. My DME is 90 miles from where I live. She said she was sending the Resp.Therapist to my house, and he would bring different masks to try on, and would get me fixed up. She is also covering the new headgear, because it's only been 3 mo. Not that it matters, but I use Wright & Filippis. They have really tried to help me when needed. The DME'S take a pretty good hit on here most of the time, but I thought this was pretty good of them to do for me. Thanks, Larry

[ColinP]

, my question is, do you guys keep track of this stuff for any certain reason? like personally? I have thousands apon thousands of pt's with company's i work for and not one of them has there own reader's. cause we do all that for them when the Dr or ins need it for compliance....

Mike,
I case you missed the point: we track our data for efficacy; not for compliace.

O.

Ozij hit the nail on the head - I don't give a fig for compliance data - in fact I'd not even call that data. I want to know how well my treatment is working, and I'm not going to find that out any other way than doing it myself.

Colin

[yardbird]

Wow... quite a mix of answers.

Let's not beat up the guy for taking the time to register and ask questions... heheheh.

Mike, as you can probably tell, there are many opinions about DMEs. Some are great and some just outright suck out loud. Your interest in why we're here and how and why we track data is commendable. I can't speak for everyone obviously, but I think most folks who track data, are tracking how well their therapy is working. They already know they're compliant.

When patients can see.... graphically... how well the therapy is working, they can look into ways to improve areas where they may not be doing so well. Most of the people on this message board are also here because they got very little help from their DME and/or doctor. So they turn to other users for assistance, a pep talk, suggestions for a new mask or technique to try. Some, who have a good doctor or DME, can take their data in and discuss it to see if adjustments should be made to their treatment. Unfortunately, that seems to be rare.

The whole notion that we're too stupid to manage our own therapy is unconscionable. Why are we kept in the dark about these mysterious machines that help us to keep breathing? I don't think it's any great secret, and I think it's been proven many times within the medical community, that when patients take an active role in their treatment, there are statistically significant benefits.

So here we are. Tracking our own data and seeking help from each other because this is how we fine tune our treatment and achieve better results. Most of us have no medical training, although some do. Anyone here is pretty quick to advise seeking a medical opinion if anything looks out of the ordinary. However the rather large pool of knowledge and experience has proven to be extremely helpful to a very large number of people.

As you can probably also deduce.... I tend to ramble. I hope this helps to give you some insight.

[jnk]

. . . there are ALOT of you guys that have there own card readers and the encorepro or resscan programs, my question is, do you guys keep track of this stuff for any certain reason? like personally? . . .

Many of us have found that our breathing and our sleep are important enough to us that we wish to track the efficacy of our treatment. Some of us may even occasionally tweak our pressures up or down on our own machines by small amounts based on the trending data gathered from a few weeks from the flow-signal information recorded by the machines.

Users long ago discovered that occasional mouth leaks can severly affect the effectiveness of PAP therapy, so we use the information from our machines to make sure our leak is within reason. And since pressure needs change from time to time and we want our pressures to be the lowest pressure needed to effectively treat our OSA, we have found that self-monitoring and occasionally tweaking our pressure based on data trends pays off huge dividends in our getting restorative sleep.

One example of how that works is related to recent industry movement toward auto-titrating machines, which react throughout the night by continually raising and lowering pressure. Some have found that keeping the human-judgment factor in the mix by restricting the range in which their machines run has made their therapy much more effective. Some, for example, raise the minimum to help reaction time of the machine, which significantly lowers AHI for them. Others find they need to lower the maximum in order to keep the machine's pressure from going unnecessarily high for them. Finding the optimal range is a process that takes some weeks or months to achieve, and it all may need to be tweaked again later (after weight loss or gain, for example), but many of us have found that process to be well worth the effort, since it has a profound effect on our quality of life during the day.

Hope that helps to explain what many of us do.

jeff

[Mtnviewer]

Welcome to the forum:

Perhaps you / DME's can present a strong argument as to why we shouldn't have our own data whenever we want it, and why we shouldn't be monitoring and understanding OUR own therapy? So far, we haven't been convinced of more than fear mongering by the medical system.

As others have said, compliance is not the reason, nor of interest, as those that can get used to the therapy INSIST on using it. I live 3 hrs one way from the nearest DME, so getting data from them is not possible, nor via the modem / phone system, not that I have insurance that would pay for it.

The point to me of the software and data is to track the therapy and to learn from it more than just how we feel with a PAP system. 2 nights ago I had a poor sleep, so I look at the data, think about what caused things to change and try to figure out a solution and then plan for any changes. The next night, with my experience and data in mind, and a few tweaks, I had a great night. Without data, I don't know if I'm snoring, having more AI's, more AHI's, more Leaks, Runs, CA's etc.. Sure the #'s aren't 100%, and going by how you feel is helpful, but how you "feel" the next day doesn't help solve the mystery of improving therapy during the night, because after all, we're asleep, unconscious to know of what is going on "during therapy".

I try to live consciously in all parts of my life. Unfortunately, the PAP therapy occurs when I'm unconscious and hopefully sleeping and while improvements are reactionary, to have to go through the time delays of getting data to a DME therapist, nurse or Dr., and then getting the data back to the patient with possible fixes, when the therapist of Dr. a) wasn't even there, b) doesn't know how you sleep or what may have skewed the #'s, c) probably isn't going to do much of an investigation to pinpoint why there are problems, which if collecting data over a long period of time could mean that there are many problems and d) the advisors may not even use the PAP therapy themselves to understand all the possibilities or ramifications of a change to a patient, but rather just give out probability advice gleaned from a text book, etc.. (which I have experienced)

It's like your helpful suggestion in another thread encouraging folks to wear their mask at other times than only when they're trying to go to sleep, in that for the patient to read the data, it helps them get used to and to understand many more aspects of their therapy beyond compliance and to get perhaps delayed and incomplete advice from a DME or other person that is interpreting the data that really the patient should be well aware of. Giving up and understanding the data to a 3rd party isn't for me, an option in taking care of myself as no one knows my situation as well as I do. It's all about educating the patient, and IME, leaving the daily or regular data from a people is keeping people ignorant of their own therapy. We may not need to know how to build a car, but we do need to know how to drive it and we should also know it's daily condition and something about it's service in the short and long term, to help save our lives, the lives of others and to save money for ourselves and the system.

Does that make sense? It may not be a complete explanation, but it's not about compliance. Isn't there a book about the Dumming Down of America? I think keeping information away from patients is of a similar vein and produces similar results. Not good for society or patients, but profitable for the corporate system. The world needs to be educated, not dumbed down.

[mdbarthe]

Mike: Welcome to the forum and thanks for taking an interest in our therapy. From you description, you sound like a great DME supplier and one most on this forum would welcome to their situation. I am very fortunate to have a DME that is client-friendly and works much the same way you do. BUT......from what I read here I am definitely in the minority. There are many horror stories on this forum from those who have been ripped off and just plain been lied to; either out of DME ignorance or greed. You can do a search and read all of that for yourself, though.

I download my data and review it daily. I've been on XPAP therapy for over two years now. I've had times that my therapy seemed to be working well and times that I felt like there was no point in continuing. I am 100% compliant, by the way. When you begin XPAP therapy, you do so with apprehension and some anxiety. The thought of wearing some obtrusive device, strapped over your breathing holes for the rest of your life, at a time of day that you are supposed to be relaxed and resting can be overwhelming. Many of us need the daily, weekly, monthly or annual confirmation that by undergoing the therapy, we are indeed saving ourselves from future fatal diseases like CHF and Diabetes.

By monitoring my therapy, I have learned that I mostly sleep through a lot of situations where, if I were awake, I would correct immediately to improve my breathing. For instance, mask leakage. Until I began monitoring my data, I had no idea my mask was leaking as much as it was. Unlike many others, I did not wake up when the air was blowing in my eyes or from my cheeks. By seeing this in the data, I was able to make a correction and solve that issue. I also know that by drinking alcohol in the evening, it effects the quality of my sleep. I have far more apneas on those evenings than when I do not imbibe. I have heard a lot about ResScan's algorythyms on this forum. I feel much better when I compare my therapy pressure to my needs throughout the evening. I can see that I am staying ahead of the curve with XPAP and not being "cheated" by the algorythym. I can also see when my apneas are occurring and how long they last. In fact, I can even tell when I'm catching some bug by how my data looks. If it is out of whack and everything else looks normal, I know I will be coming down with nasal congestion or a cold in a day or two.

In short, as yardbird said, it is validation. I also have diabetes and am forced to monitor that condition throughout the day. I am trusted by medical professionals and experts to do so and report serious issues back to them for their professional opinion. It is confusing to me why some DMEs,RTs and doctors don't want their patients monitoring their XPAP therapy. As a lot, most of us are intelligent, intuitive and responsible people who don't need someone else to tell us how our therapy is going. We can read the data and see for ourselves. If not, this forum is great for those questions that many who have less than helpful RTs, DMEs or doctors can't get their professionals to answer or take seriously.

Thanks for taking an interest and stay with us. You're input could be valuable for some of us.

[kteague]

Mike, I have some questions for you...

The Respironics web site talks about the doctor being able to change a patient's pressure through EncoreAnywhere. Does that simply mean the doctor can enter the prescription change for the DME into the program rather than paper copy or fax? Or is there magic in that telephone line that allows machines to be be reprogrammed remotely? And can it download treatment data if it is a data capable machine? Surely you didn't think we're out here wasting time downloading our compliance data, did you? I mean, we already know how long we used the machine, so that info means nothing to us.

Seems a streamlined and more automated tracking of compliance has three advantages - 1} to let the physcian know at-a-glance when a patient is lying (accountablility) , 2) to not miss qualifying for insurance payment because of no verification, and 3) to prevent insurance companies from paying for equipment not being used.

What are the direct costs for the end user (us) to have EncoreAnywhere added and maintained on their home land phone line? Are those costs billable to insurance?
Are existing machines compatible or is this a feature available only in new machines? What about those who use two machines (one for napping)? Or those travel a lot? Or those who don't have a land line?

As the system currently stands, compliance verification is supposedly required but, in my experience, seldom followed through on. Guess this will help the DMEs with the reporting and payment process, but I'm afraid it may also cost them, as noncompliance will be evidenced much sooner. (Will this mean a boon in "barely used" machines on the auction sites and more room in closets?) I just hope this isn't a step towards a requirement.

Mike, I don't doubt you or your company's intentions to be a responsive and responsible DME, or that you may even hope to help in addition to the free exposure. But in all honesty, you could not have done much reading here or you would have known the difference between what those of us who download data do and compliance data. You'll likely have a hard sell here. But keep learning, you'll be even better at your job. And well informed staff at the DME level are a always appreciated.

Kathy

[Mike@TibroMedical]

Wow I made this topic at 3:30am I guess Its a bad idea to type that much when I am to tired to be very concerned about how my grammar looks. I apologize!
I love all the reply's also. Going back through to read them now. Hahaha

[Mike@TibroMedical]

I am reading through this and wanted to stop and clarify something, I was in no way trying to make you guys think you shouldn't be tracking your data in fact I think it's great that you guys take that into your own hands. I was curious from a stand point of a provider that has never had a pt even mention the thought of learning and understanding what it all means and I was simply intrigued.

[LoneStar]

also I've read alot of you guys are having issue's with the encore pro working well, and I was wondering how many have heard of encoreanywhere which is a card less system for the M series machines now. instead of a card slot it's a modem that is wired into your home phone and automatically uploads every morning to the web based queue they set up, for DME providers. found at encoreanywhere.com that way we get daily updates on issue's s we can tackle any compliance problems

Hi Mike,

Welcome to the forum and thanks for taking an interest in it and the people who use it. You may learn from us and we may learn from you.

My story is similar to Den's; I bypassed the DME route based on things I'd read here before I purchased my initial machine and supplies online. I have a high deductible anyway and I came out ahead money-wise and was able to purchase what I wanted based on my research and learning how to read my polysomnograph and not based on what the DME was willing to give me.

The information on the EncoreAnywhere is interesting, but once again, it bypasses the PATIENT and sends the data to other people. The PATIENT is the one who needs the data so s/he knows if the therapy is effective. I would be interested in this only if I could access the data and if it was all data, not just compliance.

And compliance is the least important thing to know. Most of us here are nearly 100% compliant and we want to stay that way. Compliance data is like baby formula. Most of us are into the meat and potatoes of real data - AIs, HIs, AHIs, mask leak data, pressure range, etc. And yes, we are intelligent enough and educated enough to use it!

I chose to buy an APAP machine as I was not convinced that I was titrated properly during my PSG from the dark side. I was right. I wasn't. And the data I have from my machine proves it. And yes, I boldly and brazenly change the settings on my machine and will continue to do so PRN.

This forum allowed me to make educated choices about my xPAP and accessories. When I began xPAP, because of what I learned here, I was able to identify and quickly correct any problems I experienced. I live in the country and "town" is an half-hour away. If I have a problem, I can get on here and find the answer within minutes; I don't have to drive to town to the DME and hope that someone there has a clue and can answer my question or solve my problem.

I worked in healthcare for 15 years (Certified Prosthetist, made custom-made artificial limbs for people) and I found that the more I could educate my patients regarding their condition and the care of their prostheses, the easier my job was. I probably spent half my patient contact time educating and teaching. This knowledge empowered the patient and allowed them to take ownership of their health.

That is what we are doing. We are gaining knowledge and taking ownership of our xPAP therapy and thereby our health.

Lisa