What do you want in a DME?

sleepnationtv · Post by **sleepnationtv** » Mon Jul 25, 2011 9:15 am

Hi all,

I am trying to get some feedback about what services you would like to see in the perfect DME or online DME. Please leave your feedback in the comments I am trying to put together a list of what users want.

Thanks for the feedback.

The Texan · Post by **The Texan** » Mon Jul 25, 2011 9:28 am

Above all else...,.Truthfulness, which few display and then a little compassion towards a person facing a lifestyle change. When I find that they lied to me, or attempted to screw me, it is bye bye and on to another.

Slinky · Post by **Slinky** » Mon Jul 25, 2011 9:33 am

Well, I am past the newbie stage by 5 years, roughly 2 years on CPAP before "graduating" to bi-level.

What "I" would like is for the DME provider I am working with to have an RRT who really "knows" sleep, sleep breathing disorders, pulmonary function and the CPAPs, APAPs, the more advanced PAPs that they provide and especially the "features" each one provides for comfort and efficacy. I'd like for those RRTs to be readily available to me for assistance and questions I might need or want to ask. I'd like them to "advocate" for me w/my sleep doctor when needed. I'd like them to be truthful, straightforward and upfront w/me.

It would be great if they were well-versed in the latest Medicare regulations pertaining to PAP therapy and equipment since Medicare is the primary "insurer" for the majority of those purchasing PAPs and so many insurances pretty much follow Medicare guidelines. And willing and able to maneuver thru the insurance maze to assist patients when needed.

I'd like the DME provider to supply ONLY data capable PAPs except for a "very few" basic devices for those w/no insurance and lacking finances to purchase any but the most basic of PAPs.

For those who travel it would be nice if the DME provider staff was knowledgeable about battery needs, TSA regulations, etc.

xenablue · Post by **xenablue** » Mon Jul 25, 2011 11:20 am

I want a DME who can discern when a patient is knowledgeable and active in their own therapy and respect that - not treat patients like children who don't know what they're talking about. If a patient wants to be active in monitoring their therapy, then the DME should help them achieve this, and encourage others to BECOME more active.

IMHO, if my neurologist is comfortable with me messing with my settings within certain ranges, then my DME has no business telling me I can't.

DME should be up front and honest about mask policies, replacements, machine features.

The patient should be empowered to take care of themselves with the DME providing the tools and advice to do this.

Cheers,
xena

Alshain · Post by **Alshain** » Mon Jul 25, 2011 11:31 am

xenablue wrote:I want a DME who can discern when a patient is knowledgeable and active in their own therapy and respect that - not treat patients like children who don't know what they're talking about. If a patient wants to be active in monitoring their therapy, then the DME should help them achieve this, and encourage others to BECOME more active.

IMHO, if my neurologist is comfortable with me messing with my settings within certain ranges, then my DME has no business telling me I can't.

DME should be up front and honest about mask policies, replacements, machine features.

The patient should be empowered to take care of themselves with the DME providing the tools and advice to do this.

Cheers,
xena

Either I am really confused or 'Neurologist' has a different meaning in Australia.

But yeah, I want my DME to follow my lead and my doctors lead, not the insurance company and most certainly not their own idea of therapy.

jabman · Post by **jabman** » Mon Jul 25, 2011 11:40 am

I would like to see staff at the DME be knowledgable of the equipment they are selling. Although I have had a good DME right from the get go, I did go in once to see about switching my mask and the lady I talked to seemed ( to me anyways) not to know much about the masks she was showing me.

xenablue · Post by **xenablue** » Mon Jul 25, 2011 12:29 pm

Alshain, I am an Aussie living in the U.S. and yes, I was surprised that my endo sent me to a neuro for OSA, but she specialises in sleep disorders and has be great, so no arguments from me on this.

Cheers,
xena

Alshain · Post by **Alshain** » Mon Jul 25, 2011 12:42 pm

xenablue wrote:Alshain, I am an Aussie living in the U.S. and yes, I was surprised that my endo sent me to a neuro for OSA, but she specialises in sleep disorders and has be great, so no arguments from me on this.

Cheers,
xena

Ah, well if it works, don't knock it I guess.

robysue · Post by **robysue** » Mon Jul 25, 2011 1:02 pm

As far as xPAP equipment goes:

First and foremost I want a DME that supplies ALL their patients/customers with full efficacy data APAPs as the FIRST cpap machine the patient gets. And teaches ALL their patients/customers how to ACCESS the data that is recorded by their machines.

Second, I'd love to have a DME encourage and help their patients/customers acquire the appropriate software for their machine AND provide some patient education about the meaning of the data collected.

Third, I want the RTs to know how to properly fit the various CPAP masks and I want the DME to be courteous and helpful when a customer needs to exchange a mask that is not working out during the 30 day exchange period.

Fourth, I want the DME to be willing to do the legwork in finding out exactly what the insurance company's parts replacement schedule looks like when the insurance company won't give that information to the patient/customer directly.

But item #1 is by far the most important in my opinion: It's not enough for a DME to grudgingly provide those of us knowledgeable enough to insist on full data machines with appropriate machines while sticking all the rest of their more ignorant or more desparate customers with bricks. Every OSA patient deserves a full efficacy data machine right off the bat. With appropriate patient education, the vast majority of patients provided such machines would eventually benefit in terms of being able to understand their condition and monitor how well their therapy is going. And that simple thing, in my not so humble opinion, would go a long way in addressing the longstanding sleep medicine complaint/concern about how many OSA patients give up on CPAP within the first year----never to come back.

Getting off my soapbox ....

robysue · Post by **robysue** » Mon Jul 25, 2011 1:15 pm

Slinky wrote: I'd like the DME provider to supply ONLY data capable PAPs except for a "very few" basic devices for those w/no insurance and lacking finances to purchase any but the most basic of PAPs.

Given that cpap.com lists three full efficacy data machines for under $500, I'd rather NOT have a DME try to sell any brick to any patient, no matter how poor. I'd much rather the DME find a way to set a person with no insurance and few $$ up with something like a IntelliPAP Standard Plus CPAP Machine with SmartFlex that lists for $325 right now at cpap.com than pawn off a non-data brick like the Resmed S8 Escape or Resprionics Series M CPAP Plus all the while telling said customer they're really getting a deal even though the model is outdated and only records compliance data.

nanwilson · Post by **nanwilson** » Mon Jul 25, 2011 1:19 pm

I want to feel good about my experience, not like I just bought a lemon from a lieing used car salesman. Presently they are not interested in the patient, all they know is $$$$$$, get the patient in and out in a minimum of time and make sure they are fleeced of every dollar they can squeeze out of you. And stop lieing about the cpap police, there arn't any, it is not illegal to take charge of our own therapy and do our own pressure changes if needed.
Oh that was ssooooo good to get off my chest....now I feel better. As you can see I had a super dooper DME....NOT!
Cheers
Nan

Janknitz · Post by **Janknitz** » Mon Jul 25, 2011 1:24 pm

I have to think that DME's have a stock of used CPAP machines simply because some patients are not meeting the compliance requirements, OR they try CPAP a night or two and give up altogether. Those machines CAN be properly cleaned and restored and resold at considerable discount to people without insurance coverage (rather than selling them as new, which I suspect must happen with some frequency).

rested gal · Post by **rested gal** » Mon Jul 25, 2011 1:50 pm

Good points about supplying everyone with a machine that records more than just "hours of use."

Even more important than the machine however, imho... is THE MASK.

This is probably unrealistic, but...
I'd like to see every DME be willing to keep exchanging masks, over and over and over again... no limit... during the first month.

A comfortable mask that a person can actually SLEEP in is absolutely crucial to "doing cpap." I'd venture a guess that by far the most common reason for "dropping out" is THE MASK. Mask issues. Hurts the nose or face, can't get comfortable in favorite sleep positions, difficult getting used to the feel of a hunk of plastic strapped to the face, the noise or feel of leaks springing out here and there, the sound of a vent hitting something (arm, bed pillow, bed cover, mattress), annoyed bed partner when the exhaust blows AT the partner.

People can do CPAP successfully without "full data." People can do CPAP at just about any pressure (and adjusting the pressure can be fairly easy to get taken care of.) But THE MASK.... that's the hardest part to "get right", imho.

So, let people keep swapping, swapping, swapping during that first month -- until a mask is found that lets the person get comfortable enough to SLEEP while using CPAP and a mask.

I'd even go so far as to say, send the person home with THREE masks to start out with... a traditional nasal mask, a nasal pillows mask, and a Full Face mask. Yes. Three masks, not just one, for the new user to try AT HOME...right from the beginning.

As I said, I'm being rather unrealistic to expect all that.

AmIawake · Post by **AmIawake** » Mon Jul 25, 2011 1:58 pm

That they understand I'm a paying customer.

archangle · Post by **archangle** » Mon Jul 25, 2011 10:37 pm

A DME who does not give a newbie a Full Face Mask without working with the patient to make a nasal mask work.

What do you want in a DME?

What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?

Re: What do you want in a DME?