Compliance and data access confusion

[lliann]

I am really trying but I am getting confused by some of the lingo here.

I would love to be able to access my data at some point. For now I am just trying to see the maximum data available on my machine without having a software program yet. (I may have to have my son help me with that. it just seems over my head and I am not totally computer illiterate but still this is a foreign language to me.)

I guess I get concerned with compliance and the insurance company. Being a hospital ins. biller, I know how ridiculous(inflexible) ins. companies can be.

I only just got this machine this week. I have to be compliant 30 straight days(with a 90 day period to get it right) (which is a totally new concept to me but I will try-even to the point of taking my machine on my trip with me). I guess there is a 10 month period where they will pay for the machine usage if I am compliant. If I am not, a. I will pay the monthly charge($185) and b. they could repossess the machine. (over my dead body-I already can't believe how much better this machine is for me. I now have hope) Or I can buy the machine for the balance (which I would probably do as a default. Compliant perfection or not, I need this thing.

All that said, if I start dickering with settings and pulling cards out and reading cards or installing on my computer (how the heck does one do that?), do I jeopardize my readings, my compliance readings, my compliance, etc etc?

Since this machine is not technically mine, do I get to play with its controls like I read here?

Meanwhile, I can't even figure out the basic where are the screens. I did get into the clinician settings so I can at least read my ahi (it was higher last night from 7.4 to 11.3 and my water ran out and I woke several times with my mouth wide open in my mask and would like to learn how to keep my mouth shut (in more ways than one :sigh:), but I am not finding the oxygen level reading s02? and would like that since I know my oxygen goes way down when I am having an event.(sleep tech told me it went to 82 when I stopped breathing for over 30 seconds)

Ok, this newbie only has 5 million questions. There's a few. Thank you

Oh. 1 more. next to the place for the card, to the right is another port. What would go in there?

[GumbyCT]

1st understand that no matter what happens to the card the DME (who is reporting your compliance data) can get that data directly from your machine display. Some may not know this or be aware that is the way compliance was reported (back in the day).

[mayondair]

You can mess with the card all you want, you won't lose any data, and insurance isnt interested in your settings, they only want to know you are using the machine. There are no CPAP police You really want to get in the habit of sleeping with your machine every night, but if you missed one you can always wear the mask while reading or whatever during the day, machine does not know if you are sleeping, but does know if you are using it.
Get your son to help with SleepyHead, it really is easy to use. Don't be afraid to ask more questions. It's all overwhelming at first Kathy

[robysue]

I would love to be able to access my data at some point. For now I am just trying to see the maximum data available on my machine without having a software program yet.

The S9 VPAP Auto Bilevel you have has quite a bit of data available on the LCD. You do have to check the LCD before noon since the LCD display resets to 0 at that time.

The data is available through the long or detailed version of the Sleep Quality Report. Instructions to access the long version of the Sleep Quality Report should be in your (patient's) user manual. If you have difficult finding or following those instructions post here and some kind soul will help you out.

To see all the data recorded by your machine you will need software. Either ResScan or SleepyHead will work. Both are free to download. SleepyHead may be a bit more patient-friendly in the install process: It is no more difficult to install than any other piece of downloaded software. Again, if you need the links, post and they'll be provided.

One note about the S9's data: The wave form data (the record of each and every breath you took) and the daily detailed data that is used to make all the pretty graphs you see posted here is only stored on the SD card for seven days. It is then overwritten. So if you want the wave form, you need to down load the data at least once a week.

I only just got this machine this week. I have to be compliant 30 straight days(with a 90 day period to get it right) (which is a totally new concept to me but I will try-even to the point of taking my machine on my trip with me).

First: Check with the insurance company to double check exactly what they mean by compliant. The word compliant gets thrown around a lot around here and there are two basic meanings:

1) Insurance compliant: What you need to get the insurance company to pay their share of your machine. It typically is something like: Use the machine for at least 4 hours each night for at least 70% of the days in some 30-day period in the first 3 months. But the definition of insurance compliant varies from company to company. So check directly with your insurance company rather than relying on info that is forwarded to you through the DME.

2) Therapy compliant: Around here, being compliant with therapy is a much stricter definition. CPAP is not a part time therapy. In order for you to get maximum benefit, you need to use the machine every time you sleep. That means using it all night, every night and also every time you consciously take a nap. Now note that we are all human beings. And even the most compliant of us occasionally fall asleep unintentionally without the mask. And wake up regretting having done so. So the real goal is to never consciously fall asleep without your mask.

Which brings us to:

(which is a totally new concept to me but I will try-even to the point of taking my machine on my trip with me)

Meet your new traveling companion---the S9 VPAP Auto Bilevel. You need to plan on taking the machine on all overnight trips. Is it a pain in the rear? You betcha. But it's still necessary. Think of it this way: If you were a diabetic, would you take a trip without the necessary medicine and your glucose monitoring equipment? Of course you wouldn't. CPAP is the same thing---you need the machine every night; hence it comes with you on all overnight trips.

I guess there is a 10 month period where they will pay for the machine usage if I am compliant. If I am not, a. I will pay the monthly charge($185) and b. they could repossess the machine. (over my dead body-I already can't believe how much better this machine is for me. I now have hope) Or I can buy the machine for the balance (which I would probably do as a default. Compliant perfection or not, I need this thing.

Sounds like your insurance pays on a "rent to own" set up. Lots of them do it that way. And since you're already telling a positive difference, my guess is that you shouldn't have too much difficulty in making insurance compliance. As you sleep with the machine and feel better, the motivation to sleep with the machine 100% of the time will naturally be there. And almost everybody sleeps more than four hours each day. The folks who have to worry a lot about compliance are those who hit serious difficulties in the first several months and consequently feel worse during compliance.

All that said, if I start dickering with settings and pulling cards out and reading cards or installing on my computer (how the heck does one do that?), do I jeopardize my readings, my compliance readings, my compliance, etc etc?

All the insurance company is going to look at is the usage. If you've got an enlightened DME or a doc who actually looks at the efficacy data, they may notice that you've changed the settings and give you a wet noodle whipping.

Since this machine is not technically mine, do I get to play with its controls like I read here?

I'd suggest not dial-winging immediately. And when you do start making adjustments, make small adjustments and leave the settings alone for 4-7 days before making another adjustment. And if you are really worried about compliance (I was), then don't make any changes without going through the doc and the DME during those first 90 days. But once compliance is established, no-body is going to look at the compliance data again except for your doc.

Meanwhile, I can't even figure out the basic where are the screens. I did get into the clinician settings so I can at least read my ahi (it was higher last night from 7.4 to 11.3 and my water ran out and I woke several times with my mouth wide open in my mask and would like to learn how to keep my mouth shut (in more ways than one :sigh:), but I am not finding the oxygen level reading s02? and would like that since I know my oxygen goes way down when I am having an event.(sleep tech told me it went to 82 when I stopped breathing for over 30 seconds)

Menus and checking the AHI and other efficacy data. You should not need to get into the clinical menu to check the AHI. If you do, then the DME must have locked you out of the data. Inside the clinical menu, check the settings to make sure the patient has access to the Sleep Quality Report and that Sleep Quality is set to ON instead of USAGE.

Keeping the mouth shut. Some folks find a chinstrap helps. Some tape their mouth shut. Some just use a so-called full face mask (FFM) that covers both the nose and mouth. The advantage of a FFM is that you can open your mouth without losing therapy pressure. The disadvantage of FFM is that they larger and bulkier. Thus they are not as comfortable (to many folks) and they can be more difficult to get a good seal.

Checking O2 levels. The S9 does NOT have an oximeter built into the machine. Its only connection to you is through the hose. Hence it only records data that can be measured or inferred from the wave form---the amount of air going in and out of your lungs during the night. Because there is no oximeter and no EEG, the machine's apneas and hypopneas are flagged based only on airflow. That means that the machine is recording approximate data. It will record events even if you are wide awake if the airflow drops sufficiently for 10 seconds or more. (Try this for yourself: Put the mask on and hold your breath for 10 seconds several times in a row. You'll get an instant cluster of events recorded. What kind of event may depend on the structure of your upper airway.)

Now the S9 does have the capacity to integrate some particular brand of oximeter into its data. And I believe there's some kind of a port to plug it into. But since it's been 18 months since I last used an S9, I am no longer familiar with exactly how that is done any more. Post a thread with a title like How do I use an oximeter with my S9 VPAP? and you'll get some help from those who do this on a frequent basis.

Oh. 1 more. next to the place for the card, to the right is another port. What would go in there?

It could be a modem port (these machines can be hooked up to a modem for automatic transmission of the compliance data to the DME) or it could be a jack for hooking up a compatible oximeter.

[Pugsy]

Oh. 1 more. next to the place for the card, to the right is another port. What would go in there?

Provider/clinical manual calls that port a module/adapter port.
Looks like it is where the S9 adapter goes. I am thinking that it is used in conjunction with whatever pulse oximeter device that is compatible with the S9.

copied per the provider manual...they don't go into it much.

Data transmission adapter
The following data transmission adapter is designed for use with VPAP devices.
Note: For more information on setting up your S9 adapter refer to the relevant S9 adapter user guide.
Device
Method
Description
Type of data transferred
Oximeter adapter
Enables collection of oximetry data from an oximeter for storing data on the SD card inserted

[lliann]

The data is available through the long or detailed version of the Sleep Quality Report. Instructions to access the long version of the Sleep Quality Report should be in your (patient's) user manual. If you have difficult finding or following those instructions post here and some kind soul will help you out.

Yoo hoo, calling Kind Soul.<g> I did request a manual via email last n ight. I guess its the clinicians manual? I can see where that would be a handy dandy tool.




1) Insurance compliant: What you need to get the insurance company to pay their share of your machine. It typically is something like: Use the machine for at least 4 hours each night for at least 70% of the days in some 30-day period in the first 3 months. But the definition of insurance compliant varies from company to company. So check directly with your insurance company rather than relying on info that is forwarded to you through the DME.

Yes, I actually went on the insurance website to bring up their dme compliance policies and thats exactly what it is. I have 90 days to get 30 consecutive days of no less than 4hrs daily or 70%. I knew the trip would screw up the first 30 days UNTIL I realized that I did feel better and I don't want to not breathe at night anymore. I have officially been converted. LOL!

2) Therapy compliant: Around here, being compliant with therapy is a much stricter definition. CPAP is not a part time therapy. In order for you to get maximum benefit, you need to use the machine every time you sleep. That means using it all night, every night and also every time you consciously take a nap. Now note that we are all human beings. And even the most compliant of us occasionally fall asleep unintentionally without the mask. And wake up regretting having done so. So the real goal is to never consciously fall asleep without your mask.

Yep, it's a whole new ballgame for me. I know better than to look for perfection, but have learned in life to be ok with good enough.



Which brings us to:

(which is a totally new concept to me but I will try-even to the point of taking my machine on my trip with me)

Meet your new traveling companion---the S9 VPAP Auto Bilevel. You need to plan on taking the machine on all overnight trips. Is it a pain in the rear? You betcha. But it's still necessary. Think of it this way: If you were a diabetic, would you take a trip without the necessary medicine and your glucose monitoring equipment? Of course you wouldn't. CPAP is the same thing---you need the machine every night; hence it comes with you on all overnight trips.


I now realize the risk I was taking/exposing myself to all those years I was non compliant(using anything) I already see a change in energy level. I can't wait till I start to remember where I put things again. LOl!

Since this machine is not technically mine, do I get to play with its controls like I read here?

I'd suggest not dial-winging immediately. And when you do start making adjustments, make small adjustments and leave the settings alone for 4-7 days before making another adjustment. And if you are really worried about compliance (I was), then don't make any changes without going through the doc and the DME during those first 90 days. But once compliance is established, no-body is going to look at the compliance data again except for your doc.

Bingo, Thats what I was looking for. Once I get those 30 compliant days, I can start to play. or now even knowing the ahi is more than I had.

Now the S9 does have the capacity to integrate some particular brand of oximeter into its data. And I believe there's some kind of a port to plug it into. But since it's been 18 months since I last used an S9, I am no longer familiar with exactly how that is done any more. Post a thread with a title like How do I use an oximeter with my S9 VPAP? and you'll get some help from those who do this on a frequent basis.

I am 63. My memory and ability to concentrate or focus or stay awake has become so compromised I have been starting to worry about Alzheimers. I could work and that was it. Couldn't even do full days all the time. I know all this loosing oxygen to the brain could be causing that so I know I need to do this thing and find out the beginning and end of my symptoms.

Oh. 1 more. next to the place for the card, to the right is another port. What would go in there?

It could be a modem port (these machines can be hooked up to a modem for automatic transmission of the compliance data to the DME) or it could be a jack for hooking up a compatible oximeter.

You are awesome!! How do you know all this stuff?

[robysue]

You are awesome!! How do you know all this stuff?

Thanks !

I'm a college professor by trade. So careful reading and the ability to do a decent job of researching things of interest are necessary job skills.

I also used an S9 AutoSet for about three months at the beginning of my therapy. And I've got a really good memory for things that I do every day for any length of time. For example: Can anybody else remember their schedule from freshman year of high school? What about their 7th grade schedule?? I can.

[lliann]

You are awesome!! How do you know all this stuff?

Thanks !

I'm a college professor by trade. So careful reading and the ability to do a decent job of researching things of interest are necessary job skills.

I also used an S9 AutoSet for about three months at the beginning of my therapy. And I've got a really good memory for things that I do every day for any length of time. For example: Can anybody else remember their schedule from freshman year of high school? What about their 7th grade schedule?? I can.

I'm still trying to remember where my keys are.

I am a chronic researcher. Love the hunt for info. Understanding it all is another story. LOL!

[mrghos]

To see all the data recorded by your machine you will need software. Either ResScan or SleepyHead will work. Both are free to download. SleepyHead may be a bit more patient-friendly in the install process: It is no more difficult to install than any other piece of downloaded software. Again, if you need the links, post and they'll be provided.

Exactly where do you find these downloads? I looked on Resmed for the ResScan and I had to register but I did not appear that I fit the "type of individual" that can acutally register. Am I looking in the wrong place?

Best,

Mrghos

[Pugsy]

Exactly where do you find these downloads? I looked on Resmed for the ResScan and I had to register but I did not appear that I fit the "type of individual" that can acutally register. Am I looking in the wrong place

You can find SleepyHead in my signature line.

The ResScan page...go ahead and fill it out with anything you want. They don't check up on you. Do have to check mark box for "use under a physician" though..
When I downloaded it...Mickey Mouse at Disneyworld registered and his email was at Epcot..
They don't check anything at all...fill it in with anything...check mark agree to be under physician (you do have a doctor) and then you will get download prompts. They don't send it in an email or anything like that.

[mrghos]

Pugsy, thanks for the information! I have downloaded each of them to my computer. Wednesday cant get here quick enough for me.

Thanks again!

Best,

Mrghos

[Pugsy]

If you want to try ResScan..the tutorial is a must to watch.
http://montfordhouse.com/cpap/resscan_tutorial/

We have been having a few bugs with SleepyHead and ResMed machine data. Minor bugs but with Beta software like SleepyHead (this is really the first Beta version) that is really an infant in terms of age, you might want to watch ResScan.
I am okay with SH and it's minor bugs but it might confuse you a bit till you get a handle on everything.
Read the glossary (link in my signature) as it encompasses most of the terminology you will see in the reports.

[poppi2]

.......For example: Can anybody else remember their schedule from freshman year of high school? What about their 7th grade schedule?? I can.

I still have dreams of not remembering the lock combination to my locker in 7th grade. Plus, not knowing how to get to classrooms. Earl

[-tim]

I am really trying but I am getting confused by some of the lingo here.

I would love to be able to access my data at some point. For now I am just trying to see the maximum data available on my machine without having a software program yet. (I may have to have my son help me with that. it just seems over my head and I am not totally computer illiterate but still this is a foreign language to me.)

I guess I get concerned with compliance and the insurance company. Being a hospital ins. biller, I know how ridiculous(inflexible) ins. companies can be.

I only just got this machine this week. I have to be compliant 30 straight days(with a 90 day period to get it right) (which is a totally new concept to me but I will try-even to the point of taking my machine on my trip with me). I guess there is a 10 month period where they will pay for the machine usage if I am compliant. If I am not, a. I will pay the monthly charge($185) and b. they could repossess the machine. (over my dead body-I already can't believe how much better this machine is for me. I now have hope) Or I can buy the machine for the balance (which I would probably do as a default. Compliant perfection or not, I need this thing.

All that said, if I start dickering with settings and pulling cards out and reading cards or installing on my computer (how the heck does one do that?), do I jeopardize my readings, my compliance readings, my compliance, etc etc?

Since this machine is not technically mine, do I get to play with its controls like I read here?

Meanwhile, I can't even figure out the basic where are the screens. I did get into the clinician settings so I can at least read my ahi (it was higher last night from 7.4 to 11.3 and my water ran out and I woke several times with my mouth wide open in my mask and would like to learn how to keep my mouth shut (in more ways than one :sigh:), but I am not finding the oxygen level reading s02? and would like that since I know my oxygen goes way down when I am having an event.(sleep tech told me it went to 82 when I stopped breathing for over 30 seconds)


Oh. 1 more. next to the place for the card, to the right is another port. What would go in there?

There is a little white tab on your memory card. If you slide it the other way, your computer can only look at the data and not change it. If you forget to put it back, your s9 will tell you about it on the screen.

Also never take out the memory card if your still breathing on the hose. I would give it at least 30 seconds from off to removing the card (I wonder if this is why people report it destroyed their data... the machine is still trying to update the card)

You may be able to get the humidity under control and not start breathing through your mouth. You may have had years of training that only a chinstrap will stop.

If you don't want to risk changing things, you can press and hold the two rectangular buttons for 2 seconds and you get another menu full of data.

The extra port is where you send money to ResMed who made the machine. They make a device that cost about $1000 that plugs in there that tells your O2 levels. There are finger clip things for less than $150
that do the same job that you may find for much less.