Can the DME change my CPAP settings remotely?

[356jack]

Good morning all.

This morning when I reviewed my numbers from last night I noticed that several oftye settings on my CPAP had been changed (Resoironics modekl 560).

My question is , can the settings be changed remotely from the DME? My unit does send data to the DME for compliance, I guess but does the data link work both ways and allow the DME to change my settings?

I had changed my settings from the original settings based a lot on advice from here and had them perfect for me.
The 90% setting was just below the max sertting and the ramp was short, as I prefer it plus 1/2 way to the max, etc.
I have been tracking my AHIs and the settings provided the lowest numbers for AHIs plus I could sleep all night without being awakened by high pressures that were blosing my mask off my face. Atway--I liked my settngs. After all, isn't the goal the lowest AHIs?

Can anyone tell me if the DME could change my settings remotely?

Many thanks!

[Sheriff Buford]

Nope... at least not yet...

[356jack]

Well that is a relief. I sure wonder how the settings got changed though. I didn't do it and the unit hasn't been dropped.

Big puzzle.

[Pugsy]

I think that the DME can indeed use the modem to change the settings. It can use the modem to write RX changes to the SD card and then the changes take place....no modem...no way to make changes except manually to a SD card. Changes can be made using the software remotely.

Also a possibility...are your using straight APAP mode or the Opti Start feature where the machine makes changes on its own?

[NotLazyJustTired]

Hmm, I do know that on the ResMed devices, if you have the transmitter device plugged in, the data flows both ways. They can monitor your data, AND makes changes to therapy. It sounds like you do have a transmitter since you said the DME is monitoring your data. I think it likely that they did make a change (if you didn't). I would give them a call and ask. If they didn't make the change, then maybe your machine needs to be exchanged or at least set back to the correct therapy.

[jdm2857]

From http://www.healthcare.philips.com/us_en ... efault.wpd

EncoreAnywhere is a web-based patient compliance management system that makes treating sleep-disordered breathing patients easier and more efficient. It's powerful, accurate and HIPAA compliant. Because it's web-based, it puts the information anywhere you want it.

And, like the Internet, EncoreAnywhere is well-connected. With simple actions you can change patient pressure settings, send scripts and notes to homecare providers, track patient compliance for a particular time period and print customized reports.

[akcpapguy]

Yes the settings can be changed remotely, with that said however your DME may not be actively changing them. With regards to Respironics specifically if the machine was set using an Rx in the Encoreanywhere it will compare the setting to the Rx every time the modem connects to Encoreanywhere and if they are different it will apply the Rx settings that are in Encoreanywhere thus resetting the device.

[BlackSpinner]

Yes they can. If you met your compliance I suggest you rip the thing out.

[Conrad]

My DME did indeed change my settings remotely. So, yes, it can be done.

[356jack]

WOW---who knew that the DME could change the settings. Not to brag but I seem to know more about what I need from the machine than the DME. With the first settings I was ready to deep-six it but noow I am doing great. And isn't the proof of the pudding the low AHI numbers?

How long does a DME have to receive compliance numbers for Mediucare to pay? Is there a term after which the monitoring stops? I need to get smarter on that.

Not only is Big Brother watching, it appears that he is also fooling with my machine settings. If true, that is just unacceptable to me.

[356jack]

ps Yes--the Opti Start WAS on this morning. I had turned it off a couple of weeks ago but now it's on. I turned it back off this morning because I would rather hit the button and start it when I'm ready.

How unsettling.

[Pugsy]

How long have you had the machine?
Typically Medicare doesn't care after 90 days as long as one follow up and face to face with doctor is done between 30 and 90 days of getting the machine and you satisfied compliance requirements within that time.

If it's been over 90 days I am surprised they are even still monitoring things and also surprised they haven't asked for the return of the modem. Get rid of the modem and they can't change anything but watch it close...if changes were written to the SD card to stay stuck on the SD card...it will change back. There's an option in the software to make the change a one time deal or leave it as permanent thing on the SD card.
Solution is to use a new SD card or erase the old one...assuming compliance requirements are satisfied.

[Guest]

Thaks, Pugsy--I am at about 75 days with almost 100% compliance and have had the follow up doctor visit so I can replace the sd card adter 980 days with no notice to the DME or anything?

[jdm2857]

Note that while the DME or EncoreAnywhere automatically can reset your machine
to the original prescription, they are not allowed to change your settings from those
on your prescription without orders from your doctor.

To meet the Medicare compliance standards (also followed by most insurance companies,)
you must use the CPAP for at least 4 hours per night for any continuous 30-day period
within the first 90 days of use.

Then, for Medicare at least, within the first 90 days you must have a face-to-face meeting with your doctor at which
he documents your compliance.

If you have not met the compliance standard, you will have to reset your machine each night.

What a PITA.

[Pugsy]

Thaks, Pugsy--I am at about 75 days with almost 100% compliance and have had the follow up doctor visit so I can replace the sd card adter 90 days with no notice to the DME or anything?

Most likely.
I would expect that the DME will want the modem back very soon...call them up and ask them.
They have to pay for access to EncoreAnywhere and the modems aren't cheap.
Get rid of the modem and you can do what you want. As long as the modem is there...they can watch.
They probably will want to stick the modem on to another person's machine anyway.