My wife and I are thinking about starting a CPAP clinic to help people improve their quality of life living and sleeping with CPAP equipment.
We're both Respiratory therapists and I've been working in a sleep lab for 7 years. I also work for a small independent DME setting up CPAPs. The DME charges way too much money but at least I have the chance to help educate some folks. I also have been sleeping with CPAP for years.
The problems that I see are that physicians only order the tests and then order the therapy as indicated from the testing data. When compliance becomes a problem the physician can't help.
The DME's only want to sell equipment and supplies!!!
We don't want to sell equipment, just educate, troubleshoot problems and improve a person's sleep.
In an ideal world our service would educate a person before their tests. Afterwards we would have CPAP machines for them to see and try and all masks for them to experiment with. They would then order the equipment from CPAP.com and we would be available to help them once their equipment arrives.
Our questions to this forum are:
Would a service like this be benefical?
Would a mobile service be better than a store front setup?
What would be a fair charge for services?
Please respond back with all pros and cons and all suggestions for the ideal CPAP education service.
Thanks
Bob & Mariam
CPAP Education-Would A CPAP clinic work?
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BetterBreathinBob
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MandoJohnny
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- Joined: Sun Apr 23, 2006 11:23 am
- Location: St Louis, Missouri
I think it would be valuable. I was diagnosed with asthma years ago and it was very difficult for me to cope with. I had never had a chronic illness before and the whole inhaler thing was difficult to get compliant with. Little did I know how easy that was compared to CPAP!
Anyhow, my asthma doctor's office, in conjunction with the hospital, held a class series every month. It was 4 classes, each on a different topic, each held the same time each month. So Class 1 was always the first Tuesday of every month, Class 2 was the second Tuesday, etc. So if you missed one, you could catch it next month. One class they explained asthma, what it was, what was known about it, yadda, yadda. Another class was all on treatment: What different kinds of inhalers and meds did, how to use them, how to check them, how to clean them, etc. Another class was just on stress management and accepting asthma. I can't remember what the fourth class was, it's been years ago.
Those classes were extremely helpful in getting me compliant and more accepting of that condition. I wish there was something like that for OSA/CPAP. I think a lot of compliance is due to knowledge and attitude. But if I hadn't had good RTs and a great doc, it would have been "Here's your machine, good luck!"
You might think about getting a hospital or medical practice sponsorhip for such a venture.
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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, clean
Anyhow, my asthma doctor's office, in conjunction with the hospital, held a class series every month. It was 4 classes, each on a different topic, each held the same time each month. So Class 1 was always the first Tuesday of every month, Class 2 was the second Tuesday, etc. So if you missed one, you could catch it next month. One class they explained asthma, what it was, what was known about it, yadda, yadda. Another class was all on treatment: What different kinds of inhalers and meds did, how to use them, how to check them, how to clean them, etc. Another class was just on stress management and accepting asthma. I can't remember what the fourth class was, it's been years ago.
Those classes were extremely helpful in getting me compliant and more accepting of that condition. I wish there was something like that for OSA/CPAP. I think a lot of compliance is due to knowledge and attitude. But if I hadn't had good RTs and a great doc, it would have been "Here's your machine, good luck!"
You might think about getting a hospital or medical practice sponsorhip for such a venture.
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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, clean
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guest-greyhound
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WillCunningham
- Posts: 104
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- Location: New Hampshire
- Contact:
I think something like that would be benificial, particularly the bit about having a variety of masks to try on. When I first started with cPAP it was pretty much the "here's your machine, good luck" experiance that MandoJohnny mentioned.
One thing to consider is the huge difference between someone who has used cpap for a while and someone just getting started. I was reading another thread and a comment Chuck made jumped out at me as all too true.
There is so much we all go through getting xpap technology to work for us, there has to be a better way to transfer the info. I hate it that everyone ends up having to re-invent the wheel when the first get the news that they have OSA. There should be more help out there to help people get settled into a routine, of course cpaptalk.com is a great place for that for the people who discover it.
When I first started I had no idea the variety of masks out there and how much better some of them could work for me than others. The mask I started with had some problems, but it worked enough for me to see benifits. When I got bit by the "try new masks" bug, I got really lucky and was able to try on a number of masks. This saved me tons of mental energy wondering if one of them would have been even better than my current mask. The headgear for many of those masks did not secure to my head that well.
Someone new to OSA might not even know what questions to ask. I was treated for 1 to 1.5 years before I discovered this forum. I have learned so much just reading through other peoples questions, I found info that directly impacted me that I would have never thought to ask about. Having someone, or a clinic like the one you described, to impart that information is a great idea. In fact it is almost criminal that it doesn't already exist and isn't part of the standard process for people diagnoised with OSA.
There are propably booklets or videos that describe the condition and the treatment. There should be more out there about living with it, about how to make things work better. Things to help address specific problems people run into. Things like how to deal with mouthbreathing. From what I have been reading lately, the clinical advice is "get a chin-strap" which doesn't sound like it works to well for many people. Tips like the polydent strips and mouth-taping, and things like that should be covered somehow.
It sounds like what you are suggesting is something to help provide that info to people. I think that sounds great. I don't think I really have a point here or specific suggestions, just a hearty "cool idea".
Will
[/url]
One thing to consider is the huge difference between someone who has used cpap for a while and someone just getting started. I was reading another thread and a comment Chuck made jumped out at me as all too true.
No more cpap thread.Anyhow, since my PSG, such as it was, I've struggled as most newbies do, obsessed as most newbies do, fretted as most newbies do, tried masks as most newbies do, switched from CPAP to APAP as most newbies do, and finally settled into a routine.
There is so much we all go through getting xpap technology to work for us, there has to be a better way to transfer the info. I hate it that everyone ends up having to re-invent the wheel when the first get the news that they have OSA. There should be more help out there to help people get settled into a routine, of course cpaptalk.com is a great place for that for the people who discover it.
When I first started I had no idea the variety of masks out there and how much better some of them could work for me than others. The mask I started with had some problems, but it worked enough for me to see benifits. When I got bit by the "try new masks" bug, I got really lucky and was able to try on a number of masks. This saved me tons of mental energy wondering if one of them would have been even better than my current mask. The headgear for many of those masks did not secure to my head that well.
Someone new to OSA might not even know what questions to ask. I was treated for 1 to 1.5 years before I discovered this forum. I have learned so much just reading through other peoples questions, I found info that directly impacted me that I would have never thought to ask about. Having someone, or a clinic like the one you described, to impart that information is a great idea. In fact it is almost criminal that it doesn't already exist and isn't part of the standard process for people diagnoised with OSA.
There are propably booklets or videos that describe the condition and the treatment. There should be more out there about living with it, about how to make things work better. Things to help address specific problems people run into. Things like how to deal with mouthbreathing. From what I have been reading lately, the clinical advice is "get a chin-strap" which doesn't sound like it works to well for many people. Tips like the polydent strips and mouth-taping, and things like that should be covered somehow.
It sounds like what you are suggesting is something to help provide that info to people. I think that sounds great. I don't think I really have a point here or specific suggestions, just a hearty "cool idea".
Will
[/url]
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| Mask: Swift™ FX Bella Nasal Pillow CPAP Mask with Headgears |
| Additional Comments: 20cm cpap mode |
classes
Sounds noble in concept, but I would think the business model would not be to promising.
Think about it.
Patient goes to doc and gets sleep study and a referral to a dme.
Just how many would be willing to shell out the amt of money to support you in that scenario?
DME would feel threatened if they thought you were encroaching on their territory and be insulted if you suggested they were not competent to do their job. Never mind how true that may be.
No way such would be covered by insurance.
Many get the help here for free from very informed and helpful fellow hose heads.
Just MHO.
I could be wrong
Thought: Doing a good job around here is like urinating in a dark suit. It gives you a warm feeling, but nobody notices.
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CPAPopedia Keywords Contained In This Post (Click For Definition): hose, DME
Think about it.
Patient goes to doc and gets sleep study and a referral to a dme.
Just how many would be willing to shell out the amt of money to support you in that scenario?
DME would feel threatened if they thought you were encroaching on their territory and be insulted if you suggested they were not competent to do their job. Never mind how true that may be.
No way such would be covered by insurance.
Many get the help here for free from very informed and helpful fellow hose heads.
Just MHO.
I could be wrong
Thought: Doing a good job around here is like urinating in a dark suit. It gives you a warm feeling, but nobody notices.
_________________
CPAPopedia Keywords Contained In This Post (Click For Definition): hose, DME
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MandoJohnny
- Posts: 305
- Joined: Sun Apr 23, 2006 11:23 am
- Location: St Louis, Missouri
That's why I suggested having a hospital or a medical practice support it. They have money for patient education. That's how my asthma clinic worked. They also put out an asthma newsletter, which I still get like 15 years later. That's gotta cost.Sounds noble in concept, but I would think the business model would not be to promising.
My DME does run a CPAP clinic, every Thursday afternoon, it just isn't any good. It is just an RT, who IMHO is borderline incompetent, sitting in a room waiting to answer your questions. It is a waste of time. I can find out more on this site than I can from that guy.
I don't know if it would work-but nurses and dieticians get paid by insurance companies for diabetes education-why not CPAP education. You are RT's-you know the drill about jumping through the reimbursement hoops... developing a program with quality assurance checks, being licensed etc. If you aren't sure how to do it contact someone in diabetes education. Stanford University Sleep Disorders Clinic runs a CPAP group for $70 a session with 7 sessions in the series-many insurances cover the costs of attendance. If you can-attend that group-see what they do or don't do that you think would be helpful.
You could try the waters with a series of one night a week group sessions for new CPAP'ers and offer individual problem solving sessions by appointment. Groups have the advantage of lowering the cost for people who end up paying out of pocket. and you get more $ for less time. How about doing it through a local hospital.
Look at the HMO's for possible contracts. They are notorious for billing problems and low rates of reimbursement but they sometimes make contracts with "little guys" to save money. Also look for start up grants-there might be an advantage to doing it in your wife's name.
Sure people can get help here for free-for some people that works fine. For others it doesn't. While advice here is generally quite good and there are a few people who should be in the business of CPAP self management education-you don't know who is answering your questions and there is no accountability. I cringe when someone says you could put toilet water in your CPAP humidifier and it wouldn't matter. If there were a class in my area I would go.
You could try the waters with a series of one night a week group sessions for new CPAP'ers and offer individual problem solving sessions by appointment. Groups have the advantage of lowering the cost for people who end up paying out of pocket. and you get more $ for less time. How about doing it through a local hospital.
Look at the HMO's for possible contracts. They are notorious for billing problems and low rates of reimbursement but they sometimes make contracts with "little guys" to save money. Also look for start up grants-there might be an advantage to doing it in your wife's name.
Sure people can get help here for free-for some people that works fine. For others it doesn't. While advice here is generally quite good and there are a few people who should be in the business of CPAP self management education-you don't know who is answering your questions and there is no accountability. I cringe when someone says you could put toilet water in your CPAP humidifier and it wouldn't matter. If there were a class in my area I would go.
Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.....Galbraith's Law
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Guest
only cavet to your plan is there won't be any on-line providers to fulfill your dream.
Resmed has a Master Plan in place set forth to strike in September just like the Nazi's had to eliminate the Jews, just like the Islamic nations of Iran have to eliminate Americans, they intend on eliminating the on-line providers.
Resmed has a Master Plan in place set forth to strike in September just like the Nazi's had to eliminate the Jews, just like the Islamic nations of Iran have to eliminate Americans, they intend on eliminating the on-line providers.
Sounds like a wonderful idea.
I for one have a good DME. They are always available by phone if I have questions. They allow us to try masks until we find one we like. They even delivered one to my office because I couldn't get there.
My last visit to them, I told them I appreaciated the great service they give. The respirologist told me that they pride themselves in their service. She said all the places here in town basically sell their masks at the same price. The only thing that makes people come back to them is the service. I will definately go back to them.
The first time I looked for a mask, I went through 6 or 7 until I found one that worked for me. This time it only took 2. And I have called them with questions in the past. Realizing that the Respirologist sees people all day, I left a message and she was back to me within a couple of hours.
Now, I realize I'm one of the few and far between, that actually get this kind of service, believe me it's so nice compared to what I hear around from others.
Its all Service... service... service!!!
God bless you if you can give it to some that wouldn't always have gotten it.
Lynne (in Ottawa, ONT, CANADA)
I for one have a good DME. They are always available by phone if I have questions. They allow us to try masks until we find one we like. They even delivered one to my office because I couldn't get there.
My last visit to them, I told them I appreaciated the great service they give. The respirologist told me that they pride themselves in their service. She said all the places here in town basically sell their masks at the same price. The only thing that makes people come back to them is the service. I will definately go back to them.
The first time I looked for a mask, I went through 6 or 7 until I found one that worked for me. This time it only took 2. And I have called them with questions in the past. Realizing that the Respirologist sees people all day, I left a message and she was back to me within a couple of hours.
Now, I realize I'm one of the few and far between, that actually get this kind of service, believe me it's so nice compared to what I hear around from others.
Its all Service... service... service!!!
God bless you if you can give it to some that wouldn't always have gotten it.
Lynne (in Ottawa, ONT, CANADA)
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toilet water
Krousseau pontificated: I cringe when someone says you could put toilet water in your CPAP humidifier and it wouldn't matter. If there were a class in my area I would go.
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Cringe as much as you like, but you know full well the context of the assertion.
Illustrating absurdity with absurdity.
The point was that there was no danger from infection from a humidifier, even if you used branch water or toilet water.
Absurd yes, factual YES also.
I may cringe also, but I would have no fear of an infection.
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Cringe as much as you like, but you know full well the context of the assertion.
Illustrating absurdity with absurdity.
The point was that there was no danger from infection from a humidifier, even if you used branch water or toilet water.
Absurd yes, factual YES also.
I may cringe also, but I would have no fear of an infection.
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Guest
Cpap clinic viability
I think your idea would meet a real need. Unfortunately it's a need because of someone's failure to perform. Ideally, they should be held to task, but we all know how that story goes.
With sleep apnea's growing numbers and public awareness about the dangers and costs to society, the time is ripe for innovative ways to truly impact the problems. Health insurance is not going to pay you to do what they're already paying someone else to (not) do UNLESS you can present a tight case for dramatic cost savings to them in the long run. Here's my take on this - surely insurances incur substantial expense paying patient by patient, visit by visit, for the same services to be supplied a zillion times over (not sure who's paying to try repeated masks). Surely most of those services could be provided much cheaper grouped in one place at one time. Do the math - money talks.
Even so, I'd be more inclined to think Life or Auto Insurance companies could be convinced to subsidize such a program. It's not a redundant expense for them and has potential to save them extreme payouts. A prior suggestion of working with HMO's sounded good too. Or maybe with service provided under the umbrella of a related national organization.
I suggest that you:
1) Develop your program and supporting documentation.
2) Apply for a grant from a Foundation that supports similar causes or within a company that would stand to benefit from your endeavor.
3) Professionally survey a significant number of individuals to garner a group of noncompliant or not yet diagnosed sleep apnea patients.
4) Offer this group a free one day workshop with maybe four sessions, in return for a post workshop survey and compliance reporting at maybe 3 specified intervals on provided materials.
4) Compile data. If your patient compliance rate is greater than industry standards indicate, you'll have a leg to stand on.
A successful program model could be duplicated in other locations, sort of like franchised, if travel isn't in your plans. You may say I'm a dreamer, but I'm not the only one...every successful service being provided had to start as a good idea in someone's noggin'. If I were a betting woman, I'd bet someone will implement some variation of this concept in the near future. If your heart and your head agree on its potential, I hope it's you.
Should have posted this as a guest - I could be as wrong as two left shoes.
Just speaking from my gut.
Kathy
With sleep apnea's growing numbers and public awareness about the dangers and costs to society, the time is ripe for innovative ways to truly impact the problems. Health insurance is not going to pay you to do what they're already paying someone else to (not) do UNLESS you can present a tight case for dramatic cost savings to them in the long run. Here's my take on this - surely insurances incur substantial expense paying patient by patient, visit by visit, for the same services to be supplied a zillion times over (not sure who's paying to try repeated masks). Surely most of those services could be provided much cheaper grouped in one place at one time. Do the math - money talks.
Even so, I'd be more inclined to think Life or Auto Insurance companies could be convinced to subsidize such a program. It's not a redundant expense for them and has potential to save them extreme payouts. A prior suggestion of working with HMO's sounded good too. Or maybe with service provided under the umbrella of a related national organization.
I suggest that you:
1) Develop your program and supporting documentation.
2) Apply for a grant from a Foundation that supports similar causes or within a company that would stand to benefit from your endeavor.
3) Professionally survey a significant number of individuals to garner a group of noncompliant or not yet diagnosed sleep apnea patients.
4) Offer this group a free one day workshop with maybe four sessions, in return for a post workshop survey and compliance reporting at maybe 3 specified intervals on provided materials.
4) Compile data. If your patient compliance rate is greater than industry standards indicate, you'll have a leg to stand on.
A successful program model could be duplicated in other locations, sort of like franchised, if travel isn't in your plans. You may say I'm a dreamer, but I'm not the only one...every successful service being provided had to start as a good idea in someone's noggin'. If I were a betting woman, I'd bet someone will implement some variation of this concept in the near future. If your heart and your head agree on its potential, I hope it's you.
Should have posted this as a guest - I could be as wrong as two left shoes.
Just speaking from my gut.
Kathy
Got Guested After All
Prior post was me.
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| Mask: TAP PAP Nasal Pillow CPAP Mask with Improved Stability Mouthpiece |
| Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
| Additional Comments: Bleep/DreamPort for full nights, Tap Pap for shorter sessions |
Tomjax-I regret that I offended you personally with my comment. I should have worded it differently or explained myself more fully. I know that you did not mean it literally. And I know that you and I shall forever (or at least a lifetime) have a disagreement over the possibility of transmitting infection via a humidifier. You honestly believe it to be impossible-while I admit to a willingness to believe it possible under the right set of circumstances.
Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.....Galbraith's Law
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Guest
I'm curious if you plan to do something different from all the sleep apnea clinics out there already? I know most of the sleep labs and dmes and awake groups do clinics now where everyone goes and plays around with different masks and gets to try on the lastest and greatest masks and humidifiers and machines.
Just not sure if you are talking about doing something different than that or not.
Just not sure if you are talking about doing something different than that or not.