Stop self adjusting your pressure.

bear1mdr wrote:Keep in mind that PAP software is not intended for end-users and it's not because they think patients are a bunch of idiots who could not possibly understand how to read the data. Anyone want to venture a guess as to why?

No guesswork to it. With Encore Pro for Respironics machines it's because there is a feature in the software called "create prescription." Doesn't mean, of course, that a person can generate a prescription like written on an Rx pad. Means that a person can change their prescribed pressure settings and mode of operation (if more machine than just a "cpap") through the software itself.

Also, unless a person knew to change the "erase with every download" setting, the card's data would be erased with home downloading. Could cause some consternation at the DME's office for the FEW DME's who actually download a card -- usually happens, imho, only if the person's insurance wants proof of compliance. Most insurance probably just takes the DME's word for it that the cpap user is in compliance.

But the "create prescription" thingy and the liability to the manufacturer for allowing it to be put into the hands of a cpap user is the BIG reason the manufacturer doesn't want software intended for the DME and doctor to be sold to a cpap user.

Can you tell I don't like the word "patient"? LOL! Sounds too invalid-ish. I'm not a patient. I'm a cpap user. Just like, "I'm a reading glasses wear-er."

Most of us just use the buttons and the power cord, to access the therapy setup menu, anyway.

Fortunately, Respironics released a version of Encore Pro FOR patients. It's called Encore Viewer. "Create prescription" is not in Viewer. And it doesn't erase the card after a download. Pretty nifty.

GumbyCT, not even close. DMEs don't make any money from this software. Who would they bill? Can't bill Medicare or Medicaid because it's not covered. Can't bill private insurance companies for the same reason. Can't bill anyone to read or compile a report from the data either. Your right about the fact that MOST DME companies are in it just for the money but this kind of software is not going to make any of them a dime. So the question still remaines, why is this kind of software not intended for the end-user?

This is fun, anyone else care to venture a guess?

bear1mdr wrote:It IS against the law for your DME company to change your pressure without a new prescription from your doctor but there is no law preventing you from changing your own pressure.

So if the DME is part of the doctor's office, is it still illegal for an RT to change the pressure without a new script? Is it ok if he just crosses through it, and writes down another number? Chances are he wouldn't normally be caught at it because many patients don't ask for a copy of their prescription before they get their machine.

I've always wondered if I should have said something right then and there, but I just took the machine home, and changed it to the prescribed pressure. Through my own experimenting, I have found that I do best with something between the two numbers.

bear1mdr wrote:GumbyCT, not even close. DMEs don't make any money from this software. Who would they bill? Can't bill Medicare or Medicaid because it's not covered. Can't bill private insurance companies for the same reason. Can't bill anyone to read or compile a report from the data either. Your right about the fact that MOST DME companies are in it just for the money but this kind of software is not going to make any of them a dime. So the question still remaines, why is this kind of software not intended for the end-user?

This is fun, anyone else care to venture a guess?

Software vendor does not want to provide the resources for customer support.

I think you still need more work on forum etiquette because you still come off sounding like a dick.


[quote="bear1mdr"]GumbyCT, not even close. DMEs don't make any money from this software. Who would they bill? Can't bill Medicare or Medicaid because it's not covered. Can't bill private insurance companies for the same reason. Can't bill anyone to read or compile a report from the data either. Your right about the fact that MOST DME companies are in it just for the money but this kind of software is not going to make any of them a dime. So the question still remaines, why is this kind of software not intended for the end-user?

This is fun, anyone else care to venture a guess?

bear1mdr wrote:Keep in mind that PAP software is not intended for end-users and it's not because they think patients are a bunch of idiots who could not possibly understand how to read the data. Anyone want to venture a guess as to why?

bear1mdr, what about Rested Gal's answer? (Good answer, Rested Gal.) I really hadn’t thought about why, just my irritation at the whole thing.

Is her answer the one you had in mind, bear1mdr?

I can’t think of anything else it could be, especially since you can change the pressure without the software. Can't be they don't want us to know the details of our therapy, as now Encore Viewer is available, made specifically for the end-user.


Pam

Flying_Norseman wrote:I think you still need more work on forum etiquette because you still come off sounding like a dick.

bear1mdr wrote:GumbyCT, not even close. DMEs don't make any money from this software. Who would they bill? Can't bill Medicare or Medicaid because it's not covered. Can't bill private insurance companies for the same reason. Can't bill anyone to read or compile a report from the data either. Your right about the fact that MOST DME companies are in it just for the money but this kind of software is not going to make any of them a dime. So the question still remaines, why is this kind of software not intended for the end-user?

This is fun, anyone else care to venture a guess?

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): medicare, DME

The "software" has always seemed like an enigma to me.

(for the most part)
The doctors don't believe in it or trust it (they think they know better). And, they want the patients coming back to them. (the CONTROL factor = $$$)

The DMEs don't use it because they hand out the cheapest machines to patients in order to maximize their profits.....so, the machines don't even have the capabilities to utilize it.


Den

rested gal, you got most of the BIG reasons right but there is a little more to it then that. The software is taking in data through the tubing only which means that even though it can "sense" and record changes in flow, vibrations, etc... it can not directly measure some very important readings, which should be measured, (e.g. oxygen saturation, CO2, etc…) in order to determine whether or not a change in pressure is needed. There are also outside forces at work during an average night sleep, which the software may not be able to differentiate correctly, such as movement, coughing, swallowing, etc... and can be misinterpreted by the software as an apnea event.

There's more but I have to get back to work now, sorry.

bear,

That's a good point; however, most of us look at, say, a week's worth of data or more to see if there is a trend. So a single night's aberrant results wouldn't cause us to make a change.

My sleep doc noted that the machines are not as good at distinguishing apneas from hypopneas as the sleep lab equipment but has also ok'd me experimenting carefully with my pressures....

Mindy

bear1mdr wrote:rested gal, you got most of the BIG reasons right but there is a little more to it then that. The software is taking in data through the tubing only which means that even though it can "sense" and record changes in flow, vibrations, etc... it can not directly measure some very important readings, which should be measured, (e.g. oxygen saturation, CO2, etc…) in order to determine whether or not a change in pressure is needed. There are also outside forces at work during an average night sleep, which the software may not be able to differentiate correctly, such as movement, coughing, swallowing, etc... and can be misinterpreted by the software as an apnea event.

There's more but I have to get back to work now, sorry.

A similar argument could be made about the use of the software in a sleep lab setting with all those extra capabilities ... the environment is unfamiliar to the patient (strange/uncomfortable bed and all the wires), the one night is not represenative of the patients sleep characterisitcs, being forced to sleep in a certain postition, etc. ... so if your argument is that the software is not accurate for end users to determine pressure settings then neither is the sleep lab use of the software and yet they use it.

welcome bear---and excellent info ---thanks-------------pat

I was Titrated at 10cm and I have never had as good a night sleep as when I started changing my pressure with my new APAP machine. It turns out that I spend most of my time at 11.8 pressure with the best AHI numbers around that pressure. As long as leaks are under control. When I was setting the machine at 10cm I did feel some better, but anything was better than having 60 plus events an hour before treatment. Typically, my AHI was around 14 when my pressure was set to 10cm and from what I understand, doctors will prescribe treatment for AHI being even that "low". So the bottom line is that if I hadn't found this forum and the great folks here like Wulfman, RestedGal, Snoredog, Dreamstalker, Mindy and MANY others, I would not have fought to get a new machine and learned how to take control of MY therapy. So for someone like this guy to come out of nowhere and start spouting off expecting us to buy everything he says because he claims to be an authority, I hope people will excuse me for being dubious.

Wulfman wrote:The "software" has always seemed like an enigma to me.

(for the most part)
The doctors don't believe in it or trust it (they think they know better). And, they want the patients coming back to them. (the CONTROL factor = $$$)

The DMEs don't use it because they hand out the cheapest machines to patients in order to maximize their profits.


Den

bear1mdr wrote:rested gal, you might also be interested to know that the devices I sell on cpapauction.com are less than $50.00 over what I paid for them which is really pi**ing off my venders who have threatened to cut me off if I don't rise my prices. I guess that's what you get for trying to offer a reasonable price to the millions of people who don't have insurance or a trust fund.

Sad, isn't it.

I guess the majority of DMEs, especially the big chains, as well as the manufacturers' reps, don't want Medicare and insurance companies to see low prices for all this stuff ANYwhere. Enough attention to that could lead to lower reimbursement schedules. Rocking the gravy boat.

It's a shame when caring DMEs can't help people the way they want to.

Keep in mind that at the sleep lab you are also being monitored visually by the tech and most of the extraneous data can be manually manipulated to eliminate aberrant readings.