Need the Manual

No need to be so hard on the DME really - a good reason one needs to take full responsibility and control for one's own therapy though.

I'm with Rested Gal on this one. I think that there is every reason to be hard on the DME. There is absolutely NO EXCUSE for this type of error within healthcare. The DME have a responsibility to be accurate. If they do not know how to properly program the device, they should not be touching the device. Further, not unlike what your pharmacist does, they should be performing a double-check of the programming, ensuring correctness, before the device gets into the hands of the patient.

I agree that we, as patients/users need to have significant input, control, responsibility regarding out therapy BUT, service providers (DME) are being paid to perform a healthcare function and must perform this function with due diligence, accuracy and competence. There is no excuse for the sloppy treatment that the poster received.

That last one has a quote from NightHawkeye as the first paragraph; the rest is from me. Don't know how to get quote in the box and text from me.

Jim, I've already gone as far up the chain of command in the DME as the regional manager to get a change in their procedures on signing release forms, a major hassle. I'll inform the regional manager about the wrong setting and lack of safety information.

I plan to share my patient education handouts with 2 DMES and 2 sleep labs, as well as physicians involved in my treatment. See tips for newbies on this forum. (I'm still writing and revising). PM me if you want the latest Word files.

All, if we all share information with other users and the medical establishment, especially DMEs, we could help set a higher standard for xPAP user care. At the first AWAKE (ASAA, American Sleep Apnea Association) meeting I attended, several DME people were there, and they were knowledgeable. I conclude that not all DMEs have poor quality of care and service.

Mile High Sleeper wrote:Gimme a break, NightHawkeye!

I'm sorry Mile High Sleeper. I chose my words poorly. I do think I've made my feelings clear in other posts about how the medical community makes it difficult for one to take personal control and that's the point I was trying to make here. Again, my sincere apologies if it felt directed at you. I certainly didn't mean it that way.

Regards,
Bill

P.S. To close the quotation box you just have to start your text after the very last [/quote].

NightHawkeye,

Thanks.
We are in agreement about personal control.

Mile High Sleeper wrote:For a manual written for the user:

http://www.respironicsremstar.com
Go to Literature, Instructions, REMstar Auto.

This is not the manual that gives instructions for changing pressure. For that information you need the clinician's manual which your DME quickly removed from the box before giving you your machine. You receive the clinician's manual when you purchase a machine online, but DMEs withhold this information from you so you need to return to them again and again. Job security, I guess. Then, to make a few extra bucks on the side, they sell your clinician's manual on ebay. Very infuriating.

Many here are more than happy to communicate via PM to arrange to get the clinician's manual to those who need it.

Dear Guest, right on! The online manual is the same as the user's manual the DME gave me. Helpful for a few minor settings.

A kind person on this forum gave me several pages of the clinician's manual, enough to change the settings (pages 4 through . In the other portions of the manual, is there info on interpreting the smart card data? Do you recommend that I get the whole manual for this or other reasons?

Mile High Sleeper wrote:A kind person on this forum gave me several pages of the clinician's manual, enough to change the settings (pages 4 through 8 ). In the other portions of the manual, is there info on interpreting the smart card data? Do you recommend that I get the whole manual for this or other reasons?

Mile High Sleeper, with pages 4 through 8, you got all the good stuff. Pages 9 and above are EMC requirements (trust me, it's all legal stuff). Pages 2 and 3 are all warnings and cautions (more CYA legal stuff than useful info). Page 1 has some specs if you're interested in technical details, but you can get that from the Respironics website I'm sure.

Regards,
Bill

Bill is right. Pages 4 - 8 are all that matter. We commonly call it the "clinician manual." It's really just a booklet called "Home Care Provider Setup Instructions."

There is no manual with information about interpreting Smart Card data to make treatment decisions. The reason there's none probably is because the only things the DME's and doctors are interested in are:

1. Compliance -- How many hours a night are you using the machine. The DME cares about that only if an insurance company wants to know before the insurance company will keep forking rental money over to the DME.

2. 90th percentile pressure -- What pressure does the machine say is the best single pressure to take care of you effectively most of the time. The doctor is interested in this only if a titration pressure wasn't arrived at for sure at your sleep study, or if you are still complaining of daytime sleepiness after being on a straight cpap pressure for awhile. The doctor might order a trial on autopap to see what pressure the autopap finds for you. Then they slap you back on straight cpap at that single pressure.

In either case, it would be a rare doctor or DME who is the least bit interested in seeing the kind of overnight details we're all interested in. The kind of details you can see if you checkmark "Full Details" instead of Summary when viewing the download from a Smart Card. "Summary" is the default, and that's because that's all the doc or DME cares about.

Actually, very few people have had their doctor or DME even ask for the Smart Card....ever. Unless the insurance company requires it, no DME is going to bother with a download at all. Not even to take a look at the "hours of use." Most DME's couldn't care less if you use a machine or not. All most of them care about is getting paid by the insurance company each month, even if the machine is just sitting in a closet.

We do have to take up the reins of our own treatment in many cases. Even if there were such a thing as a clinician manual with lots of information about how to interpret information from the Smart Card, I doubt that one DME in a thousand would even glance at it. LOL!!

"Hours of use" for payment by the insurance company. That's all they want to see. If the insurance company pays without even asking for that, the DME isn't going to bother doing a download at all. Ever. They don't need no stinkin' manual.