IDS Sleep for Physicians
How IDS Sleep Works
The IDS Home Sleep Testing process is simple for patients and treating physicians. Start with a simple evaluation, fax our referral form and we'll handle the rest.
Details follow...
How Home Sleep Testing Works
Working with DMEs
As a physician, you may have been told about our new program by one of your local HME/DME suppliers respecting the strict Medicare guidelines which state that they cannot be involved in home sleep testing themselves. Like you, they may have good relationships with local sleep labs, but know there are millions of patients not yet diagnosed with sleep apnea because in-lab testing can be burdensome.
If this is the case, your preferred DME can still provide you with patient awareness brochures for your waiting room and pre-filled order forms so that you can fax Home Sleep Testing referrals directly to IDS. They will also work with you to determine the best course of action for patients who do qualify for CPAP.
Requests from Patients
You may have heard about our service another way, such as a patient or other physician. Resourceful patients who don't like the idea of going to a lab or are in cost conscious, patient-driven health plans often find IDS on their own and will ask for a referral. If they don't present you with an order form, you or your office staff can sign up on our website and print them out by following the direct link provided:
http://www.aasmnet.org/Resources/PracticeParameters/PP_Autotitrating_Update.pdf
Identifying Appropriate Patients
HST is best for patients with symptoms consistent with OSA such as daytime sleepiness or loud snoring. Those with certain known health conditions which could cause misleading findings without additional polygraphic channels, specifically COPD and CHF, should be referred for an attended study. Also, those whose complaints include leg cramping or kicking, sleepwalking or cataplexy need to be evaluated by a trained sleep physician for possible RLS, REM Behavior Disorder or Narcolepsy.
Not all OSA patients are obese middle-aged men, though this is the group with the highest risk. However, all other patients should be screened using the Epworth Sleepiness Scale (link) or the Berlin Questionnaire (link) or by asking the patient simple questions such as:
Do you snore?
Are you excessively tired during the day?
Have you ever been told you stop breathing during sleep?
Do you ever wake up with a headache?
Uncovering these things, alone or in combination with a history of uncontrolled hypertension or diabetes or a neck circumference greater than 17 inches in men and 16 inches in women, should cause you to suspect possible sleep apnea.
Document Your Findings
CMS has made it very clear that an assessment for OSA risks should be documented by the treating physician prior to referral for HST and prescription of CPAP. Simply discuss with the patient your suspicion based on the findings above, check the BMI and neck circumference, check the upper airway for soft tissue abnormalities (such as enlarged tonsils or asymmetry) or nasal obstruction and document your findings in the patient's chart. By signing the IDS referral form, you are confirming you understand the importance of this assessment in the process (see statement above signature).
The Testing Process
Upon receipt of your order, IDS contacts the patient and ships a ResMed ApneaLink (type IV) device to their home. The patient applies two sensors at bedtime, a slip-on finger pulse sensor and a nasal cannula to record airflow and snore. A video and explicit, professionally drawn illustrations detailing each step are provided. Trained sleep technologists are available for patient assistance toll-free and 24/7.
The Results
Study results are reviewed by a board-certified sleep physician who will make recommendations for treatment based on the findings. Reports are easy to follow, and reading physicians are available for consultation by e-mail. Typical turnaround time is 5 days from referral to report.
Treatment
For patients that qualify for PAP, your preferred DME provider can work with you and your patient to help ensure optimal care and documentation of APAP CPAP usage prior to the required follow-up visit between the 31st and 91st day of therapy. You’ll be amazed at how easy it is to uncover and treat sleep disorders in your patients, and how well their improved sleep correlates to other areas of their health.
For Practice Parameters recommended by the AASM for implementing treatment using Auto-Titrating Positive Airway Pressure (APAP), please visit the AASM website or use the following direct link (link to AASM site subject to change):
http://www.aasmnet.org/Resources/PracticeParameters/PP_Autotitrating_Update.pdf
Home sleep testing now makes it easier than ever to uncover and treat sleep apnea in your patients.