What are we to do?

Topics related to in home sleep testing (portable monitoring)

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Postby Drake » Fri Dec 14, 2012 2:00 am

:?: :shock:
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Postby Drake » Mon Dec 17, 2012 1:24 pm

So,were will the jobs be in Sleep in the future? Or will this field completely disintegrate?
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Postby stars » Tue Dec 18, 2012 4:46 am

Ask WH :lol:
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Postby Drake » Tue Dec 18, 2012 5:11 am

Who is that? Anyway,I'm just upset!!!! I've spent money to become a Polysomnographic Technologist ,why wasn't the possibility of the field imploding not discussed ? I feel as though I have wasted time/money... :evil:
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Postby Rick » Tue Dec 18, 2012 9:37 pm

Drake, at least you were not in the field when self titrating CPAP machines ended it, or earlier when computerization cut staffing considerably at all sleep facilities. Super sarcasm filter needed.

It is not just sleep but all of medicine is in trouble when insurance companies practice medicine by limiting what they will pay for to only those processes that they have deemed necessary for any particular condition.
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Postby Rocklandish » Wed Dec 19, 2012 2:52 am

The loophole lies in modalities and secondary sleep disorders such as RLS/PLMS. If you can prove either then the insurance company will approve the PSG.
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Postby wakingupinvegas » Wed Dec 19, 2012 6:03 am

I have talked to our day staff and they said that they have tried to get PSG approved vs. HST due to PLMD/RLS and she told me even with that some insurance companies will deny in lab PSG.
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Postby Rick » Thu Dec 27, 2012 8:15 pm

Okay, a patient presents with a sleep disorder. Don't know which one but the symptoms include inability to stay awake in the daytime when bored. A PSG is ordered, sent to insurance company for review. Insurance company notes that patient appears to fit the habitus for a typical OSA patient, approves an HST only.
If the HST is done and scored and does not reveal a sleep breathing disorder, the patient must now go through a full PSG.
Once the HST is all that will be done, the diagnosing is not complete, the patient must be followed up with, there are 80 different sleep disorders that could be causing this patients problems.
The more times that an insurance company sees this happening, hopefully they will learn that the HST can be a waste of time.
Insurance companies are only beginning to learn how to practice medicine.
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Postby somnonaut » Thu Dec 27, 2012 8:25 pm

That is why silly economics based 'standard of care" will not suffice. We need true STANDARD OF CARE to rule the patient sleep interactions.
www.apneanetwork.com
The currect BCBS new HST clearing process through a company called AIM is almost exactly what I have been proscribing over the last 3 years thru my ApneaNetwork, except theirs does not use AASM standard of care, but their own Cardiologist inspired (not sleep doc) standards. (good thing they have a cardiologist involved in people's sleep care)
We need to think of the original rationale that HST was asking.
I found this at Clevemed which finally shows what the path was.
Image

Why did everyone forget the speed to treatment part????
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Postby somnonaut » Thu Dec 27, 2012 8:26 pm

Should read "The current BCBS new HST..."
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Postby Dcrazy » Fri Mar 01, 2013 3:21 am

So are sleep techs dead? I know private labs will suffer...However, your seeing schools sell sleep...go to any school site that has polysom, read it. At the same time, since sleep is based off a technology....will sleep techs( registered ) end? If you look at the stats, students have doubled since 2008. However, read this article... http://respiratory-care-sleep-medicine. ... ast-3.aspx I want to point out this article was in 09'. I mean you just had the RST. I know the manufacturers of sleep devices promised good return on docs, but they didn't as promised. So it will hurt private labs...To replace everything, etc... I called a HST for the heck of it....I asked, " So who does the scoring, doctor, a sleep tech, RRT?" Response: " We train people." So I look at my states respiratory care act....LOL. You don't even have to be registered for anything. My state had one sentence..-.ok it was a run on sentence- on the resp. care act. Ok, so then you have that on top of lack of reimbursements. Sleep should, or should have followed the OT( occupational therapists ) model of business. Any who, my problem is I don't go to bed until 3 A.M normally, so I looked into sleep tech as career. Only need 22 credits for an A.S- all my other sciences are complete. So idk?
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Postby somnonaut » Fri Mar 01, 2013 4:56 am

In NY, now that we got the legislation passed covering Sleep Technologists, it provides that ANYONE who provides ANY testing for sleep disorders MUST be Authorized under this authorization. I had written this to make sure that this new technology would not skirt the issue of having qualified people hand these things out. So, as you point out, it will get interesting to see how offices who routinely hand out HST over the counter, now must have authorized techs to do this, and the scoring and reporting of such testing.

Hey, we tried to be proactive.
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Postby labman2 » Fri Mar 01, 2013 2:29 pm

somnonaut wrote:In NY, now that we got the legislation passed covering Sleep Technologists, it provides that ANYONE who provides ANY testing for sleep disorders MUST be Authorized under this authorization. I had written this to make sure that this new technology would not skirt the issue of having qualified people hand these things out. So, as you point out, it will get interesting to see how offices who routinely hand out HST over the counter, now must have authorized techs to do this, and the scoring and reporting of such testing.

Hey, we tried to be proactive.


But in NY if you work one shift a week you can not get certified right now!
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Postby #42dreamweaver » Fri Mar 01, 2013 3:46 pm

Dcrazy wrote:Any who, my problem is I don't go to bed until 3 A.M normally, so I looked into sleep tech as career. Only need 22 credits for an A.S- all my other sciences are complete. So idk?


I'm assuming you're 20-25 years old. You need to have a plan B. I know you don't go to sleep till 3AM which is why nursing and respiratory were ruled out since their clinicals are at 6am. With that mindset, you're limiting yourself to what you can do. Truth of it is, we live in a 9-5 society with many jobs that fit you're sleep hours if you plan to keep those sleep hours the rest of your life. Sleep as a career is something to consider, but given the way the field is going, you may want to re-consider nursing or RT to have a back up plan. I'm closing in on 40 years of age and 10 years in sleep. I have been working a combination of days/evenings/overnights and I can tell you if I had completed my RN, I wouldnt have the angst I have now over the way things are going in sleep.
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Postby bduce » Sat Mar 02, 2013 1:14 am

Just different perspective Dcrazy (and I certainly do not know all that is going on in your life) but....

Instead of getting all worked up about sleep and jobs that fit in with your current sleep schedule, have you actually thought of seeing somebody to sort out your circadian rhythm disorder?

By what you have described so far it seems that your sleep schedule predates your career in sleep. So why not sort that out and open up a wealth of career options? That would seem logical to me at least.
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