Marry technology, service to succeed in sleep

Consistent advances in electronics and information technology is bringing sleep therapy to a new potential for HME providers in the marketplace, specialists in the field say. Yet they contend that success in the continually burgeoning field does not solely hinge on new hardware and software, and that it must be complemented by thorough research, context and specialized services.
"Technology in the sleep market has continued to advance and can greatly assist HME suppliers in dealing with declining reimbursement and the competitive bidding program," said David Lyman, vice president of Waterloo, Iowa-based VGM Respiratory. "There may be some truth that some of the technology, such as mobile apps for monitoring disease state and educational videos to assist with cleaning and mask fitting, are becoming more available, but I still believe that the sleep education program that suppliers provide has a larger role in compliance. Technology plays a part in this, but it is not the main contributor to compliance."
Ron Richard, co-founder of Deerfield Beach, Fla.-based AirAvant, concedes that monitoring patient compliance related to sleep therapy as well as other conditions such as diabetes has become easier and more affordable. Treatment options for patients have also increased and improved, he said, pointing to more comfortable masks, oral appliances, auto-pap and other features built into the devices.
Even so, "another area where we are starting to see an impact in improving overall care is the addition of telemedicine visits and sleep 'coaches,'" he said. "It's a well-known fact that patients who engage in weight loss programs do much better when they have access to a coach or person who can educate them about their progress and fine tune the program to the patients' needs. Sleep is a complex part of life and utilizing sleep coaches as well as other such tools will further benefit patients and increase adherence. I think we will see the evolution of sleep therapy devices increase as more patients are seeking better and more comfortable means of treating their OSA."
Studies have shown that patients who are engaged in a regular resupply program are more likely to remain compliant with their therapy and have improved clinical outcomes. For instance, a recent study of more than 2.6 million sleep apnea patients by San Diego-based ResMed reveals a 75% adherence rate when patients are remotely monitored. A separate study by ResMed shows enrolling in resupply programs increases long-term device usage and decreases termination rates.
"By having compliance data readily available, providers, physicians, and payers alike can clearly understand who is benefiting from sleep therapy and how," said James Barrett, customer and partner marketing manager for Lawrenceville, Ga.-based Brightree, a division of ResMed. "This ensures that those patients who are participating in a successful resupply program are supported by their payers, where those who are non-compliant are not an undue burden on those same payers. Compliance is a critical component to successful sleep therapy, and Brightree has found that providing key integration and making compliance easily accessible for providers gives them the necessary visibility to stay proactive, narrowing any gap a patient may be experiencing and leading to better patient engagement and patient outcomes."
As more patients begin using CPAP therapy and other sleep and respiratory products, HME providers and physicians are in need of finding ways to better manage their growing patient populations, said Jim Doty, senior director, North America Field Marketing for Murrysville, Pa.-based Philips Sleep and Respiratory Care
"Connected care helps HME providers and physicians do this by providing critical data and actionable insights that measure and inform effective care pathways and document the benefits of therapy," Doty said. "By helping patients become successful on PAP therapy, HMEs now have the potential to be partners in post-acute care, as well as provider quality service that results in a customer for life. Serving patients requires ongoing resupply of new masks, hoses, filters and water chambers, which ensures patients to continue getting comfortable and efficacious treatment, allowing for HMEs to earn an ongoing revenue stream for their continued service."
Retail opportunities
The sleep market is also becoming a force in new retail-oriented products, including CPAP cleaners and alternatives to CPAP. These new products are creating a buzz within manufacturing circles and representatives are waxing optimistic about the opportunities for HME providers.
"These products have huge growth potential," said PJ Ruflin, director of national accounts for Chicago-based Sunset Healthcare Solutions. "More people are being diagnosed with sleep apnea and more providers are searching for ways to increase compliance and drive better patient outcomes. If a product can accomplish those things, along with increasing the bottom line for the provider it can create a great opportunity for everyone."
Fort Belvoir, Va.-based Barber DME is banking on retail as a key component of the sleep therapy business, said CEO Tim Barber.
"We have been early adopters of many of the new retail products and have seen considerable growth in this area," Barber said. "People are really taking their CPAP therapy quite seriously and as a part of that they're much more focused on the overall hygiene of their equipment. We feel that as more quality products are introduced to the marketplace, consumers will feel that they truly do have options and will embrace these products as an additional element to their overall treatment."
To be sure, retail "is playing a bigger role in many sleep providers' business models as cash helps offset declining margins in other areas," Richard noted. "I think the growth for pharmaceuticals and over-the-counter medical products have great possibilities based on the ways our healthcare reimbursement system is working. Higher co-pays, along with fewer new codes to cover emerging technologies is driving patients towards cash-pay products and procedures."
Lyman adds that "providers must embrace the retail products for sleep, because they help with compliance and patient outcomes." For instance, he says PAP cleaners can save patients time and keep their mask and tubing clean of bacteria that can cause skin irritation or viral infections. PAP wipes can help provide a more sanitized mask between use and cleaning, while PAP pillows can assist patients who are on a nasal or full-face mask if they are side sleepers.
"These products are in demand by patients, and by offering them you are providing life-altering solutions, all while generating additional cash sales," he said.
Where Fitbits fit
Wearable technologies such as Fitbits have also made inroads as electronic monitors for public health and wellness have gained in popularity with consumers. Even though these products are typically sold at national retail chains, market specialists believe they can also be applicable to the independent HME segment.
"Any viable new introductions to the market that have a direct benefit to the HME provider should be embraced," Barber said. "Technology is a great thing when properly utilized and understood. The introduction of Fitbit and other wearable technologies may be viewed as competition by the traditional CPAP equipment providers, but from a purely HME retail perspective, it's long overdue and should fit nicely into existing business models."
Ruflin adds that wearables and other consumer electronics should be viewed as compatible with the HME wheelhouse.
"The idea behind a lot of these items is to keep patients out of the hospital and in their homes—this is right where HME providers want their patients, as its where HME's can provide the most value," he said. "If you think about how many issues are undiagnosed or properly dealt with, and how much recognition many of these wearables will bring to those issues, HMEs should be excited—not afraid—about the opportunities they present."