Virtual visits expected to continue for sleep

As the country prepares to transition away from COVID-related restrictions, the sleep therapy industry is looking at how to proceed with patient care, CPAP provision and sleep testing going forward. One of the main issues is whether continuing with virtual technology applications used during the height of the pandemic is beneficial or necessary. According to some sleep specialists, the trend will continue.

Katherine Royster, vice president for sales and marketing at Winter Haven, Fla.-based 3B Medical, cites the successful implementation of virtual setups and patient visits as a reason why things aren’t likely to change.

“The way the industry is operating and the acceptance of patients has been amazing,” she said. “I believe that providers will add virtual visits permanently to their options for patient setups in the future.”

The past year has also pushed manufacturers to be more creative in their offerings to HME providers to serve patients in a touch-free manner. For example, Royster said 3B Medical is about to roll out its “3B 2 Go!” program, which defrays risks to a provider from patient non-compliance.

Alternatives arise

One of the pandemic’s important influences on technology is how it has been universally accepted, said Curt Merriman, chief sales officer for Frankenmuth, Mich.-based rtNOW. Yet certain aspects are susceptible to change, he said.

“The acceptance by payers, providers, patients and HME organizations has been essential in providing patient care,” he said. “We have seen a jump in use of virtual equipment setups and follow-up visits and are seeing this to be as similar in effectiveness as in-person setups. Organizations will need to be keenly aware of HIPAA rule changes as the emergency peacetime pandemic rules change. Currently, non-HIPAA compliant video chats are acceptable; however, this will likely revert back to video chats for telehealth requiring a HIPAA compliant platform.”

While connective technology has expanded greatly during the past year, Robyn Woidtke, vice president of regulatory, clinical and quality at Brisbane, Australia-based Oventus Medical, cautions that it doesn’t cover everyone.

“As the pandemic continued, it was clear that patients needed an alternative for their sleep health needs,” she said. “Telehealth technology has created the opportunity for many patients who may not otherwise have access. Technology has to some degree addressed social determinants of health, but those without internet or mobile technology may still be at a disadvantage, so increasing access is something to work toward.”

Sleep testing status

Regarding CPAP units themselves, the adoption of auto-setting algorithms is making a deep dent in brick-and-mortar sleep lab testing, said Thomas Miller, general manager, North Billerica, Mass.-based Breas Medical.

“Physicians were initially reluctant to accept auto-setting units because they saw it as the beginning of the end for sleep lab testing and they were right,” he said. “Yet they do now accept it, and titration studies aren’t needed anymore. Sleep labs still play a valuable role in diagnosing sleep disorders, but not for garden variety sleep apnea, which is about 80% of the sleep therapy business.”

Digital communications channels played a huge role in getting patients diagnosed during the pandemic, and it “fast-tracked the usage and demand of home sleep testing,” said Sonal Matai, market leader for sleep and respiratory care for Murrysville Pa.-based Philips’ North America division.

“Both in-lab polysomnography and home sleep testing will remain as we go forward, and both will be instrumental in diagnosing patients to improve outcomes and give the right therapy,” he said. “But as this shift to virtual care continues to expand, the trends will be all about making home sleep testing more robust to deliver better diagnostic accuracy, and broader physician acceptance.”

Emphasizing hygiene

COVID-19 has greatly increased awareness of germs and the importance of hygiene, which extends to sleep products, Royster said.

“Sleep items that are worn on the nose and mouth can be magnets for germs and bacteria and patients want a simple and convenient way to keep their equipment clean,” she said. “Products that are proven to kill germs and bacteria in five minutes like the Lumin ultraviolet sanitizer offer a hassle-free way to keep equipment clean and patients free of harmful germs.”

As with any medical product used by the patient at home on a regular basis, “the need for good hygiene has always been there,” Woidtke said.

“Oral appliances for OSA are not any different,” she said. “The manufacturer’s instructions for use likely include a regimen for patients to follow for daily cleaning and twice-a-week deep cleaning using denture-type cleansers. Of course, during this pandemic there is a heightened awareness and compliance with hand washing and reduction of aerosol contamination.”