By Jane Kollmer
For many people, the end of the year includes family gatherings, holiday festivities, and—perhaps—sleep studies.
Several factors could influence people to address sleep problems during the final months of the calendar year. In areas with cold temperatures and shorter daylight hours, people might pay more attention to sleep health concerns. “Additionally, holiday stress can exacerbate sleep problems, prompting more individuals to seek solutions,” says Kayla Sidorski, MBA, RPSGT, director of the home sleep apnea testing department at sleep testing services company MedBridge Healthcare.
Also, patients with high-deductible insurance plans may wait until they reach their deductibles. “The increasing adoption of high-deductible plans by consumers has resulted in a trend of delaying non-preventative diagnostic tests, such as sleep diagnostic tests, until deductibles are met,” says Skip Ashmore, chief commercial officer at Onera Health, developer of a patch-based sleep test. “On average, enrollees in health plans that meet their deductible do so in mid-May, leading to increased demand [for medical services] in the second half of the year.”
This means the last four months of the year can be exceedingly busy for sleep businesses. The increase in patients seeking home sleep tests (HST), for example, can be illustrated by MedBridge Healthcare. In the fourth quarter of 2023, the company saw 36% of its annual home sleep study shipping occur, according to Sidorski.
To take advantage of the upcoming consumer interest in sleep medicine, experts at sleep testing manufacturers and service companies offer practical tips for meeting the increased demand for tests, services, inventory, and staffing.
Prepare Your Operations
Operational readiness is key to accommodating more patients than usual. Sleep physicians should review their workflows to determine where they need additional support.
“Perhaps they are short on testing equipment, short on staff, or their staff members don’t have enough time to manage the testing process,” says Ayelette Raviv, director of communications and sales operations at sleep testing services company Snap Diagnostics.
Patients managing their end-of-year healthcare costs are also frequently concerned with beginning treatment quickly. So sleep practices will need to plan for the uptick in tests being ordered by having equipment and staff available to turn around the HST promptly, according to Sarah Weimer, vice president of sleep products and services at sleep diagnostics company CleveMed.
Prepare by having the device capacity to handle the anticipated load, echoes Troy Pridgeon, vice president of US sales at software as a medical device maker SleepImage. “Look for a solution that is quickly, easily, and inexpensively deployed that will render results with minimum staff effort,” he says. “It will also help to have form factors that require minimal cleaning effort and fewer or no consumables in stock.”
Consider single-use HST devices and/or those that upload data to the cloud the morning after the study. “While you can rally staff to put in extra hours or shift focus to addressing a surge in HST demand, you can’t get a device to work overtime,” says Edmund Shaw, vice president of marketing at SleepImage. With traditional multi-patient use HST devices, it is nearly impossible to achieve more than three turns in a five-day period. Not every patient is going to get the device back the morning after.”
[Related: How to Get Your Home Sleep Testing Devices Back on Time]
Other potential solutions include:
- temporarily extending hours,
- hiring additional staff,
- adding or expanding use of software solutions,
- and/or expanding home sleep testing to alleviate the demand for in-lab resources.
“You want to support the lowest cost, easiest process for the patient but never recommend an HST when a PSG is more appropriate for the patient’s condition and symptoms,” says John Mathias, chief development officer at MedBridge Healthcare.
Leverage Technology
One of the most efficient ways to manage more patients is to streamline the intake process with technology. For example, utilize digital pre-screening tools to eliminate some in-office time. Consider software that lets patients self-schedule their appointments to decrease the load on front desk staff. Increase offerings for telehealth consultations, which are faster than in-person visits.1
Patient Education
To prepare for a strong end-of-year finish, sleep businesses should consider ramping up their patient education efforts early in the fourth quarter. This includes identifying people who delayed or declined sleep testing earlier and reminding them to complete their testing before their insurance deductible resets.
“Communicate the whole process from testing, diagnosis, to treatment with patients,” Weimer says. “Patients that move through testing promptly now will be able to have treatment fully initiated before the end of the year.” Emphasize how delaying diagnosis and treatment for sleep disorders can profoundly impact a person’s health, especially if they have cardiovascular disease, metabolic disorders, mental health conditions, and/or respiratory conditions.
Also continue to educate referring physicians on the importance of sleep health, so they can help their patients resolve sleep problems sooner.
When Patient Demand Remains Too high
In some cases, the demand for certain types of testing may still be too high for a sleep lab or practice to accommodate before Dec 31. In those cases, potential solutions include:
- utilizing at-home type II sleep testing,
- outsourcing to an HST services vendor, and
- prioritizing high-risk patients.
Type II Home Sleep Testing
Sleep medicine has seen new launches in the type II home sleep testing space. This means some patients who are not good candidates for the more common type III HST, including those who had an inconclusive type III study, could potentially still test at home instead of using in-lab resources.
“The number of patients in sleep labs is increasing, exceeding available resources. However, technological advances are providing innovative ways to efficiently and effectively gather the necessary and comprehensive data for diagnosis,” Ashmore says. “By utilizing these options and triaging patients into the most efficient pathways, the highest level of productivity can be achieved.”
Outsourcing HST
Utilizing an HST service during this busy period can also be part of the solution.
“Usually, practices either have to rely on the number of HST systems they own or purchase more systems to handle the influx of studies,” says Richard Kaplan, PhD, president at General Sleep, which recently launched Zmachine HomeDirect, which can be used by practices as a supplement to their inventory of devices. “This hybrid approach allows them to comfortably handle changes in patient load without having to increase their overall capital equipment spending when finding themselves in the occasional backlog situation.”
Home sleep testing outsourcing solutions come in many forms, and practices can choose to have a company handle the entire process, including interpretation and billing, or just the testing. These services and logistics solutions can be ramped up quickly as demand increases.
“This can help sleep professionals complete studies when patients are motivated for the test without needing to invest in more equipment and allow staff to focus on study results and follow-up,” Weimer says.
Ashmore recommends that sleep professionals invest time early in finding an outsourcing partner that not only has the technology they trust but can also provide excellent service to their staff and patients. He says, “Integrate these partners into your practice and ensure they meet your standards before the rush at the end of the year.”
Triage to Identify High-Priority Patients
“If providers do experience a large amount of new patients requiring HST, which creates a backlog, it’s important for the provider to risk-assess each patient by potential severity, like high [body mass index] and contributing comorbidities, so they can get those patients to the front of the line,” says Kyle Miko, CRT/CSE, founder and chief marketing officer of VirtuOx, a sleep and cardiology testing company.
Also understand both the power and limitations of the tools in your lab, advises SleepImage’s Shaw. “Overscoring should focus primarily on any portions of poor signal quality,” Shaw says. “Check the 510(k) of your solution to see exactly what editing is mentioned in its indications for use. Many mention specific event types that need to be manually edited.”
Plan Ahead for Year-Round Testing
Of course, many of these solutions can be used throughout the year—not just during the fourth-quarter rush.
“We recommend to be prepared in all seasons and quarters, as per our experience, patient and provider needs are always changing,” Raviv says. “It can help ensure your patients get tested within a reasonable amount of time during peak periods (before the end of the year if that is their goal) and, most importantly, keep your referral sources happy.”
Reference
1. Hoi KK, Brazina SA, Kolar-Anderson R, et al. A longitudinal comparison of telemedicine versus in-person otolaryngology clinic efficiency and patient satisfaction during COVID-19. Ann Otol Rhinol Laryngol. 2021 Dec 3:34894211055349.
Photo 171685505 © Andrii Yalanskyi | Dreamstime.com
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