Current Healthcare Innovation by Sarah Brown https://padlet.com/sbrown611/5e0qnni6qed2 For Healthcare Informatics NURS 5324 en-us 2016-10-15 12:29:36 UTC 2017-05-17 09:54:50 UTC hello@padlet.com At Home Monitoring for the Diagnosis of Obstructive Sleep Apnea  sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130911766 2016-10-15 12:40:22 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130911766 References  sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130913174 Cattrysse, F., Peeters, M., Calaerts, S., Ferson, K., & Degryse, J. (2014). Detection of sleep apnea by case finding and home monitoring with Somnolter: a pilot study.  BioMed Central Research Notes. (7)(616) 1-9 retrieved from http://biomedcentral.com/1756-0500/7/616 

Smith, W. (2015). Obstructive sleep apnea and home sleep monitoring overview of obstructive sleep apnea. Medscape. Retrieved from http://emedicine.medscape.com/article/1518830-overview#a1

Woodson, B. & Ishman, S. (2013). Portable monitoring for diagnosis of sleep apnea. Current Otorhinolaryngology Report. (1) 16-19.   

]]> 2016-10-15 13:11:20 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130913174 Image of patient with HST in place. Image courtesy of Kristen Pickard, Embletta. sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130914472 2016-10-15 13:40:45 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130914472 Summary of Innovation sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130914699
  • Obstructive sleep apnea (OSA) is a frequently under-diagnosed condition that is linked to significant morbidity and mortality.  Common symptoms include snoring, restless sleep, daytime fatigue, and morning headaches.  Obstructive sleep apnea is the most common sleep-related breathing disorder, despite high prevalence, 70-80% of patients with OSA remain undiagnosed (Cattrysse, Peeters, Calaerts, Ferson, & Degryse, 2014).  If not treated, OSA is connected to an increased risk of cardiac, respiratory, and metabolic conditions, including hypertension, stroke, congestive heart failure, and sudden death (Smith, 2015).  
  • In-facility polysomnography (PSG) is the historical standard for the diagnosis of OSA. For the appropriate patient, however, home sleep tests (HSTs) can be used to diagnose this condition. PSG and HSTs use the same respiratory equipment, pulse oximetry equipment, and movement and position sensors (Smith, 2015). Data generated from each test is analyzed in the same manner. A number of studies of several different models of HST have concluded that the results are comparable to the traditional in-facility PSG (Smith, 2015).
  • HST allow a patient to sleep in their own home, following their normal sleep routines.  They wear the monitoring device for the prescribed number of hours of sleep and the device will alert the patient to any malfunctions or monitor displacement.  Having the HST completed at a much more convenient time, place and familiar surroundings for the patient eliminates the barrier of finding a night to sleep at an in-facility testing center and being in unfamiliar sleep surroundings.  
  • Several models of HST transmit the collected data over the internet, saving the patient a trip to deliver the device to the provider’s office for data analysis.  This data can then be immediately uploaded into the patient’s EHR, evaluated and treatment prescribed based on findings.   

    • ]]>     2016-10-15 13:45:51 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130914699     sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130918723 2016-10-15 14:48:18 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130918723 PROS to using Home Sleep Study  sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130918788
  • Provides a more natural sleeping environment which for some patients allows more accurate results
  • Reduced costs for some patients with the reduction of visits necessary to obtain a diagnosis which is necessary to prescribe appropriate treatment 
  • Recognized by the American Academy of Sleep Medicine as an acceptable diagnostic test for suitable patients, for the diagnosis of OSA (Woodson & Ishman, 2013)


    • ]]>     2016-10-15 14:49:41 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130918788     CONS to using Home Sleep Study sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130919661
  • Not all patients are suitable candidates for this type of testing, it is not approved for use in children
  • Some insurers (Medicaid, Medicare) do not reimburse for HST
  • Inability to distinguish between OSA and other sleep disorders such as hypersomnia, narcolepsy, and circadian rhythm sleep disorders
  • Testing equipment placed by patient and is not monitored by a technician, inaccurate placement or malfunction may lead to inaccurate results or additional testing   
    • ]]>     2016-10-15 15:04:32 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130919661     Opinion sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130921003 Caring for many patients over the years with un-diagnosed OSA, it has been a common excuse for not pursuing treatment because of the required in-facility sleep study needed to obtain a diagnosis.  The HST removes many barriers for a significant patient population. OSA is most frequently treated with Continuous Positive Airway Pressure, more commonly referred to as CPAP.  A diagnosis of OSA and prescription are needed to obtain this medical device which is worn by the patient while sleeping to keep the airway unobstructed.  HST is an advancement in healthcare possible because of the advancements made in informatics.  Accessibility to testing, convenience and almost immediate analysis of the recorded data improves patient acceptance and compliance with the innovation.     

    ]]>     2016-10-15 15:26:33 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130921003     Another type of HST monitor  sbrown611 https://padlet.com/sbrown611/5e0qnni6qed2/wish/130922863 2016-10-15 15:57:24 UTC https://padlet.com/sbrown611/5e0qnni6qed2/wish/130922863