CLEVELAND – Awareness about the value of clinically proper sleep is high, but CPAP compliance among patients remains a challenge for HME providers. Josh Marx (pictured), managing director, Sleep, and vice president, Business Development at Cleveland-based Medical Service Company, has thought about CPAP compliance over the past few years, all the while showing a willingness to try new ideas.
With 2022 finally upon us, Medtrade Monday sat down with Marx to get the latest on his thinking about CPAP compliance and the best ways to improve it. He is optimistic about the category in the new year, but he adds, “2022 isn’t gonna be easy.”
Medtrade Monday: What is your assessment of “sleep awareness” these days?
Marx: The importance of restful sleep continues to gain national exposure. At a macro level, the American Academy of Sleep Medicine established a Congressional Sleep Health Caucus in late 2020. The growing prevalence of sleep disordered breathing helps as well. My only fear is that because of the limited supply of CPAP devices, there may be a hesitation from providers to screen and diagnose as rapidly as before.
Medtrade Monday: Among HME providers who are looking to improve their PAP adherence program, what is the biggest misconception?
Marx: I think there are two: 1) If you call them, they will answer. That’s probably the most obvious one, because most of us know that we are leaving far more voicemails than having valuable clinical discussions with our patients. 2) Using your device four hours per night is a ‘compliant’ therapy user. We have thousands of patients who meet the hourly use criteria to ‘meet compliance’ that have other challenges with their therapy that merit intervention, such as leaks, continued apneas, etc.
Medtrade Monday: Why did you change your PAP adherence program back in 2020?
Marx: The initial reason for reimagining our program was due to the fact that we were employing compliance agents, calling our patients each day to help them with their therapy when the compliance platforms indicated they were not meeting compliance. Sadly, 80% of our calls were going to voicemails. So, as we grew, the idea of adding more agents to leave voicemails felt like the definition of insanity.
Our goal then became to create valuable and automated outreach to our patients, compelling them to reach out to us how they want and when they want—and having a team of agents available for those inbound inquiries. The secret sauce of the program came from our vice president of Clinical Services, Scott Owsiak, MHA, RRT when he opened our eyes to a four-hour/night user who was not necessarily a compliance patient, as mentioned before. Because of this, we enrolled patients into three different pathways depending on their therapy needs—clinical, adherence, and rescue. Each pathway engages with patients at a different frequency offering different points of value.
Medtrade Monday: How did compliance evolve when the pandemic hit?
Marx: The two major data points that we monitor more closely upon the pandemic are compliance and mask refit rate by method of CPAP setup. We offer several different options for setup—Zoom, audio, self-guided, and in-person. Each patient consumes the education differently, and it’s our responsibility to make the experience simple and educational for any option the patient selects.
Medtrade Monday: With the new year upon us, what is your level of optimism about the CPAP business?
Marx: CPAP remains an important therapy for patients and providers. I think the importance and value it offers to the healthcare ecosystem has been magnified due to the Philips recall, so I still am very optimistic about the category. That said, 2022 isn’t gonna be easy.