“When you look at the numbers, with so many—80%—of those people undiagnosed, there will be increased spending in this space, Americans with sleep apnea,” Nelson says. “And unfortunately many Americans are becoming more obese,” he says. More and more, he says, patients will need comprehensive care for sleep disorders, which means more income for companies like his and hospitals. With growing awareness, there is an opportunity for “consolidating programs for a continuity of care.”
Success Key No. 1: Patient screening
The Carle Foundation Hospital in Urbana, IL has seen significant growth in its sleep care program by screening all patients admitted to the 315-staffed-bed hospital for sleep apnea. The hospital has increased its population in its sleep labs by as much as 9% in the past two years, which Bill Vogel, RRT, BSRT, MBA, FACHE, director of pulmonary services, says he attributes in part to the new screening.
Patients who already have been diagnosed with sleep apnea are asked to bring their continual positive airway pressure masks with them to the hospital and are placed on automatically adjusting positive airway pressure during the time they are in the hospital for evaluation.
Patients who have not been previously diagnosed with sleep apnea are asked a series of questions to determine if they are at increased risk for sleep apnea. When patients answer four or more questions affirmatively, the hospital’s EMR automatically opens an alert that is made available to the nurse or therapist caring for the patient.
“We felt we were missing a lot of people who had sleep apnea,” says Vogel. “If patients were coming in for a hip replacement, they weren’t saying, ‘By the way, I have sleep apnea.’” For many, they didn’t realize they had sleep apnea, Vogel says.
When the hospital began the screening program, 20% of admitted adult inpatients screened positive for risk of OSA. An additional 10% already had been diagnosed with OSA and were treated for it when they arrived at the hospital, according to Vogel. For “whatever reason,” he says, “only about half of those patients follow through.”
Referring to the sleep lab’s growth in volume, “we don’t know how much of that is due to our screening program, but we know it has had some impact on those numbers,” Vogel says.
“We are doing a much better job of recognizing those patients and getting appropriate care, and putting those screening programs in place,” says Vogel. “We are able to capture those patients at risk and monitor if we see that; before, they were totally going through the system without any significant monitoring or awareness.”