Sleep Disorders

Home Sleep Apnea Testing

An enterprise-wide home sleep apnea testing (HSAT) program was launched in 2013. HSAT is an integral component of the Obstructive Sleep Apnea (OSA) Care Path that provides the framework for implementing a standardized, cost-effective approach for identifying and setting the stage to treat OSA. HSAT, a confirmatory test for patients with high pretest probability of moderate-to-severe OSA, has experienced consistent volume growth: from 2013 to 2018, there was an approximate 7-fold increase in HSAT volume, including a 20.2% increase in the HSAT volume in 2018 as compared with 2017.

The HSAT failure rate was 6.3% for 2018 with a range from 4.1% to 8.9%. As HSAT failures in existing reports are typically 10% to 20%, the center’s goal is to maintain a rate < 10%. The failure rate decreased from 6.4% in 2017 despite an increase in the number of home tests that were completed. Ensuring low HSAT failure is important to enhance efficiency of OSA diagnosis and limit burden to patients in terms of repeat testing. Of the failed studies (defined as being of insufficient quality or duration to lead to a diagnosis), approximately 93% were due to patient’s inappropriate use of the device and 7% were due to a machine malfunction.

Changes were implemented to continue to facilitate patients’ use of the HSAT device. A new checklist provides answers to commonly asked questions that patients may have about how to use the device, useful troubleshooting tips, instructions in terms of how to return devices, and information about how to follow up with their providers regarding the results of the tests. An electronic medical record-based message was also created that includes troubleshooting tips and phone numbers that patients can call to reach a sleep technician to address any questions pertaining to HSAT.

Percentage of Home Sleep Apnea Testing Failures for Devices Deployed in Ohio

December 2017 - December 2018