today is not tomorrow in sleep technology...

TodayIsNotTomorrowinSleepTechnology”

AASPSunSandandSleep

LauraLinley,RPSGT,RST,CRT

Objectives

• Discusshowsleepeducationwillprogressinpolysomnography.

• Describethespecificjobresponsibilitiesthatsleeptechnologistswillfulfill.

• Differentiatethecurrentsleeptechnologistfromthefuturesleeptechnologist.

ChangeisHere!

• Payattentiontothechangesoccurringinthehealthcareenvironment!

• Thesechangeswillaffect…• Howsleepcentersarestructured• Theroleofthesleeptechnologist

TheFutureofSleepTechnology:AReportfromAAST SummitMeeting9/21/2013

RegulatoryandEconomicPressures• Pre-Authorizations• HSATUtilizationFocusShiftfromDiagnosistoOutcomes• PatientEducation• Monitoring/Follow-up• SleepTeam

A2ZzzArchiveVol23,Number3

KeyFactorsDrivingDiagnosticChanges?

Frost&Sullivan/AASMreport2015

$12.4billionspentDXandTXforOSA

5.9U.S.adultstested

$49.5billionneededtocareforthe23.5millionundiagnosedOSA.

Directcostofdiagnosisandtreatmentvs.costsofuntreatedOSA

Bundledpayment;outcomesbasedcare

PrevalenceandTreatmentofOSA

Source:AASM2016www.sleepeducation.org

IMPACTOFTREATINGOSA:QOL

InanAgeofConstantActivity,TheSolutiontoImprovingtheNations'HealthMayLieinHelpingitSleepBetter:2016AASMFrost&Sullivan

PhysicianSupplyPipelineShortageshttp://www.nmp.org/wp-content/uploads/2016/03/Results-and-Data-SMS-2016_Final.pdf

SleepSpecialist

SleepPhysicians:7,500

PersonsinUSwithOSA18,000,000RLS:30,000,00Insomnia:30,000,000

Ratio:10,400-1 NFWatson,IMRosenandRDChervin .TheFutureofSleepMedicine.http://dx.doi.org/10.5664/jcsm.6406

WorkforceNursePractitioners

• Projected35%increase2014-2024

PhysicianAssistance• Projected30%increase2014-2024

SpecialistCare(vs.PrimaryCare)• 48%NP/57%PAsinspecialtycare2010• 40%ofsleepcentershaveNP/PA2012

Unevengeographicdistributionofthehealthcareworkforcecreatesproblemswithaccesstocare

https://www.ahrq.gov/research/findings/factsheets/primary/pcwork3/index.html

Heat map of the geographic distribution of American Board of Medical Specialties (ABMS) board-certified sleepmedicine physicians (BCSMPs) across the United States.

PatientCenteredCare

SleepTeamMultidisciplinarycollaboration

PCPandHSATutilization

Telemedicine:PAPassessment—Insomnia(CBT)--RLS

HubandSpokeModelforIntegratingPrimaryCareProviders(PCP)intoEstablishedSleepCenters

• Patientevaluationandhomesleepapneatesting(HSAT)mightbeaccomplishedinthePCPofficeandinterpretedbyboard-certifiedsleepmedicinephysiciansinthesleepcenterhub• Morecomplexpatients,andthosewithindeterminateHSATs,wouldbereferredtothesleepcenter• PatientswouldbereferredbacktothePCPforlong-termmanagementoncetheircomplexissuesareaddressedandtreatmentisstable

NFWatson,IMRosenandRDChervin .TheFutureofSleepMedicine.http://dx.doi.org/10.5664/jcsm.6406

TheFuture

Sleepmedicineisshifting• fromanemphasisondiagnosistoafocusondisease-management

InlabPSGwillbereservedforthemorecomplex sleeppatients

ExpandingServicesThruTelemedicine

Leveragingtechnologysuchastelemedicineandsimplesmartphoneapplication-basedmonitorswillafford

increasesinpracticeefficiencyandpatientsatisfaction,andreducethecostofsleepcare

Buildingandnurturingthesleepteam,withspecialemphasisonengagementofprimarycare

providers,willbringsleephealthintotheforefrontofconsciousnessofthesefront-lineprovidersandincreaseaccessfor

patients

• Thereisanewemphasison• patienteducation• assistinginfollow-up• andoutcomesmanagement

• Expandyourhorizons- ourrolesareexpanding!

TheFuture

TraditionalRPSGTSkills

NewEssentialSkills

SleepTechnologistOpportunities

TheSleepTechnologistTherangeofservicesprovidedincludes• comprehensiveevaluationandtreatmentofsleepdisorders• diagnosticandtherapeuticinterventions,• comprehensivepatientcareanddirectpatienteducation.

Thisbroadrangeofservicesrequiresthatthesleeptechnologistexercise• criticalthinkingandindependentjudgment,and• possessanadvancedknowledgeofsleeptechnology,• sleep/wakedisorders• associatedco-morbidconditionssuchascardiacdisease,pulmonarydisordersanddiabetes.

AASTPOSITIONSTATEMENTInordertoattaincompetenceandadequateknowledgeofsleep/wakedisordersandtheirtreatment,theAASThasadoptedthepositionthatindividualsperformingsleeptestingproceduresandpatientcareservicespossessatminimumthefollowing:• Successfulcompletionofanaccreditededucationprogramleadingtoa

certificateorassociatedegreewithanemphasisinsleeptechnology.Bachelor’sDegreeandexperienceinthesleeptechnologyprofessionispreferred.

OR• AnAssociate’sDegreeorhigherfromanaccreditedcollegeoruniversity.AND• Certificationbyanationallyrecognizedcertificationboardandholdsthe

RegisteredSleepTechnologist(RST),RegisteredPolysomnographicTechnologist(RPSGT),orSleepDisordersSpecialist(SDS)credential.Iftheindividualisnotcredentialedatthetimeofhire,adeadlineforobtainingthecredential,establishedbytheemployer,isstronglyrecommended.

AND• Alicensetopracticesleeptechnologyinanystatethathasenacted

licensurerequirements.

RecognizedasaProfession

ThispositionsupportsbestpracticeandencouragescredentialingbodiesfortheSleepTechnologyprofessiontorequireaminimumeducationlevelforentryintotheprofession,thuseliminatingtheclinicalexperiencepathwayforcredentialingexaminationeligibility.

Sleeptechnologydoesnotbecomeaprofession untilminimumeducationlevelsareestablished.

EducationRequirement-howdoesthatlook?

• Whatwouldthefieldofsleeptechnologistslooklikeifthischangeweretotakeeffect?

• Wouldthecurrentpipelineoffutureprofessionalsberobustenoughtomeetthemarket’sdemandforsleeptechnologists?

• Howwouldthechangeaffectinstitutionswithsleeptechnologisttrainingprograms?Wouldtheyhaveenoughcapacity?

• Andperhapsmostimportantly,wouldthechangeleadtohigherqualityofserviceinthefield?

NeedsAssessment

TheAmericanAssociationofSleepTechnologists(AAST)retainedMcKinleyAdvisors(McKinley)toconductmemberresearchtoexplorethestateofthesleeptechnologistprofessionandhowchangestoeducationrequirementsforcertificationcouldaffectcurrentandfutureprofessionals

PREVIEW

• Sleepownersanddirectorsagreedthateducationplaysacriticalroleinthesuccessofsleeptechnologists. Thoughtheyacknowledgedthatit’sa“choretomaintaincredentials”theywereunwaveringintheirsupportforhigherandcontinuingeducation

• Formost,educationwasnotedashavingasignificantimpactontheirprofessionalsuccess,Onthejobtrainingwasalsonotedasprovidingvaluableexperiencesintermsofpracticalapplicationsinpatientcare

• Focusonprofessionalcompetence

Hurdles

• ConcernsinnothavingappropriateaccesstoAASPolysomnographyprograms

• ManytechnologistalreadyhaveAASandfeeltheBachelor’sDegreewouldhaveagreaterimpact

• Educationrequirementwouldpreventtalentedtechnicianswhoaren’tabletogetthroughschool

Conclusion

AASTtoworkwithcredentialingbodiesandCoAPSG

ContinuedfocusedsupportfortheCCSH

DevelopPBLtrainingtosharpencriticalthinkingskills

TechnicalGuidelinesandcompetenciesforAdvancedTherapy,TelemedicineandOutcomeManagement