today is not tomorrow in sleep technology...
TRANSCRIPT
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