How to Establish Effective Technical Guidelines for Sleep Studies
AAST Board of Directors member Joanne Hebding shares her insight on technical guidelines for sleep studies
Meet AAST board of directors member Joanne Hebding, RPSGT, RST, who shares her professional and personal insight on how to successfully understand the technical guidelines for conducting sleep studies.
About Joanne and how she got her start in sleep medicine
In our AAST director spotlight, Joanne shares her professional background and how she got her start in sleep medicine.
I went to college majoring in marine biology but like many current college students, my life course changed when I was hired by a prominent neurology group in the Chicagoland area as a Research Study Coordinator (working on the drug protocol that is currently marketed as Ticlid™) and Neurodiagnostic Tech.
In 1987, the hospital in which I was born (Little Co. of Mary, Evergreen Park, IL) opened a 2-bed Sleep Center and I was hired as the first technologist. I was trained for two weeks in sleep by the Chief Tech at the University of Chicago, Diane Nummey. I sat for the old RPSGT boards (both written and practical) and achieved my registry in 1992.
I moved to take a job as the Chief Tech at the University of Miami/Miami VA Medical Center in Miami, Florida. I was exposed to research and was first published on PTSD with Dr. Thomas Mellman. The UM lab was the first of four labs I helped to secure AASM accreditation. I transitioned to Baptist Hospital of Miami in 1996 as the Manager of the Sleep Center, EEG and Bladder Center.
During the UM - Baptist days, I began to network with a regional sleep society: SE/SW RAPT where I held office for several years. With the encouragement of Theresa Shumard, past editor of A2Zzz, I began writing articles for the magazine. Speaking at different meetings, APSS, state and regional meetings, brought another skill set. I became involved with several APT-AAST committees as a volunteer and was encouraged by many to run for a position on the AAST Board of Directors. I worked for XLTEK for several years. I currently am the Manager of Tallahassee Memorial Sleep Center, a 12-bed center.
I have been a Director-at-Large several times and am currently serving in that position today. I have met many wonderful sleep professionals in my 25+ sleep years, and am always looking to meet many more new ones in the future.
Joanne's tips on how to become an expert on the technical guidelines of your sleep center
1. Make sure you, your colleagues and your facility have the right credentials
It's an obvious point, but also the most important part of administering sleep studies is to ensure that those conducting the studies have the basic knowledge to monitor the unusual activities they may encounter in patients.
"Having the basic knowledge to monitor what you're seeing in patients as well as having the ability to understand the pathology underneath what you're seeing to determine treatment options," says Joanne.
It's important to also ensure that your sleep center facility and staff is also accredited by the American Academy of Sleep Medicine (AASM), TJC or even the ACHA.
The AASM offers a variety of accredation options, which include one for sleep facilities and clinics where patient evaluation, management and laboratory testing occur that utilizes in-center overnight polysomnography for the diagnostic testing of patients.
"In the case of my sleep center, we run under the practice parameters, rules and regulations established by the AASM," she says. "The AASM scoring manual is especially important in providing the necessary tools to run sleep studies in terms of providing guidelines for what is needed for a CPAP titration, what is needed for diverse treatment modalities and what you need to do to get reimbursement through your local insurance providers."
2. Keep in mind that certification and registration is key to receive reimbursement from your local insurance providers
In order to receive reimbursement from Medicare, it's important that the sleep study the patient is undergoing is conducted by a registered sleep technologist who is also board certified.
Medicare and most other insurance companies will pay for a CPAP or bi-level device and related accessories and supplies, provided that specific coverage criteria are met. The AASM provides comprehensive guidelines for navigating sleep study reimbursement issues whether it is coding or determining whether your facility has the correct certifications and registrations to be eligible for reimbursement.
3. Always remember that keeping your policy based on good practice means that you should also adjust your technical guidelines when needed.
Sometimes you need to adjust your facility's technical guidelines according to events and changes that happen within sleep medicine, according to Joanne.
A great example is the recent field safety notice that recommended that patients with symptomatic, chronic heart failure avoid using ASV to treat their moderate to severe central sleep apnea syndrome. The AASM, along with companies like Phillips Respironics released statements on the notice, and recommended that some sleep facilities change their technical guidelines accordingly.
"And that's what we did because patient safety comes first," Joanne says.
Do you think you have the right technical guidelines, yet you do not see positive growth in compliance rates?
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