ResMed AirSense Remote CPAP setups User Guide

User Guide for ResMed models including: AirSense, Remote CPAP setups, AirSense 10 Remote CPAP setups

ResMed guidebook Remote CPAP setups

a. Establish a method for identifying your remote setup patients (i.e. AirView location or clinical user fields). b. Leverage remote tools to support patients: . - AirView Action Groups or U-Sleep. - AirView Remote Assist. - AirView remote prescription settings. c Follow up with each patient having any challenges within

Remote CPAP setups - ResMed

ResMed guidebook Remote CPAP setups 1 Table of contents Helpful tools for getting started.................................. Page 3 Home delivery & remote setup checklist.................... Page 4 Key payer requirements to keep in mind .................... Page 5 Patient touchpoints map............................................. Page 6 Key steps and resources Intake.......................................................................... Page 7 ResMed MaskSelector & resources ........................... Page 8 Pack, ship & deliver..................................................... Page 13 Boarding & prescription .............................................. Page 15 Scheduling & resources.............................................. Page 16 Setup .......................................................................... Page 18 Compliance support.................................................... Page 25 Download PDF Download PDF Download PDF Download PDF Download PDF Download PDF Download PDF Download PDF Note: throughout this document you may click on the color-coded tabs at the top to skip to each section. 2 Helpful tools for getting started Email Obtain patient email address and use a secure platform to communicate on equipment delivery, setup and support. Electronic signature Collect intake paperwork and credit card authorizations electronically with platforms such as DocuSign®. Video/web conferencing Set up your patients virtually using communication platforms such as ZoomTM, Apple® FaceTime® or SkypeTM.* ResMed videos Visit ResMed.com/SleepApneaBasics for patient education and support videos to optimize setups. *Effective 3/17/2020, the HHS Office for Civil Rights (OCR) will exercise enforcement discretion and waive penalties for HIPAA violations against healthcare providers that serve patients in good faith through everyday communication technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency. Under this notice, however, FacebookTM Live, TwitchTM, TikTokTM and similar video communication applications are public-facing, and should not be used in the provision of telehealth by covered healthcare providers. Guidance is subject to change without notice. For further details, visit https://www.hhs.gov/hipaa/for-professionals/ special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html 3 Home delivery & remote setup checklist Ensure you have everything you need for successful home delivery and remote setup by downloading a copy of our printable checklist. 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4 Key payer requirements to keep in mind All coding, coverage policies and reimbursement information is subject to change without notice. Verification is always the responsibility of the provider/supplier. Instructions for use1 · The beneficiary and/or their caregiver has received instruction from the supplier of the device in the proper use and care of the equipment. Proof of delivery/date of service2 See Pack, ship & deliver module for CMS guidance related to COVID-19. Proof of delivery (POD) · POD documentation, as well as claims documentation, must be maintained in the supplier's files for seven (7) years (starting from the date of service). · For delivery via shipping or delivery service directly to a beneficiary: · If the supplier utilizes a shipping service or mail order, the POD documentation must be a complete record tracking the item(s) from the durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) supplier to the beneficiary. · An example of acceptable POD would include both the supplier's own detailed shipping invoice and the delivery service's tracking information. · The supplier's record must be linked to the delivery service record by some clear method like the delivery service's package identification number or supplier's invoice number for the package sent to the beneficiary. · The POD document must include: · Beneficiary's name. · Delivery address. · Delivery service's package identification number, supplier invoice number or alternative method that links the supplier's delivery documents with the delivery service's records. · A description of the item(s) being delivered. The description can be either a narrative description (e.g. full face mask), a Healthcare Common Procedure Coding System (HCPCS) code, the long description of an HCPCS code or a brand name/model number. · Quantity delivered. · Date delivered. · Evidence of delivery. · Suppliers may also utilize a return postage-paid delivery invoice from the beneficiary or designee as POD. This type of POD document must contain the information specified above. Date of service · As a general Medicare rule, the date of service shall be the date of delivery. · If a supplier utilizes a shipping service or mail order, they may also use the shipping date as the date of service. 1. Be sure to check with payers for any specific guidance that may differ from CMS. 2. We suggest that you ask the patient for permission to record the setup session for billing purposes. WARNING: many states prohibit recording phone calls without permission of all parties. 1 CMS LCD: PAP Devices for the Treatment of OSA (L33718). Eff 01.01.20 2 CMS LCA: Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426). Eff 04.06.20 5 Patient touchpoints map Calls Emails Intake MaskSelector tool & resources Intake call / MaskSelector invitation Mask selection & therapy education call (only if using Option 2) Therapy resources email Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Scheduling call Setup call myAirTM invite Setup appointment, tracking info & resources email Setup follow-up email As-needed interactions 6 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Intake 1 If you use a billing management system, such as BrightreeTM, create a profile for the patient using the information from the referral source, following your standard process. 2 Call the patient to confirm patient qualification: · Phone required, recommend a video-enabled device. · Internet access for online support materials. · Patient willingness. · Any other internal requirements. 3 If the patient is qualified, confirm the shipping address and email. · Update patient record, including contact information, as needed. · If the patient does not qualify for home delivery and remote setup, follow standard processes. 4 A mask assessment will need to be completed if the mask is not prescribed. · If not prescribed, there are two options you can use to determine the right mask: Option 1 The ResMed MaskSelector tool will automate your mask selection and sizing process. · Send the patient a unique link to have them complete this process. · See the ResMed MaskSelector module for more information. Option 2 Transfer to a clinician after the intake call OR schedule a follow-up call with a clinician to determine the mask. · You may have the scheduler collect initial mask information and transfer to a clinician for further assessment. · Guidance for remote selection/fitting is in the MaskSelector tool and resources module. 5 Documentation: · Patients need to sign all of your standard consents, as well as provide approval for outreach via additional modalities such as video, email and/or text message, if applicable. Many patients are being extra vigilant about scams. It's best practice to send emails while while you're on the phone with the patient, so they can open them, as well as to confirm the sender, what information will be requested and what actions will be recommended. · Obtain credit card authorization for co-pays. · When you receive these documents, file them in your patient records per your standard practice. 6 Once the proper mask is determined and consent is received, let your team know the mask and device requirements. Steps 1-5 MUST be completed before moving to step 6. 1. You can easily obtain patient consent remotely. There are companies that allow you to e-sign documents, forms and agreements online through a secure platform. They allow you to add your existing forms and utilize their tools to create entry fields for inputting information such as name, signature, etc. You'll need the patient's name and email address to send documents or request an e-signature. Note: Some companies may offer free trials. Please remember to always enable security features when using these technologies. 2. Shipping & device setup task template: Hello, Please place an order for the following: ________ ResMed Air10TM with air tubing ________ Mask ________ Cushion ________ Other materials Please reference the PO #_____________ Please set the device to the following settings from the prescription: ________ Therapy mode ________ cm H20 (CPAP mode only) ________ Min cm H20 (AutoSetTM mode only) ________ Max cm H20 (AutoSet mode only) ________ Response (AutoSet mode only) ________ EPRTM ________ Ramp Time 7 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Option 1: Mask selection 1 Select a mask that's suited for the patient and provide that information to your team. 2 Provide therapy education and highlight available pre-therapy resources such as the HelloSleepTM app, and encourage the patient to review and create a list of questions before the setup appointment. * What is it? ResMed MaskSelector is an online portal that makes mask selection and sizing easier and more effective by creating personalized mask recommendations based on a patient's health, sleep attributes and facial measurements. So, whether you're doing remote, face-to-face, curbside, or a combination of these setup methods, MaskSelector is here to help. ResMed MaskSelector is not a medical device. It's designed to provide a recommendation for a ResMed mask. ResMed MaskSelector offers recommendations for the following ResMed masks: AirFitTM F20, AirTouchTM F20, AirFit N30i, AirFit N20 and AirFit P10. If you are not using this tool, please refer to pages 9 and 10 for guidance on mask selection and sizing. How does it work? Your staff will access the MaskSelector portal, which hosts specific mask recommendations for each remote setup patient. To begin the process for a new patient, your staff sends a unique invitation to the patient via the portal. ResMed MaskSelector will then prompt the patient to: · Answer a questionnaire · Take three facial measurements Based on each patient's questionnaire and measurements, a recommended mask and size will be shown in the portal. There will also be recommended sizes for other masks in the ResMed portfolio. Clinical staff portal: How do I get more information and/or sign up? Reach out to your ResMed Solutions Consultant or Sales Representative to get started. Patient identity and data are fictional * There is no charge for the ResMed MaskSelector during the COVID-19 public emergency 8 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Option 2: Mask selection This option can be used for those who do not sign up for ResMed MaskSelector. Use the decision tree on this page to determine the mask type and the sizing instructions on page 10 to determine the correct size. While there are plenty of mask options for patients to use, we recommend the following ResMed masks because they are designed to offer a broad fit range for a majority of patients. · ResMed AirFit F20: universal mask with a broad fit range, easy to put on and take off. · ResMed AirFit N20: the Medium cushion is designed to fit the vast majority of patients. · ResMed AirFit P10: comes in a starter pack, therefore remote sizing is not necessary. Do you know if you breathe through your nose or mouth? While we are recommending the mask types suited for a remote setup, the decision-making ultimately lies with the clinician. Patient breathes through their mouth Patient breathes through their nose and/or doesn't know Do you have a deviated septum? Do you have trouble Yes breathing through your nose at night? Do you wake up with a sore throat and/or dry mouth? Do you experience a clammy/ sticky feeling in your mouth when you wake up? Do you have arthritis or any dexterity issues? Do you have any active No implantable medical devices? Do you have sensitive skin? Are you claustrophobic? Yes Are you an active sleeper? No [Internal]: Is the patient on a high pressure? Yes 9 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Option 2 continued: Mask selection Sizing for AirFit F20 Sizing for AirFit N20 Sizing for AirFit P10 Option 1: Clinician determines based on facial structure · If the follow-up call is conducted with video, the clinician can use their best judgment to size the patient. Option 2: Patient uses a tape measure at home · The patient uses a tape measure at home to size themselves. · Instructions for how to do this can be found on our website: ResMed.com/SizingAtHome Option 3: Patient prints the sizing template at home · The sizing template and instructions can be found on our website: ResMed.com/SizingAtHome Option 1: Clinician determines based on facial structure · If the follow-up call is conducted with video, the clinician can use their best judgment to size the patient. Option 2: Patient uses a tape measure at home · The patient uses a tape measure at home to size themselves. · Instructions for how to do this can be found on our website: ResMed.com/SizingAtHome Option 3: Patient prints the sizing template at home · The sizing template and instructions can be found on our website: ResMed.com/SizingAtHome AirFit P10 comes in a starter pack so pre-shipment sizing is not necessary. F Female patients should be sent the AirFit P10 for Her starter pack. If you're unable to size the patient: F M The majority of females will fit on an S or M cushion. If the patient is unable to size themselves at home, we suggest sending an M cushion and an S cushion. Males have more variability in their face. If the patient is unable to size themselves at home, we suggest sending an M cushion, in addition to both S and L sizes. If you're unable to size the patient: FM The majority of males and females will fit on a Medium cushion. We suggest sending an M cushion only. M Male patients should be sent the AirFit P10 starter pack. We recommend that the sizing instructions (tape measure or printing template at home) are sent to the patient prior to this call. These resources are available at ResMed.com/SizingAtHome. Instructions could be for the patient to locate a tape measure/ ruler or print both AirFit F20 and AirFit N20 sizing templates at home (pending which mask the patient qualifies for). The clinician can then instruct the patient over the phone which measurement/template to use. 10 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Mask selection & resources We recognize the importance of educating patients on why they should treat their sleep apnea, and how it contributes to short-term and long-term health benefits. · If you're already on the phone with the patient for mask selection, we suggest a brief conversation during this phone call to discuss the importance of treating sleep apnea. · Once the phone call is finished, we suggest sending a follow-up email reinforcing pre-reading/educational material before the scheduling/pre-equipment education (see email template on page 12). · If you're not setting up a separate call to run through initial mask selection, we suggest sending the patient a follow-up email (template on page 12) offering pre-reading and educational material. Setup Compliance support Topics to cover: Sleep apnea overview Importance of treatment myAir app education Support & education resources 11 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Mask selection email Hello [Patient Name], I enjoyed speaking with you today about preparing for your journey to better sleep and better health! Now that we've selected a mask that will work best for you, I wanted to recommend some helpful education and support resources available to you: · Visit ResMed.com/SleepApneaBasics to learn about the importance and benefits of treating your sleep apnea, along with some tips for getting started with CPAP therapy. · Download the myAirTM for Air10TM by ResMed app through the app store on your phone and create an account to track your therapy progress and receive personalized coaching to help you adjust to therapy. We encourage you to read the app's terms and privacy policy, available at ResMed.com/myAir. One of our representatives will be in touch with you once your CPAP equipment has shipped to schedule your remote setup appointment. If you have any questions or need assistance, please contact [CONTACT] at [XXX-XXX-XXXX] or via email at [EMAIL ADDRESS]. We are available during the following times: [DAYS AND HOURS]. We look forward to helping you get started on your sleep therapy journey! Sincerely, [YOUR ORGANIZATION / PERSON SENDING EMAIL] Did you know that more patients are compliant with myAir and AirView? Online self-monitoring tools that engage patients may significantly improve compliance and adherence to treatment. An observational study of 128,000 new PAP users found 87% were compliant when using myAir and monitored with ResMed AirViewTM vs. 70% when monitored with AirView alone1. 87% of PAP users were compliant1 1 Crocker M et al. CHEST 2016. 12 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support What to include in an optimal remote setup kit · With a variety of device and mask choices available to patients, we recommend including the following components for a remote setup to help optimize the patient experience and adjustment to therapy. · Auto-adjusting positive airway devices help adjust the pressure in response to changes in your patient's upper airway patency, especially as pressure needs can vary and change over time. Clinical studies1-3 support the clinical outcomes of the AutoSet algorithm citing the therapy, compliance and quality-of-life benefits associated with using AutoSet devices. Device Mask Alt. size cushions Supporting info PN 37207/37208 PN 37211/37212 PN 63401 (Medium) OR For full face mask users If you're unable to guide patients to size themselves remotely, include supplemental size cushions to help ensure a broader fit range. HME contact info PN 62900/62910 (for Her) OR PN 63501 (Medium) S PN 63467 (Males & females) L PN 63469 (Males only) Patient education materials · AirFit F20 remote setup guide (PN 10111957) · AirFit P10 remote setup guide (PN 10111959) · AirFit N20 remote setup guide (PN 10111958) · Living with CPAP brochure (PN 1019759) · myAir registration brochure (PN 10111223) · Stay on track resupply brochure (PN 1016061) 1 Massie CA et al. "Comparison between automatic and fixed positive airway pressure therapy in the home." Am J Respir Crit Care Med 2003;167:20-23. 2 Netzel T et al. "APAP device technology and correlation with patient compliance." Somnologie 2014;18(2):113-120. 3 Armistead JP et al. "Study of an auto-adjusting CPAP algorithm for the treatment of obstructive sleep apnoea." Am J Respir Crit Care Med 2009;179:A3570. 13 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Pack, ship & deliver Ensure the device is configured with the patient's prescription and comfort settings prior to delivery. This can be accomplished in one of two ways: 1. Unbox the device, plug it in and apply the settings before placing it in the shipping box. 2. Use AirView to remotely apply the settings. Provide device number and serial number to your team to board the patient into your patient management system and apply the settings via AirView. Note that some device settings are not available to be set remotely using AirView. Important note for ResMed AirCurveTM 10 ST and AirCurve 10 ST-A bilevel devices: require at least one therapy session to be run before they can accept a new prescription from AirView, therefore we recommend only applying settings directly to the device. Pack · Select a plain box that fits the sleep therapy contents snugly to minimize the potential for any shipping damage. · Avoid labeling or marking on the shipping box that indicates its contents to protect patient privacy. Ship · If shipping via a carrier, choose delivery confirmation to track and confirm the shipment is delivered. · Provide shipping information, including delivery expectations and the tracking number to your team, so they can schedule the patient's setup. Deliver · You may opt to deliver directly to the patient's doorstep or offer a curbside pick-up option. · Obtain recipient's signature for secure delivery (if required) and applicable proof of delivery documentation for payer requirements.1 · If shipping via a carrier, confirm the setup kit was delivered using the tracking number. 1. Example box dimensions 16" x 16" x 8". 2. Use void fill (if possible) to help protect contents during shipping. 3. Include HME contact information in the shipping box to help patients know who sent their therapy equipment and how to reach out for questions and support. 1 During the COVID-19 public health emergency (PHE), CMS will not be enforcing the signature requirement. During the PHE, suppliers should document the appropriate date of delivery and that a signature was not able to be obtained because of COVID-19. Learn more at CMS Provider Burden Relief FAQs. 14 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Boarding & prescription Setup Compliance support Boarding Board the patient into ResMed AirViewTM per your standard process utilizing the device number and serial number provided by your team. 1. We recommend using the delivery date as the setup date. · The setup date can be set as a future date. 2. For U-SleepTM customers, if using the delivery date for the setup date, we recommend boarding the patient upon delivery. 3. Based on the patient's interest, enter the patient's email address to send a myAir invite. · Note: if you utilize a BrightreeTM integration, this may automatically go out per the normal process. 4. Associate the patient's physician. Update prescription If your workflow is to update the prescription using AirView, input it at this time. The device will automatically update once the patient powers the device On. Boarding all remote setup patients into a unique location or by a dedicated clinical user can enable you to track your remote setup patients for easy sorting in Action Groups and compliance reporting. Download our Remote location setup fact sheet and learn how to create a remote location. If you would like to minimize handling and unboxing of the device, you can use AirView to apply settings remotely. In U-Sleep, the setup date cannot be updated if the delivery date or setup appointment changes. You may prefer to board the patient right before the setup to give the patient the full compliance period. 15 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Scheduling & resources Schedule the setup appointment · Once the delivery time is known, contact the patient to set up their appointment. Note: if your organization is confident in shipping timelines, this can be done during the intake call. · Send a calendar invite to the patient with details on how to connect for the setup appointment. · Encourage the patient to register for myAir. Appointment via video conference · We recommend setting up a secure video conference with the patient to facilitate a good teaching environment where your team member and the patient are able to watch, mimic and troubleshoot through the appointment. Email supplemental information · Email supplemental product information to the patient in advance of the remote setup appointment that includes your contact information so they know who to contact for support: · Encourage myAir registration. · Include your contact information so the patient knows who to contact for support. · Include delivery timeline and shipping details, such as a tracking number. · Setup appointment details should include: the date, time, how to connect (i.e. link for video conference, phone number, etc.), and who the appointment is with. · Actions for the patient to complete prior to the setup: purchase distilled* water. · Include resources. See next page for templates. The goal is to perform the remote setup as close to the delivery date as possible. · We recommend scheduling the setup two to three days after the expected delivery to avoid having to reschedule if the delivery is delayed. · Pay close attention to delivery schedules as carriers may be experiencing delays. For patients who are unable to get to a store, many grocery delivery services allow distilled* water to be ordered and delivered. Fees may apply and services vary by geography. * As stated in our clinical and user guides, only distilled water should be used with a PAP humidifier for optimal operation. Distilled water has had most/all minerals removed from the water which would otherwise cause a mineral buildup in the humidifier tub. While the use of tap or bottled water may require more rigorous humidifier cleaning in the short term and excess mineral buildup in the tub over the long term, the use of tap or bottled water will not harm the therapy device or pose a risk to patients. 16 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Pre-setup email Hello [Patient Name], It was a pleasure speaking with you today! Your sleep products have been ordered and should be arriving by [DELIVERY DATE]. Here is your tracking number: [TRACKING NUMBER]. Your sleep apnea therapy setup appointment is scheduled for: · [DATE AND TIME OF APPOINTMENT) · With [SETUP APPOINTMENT PERSONNEL], [ROLE] During your call, you will speak with a sleep coach who will walk you through setting up and getting comfortable with using your machine. They are here to answer any questions you may have regarding your therapy, the machine, the mask and how to adjust to starting therapy. Our goal is to make sure you're comfortable with using your therapy and are ready to use your machine that night. Here's how to get ready for your setup appointment: 1. Purchase distilled water.* This can be found at most major grocery stores or pharmacies. 2. [DOWNLOAD APPS / SOFTWARE NEEDED TO CONNECT TO THE SETUP APPOINTMENT] 3. You should have received an email invitation to register for ResMed myAirTM. Consider registering for myAir using your smartphone, tablet or computer. · This app will help you track your own progress on therapy and will provide personalized coaching to help you adjust to therapy. · Please let us know if you did not receive this invitation, and we will happily resend the invite or help you register during your setup appointment. 4. Review the pre-setup resources available on these helpful website pages: [INSERT APPLICABLE RESOURCE LINKS] 5. Make a list of questions, concerns and goals for sleep therapy to discuss with your sleep coach. It's important to complete these prior to your scheduled appointment as they will assist with your success on therapy. Video conference tools can be downloaded onto computers, smartphones or tablets. Security features on these tools, when appropriately enabled, can help protect patient privacy. You and your patients will benefit from using these tools during setup appointments. The NIH referenced data1 indicates that COVID-19 is stable for up to 24 hours on cardboard and 2-3 days on plastic and stainless steel. In an abundance of caution, you may opt to recommend a delay in patient handling after delivery. Resources Resource links are outlined on page 22. On [DATE AND TIME OF APPOINTMENT], please [ACTION TO CONNECT TO SETUP APPOINTMENT] for your setup appointment with [NAME]: · For your setup call, choose an area with a large flat surface (dining room table or other large area) to set up all of the different items in your therapy equipment and be able to have them within reach. · You will need to have a power outlet near your setup area to plug in the device. · If possible, have a family member or support with you, in person or remotely, during the setup to ask questions and learn with you. If you have any questions or need assistance, please contact [CONTACT] at [XXX-XXX-XXXX] or via email at [EMAIL ADDRESS]. We are available during the following times: [DAYS AND HOURS]. We look forward to helping you get started on your sleep therapy journey! Sincerely, [YOUR ORGANIZATION / PERSON SENDING EMAIL] * Per the user guide, only distilled water should be used with your PAP machine 1 https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces 17 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Setup Recommendations Block enough time We recommend blocking a few minutes on either end of each appointment for technology setup and wrap up. Ensure you have the patient's phone number Some patients may struggle to follow instructions and connect remotely, so ensure you have their phone number available to call them in case they need additional support. · When troubleshooting any connection issues, learn what device (i.e. computer, tablet or phone) is being used, including the manufacturer/operating system and browser as each technology may experience unique issues. Understanding the process for each can enable patient support when needed. Have equipment & be prepared to demonstrate Have equipment with you mirroring what the patient will have during the setup and demonstrate how to use each piece. · For instance, take time to assemble and put on the mask so the patient has a clear understanding of what they need to accomplish. Then allow the patient time to complete the action themselves. If they struggle or experience confusion, it may help to re-demonstrate the specific action. Establish WHY patients are on therapy It's very important to explain to patients why they are using therapy. Ensure they understand why it's important to their health. The "why" is key to building this new habit. Keep it simple Because the patient is going to be working to build a new habit, try to simplify information as much as possible. Support is crucial Make sure the patient knows where they can find support if and when they need it. Whether it's online, phone, text message or email support, they'll appreciate knowing where to find it. 18 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Setup Call outline Introduction · Confirm the patient's identity by verifying data elements such as their name, date of birth, medical/health record identifier and phone number. · If recording, obtain consent from the patient before the recording starts. · Why we are here: A sleep study identified the need for CPAP therapy due to obstructive sleep apnea (OSA). · Goal for today: Getting comfortable with therapy. Learn the patient's goals and motivation for therapy. · To ensure you're teaching effectively, ask them to repeat the information and demonstrate. If anything is unclear, review it again. · Share the agenda. · What questions does the patient have? Sleep apnea education · Sleep apnea definition: What are the common symptoms? Ensure the patient understands what it is and why treatment is important. · Explain the impact of comorbidities. · Explain how the device and mask work, and how they treat sleep apnea. Getting started · Resources to help them achieve their goals: · myAir: If they haven't registered, explain the benefits, privacy notice and how to register. · Review resources sent in pre-setup emails. · Have them gather items (device, mask, etc). Equipment overview · ResMed device: APAP (auto-adjusting positive airway pressure) is our recommended sleep apnea treatment. · 2 modes: CPAP + APAP adjusts based on their upper airways requirement to be best splinted open. · Equipment received: mask and equipment start guide. · Travel bag: Includes water chamber, power supply, air tubing and device. · Device: black (AirSenseTM) or gray (AirCurve) depending on which model they received. · Air filter: Disposable white square on the left side of the device. Filter door has holes. · Water tub: Clear tub, measurement lines in front. Insert on the right side of the device. Fresh distilled water daily.* Empty after each use. Be sure not to overfill. · Power supply: Provides power to the device. There should be two pieces in the bag. · Air tubing: Connects the mask to the device. The heated hose warms the air. · On the back side of device: The serial number (SN) is 11 digits and the device number (DN) is 3 digits. This information is needed to register for myAir. Navigating comfort settings · These are settings patients are able to change to have a more comfortable experience using therapy. · Ramp: Device is pre-set to AutoRamp, which is the suggested setting. It detects snoring, patterns of consecutive breathing or apneas. · Humidity level: Allows the patient to modify the humidity settings to their environment and preference. · Mask: If the patient has a full face mask, have them set their mask setting to full face. * As stated in our clinical and user guides, only distilled water should be used with the PAP humidifier for optimal operation. Distilled water has had most/all minerals removed from the water which would otherwise cause a mineral buildup in the humidifier tub. While the use of tap or bottled water may require more rigorous humidifier cleaning in the short term and excess mineral buildup in the tub over the long term, the use of tap or bottled water will not harm the therapy device or pose a risk to patients. 19 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Setup Call outline Other key settings to review · Prescription pressure & Expiratory Pressure Relief (EPR): can be adjusted if the patient needs changes between inspiratory and expiratory pressure. · Climate Control: Pre-set to Auto if the ResMed ClimateLineAirTM heated tube is connected to the device. It can be set to Manual. · Tube temperature: Controls the air temperature. The suggested setting is Auto. This may be changed to Manual to increase the temperature up to 86° F if necessary. Mask setup and sizing Many therapy and comfort settings can be adjusted remotely for patients within the AirView Prescription tab. Full face mask · Remove mask from the box and bag it was shipped in. Be prepared to guide patients on how to separate the mask from the support packaging. · Mask cushion: The plastic exterior and translucent silicone that covers the edge (one piece). The narrow part of the cushion sits on the bridge of the nose and the bottom fits between the lower lip and chin. · Size marker: Located on the bottom front. Use large size if medium hits the lip, use small size if medium hits the chin (if multiple cushions were provided). · Removing the cushion: Squeeze both sides of hard plastic and remove. When reattaching, push until you hear an audible click sound. · Mask elbow: Attach the elbow to the air tube then connect the elbow to the mask. Explain venting purpose. · Mask headgear: Straps will fit on the head and attach to the mask frame. The top strap sits across the crown of the head and the lower strap on the base of the neck. The magnetic clips allow for easy connection or removal without having to readjust the straps. · Demonstrate putting on the mask: Fit the cushion. Adjust the straps. Start the device and run mask fit. Nasal mask · Remove mask from the box and bag it was shipped in. Be prepared to guide patients on how to separate the mask from the support packaging. · Mask cushion: The plastic exterior and translucent silicone that covers the edge (one piece). The narrow part of the cushion sits on the bridge of the nose and the bottom sits just under the nose. · Size marker: Located on the bottom of the cushion (if multiple cushions were provided). · Removing the cushion: Hold frame by placing your thumb over the side slot. Pull cushion away from frame. When reattaching, push until you hear an audible click sound. · Mask elbow: Features short tubing and attaches to the air tube. · Mask headgear: Straps will fit on the head and attach to the mask frame. The top strap sits across the crown of the head and the lower strap on the base of the neck. The magnetic clips allow for easy connection or removal without having to readjust the straps. · Demonstrate putting on the mask: Fit the cushion. Adjust the straps. Start the device and run mask fit. Pillows mask · Remove mask from the box it was shipped in. · Mask cushion: The plastic edge and translucent silicone material sit at the nasal opening (one-piece). · Size marker: Located on the bottom of the cushion. The top of the cushion says ResMed. · Removing the cushion: Hold the top of the mask tubing, squeeze and pull the cushion away from the mask frame. To reattach, push until you hear an audible click sound and ensure the ResMed logo faces up. · Mask frame: Features short tubing and attaches to the air tube. Explain venting purpose. · Mask headgear: Straps will fit on the head and attach to the mask frame. The headgear consists of a single strap with a split in the middle. The lower strap sits across the nape of the neck, the top strap sits at the top of the head. · Demonstrate putting on the mask: Fit the cushion. Adjust the straps. Start the device and run mask fit. 20 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Setup Call outline Run mask fit option on ResMed Air10 device · Identifies what a normal amount of air escaping from the mask should feel like. · Runs at 10 cm H20 of pressure. Run Warm Up · Pre-warm the water in the humidifier to receive the benefits of humidity immediately. Frequently asked questions · Cleaning instructions: Clean cushion/pillows every day with mild soap and warm water, air dry out of direct sunlight. Clean frame, water tub, headgear, air tubing weekly with mild soap and warm water, and air dry out of direct sunlight. Always be sure to reference the user guide for mask and device cleaning instructions. · Compliance or regular use of device: Importance is overall long term benefit and improvement to health. Use a minimum of 4 hours/night. Insurance provider may have different guidelines. · Resupply: Helps maintain good equipment performance and mask seal. Replace equipment as it begins to wear down. Insurance provider may have different guidelines for resupply replacement. · Travel: CPAP as a carry-on. Confirm with your airline if it counts toward max allowed carry-on bags. Do not place in checked luggage. · Airplane mode: Will prevent the device from transmitting data. Turn on if using during a flight. · Further clinical questions: Follow up with their physician for clinical questions regarding the prescription, therapy or anything involving their individual medical history. What to expect as you start therapy · Acclimation strategies: · Have them wear for a few minutes before going to bed to get used to breathing with it. · Have them pay attention to what feels challenging (wearing a mask, air pressure, leak, anxiety, etc.) · myAir has resources to address many common challenges. · Review available resources. · Tell patients to stay positive! Many patients find therapy challenging at first, but most are successful after adjusting. Encourage them to stick with it and seek help when they need it, and they can be successful too. · Review the patient's questions from the beginning to ensure all questions were answered. · Review the patient's goals and reiterate how applying learnings will help achieve those goals. · Encourage the patient to set a usage goal for that night and the coming week and commit to doing it. Compliance support 21 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Setup Follow-up email Following your setup appointment with your patient, send them a follow-up email reinforcing the key learnings, available resources if they need more support and how to reach your organization if needed. Hello [Patient Name], It was a pleasure speaking with you for your therapy setup appointment. Remember to try out your machine tonight don't wait to get started. It may take some time to adjust on therapy, and that's okay. We will be monitoring your progress and following up if we see you are having challenges. If you need any additional support, you can reach us at [xxx.xxx.xxxx] or [EMAIL]. Watch the videos below for some helpful tips as you get started. As you continue, these resources can help you build confidence and comfort on therapy be sure to check them out! · myAirTM ResMed.com/myAir · [OTHER RESOURCES] It's important to use your therapy equipment on a regular basis in order to meet compliance and to receive the benefits of therapy. If you have any questions or need assistance, please do not hesitate to reach out. We are available via phone [XXX-XXX-XXXX] or [EMAIL] during the following times: [DAYS AND TIMES] Thank you for letting us be part of your sleep therapy journey! Sincerely, [YOUR ORGANIZATION / PERSON SENDING EMAIL] Resources are available to support patients in getting started on therapy. Introduction ResMed.com/SleepApneaBasics myAir ResMed.com/myAir Getting started on therapy Resources are provided specific for each of the masks recommended for remote setup to to help you direct the patient to curated content: AirFit F20: ResMed.com/F20-GettingStarted ResMed.com/F20-Resources (subsection on same page) AirFit N20: ResMed.com/N20-GettingStarted ResMed.com/N20-Resources (subsection on same page) AirFit P10: ResMed.com/P10-GettingStarted ResMed.com/P10-Resources (subsection on same page) 22 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Compliance support Setup Printed patient resources Remote setup guides* · Provides patients with step-by-step instructions on how to setup and use their therapy equipment, assemble and fit their mask, acclimate to therapy, and get started with the myAir app. They'll also have access to an accompanying setup video. · Available for AirFit F20 (PN 10111957), AirFit N20 (PN 10111958) and AirFit P10 (PN 10111959) masks. Additional education materials · A selection of brochures to help prepare and support patients along their therapy journey. * A nominal charge applies Living with CPAP PN 1019759 myAir registration PN 10111223 Stay on track resupply PN 1016061 Available to order from the ResMed Online Store 23 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Setup Digital patient resources ResMed online Setup Compliance support Sleep apnea basics ResMed.com/SleepApneaBasics ResMed apps ResMed MaskSelector See page 8 for more information HelloSleep Getting started ResMed.com/ F20 - GettingStarted ResMed.com/N20-GettingStarted ResMed.com/ P10 - GettingStarted 24 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Compliance support After setting up a paitent, follow your organization's standard compliance support protocol. · Consult the Air Solutions Troubleshooting Guide for best practices. · This guide walks you through remote resource utilization; mask, comfort and therapy optimization; and device FAQs. Remote setup considerations 1. Establish a method for identifying your remote setup patients. · We recommend using the Location or Clinical User fields in AirView to "identify" remote setup patients and filter in AirView Action Groups and reports. · Download our Remote location setup fact sheet to easily identify and filter your remote setup patients in AirView. 2. Leverage remote tools to support patients: · Encourage patients to self-support with myAirTM. · Leverage remote monitoring tools like AirView Action Groups or U-Sleep to identify patients who are struggling with therapy. · Leverage Remote Assist to understand device functionality and working status. · Leverage Prescription settings to enable remote updates for therapy and comfort settings. 3. Remember, learning in a remote setup environment is new for some patients, which can impact their retention. Follow up with patients within 3 days of setup if they are having any challenges (frequent monitoring may allow you to catch and correct therapy issues early). · In your initial interactions following setup, pay special attention to the following topics to ensure the patient is set up for success: · ResMed myAir. · Mask fit. · Device use and setup. · Acclimation and resources to overcome challenges. · Cleaning instruction. · Compliance or regular use of the device. · Using the device while away from home. · Resupply. Setup Compliance support 25 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Compliance support 1 myAir Visibility to each patient's myAir status in AirView, provides users the ability to invite a patient to myAir at any time directly from AirView. Setup Compliance support 1 Identify a patient who is not on myAir 2 Enter patient email and send myAir invite 3 Indicator reflects that the patient has been invited 4 Indicator reflects that patient has registered with myAir 00012361049 3/22/1964 9/3/2019 20% 00012361049 3/22/1964 9/3/2019 20% 00012361049 3/22/1964 9/3/2019 20% Patient identity and data are fictional 26 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Compliance support Utilizing the myAir status, AirView users have the ability to invite a patient to myAir at any point in time. Setup Compliance support 00012361049 3/22/1964 9/3/2019 myAir status icon will update to reflect "Patient invited to myAir" Back to patients Note: This is the same content as the previous page, it's just displayed as a single workflow here. Email address Send invite Cancel Back to patients Back to patients Invite sent successfully Ok Patient identity and data are fictional 27 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Compliance support 2 AirView Actions Groups · Leverage remote monitoring tools like AirView Action Groups or U-Sleep to identify patients who are struggling with therapy. · Focus on Low usage/Compliance risk, therapy issues and no data buckets to identify struggling patients. Compliance risk Identifies patients who've demonstrated low device usage prior to achieving initial compliance. Setup Compliance support Therapy issues Identifies patients who've experienced mask leak, AHI or CAI values above the previous threshold at any point in their therapy. No data received Identifies patients who have not had their data transmitted for 3 consecutive days within their first 90 days of therapy, or during the most recent 10-day period after their initial 90 days of therapy. 28 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Compliance support 3 AirView: Remote Assist · Use Remote Assist to understand device functionality and status. Setup Compliance support Device status. A green bar indicates the device is functioning properly. A red bar indicates an issue and provides details on steps to take to resolve it. Ambient humidity. Quickly view the patient's room humidity level and recommend changes to make therapy more comfortable. Patient identity and data are fictional Last 5 days of usage/leak data. Get a snapshot of compliance, leak and AHI data for the previous 5 days. Mask type. Troubleshoot comfort issues or recommend a different mask type based on patient feedback. 29 Table of contents Intake MaskSelector tool & resources Pack, ship & deliver Boarding & prescription Scheduling & resources Compliance support 4 AirView: Remote Prescription updates · Use Prescription tab to enable remote updates for therapy and comfort settings. Setup Compliance support Patient identity and data are fictional 30 ResMed.com This reimbursement information is being provided on an "as is" basis with no express or implied warranty of any kind, and should be used solely for your internal informational purposes only. Verification is always the responsibility of the provider/supplier. The information does not constitute professional or legal advice on reimbursement and should be used at your sole liability and discretion. All coding, coverage policies and reimbursement information is subject to change without notice. ResMed does not represent or warrant that any of the information being provided is true or correct and you agree to hold ResMed harmless in the event of any loss, damage, liabilities or claims arising from the use of the reimbursement information provided to you. Before filing any claims, it is the provider's/supplier's sole responsibility to verify current requirements and policies with the applicable payer. The Centers for Medicare and Medicaid Services (CMS) have encouraged remote setup and other means to reduce the spread of the coronavirus during the public health emergency. It is the responsibility of the provider to determine the current CMS guidance on use of remote tools. Distributed by ResMed Corp, 9001 Spectrum Center Boulevard, San Diego, CA 92123 USA (858) 836-5000 or (800) 424-0737 (toll-free). See ResMed.com for other ResMed locations worldwide. Air10, AirCurve, AirFit, AirSense, AirTouch, AirView, AutoSet, Brightree, ClimateLineAir, EPR, HelloSleep, myAir and U-Sleep are trademarks and/or registered trademarks of the ResMed family of companies. Apple and FaceTime are trademarks of Apple Inc., registered in the U.S. and other countries. DocuSign is a trademark of DocuSign, registered in the U.S. and other countries. Facebook is a trademark of Facebook, registered in the U.S. and other countries. Skype is a trademark of Microsoft, registered in the U.S. and other countries. TikTok is a trademark of Bytedance Ltd., registered in the U.S. and other countries. Twitch is a trademark of Twitch Interactive, Inc., registered in the U.S. and other countries. Zoom is a trademark of Zoom Video Communications, Inc., registered in the U.S. and other countries. Specifications may change without notice. For patent and other intellectual property information, see ResMed.com/ip. © 2020 ResMed. 10111973/3 2020-08

ResMed guidebook Remote CPAP setups

Remote CPAP setups - ResMed

References