RE:PROMOTING ACCEPTANCE AND ADHERENCE TO NIV in COPD Telemonitoring is the big change impacting patient adherence. Just look at how Viemed use to do it.
[CYs 2016, 2017] Generally, Sleep Management’s respiratory therapists visited beneficiaries every 3 months to monitor the beneficiary’s usage of the NHV, replenish supplies, and re-educate the beneficiary about device usage as necessary. During the visit, the therapist downloaded statistics from the NHV that detailed the beneficiary’s usage since the previous visit. Sleep Management maintains these usage reports in the beneficiary’s patient file. Sleep Management’s policy stated that if the therapist discovers “zero or minimal usage time” during the visits, the beneficiary should be asked to participate in a “7-day achievement plan.” The policy stated that Sleep Management should discontinue service if the beneficiary’s usage of the device does not improve during the 7 days.
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The recent advent of remote ventilator telemonitoring has the potential to revolutionize home-assisted ventilation care in the United States and elsewhere. Home ventilation machines (i.e., respiratory assist devices and portable ventilators) can now wirelessly transmit usage and performance data to cloud-based web servers for remote access by participating clinicians. In this Focused Review, we provide an update on available technology, suggest practical applications for clinical care and research, and review supporting literature. Remote monitoring permits early data review, refinement of device settings to optimize ventilatory function, and troubleshooting if a new problem arises after initial setup. Data from home spirometry and noninvasively measured blood gas tensions can complement ventilator data to reflect physiological response. Acknowledging a paucity of published outcome studies, remote telemonitoring may be a cost-effective strategy to reduce emergency room visits, urgent clinic appointments, and hospitalizations. Ongoing clinical trials in Europe aim to expand on the benefit of this rapidly evolving technology. However, several barriers may hinder widespread implementation, especially in the United States. Clinicians must familiarize themselves with each ventilator manufacturer’s proprietary software to safely leverage this technology for improving care. Legal and ethical considerations threaten clinician interest. Medical insurance payers must adapt a reimbursement scheme to incentivize clinicians and durable medical equipment companies to perform this time-consuming service. Cohort-level ventilator data will facilitate multicenter clinical trials focused on improving the respiratory care of this vulnerable population.
https://www.atsjournals.org/doi/10.1513/AnnalsATS.202101-033CME