0091 The Practicality of Implementing Nightly Remote Patient Monitoring (RPM) of OSA Patients in Clinical Practice
Authors: Simmons Jerald , Sadeghian Hesam 
Published: May 2022

Introduction

If Remote Patient Monitoring (RPM) is to become integrated into sleep medicine practices, patient compliance and reliability of data acquisition needs to be determined. We developed the REST Tracker platform to monitor OSA patients nightly, using an oximeter ring with data analyzed by a recognized method (1) to render a sAHI that has been FDA approved (FDA reference number K182618) providing an equivalent to the AHI. The REST Tracker tracks the sAHI along with multiple other parameters, providing the clinician nightly physiologic data to assist in OSA management decisions. Here we present patient compliance and system reliability data.

Methods

Data obtained from a ring pulse oximeter worn nightly is transmitted by Bluetooth to a cellular device at the bedside. Nightly data from bedtime to final morning awakening is transmitted to the cloud and retrieved by the REST Tracker system which tabulates and displays the data in a format that assists the clinician in OSA management decisions. Compliance and reliability performance criteria used to assess the REST Tracker system were as follows: Patient Retention Rate (patients were considered a Drop Out if there was no usage within 15 days prior study termination on Dec 15th), Data Acquisition Reliability = percentage of nights with &gt; 3 hours of data on those nights the ring was used. Successful Monitoring Achieved if a patient had over 70% of nights containing &gt; 3 hours of data. Data acquisition was initiated on 1/1/21 and ended 12/15/21 with a minimum of 6 weeks of monitoring.

Results

A total 38 patients (28 M / 10 F) Ave age 60 (SD +/-13) enrolled from 1/1/21 to 10/31/21, and acquisition ended 12/15/21. Monitoring ranged from 6 to 50 weeks. 10 patients dropped out, rendering a 74% Patient Retention Rate. Data was collected for a total 4072 nights from all patients, of which 3441 nights had &gt; 3 hrs of data, rendering an overall Data Acquisition Reliability of 84.5%. There were 33 patients that achieved Successful Monitoring (87%) as defined above.

Conclusion

In our practice RPM has been well accepted with 74% Patient Retention Rate and 87% achieving Successful Monitoring. This study demonstrated the feasibility of this approach. We are currently implementing methods to achieve higher retention successful monitoring rates. The REST Tracker has been used in our practice for the management of OSA patients undergoing a variety of treatments approaches ranging from PAP, dental appliances and Inspire (HGNS). The REST Tracker has enhanced our ability to assess these patients on an ongoing basis, decreased the need for in lab sleep testing and expedited management decisions. Clinical cases are currently being accumulated and will be presented to demonstrate the utility of the REST Tracker RPM approach.

Support (If Any)

Reference: (1) Al Ashry HS, Hilmisson H, Ni Y, Thoms RJ, Investigators A. Automated Apnea-Hypopnea Index from Oximetry and Spectral Analysis of Cardiopulmonary Coupling. Ann Am Thorac Soc. 2021;18(5):876-83.