CPAP modems and remote changes to your settings without your knowledge

[robysue]

Folks,

Back in the thread ResMed S9 wireless modem I brought up my concerns about a DME or sleep doc's office using the modem to remotely change the settings on a PAP without telling the user about it in this reply and again in this reply. At that time, I had not seen any posts on any of the forums that I frequent where a poster described a scenario similar to what I was proposing as an unacceptable, but certainly possible situation.

Well, tonight over on the forum sponsored by Vendor #1, a user HAS posted that her DME changed the settings on her PAP without telling her about it:

So I'm 60 days into my therapy. The first month sucked. I used "prescribed" settings. I was tired, headachy, blah.Then I took charge of my therapy and have tweaked settings. In 60 days I have had TWO days of AHI over 5...and two more that barely topped 4. I think I'm doing just ducky. So I got compliance info sent to DME earlier, and she REMOTELY RESET MY MACHINE. No warning, even. How RUDE. I noticed tonight as I set myself up for bed that the pressure felt low...stuffy...settings were wrong. So I popped the SD card into the laptop to check against SH...yep. Back to wide open, humidity wrong, etc. As of TODAY. I changed it back. Monday I call my handler and tell him I'm too close to menopause for this to be healthy for the DME to pull again. Tomorrow DME gets an ear chewing, and I will tell them to shove the modem, if this is what they plan to do. I will find an alternate way to get them compliance data.

Seriously folks, those modems represent a brave new world and I really do think that it's only a matter of time before the DMEs tell the manufacturers to drop the SD cards and let them collect the compliance data wirelessly with some kind of "SD card add-on" for those folks in remote spots where wireless is hard to come by.

And once the compliance data is routinely gathered through modems and most of us don't have an SD card slot in our machine, it will become increasingly difficult for us to (legally) obtain our own raw data: Hacking into the secure wireless transmission of our data will be regarded as a computer security breach, and my guess is the DMEs and the manufacturers will have a very strong ways of dealing with any hackers they catch in their systems.

Just because you're paranoid doesn't mean they're not out to get you.

[SuperSleeper]

Agreed. DMEs want modems, not SD cards. They don't like it when patients take control of their own therapy and act independent of DME control. We have been trying to tell the CPAP manufacturers for years now that WE (the CPAP users) are their actual customers, not the DMEs. Some have listened a bit, but the DMEs don't like that one bit and will undoubtedly be pushing for modems over memory cards in the future. And the CPAP manufactures like dealing with DMEs rather than each individual sleep apnea patient - it's much more efficient and profitable for them that way.

It's the same reason behind the big push for RFID chips in everything we purchase and the resulting "Internet of Things". It's all about big government in bed with big business to actively and dynamically track, categorize and analyze each and every purchase we make - thereby being in control of every thing in order to maximize profits (the love of money).

And they are out to "get you" (or rather "control you").

And if you think I'm kidding, I'm not. Ask Edward Snowden. The rabbit hole goes much deeper than even the most wild-eyed conspiracy theorist can imagine. The love of money is the root of all evil, and that's what's behind this entire movement. We've living in a world that is now a combination of Nineteen Eighty Four and A Brave New World, and CPAP machines are not exempt from this fast-moving trend.

[zonk]

I can see it happening in Australia too
I don,t have DME as such but to keep my driving license, the transport dept send me a forum each year to be signed by my doctor otherwise the license can be cancelled

For now I don,t have a modem stuck in the back of the machine but who know what would happen down the track if ever the transport dept with assistance from ResMed or someone else decided to collect CPAP compliance data through modems and do away with the paper works

[big_dave]

Seriously folks, those modems represent a brave new world and I really do think that it's only a matter of time before the DMEs tell the manufacturers to drop the SD cards and let them collect the compliance data wirelessly with some kind of "SD card add-on" for those folks in remote spots where wireless is hard to come by.

And once the compliance data is routinely gathered through modems and most of us don't have an SD card slot in our machine, it will become increasingly difficult for us to (legally) obtain our own raw data: Hacking into the secure wireless transmission of our data will be regarded as a computer security breach, and my guess is the DMEs and the manufacturers will have a very strong ways of dealing with any hackers they catch in their systems.

When that day comes, those of us who read the boards will have plenty of warning. I'll be sure to buy 2 new machines of a model I know that I can control, a dozen new masks, and a boatload of other supplies. I feel for the people who start CPAP after us.

[me50]

Resmed already deals with the end user on an individual basis. I have called them on a few occasions when my old cpap was not working (mainly because the DME wasn't dealing with it so I had to) right. While this is a strong possibility of happening, I will use the 2 machines I have until they are on their last leg before I attach a modem to any cpap machine. I think that there is power in numbers and their are more end users than there are DME's and if we all bombard the manufacturer, they may think twice about making their end users unhappy. I treasure what little privacy that I have left and I just am not willing to sacrifice that without a fight.

[big_dave]

If you get stuck with a modem, you could always build a Faraday cage for the machine to block the modem. (A Faraday cage blocks out all radio signals.) However, getting the hose through a Faraday cage would be tricky.

[Joker1952]

I don't know why DME's are changing pressures, this should be a collaboration between the doc and user. I never had a modem on my machine. Do they keep them on forever or take them once you are past 90 days?

[archangle]

I don't know why DME's are changing pressures, this should be a collaboration between the doc and user. I never had a modem on my machine. Do they keep them on forever or take them once you are past 90 days?

I think in this case, the user changed their own pressure and it got changed back to the original system.

It might have been deliberately done by the DME, but it may have just been "in the system." The prescribed settings may be programmed into the computer that controls the modem and it may just automatically send the settings to the CPAP machine automatically every so often, or when certain things happen. The medical mafia mindset is that no patient could possibly want to change the settings or know how to do so, so any changes must be some sort of technological glitch.

Of course, it could have been an evil DME trying to keep the peasants in line, too.

[robysue]

I don't know why DME's are changing pressures, this should be a collaboration between the doc and user. I never had a modem on my machine. Do they keep them on forever or take them once you are past 90 days?

I think in this case, the user changed their own pressure and it got changed back to the original system.

It might have been deliberately done by the DME, but it may have just been "in the system." The prescribed settings may be programmed into the computer that controls the modem and it may just automatically send the settings to the CPAP machine automatically every so often, or when certain things happen.

In my opinion, NO changes to the prescribed settings should be made through the modem without the patient's knowledge.

Yes, in this case, the poster had made a change in her pressure settings without telling the DME about it. (She's never had the privilege of meeting with a sleep doc.)

But that's beside the point.

What if the receptionist/clerk at the DME makes a typo when entering the script? So every day at 2pm the automated system resets your machine to the WRONG script? And no-one tells you, the patient, this is being done?

The DME doesn't have to be malicious for this to be a really serious problem.

[archangle]

In my opinion, NO changes to the prescribed settings should be made through the modem without the patient's knowledge.

Yes, in this case, the poster had made a change in her pressure settings without telling the DME about it. (She's never had the privilege of meeting with a sleep doc.)

But that's beside the point.

What if the receptionist/clerk at the DME makes a typo when entering the script? So every day at 2pm the automated system resets your machine to the WRONG script? And no-one tells you, the patient, this is being done?

The DME doesn't have to be malicious for this to be a really serious problem.

What if the DME makes a typo when making a change that the doctor and patient both know about? Or if the DME makes an error in settings through an SD card exchange or through the buttons on the top of the machine?

The assumption on their part is that the patient doesn't know how to adjust the machine on her own, or even to check what the machine is set at.

What if the doctor programs in a pressure change via modem and the change doesn't work the first night due to poor cell coverage? Maybe the system tries again every night to be sure the changes actually get there.

I'm not sure I think the current setup is right, but I don't think us empowered patients are even on the radar of the medical mafia. There are so few of us that they probably don't bother to set things like this up to thwart us. They may consider "reset settings every night via modem" to actually be in the interest of the patient.

I don't know for sure that the system DOES automatically reset pressure every night via modem, or if it takes special effort on the part of the person entering data into the system controlling the system. For Encore, (not the modem version) there is a check box to make it reprogram the machine settings every time you insert the SD card into the machine. I think you have to click the box, but there may be a way to make it do it for every SD card or modem you work with. The modem systems may work the same way.

And to be clear, I think there is NO possible justification for it if the DME or anyone realizes the patient has changed her settings and deliberately sets it back without telling the patient.