ResMed S9 wireless modem

[The Latinist]

My DME set me up with a modem when I got my machine. I asked them how long I had to keep the modem on the machine and they said, "always." Like hell. My insurance company doesn't pay for supplies, only covers half of the machine and humidifier, and I have no plans to purchase my next machine from them (I'll pay cash to an online supplier to avoid the hassle of a DME). That modem will be coming off just as soon as the rent-to-own period is up. I'll be happy to drop it off if they want it back.

You don't have to be in the dark. Once u get full acess, yiu can pretty much view most data that's been collected. Even with no sd card, it has internal memory.

Done right, you are never kept in the dark.

How am I supposed to know that the changes have been made so I can change them back? Are you suggesting that checking my settings every day before going to bed is a workable solution to the problem of doctor and DME being able to change my settings without informing me?

[Please note: I do not think that my doctor would do so -- how's he going to get paid for the effort it would take, after all?]

[becker44a]

My DME (Apria) provided my S9 Autoset on January 21 of this year, under a rent-to-own arrangement. It was fitted with a wireless modem, which was a "loaner", intended to be returned when compliance was achieved.

I can absolutely confirm that this modem is bi-directional, and allowed the RTs at Apria to change my pressure settings. My initial Rx was 10 - 14. In the early days, I was having trouble getting the AHI below 10. I called in and spoke to the Apria RT, who linked into the modem, and reviewed the results so far. She said "it looks like your'e up against the upper limit quite a bit. I can message your Dr. and ask for a pressure increase." She did so, and the Rx was quickly changed to 10 - 20. I asked if she could change the machine settings via the modem. She said "I don't know, let me try. . ." She did, and the change was successful. I confirmed the change by looking at the data in Sleepyhead, and thru the Clinician's menu.

Of course, my AHI did not start to improve until I started to experiment with ways to avoid being on my back, but that's another story.

The modem is gone now - they asked for it's return after confirming that I had met the compliance standard for Medicare, and I don't recall what marking was on it. But there isn't any question about what they can do with these devices: in addition to basic compliance data, they can also see some efficacy data, and they can adjust the machine's settings.

[Skypilot]

Also the modem is RX (Transmit only). So new settings can NOT be uploaded to it.

In telecommunication terms Rx is receive and Tx is transmit so to say as the modem is Rx (transmit only) is incorrect.

In this case I suggest the Rx refers to a medical term.

[Webbie73]

I had been using a resmed elite 8 cpap machine and was very compliant. After 5 years I had problems with the machine and got new resmed 9s auto. When I picked up my new machine I was told of a new more efficient way to report data... A wireless modem. I did not have a say as to if I even wanted it. I was not thrilled about the idea. At the time the modems were out of stock so they mailed it to me.

It arrived and I not too happily went about plugging it into my machine. Modem light blinked then went solid indicating all was good. 4 days later I received an email from U-sleep. I almost deleted it as trash. It was informing me that I was not in compliance! My thought was who the heck is U-sleep and how did they get my information? Who are they? Who said I wanted a 3rd party checking up on me? Monday morning my DME will be getting a call from me. U-sleep and my DME are not the same people. What ever happened to HIPPA?

This all smacks as invasive and a bit on the side of Big Brother watching. I have no problem with me sending a scan card to the DME right before my yearly doctor visit. They print it and place it in my file. All data is forwarded to the doctor and we discuss it during my visit.

I want to add that I have not reached my $4,000 deductible for my insurance so this machine was out of pocket and will be billed monthly. So basically insurance does not even need to know if I am compliant.

[Mac_Sheepcounter]

I got the ResMed S9 AutoSet and also the WirelessModem.

Afaik the Modem just transmits data to my regional RedMed office, they transfer the usage to my health insurance company.

It's ok for me, because the insurance company doesn't want to spend money for a device, that's not used.
With the SleepyHead Software, i'm able to monitor my "success" better, than they do (the quotes are neccessary, because i fight with massive leaks, so my personal success is a bit sub-optimal...)

All informations i got so far definitely say, it's a "one way ticket". Data is sent from the S9 to the data-collector. But it's not possible to change settings remotely. Your actual settings (as mentioned above) are available by press and hold the SetUp and Select key and knob for a few seconds.

For me personally i'm advised to undergo a yearly monitoring of my sleep with an additional diagnostic device. So i would bet at least $1 that a remote access to the device is not possible

The S9 has two memory areas. The SD-Card with extremely detailed data for every day and an internal memory with more compressed information (dunno, what is stored there, because it's absolutely internal and secured from any external access). But with the SD Card and a nice piece of Software like SleepyHead you should have more information, than the exernal guys.

Just my 2-(EUR)-cents

Mac

[archangle]

Who has access and HIPAA

The modem connects to the cellphone network. Data is transmitted through the cellphone network (and probably the internet) to a central server. The central server is probably national, and may be run by ResMed or it may be run by U-sleep. It might be run by some other third party. Your doctor, your DME, the medical group your doctor is affiliated with may have access to this data. They might even subcontract with some other outside firms to do certain things with this data. The insurance may have access.

HIPAA allows all of this as long as certain rules are applied. In theory, each person or company in the chain has to meet certain HIPAA requirements.

This isn't that unusual. Imagine you go into the doctor's office for a physical. The doctor records information. My doctor is affiliated with a large medical chain. That company has access to my data. Their billing may be a third party company hundreds of miles away. Their computers may be run by a fourth company. It may use medical software written by a fifth company. It's built by a 6th company that may have to do service. There may be a 7th company that audits their process, including HIPAA. The doctor may do a lab test that goes to another company. That company has several other affiliated companies who do part of the process just like the doctor.

As to the CPAP data, I'm guessing it's encrypted in some sense when it's on the cell phone/internet system, but experience shows that big high tech companies often don't do a very good job at protecting the data.

We might be upset about this, but there is basically zero chance of anything happening. Medical providers are allowed almost free reign in terms of giving the data to other "HIPAA compliant" parties as long as the other party is actually involved in the process of providing medical care. (Note that I may not have the legal terminology right, but that's the idea.)

I'm not sure it's really a big thing to be worried about from a practical standpoint. If you are worried about it, a similar situation applies for almost ANY medical visit.

U-sleep has a web site. I'm not sure I can post it but googling cpap usleep will find it.


TWO-Way communication:

As for what the modem does, it's DEFINITELY two way. The system can send new pressures and other settings to your CPAP machine. I can dig up a link if you want, but lots of people on this board have had their settings changed remotely.

In many ways, the modem is a good idea. If you have a bad night, you can call your doctor, he can look at last night's data, figure out there is a problem, and make an adjustment to the pressure and fix the problem while you're at work.

As for compliance data for insurance, that information is sent by the modem, stored on the SD card for 365 days, and stored inside the machine itself for 365 days. If the modem or SD card fails, the data is still there. As long as you don't reset the data on the machine and/or lose the SD card, the DME can still verify compliance for insurance purposes. The DME may be too stupid, to lazy, or too arrogant to do this, unless you lean on him.

[Webbie73]

Just spoke with my not too happy DME. The modem is mostly used for compliance. You have the right to return the modem and just have the SD card for data reporting. It is going in the mail today!

One question, what data are you all looking for everyday using a card reader? I only look at my leak rate, AHI, HI and if there were any central apneas.

[Mac_Sheepcounter]

---snip---
TWO-Way communication:

As for what the modem does, it's DEFINITELY two way. The system can send new pressures and other settings to your CPAP machine. I can dig up a link if you want, but lots of people on this board have had their settings changed remotely.

In many ways, the modem is a good idea. If you have a bad night, you can call your doctor, he can look at last night's data, figure out there is a problem, and make an adjustment to the pressure and fix the problem while you're at work.

As for compliance data for insurance, that information is sent by the modem, stored on the SD card for 365 days, and stored inside the machine itself for 365 days. If the modem or SD card fails, the data is still there. As long as you don't reset the data on the machine and/or lose the SD card, the DME can still verify compliance for insurance purposes. The DME may be too stupid, to lazy, or too arrogant to do this, unless you lean on him.

Oooops. That's a very new information for me. Or maybe the things are handled a bit differently here in Germany (my device doesn't send the data to my doctor, just to the local ResMed people and they report to my health-insurance company).

Thanks for the info, i'm going to do a bit research about it. Sorry, but i'm sort of a nerd like "Everything in my home is running Linux now, only the cat is effectively refusing..."

[archangle]

Oooops. That's a very new information for me. Or maybe the things are handled a bit differently here in Germany (my device doesn't send the data to my doctor, just to the local ResMed people and they report to my health-insurance company).

Here in the US, it sends the data to a service, and then authorized users can access the data through a web site or other programs. The users might be a doctor, the DME, some sort of health management system, or insurance.

I suspect it's the same worldwide, maybe with differences in who runs the service and who is authorized to access it.

[archangle]

We might be upset about this, but there is basically zero chance of anything happening.

Clarification: I mean that there's basically zero chance of the government or the medical system doing anything if we complain. It's all "according to the rules."