Prior to 2010, a great majority of sleep centers focused almost exclusively on in-lab testing, with the polysomnography test (PSG) leading the way. From 2010 to 2020, however, the home sleep testing (HST) market has experienced a growth explosion, jumping roughly 20X in total volume in the United States over the course of the decade. From 2015 to 2018, HST volumes doubled, and all signs pointed to record highs in 2020 prior to the pandemic. For sleep centers around the country, the COVID-19 pandemic has created a tremendous strain on in-lab testing volumes. However, with the rise of telemedicine and dropship home sleep testing, savvy sleep centers are finding ways to keep their home sleep test operations running, and in some cases, growing.
How a New York State Sleep Center Has Grown Home Sleep Test Volumes
In case you missed it, last month’s sleep story featured Dayana Arellano and her team, who are putting patient care back into healthcare. This month, we’re excited to share the story of the Sleep Insights team, led by the Medical Director and Practice Owner, Dr. Jacob Dominik, MD, and the President and CEO, Jeff Dann. The team has 10 locations across the Central and Western sections of New York, employing over 80 people. According to Dr. Dominik, it is their focus on sleep medicine from front to back that helps them stand out from the rest.
“Being able to focus on sleep medicine exclusively if possible is to the benefit of patients,” said Dr. Dominik. “Longitudinal care is important. We’re not curing patients with one meeting. It’s a long-term sleep management relationship with our patients, and having a provider that sees the same patient each time is crucial.”
However, longitudinal care during the COVID-19 pandemic comes with new challenges.
Sleep Center Changes brought about by COVID-19
Like many centers in the U.S., the Sleep insights crew had to implement a telemedicine offering quickly or risk delaying patient testing and care. According to Dann, the office closed on a Friday and began offering telemedicine on Monday. It was quite a busy weekend for the whole team, but telemedicine wasn’t new to the Sleep Insights team.
“We had explored using telemedicine prior to COVID,” said Dann, “so when COVID hit, we were able to transition quickly.” And even as COVID-19 restrictions have lifted, Sleep Insights has opted for continued usage. “We decided to continue to offer telemedicine even after the COVID restrictions were lifted,” added Dr. Dominik. “Once we made that decision, the idea began to snowball and we soon found ourselves exploring what a robust Virtual Care platform would look like for patients and providers.”
The backbone of a virtual healthcare platform is the rise of the home sleep test. It’s not surprising that home sleep testing volumes haven’t been as impacted by the COVID-19 pandemic as PSG testing volumes. According to EnsoData’s COVID-19 Sleep Center Impact Study, with n=100 surveyed centers, only 28 percent maintained full PSG volumes, while 79 percent maintained full HST volumes in the first month of the pandemic.
An Opportunity in Disguise
Of the 79 percent of unaffected HST operations, 48 percent reported expansion in their market share or volume during the pandemic. We asked the Sleep Insights team if they had a similar experience, and Dr. Dominik’s commentary mirrored the study results.
“In essence, the COVID crisis has allowed us to expand from our physical locations to a virtual platform, allowing patients the convenience of remote telemedicine visits and ongoing follow-up care, along with providing at-home testing and CPAP therapy services, all completed remotely by our staff.”
One big advantage for private sleep practices is the ability to service patients from the first contact through care. For sleep centers that can claim independence and accreditation, a plethora of opportunities are available. Your center may be able to add or expand your services, including initial consultations, PSGs, HSTs, DME support and supply, CBTi, and newer respiratory and other sleep therapies.
“Our focus has been and will continue to be on longitudinal patient care. We stress the need for clinical evaluations before testing, as well as the importance of continuity of care,” said Dr. Jacob Dominik. “We use an integrated approach which provides a continuity of care from initial evaluation to testing, to identifying the right therapy for the sleep disorder and the patient.”
By focusing on the full patient experience, Dr. Dominik and his team are able to better offer the right options for each patient who comes to sleep insights. But what about the patients who are “out of network” and don’t have a good testing option available to them? That’s the next step for Dann, Dr. Dominik, and the whole Sleep Insights team.
Growing Home Sleep Test Volumes Beyond the Local Market
Growth is exactly what Sleep Insights has in mind for HST volumes. For Dr. Dominik, the priority is geographical market expansion. “We believe we’ve hit the HST equilibrium in the local markets. But now that the restrictions [to testing] have been lifted, we’re looking to expand beyond our geographic areas throughout New York State.” By expanding access for unsupported patients in New York State via HSTs, Sleep Insights is looking to better provide access for people in underserved and untreated areas of New York.
While he wants to corner the market, Dr. Dominik also anticipates national players like Walmart will become a threat to local HST volumes. “National companies will get into the HST market,” he said. “They’re getting into CPAP, and big tech companies will be really disruptive in sleep. Before that happens, we need to get a bigger footprint in HSTs locally.”
The Sleep Insights team is working diligently to expand every aspect of their business, but home sleep testing is the primary focus at present. To provide some specific takeaways, Dr. Dominik suggests five important tips for HST expansion.
He also mentions setting up a direct phone line to call, day or night. Patients have a lot of questions, and for many, phone calls are the preferred method of communicating. Keep it simple, silly.
Final Advice for Growing Home Sleep Test Volumes
“If I could give a final piece of advice to sleep center operators, it’s this: You must have a willingness to adapt to disruptive tech,” said Dr. Dominik. “There are lots of new ways on the horizon to diagnose sleep apnea – from watches to rings – and as tech advances, there will be simpler ways. Don’t be left behind out of fear.”
We would encourage practices looking to grow HST volume to heed Dr. Dominik’s advice. We help similar sleep organizations grow HST volume by simplifying the scoring process, allowing larger tech: patient ratios, and bringing down costs. According to Dr. Dominik, Sleep Insights have technicians scoring at night, with a 3:1 tech to patient ratio, but for home sleep tests, technicians score tests the following day. With EnsoSleep, the same number of employees can review more home studies, allowing Dr. Dominik and other teams like Sleep Insights to bring HST expansion goals to fruition.
If expanding HSTs is on your to-do list, we’d love to talk with you about EnsoSleep, and how it can help ramp up your volumes. Simply fill out the form below, and a member of our team will be in touch to talk about how an AI sleep scoring solution can help modernize and scale your sleep business.
EnsoData simplifies the process for analyzing the human body to accurately diagnose health conditions. Using artificial intelligence, EnsoData’s technology transforms billions of waveform data points collected from sensors in medical devices and wearables into an easy-to-read report, so clinicians can make faster, more accurate diagnoses. Waveforms are used in healthcare to diagnose, monitor, and treat patients. Heartbeats on an EKG, eye movements through an EOG, and brain waves through an EEG all output as waveform data, with over 1.5 billion waveforms run per year globally across specialties. EnsoData leads the world in reading and understanding these waveforms, starting with sleep disorders and the flagship product, EnsoSleep.
Cover image: Depositphotos wittaya2499 74071051