CleveMed Blogs

CleveMed’s DreamPort^™ was recently launched at Sleep 2009 in Seattle, WA:

DreamPort expands the reach of your sleep lab by allowing remotely attended sleep studies to be done from anywhere using a bedside system controlled by sleep lab technologists miles away - over the internet!

CleveMed showcased this innovative product with a Live Remotely Attended Sleep Study! A patient located in Cleveland, Ohio was hooked up to a Sapphire PSG™ which wirelessly transmitted the real time data to the DreamPort located in the patient’s room. Using the camera and broadband technology that the DreamPort provides, the patient’s full PSG data was viewed live by sleep technicians in Seattle, Washington at Sleep 2009!

DreamPort Benefits:

DreamPort is especially ideal for those who are unable to make it into the sleep lab, such as pediatric patients, cross country truckers, the elderly, those with chronic pain and hospital inpatients. In addition, this system gives clinicians and researchers greater flexibility to conduct sleep studies in anyplace. DreamPort is suitable for clinical trials as it allows for cost effective research studies to be conducted in the patient’s home while adding an additional element of home care. Moreover, DreamPort is easy to use. The small, portable and single-button design simplifies the overall process and deployment.

DreamPort’s Easy Process:

Step 1: Patient is hooked up with Sapphire PSG
Step 2: Patient pushes power button on DreamPort
Step 3: Sleep tech remotely starts study from sleep lab
Step 4: Sleep tech controls video and full PSG data remotely

Broadband technology combined with a camera is used to transmit the patient’s full PSG data and video to technologists in real-time, allowing studies to be conducted anywhere the patient is.

As the market changes it is rapidly becoming important to offer flexible solutions for collecting sleep studies at varied locations. With the entrance of Wireless Polysomnography, sleep study setups outside of the lab become more feasible. A comprehensive sleep diagnostic service can now come to the patient instead of the patient having to come to the lab for a PSG. Wireless PSG also brings several benefits to the traditional in-lab setting. Here’s a quick introduction to the traditional and new & upcoming, non-traditional settings for a polysomnography.

Traditional Setting:

In-lab sleep facilities offer onsite sleep techs, medical equipment, and a full bedroom set. This is an expensive set-up, but wireless PSG completely eliminates the cost of running cables throughout the facility with its ability to transmit data through multiple walls. Also, there are typically fewer components with wireless devices and lower risk of individual component failure. Sleep labs will also benefit from expanding their sleep services to include non-traditional off-site testing. Sleep labs volume will not diminish but their patient mix will differ. Typically overcrowded labs will only have deal with those who strictly require in-lab testing, and they can service a larger total volume of patients (since they do not all need to be onsite). Each patient population can then receive a faster diagnosis and therefore faster treatment initiation, cutting out the need for long waits or investing in additional beds for the lab.

Non Traditional Settings:

Home Sleep Test: While some extreme conditions strictly require in-lab sleep testing, many patient populations are well suited for home sleep diagnostic testing, like those tested for occupational reasons, or the home-bound suffering from chronic pain. Home Sleep Testing (HST) allows patients the comfort of home and a familiar environment. It is also increases affordability by cutting out the facility costs of the sleep lab, and the costs involved in moving a patient to the sleep lab which can be expensive in some cases.

Hospital Inpatient PSG: Hospital networks, wireless or intranets are used to transfer sleep studies from the bedside to the sleep lab. Technicians can monitor and respond to problems, yet the patient is still under the immediate supervision of skilled nurses. Since Sleep Disorders Breathing is a complicating factor in many surgeries, the ability to conveniently conduct a sleep study in those settings may avoid complications intraoperatively and postoperatively (particularly for bariatric and cardiac surgery patients)

Hotels: Sometimes sleep labs use hotel rooms to conduct sleep studies because of reduced costs. Some patients are better able to relax in this more familiar setting, and benefit from a reduced first-night-effect.

CleveMed offers the technologies that can expand the reach of sleep services with its wireless systems that are suitable for both HST, follow-up and in-lab sleep studies. This post draws on the experience of several experts at CleveMed and the following web page: www.clevemed.com/PSGAnywhere

When opening a new sleep lab, the cost of hard-wiring the rooms can be a significant portion of the cost of the installation. The installation team must work with hospital technical staff, often for a day or even two days before systems are up and running. Cabling must be run and tested.

Wireless Advantages:

On the other hand, wireless devices can transmit data through multiple walls without any cables running through ceiling tiles. There are often less components, meaning easier setup and lower risk of individual component failure. Setups outside of the lab become more feasible. For example, mobile diagnostic studies in hotels, long term care facilities or nursing homes mean that a comprehensive sleep diagnostic service can come to the patient instead of the patient having to come to the lab for a PSG. Hospital networks, wireless or intranets are used to transfer sleep studies from the bedside to the sleep lab. Technicians can monitor and respond to problems, yet the patient is still under the immediate supervision of skilled nurses.

Wireless Not Flawless:

But, anyone who has ever lost a connection on a cell phone knows that wireless technology is not yet flawless. If a PSG study is interrupted several times through the night, since typically the amount of PSG data being transmitted is so large, even brief lapses can disrupt acquisition, annoy sleep techs and may affect data interpretation.

Workarounds:

Wireless systems work by transmitting data via electromagnetic waves at a defined frequency. With so much congestion in the 2.4 GHz band (the most commonly used, from Wireless Local Area Network to microwave ovens), the probability of losing data due to radio frequency interference increases. In order to enhance their immunity to interference, most wireless devices operate in a pseudo-random fashion, a strategy known as “hopping“. Because this signal is not stationary, the approach works well for small and intermittent transmissions, like browsing the internet. Sleep studies however, have large data files that are continuously streaming for hours, which make the process of data recovery more difficult if not impossible. One potential way to mitigate this problem is to simultaneously store the PSG data in memory inside the bed-side unit and use the transmitted data only for basic patient status check and to confirm electrode connections.

Our next post:
Questions that you should definitely be asking your potential equipment supplier if your sleep lab is considering going wireless.

This post draws on the experience of several experts at CleveMed and is an adaptation from “Wireless Polysomnography” as seen in Sleep Diagnosis and Therapy, June⁄ July 2006.