Our Sleep Software evaluation approach

The delivery of high-quality care and associated healthcare outcomes, in any healthcare system, is entirely dependent upon the implementation of clinical guidelines.

There are effectively two aspects in relation to the delivery of evidenced based guidelines:

• The creation of the guidelines themselves

• The implementation of the guidelines

LungHealth is focusing their support around the implementation of the guidelines and that is the purpose of our Computer Guided Consultation (CGC) for Sleep. LungHealth has created a product that assists specialist and non-specialist healthcare professionals to deliver a full and thorough guideline level review, for all patients referred for investigation and management of Obstructive Sleep Apnoea (OSA).

In addition to the above, in the area of sleep medicine, there can also be considerable waiting times to see a consultant, in some instances up to two years, hence an ‘alternative pathway’ needs to be explored if patients are to be managed effectively, receive treatment in a timely manner and if specialist resource is to be utilised effectively in those areas where it is needed most.

We evaluated the diagnostic accuracy of the software, when used by a ‘non-clinician’ and compared this to the diagnosis made by a Sleep specialist physician when assessing the same patients from unselected referrals with suspected Obstructive Sleep Apnoea. (OSA)

The Results

The software was shown to have a high level of diagnostic concordance when compared with a sleep specialist but also highlighted those patients with unexplained symptoms or where there was diagnostic doubt and recommended referred to a sleep specialist. The results, published in the European Respiratory Journal are statistically significant and demonstrate that the software enables both a safe and accurate diagnosis in patients with suspected OSA.

In addition to implementing the American Academy of Sleep Medicine/NICE guidelines for OSA, the LungHealth app also allows users to take a careful holistic medical history in order that the presence of other co-existing sleep conditions e.g. restless legs syndrome, insomnia and conditions of hypersomnia may be quickly recognised and investigated where appropriate thus leading to earlier diagnosis.

Furthermore, the presence of sub-optimal treatment outcomes in OSA can be identified and managed in a proactive manner e.g. those patients who have residual daytime sleepiness despite adequate CPAP treatment can be identified and receive an appropriate intervention for their condition in order to improve their quality of life.

All patients data is presented in a clinical dashboard, which creates an electronic patient record (EPR) for sleep and allows for effective management and prioritisation of patient caseload including the “real time” identification of “high risk” patients such as sleepy drivers. This represents a significant step forward in the delivery of a proactive Sleep service as in the majority of cases NHS Trusts are reliant on paper-based or manual systems to run a multi-disciplinary team meeting (MDT).

During the CGC review, the clinician is prompted to consider each of the modifiable aspects of care. It remains up to the clinician and indeed the patient to decide whether to follow the prompt made by the software or not (note some patients will decline what is on offer and that is their right).