February 2015 – Second Edition
 
 

Dear Colleagues:
Welcome to the first Sleep Activist newsletter in 2015!  The Sleep Activist is an electronic newsletter for healthcare providers who work directly with sleep medicine patients, families and practitioners to coordinate and manage patient care, improve outcomes and patient self-management, educate patients and the community, and advocate for the importance of good sleep. The purpose of this newsletter is to serve as a forum for new developments regarding the advancement and recognition of clinical sleep health specialists, provide relevant and timely information to spark your interest, and share sleep educator stories from the field (we would love to hear of your experiences). 

This past year has been a whirlwind of activity!  The CSE program continues to thrive and the first Certification In Clinical Sleep Health (CCSH) examination was offered in May.  The CCSH exam is now offered on-demand with immediate test results. For more information on the CCSH exam, please visit http://www.brpt.org/default.asp?contentID=300.

Now it is up to clinical sleep educators and CCSH credential holders to continue the forward momentum by engaging professional and local communities, and enhancing awareness of the value of this professional specialty.  We want to hear from you!  Let us know if you have talked to your elected officials or worked with your administration to become a part of an interdisciplinary team to address the spectrum of health issues associated with sleep disorders. 


 
 
Spotlight On A CCSH Credential Holder
Tamara Kaye Sellman, RPSGT, CCSH
Sleep Lab Technologist, Harrison HealthPartners
Pulmonary & Sleep Medicine, Poulsbo, WA
Curator, SleepyHeadCENTRAL.com,
Bainbridge Island, WA

I'm a relative newcomer to sleep, earning my RPSGT credential in August 2013, one month after taking my first job as a sleep technologist, and only two months after completing my CAAHEP program (September 2012 through May 2013) and receiving my certification.

I entered the field after spending my 20s, 30s and 40s working in publishing; I've been a writer my whole life. Professionally, I've edited, published, designed, coached and worked with literary communities in a number of ways. I hold an Associates Degree in communications and a Bachelors Degree in journalism.

Of all the reasons behind this career switch in midlife, key among them is the fact I am also a sleep health patient. Seven years ago, I had inexplicable and irresistible fatigue, my snoring had worsened, and I was face planting into my laptop during live teleconferences.

At my sleep study, I didn't have to split, as my AHI was low, but my high RDI later confirmed suspicions of upper airway resistance caused by narrow airways and allergies. I also passed my MSLT, ruling out narcolepsy formally, though idiopathic hypersomnia remained an open question until I treated the UARS.

I was an early adopter of the oral device, fitted by my dentist, which I use with 100 percent compliance. My severe snoring stopped. My postnasal drip disappeared, thanks to that slight additional opening in my airway, allowing me to clear my nasal passages normally. I swapped multiple drugs for a single nasal steroid as needed, ending years of sinus infections, laryngitis and bronchitis.

Like a CPAP devotee, I felt more energized than ever! I became a walking, talking evangelist for sleep health even before I became an RPSGT.

At the same time, my journalist training prompted me to learn everything I could about sleep. What I found in books and online was useful, but I discovered that the most legitimate and reliable resources were, ultimately, out of the reach of "average" people.

The general population is either unable to interpret medicalese or they can't access real studies which are, by and large, trapped behind a payment barrier. And less-than-stellar sources – some of them offering outright "snake oil" in their advice – also supplant some of the better websites because of all the curative promises they make.

When I started the sleep technology program in 2012, my key goal was to not only find work in a sleep lab, where I could interact with patients and doctors, but to also write about sleep health for the general population. Credentials can help to land better assignments and, perhaps, better pay for me as a writer.

When I saw the Clinical Sleep Educator (CSE) certificate program offered at the Louisville BRPT conference in September 2013, I couldn't have been more thrilled. Based on the success of previous diabetes and asthma educator programs, the new CSE program seemed built for people just like me: sleep techs with communications skills and passion built on personal motivation.

Inspired, I began work on a new website after returning from Louisville. It took a year to design, write and launch. In the meantime, I wanted to take the next step so I studied for the Certification In Clinical Sleep Health (CCSH) credential exam and took the test on the last day of the exam window in May of 2014. I passed just weeks before launching SleepyHeadCENTRAL.com.

Its subtitle, "Sleep Health Information Clearinghouse," says it all. I call myself the curator because that's what the work feels like: I'm conducting a tour through a huge museum housing diverse ideas about sleep health. I'm adding to the collection all the time.

While I don't get paid for this work yet, in the world of communications and media, it's a pretty substantial calling card I can put out into the digital wilderness. Past experience tells me there are paying jobs that come from this type of work. And as imperfect as the website is (let's face it, all websites are "works in progress"), it's already connected me with some amazing leaders in sleep health, technology, public education and health policy.

I've also had the privilege and opportunity to help ordinary people navigate their sleep health issues. Making the site a friendly, interactive place with fun elements like giveaways, polls, links to Pinterest, etc. means I can reach them—the very same people you and I encounter every day in the lab—"where they are." What I learn in the lab benefits what I learn as a curator, and vice versa.

One thing I've learned over 25 years of work in publishing, social networks and media literacy is that when readers say they want information, what they're really asking for is a "story." A good story is a compelling narrative that includes anecdotes, first-person accounts, confessionals, dialogs, monologues, and tales told around the metaphoric fireplace.

People don't always absorb website "information" or "fact sheets." But when you contextualize this information through storytelling – this humanizing element makes it personal. It sticks in one's memory and has emotional power. Stories can serve as strong motivators for those willing to rethink their habits or to make important changes.

And isn't that what we want as patient educators? To inspire, to motivate, to give patients tools for positive change?

As both an RPSGT and a CCSH, and as a sleep health patient, this is exactly what I want, for myself and for many others.


 
 

Value! It is important to think about how we will be recognized for our services in terms of demonstrating value to payers to ensure payment. As this new specialty continues to grow and develop, it is critical for those of us who are working in a practice setting to document what we are doing every day in practice (educate, train, chronic care management, etc.), what codes we're using and if payment is obtained.

Each state or the various payers may have different policies regarding patient education and chronic care management; be sure to contact them to determine and understand their policies. It is also important for you to begin to establish a state-wide community of clinical sleep health providers. For example, establishing in your state and community common CPT codes and using them on a regular basis is one way to establish a payment structure. Communicating with one another, and strategizing and providing the outcomes that payers want to see is imperative. Consider introducing discussion at your next sleep society meeting and establish a communication network to exchange ideas and strategies.

For those of you attending the BRPT's CSE program at FOCUS 2015 in Orlando, Robert Holden, Esq. will be speaking on reimbursement issues on Wednesday, May 6: Healthcare Policy Change and Engagement: Reimbursement Opportunities and Challenges. Robert Holden specializes in health care and professional licensure regulatory issues and manages Stateside Associates' Health Care Issue practice in Arlington, VA. This is a great opportunity to ask questions! http://foocus.com/wp-content/uploads/2014/12/2015DisneyRTSleepBrochure_updated-Dec-09-web-FINAL.pdf

Watch Your Inboxes For A Survey Coming Soon!
This Spring, the BRPT will be sending out a survey to collect information from you regarding billing practices and codes. We want to hear what's worked and what hasn't. An analysis and needs assessment of the current landscape will help provide the foundation we need for lobbying efforts and the development of future codes. We need your help. In addition, please send emails with billing information and stories to the BRPT. We'd love to hear from you!


 
 

Building a relationship with your elected officials is an important first step.  This section will help you locate your contacts in the senate and congress as well as provide tips for connecting with them.  The goal of communication is to enhance their knowledge about sleep and associated disorders as well as the public health dangers.

  1. Schedule a meeting.  Don’t know who works for you? 
    http://www.usa.gov/Agencies.shtml
    .
    Use the link above to locate your elected official. 
    Then log onto the following section:

    Contact Elected Officials
    • Congress and the White House
      These steps can help you identify and contact your representatives in Congress, as well as contact the White House.
    Be persistent; it may take a few months to secure a meeting.  I met with my Congressman last April on Sleep Apnea Awareness Day. I was fortunate as his local office was fairly close to home.  I also email him as well as my senators on a regular basis.

  2. Learn about your elected official.  What committees does he or she sit on?  Do they have any special caucuses that can work in your favor?  For instance, my congressman sits on the Congressional Diabetic Congress.  As I reviewed the website it was apparent that something was missing:  SLEEP!  This gave me an opportunity to provide important information with regards to the bi-directionality between sleep deprivation and sleep disorders as a contributing factor for diabetes.

  3. Familiarize yourself with any relevant pieces of legislation.  There are several bills that are currently important to our field including H.R. 4695. This bill amends title XVIII (Medicare) of the Social Security Act to include sleep apnea screening in the initial preventive physical examination covered under the Medicare program.  Wow! Just think how this one bill could impact the sleep health world!  In 2012, Kathleen Sibelius (then Secretary for DHHS) stated that 11,000 people a DAY qualify for Medicare1.  For those of you who reside in Ohio, a new bill (Senate Bill 276) passed in June entitled the “Safe Sleep Education Program”2.  This could be the perfect opportunity to hone those skills for parents of infants and to find facilities that need our expertise.  And I am sure that many of you are familiar with bill number H.R.3095 with relation to commercial drivers:  “To ensure that any new or revised requirement providing for the screening, testing, or treatment of individuals operating commercial motor vehicles for sleep disorders is adopted pursuant to a rulemaking proceeding, and for other purposes.” These bills are just a few that can significantly impact our field.

  4. For additional information, go to the AASM site for an informative billing FAQ: http://www.aasmnet.org/codingfaq.aspx



    1 http://cnsnews.com/news/article/senior-boom-11000-new-seniors-become-eligible-medicare-every-day

    2 http://www.ohiosenate.gov/jones/press/jones-initiative-promotes-safe-sleep-education-continues-battle-against-sids



We Want To Hear From You!

That’s it for this edition.  The Sleep Activist will be published three times a year. We love feedback. Please send comments and/or suggestions to info@brpt.org with the subject line “Sleep Activist.”  And, please send us your stories for publication!  Sharing your stories and experiences will help other clinical sleep health specialists to perform, expand, and refine their services.  Information sharing will bring cohesion, advance the field, and strengthen the content of this newsletter.  I’m happy to provide editorial support.

Stay tuned for the next edition of the Sleep Activist which will enhance your knowledge about ACO’s and the role of the allied health sleep professional.

Remember, sleep and associated disorders know no boundaries – not age, gender, race or condition.  But there is one common and critical factor: healthy sleep is the glue to keeping us all functioning well.


Be Active-Be Engaged!

Robyn Woidtke, MSN, RN, RPSGT, CCSH
CSE Task Force Chair