Darren Umbers (UK Sales Director, Philips Respironics) (pictured) Darren will talk about both devices and support services Philips is offering in the UK for sleep apnoea patients. This will include CPAP devices to aid breathing and nebulizers able to report compliance. He will also talk about “back office” support for these devices. Darren will therefore pick up on the references that Steve will make to monitoring devices and treatment and cover patient support to some extent.

1. Evolving the Management of Patient
Care in the Home
Darren Umbers, Regional Director UK and Ireland
Home Healthcare Solutions
28th April 2010
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”

2. Content
• Sleep, what is it?
• Sleep Apnoea
• Why we address the problem
• Challenges
• Innovative treatment support models
• Questions
• Conclusions and Questions
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

3. Three Pillars of Good Physical Health
• Good Diet
• Regular Exercise
• Healthy Sleep
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

4. • Sleep Disorders are common in the general public and
contribute to impairment of academic and occupational
performance, increased risk of accidents, disturbances of
mood and social interaction.
• Sleep disorders may lead to or exacerbate medical and
psychiatric conditions.
• Sleep disorders are common
• Sleep disorders are serious
• Sleep disorders are treatable
• Sleep disorders are under diagnosed
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

5. Sleep Terminology
Definition of OSA
OSA (Obstructive Sleep
Apnoea) occurs when the
upper airway repeatedly
collapses during sleep,
causing cessation of
breathing (apnoea) or
inadequate breathing
(hyperpnoea) and sleep
fragmentation.
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

6. Sleep Terminology
Obstructive Sleep Apnea
Normal Airway Obstructed Airway
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

7. What is obstructive sleep apnoea?
Thus obstructive sleep apnoea syndrome is:-
Airway incompetence brought on by sleep
Recurrent brief arousal from sleep to clear the airway
Markedly fragmented sleep throughout the night
Daytime consequences of sleep fragmentation, mainly excessive
daytime sleepiness
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

8. Overnight (8 hours) oxygen saturation levels (oximetry)
in OSA:
>400 dips/apnoeas in total
Beginning
of night
1st hr
2nd
hr
3rd hr
End of
night
8th hr
60 minutes
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

9. Symptoms
Nocturnal Daytime
Cyclical silence and loud snoring Excessive daytime sleepiness
Choking Morning headaches
Restless sleep Unrefreshing sleep
Nocturia Memory impairment
Sweating Increased risk of accidents
Reduced libido Impaired cognitive function
Associated hypertension
Polycythaemia
Heart failure
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

10. Arterial blood pressure during OSA
Recurrent dips with Rise with
every obstructed breath every arousal
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

11. Effects of OSA
• Systemic hypertension
• Cardiac Function
• Ischaemic Heart Disease
• Cardiac Arrhythmias
• Cerebrovascular Disease
• Pulmonary Hypertension
• Psychological
• Endocrine
• Renal
• Cognitive
• Mortality
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

12. Obesity Trends* Among U.S. Adults
BRFSS, 1985 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
Behavioural Risk Factor Surveillance
No Data <10% 10%–14% System
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

13. Obesity Trends* Among U.S. Adults
BRFSS, 1986 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

14. Obesity Trends* Among U.S. Adults
BRFSS, 1987 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

15. Obesity Trends* Among U.S. Adults
BRFSS, 1988 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

16. Obesity Trends* Among U.S. Adults
BRFSS, 1989 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

17. Obesity Trends* Among U.S. Adults
BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

18. Obesity Trends* Among U.S. Adults
BRFSS, 1991 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

19. Obesity Trends* Among U.S. Adults
BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

20. Obesity Trends* Among U.S. Adults
BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

21. Obesity Trends* Among U.S. Adults
BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

22. Obesity Trends* Among U.S. Adults
BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14 15%–19%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

23. Obesity Trends* Among U.S. Adults
BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

24. Obesity Trends* Among U.S. Adults
BRFSS, 1997 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

25. Obesity Trends* Among U.S. Adults
BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

26. Obesity Trends* Among U.S. Adults
BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

27. Obesity Trends* Among U.S. Adults
BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

28. Obesity Trends* Among U.S. Adults
BRFSS, 2001 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

29. Obesity Trends* Among U.S. Adults
BRFSS, 2002
(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers 28 April 2010 Cambridge Health Network Talk

30. Obesity* Trends Among U.S. Adults
BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

31. Obesity* Trends Among U.S. Adults
BRFSS, 2004 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% ≥25%
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

32. The USA
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers 28 April 2010 Cambridge Health Network Talk

33. Key facts about obesity in England
• The four most common problems linked to obesity:
– Heart disease
– Type 2 diabetes
– High blood pressure
– Osteoarthritis
• 1 in 5 adults is obese
• The number has trebled over the last 20 years
• Nearly two thirds of men and over half of women are
overweight or obese
Tackling Obesity in England :REPORT BY THE COMPTROLLER AND AUDITOR GENERAL 2004
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

34. OSA - Why should we be addressing the
problem?
• As society faces an obesity ‘epidemic’ with more and more of the
population becoming obese, the link between OSA and obesity is also
highlighted.
• If current trends continue, at least half the population will be obese by
2032. In less than 15 years, 86 per cent of men will be overweight,
and 70 per cent of women will reach the same level of obesity in 20
years time*.
• About 1 in 25 men and 1 in 50 women are affected by OSA
• 80% of OSA sufferers who should be receiving CPAP have either not
been diagnosed or have not received treatment.
* T. Marsh, Associate Director, National Heart Forum
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

35. Why should we be addressing the problem
cont…
• OSA is associated with an increased risk for:
• Type II diabetes
• High blood pressure
• Heart disease and heart attack
• Stroke
• Fatigue-related motor vehicle and work accidents
• Decreased quality of life
• NICE Endorsed
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

36. OSA causes more accidents
OSA patients have more accidents than non-OSA
patients.
HGV OSA drivers have twice as many accidents (Stoohs,
1994)
16%-20% of all RTA’s are sleepiness related
(Horne, 1995)
Twice as likely to have an accident and have more
accidents than non-OSA patients (Barbe, 1998)
6 times more likely to have an accident (Masa,2000)
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

37. Principles of nCPAP
• Continuous positive pressure
• Nasal mask
• Pneumatic splint
• Prevents collapse of upper airway
• Moderate - severe SAHS
• NICE Endorsed
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

38. Therapy Objectives
• Abolish abnormalities
• Restore normal sleep
• Relief of nocturnal & daytime
symptoms
• Improve comfort
• Optimal compliance
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

39. Resource and service management
• Staffing
• CPAP Service Staffing per 1000 patients on
nasal CPAP
– Nurses / physiologists
• CPAP induction
• CPAP titration
• CPAP Clinic review
• CPAP problems / maintenance
• Patient support / advice
• 1.3 WTE
– Secretarial
• Phone calls
• Clinic letters
• Booking CPAP patients
• 0.2 WTE
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

40. Review
• Compliance
• Problems
• Benefits
• Changes
• Equipment
• Consumables
• Internal / external
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

41. Resource and service management
– Technical support
• Sleep studies
• Ordering
• Replacement parts
• Replacement machines
• Loan machines
• 0.3 WTE
– Medical engineering
• New equipment evaluation
• Electrical safety testing
• Machine faults / repairs
• 0.3 WTE
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

42. Resource and service management
• Finance
– Pay costs
– Non-pay
• Overheads / rooms etc.
• Equipment
– Machine costs
– Disposables (mask/tubing
etc.)
– Accessories
(Humidification)
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

43. Who provides the service?
• Respiratory
• Cardiology
• ENT
• Neurology
• Anaesthetics
• Psychiatry
• NHS based mainly
• Room for service
innovation??
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Sector, MMMM dd, yyyy, Reference

44. Conclusions
• Treatment of OSA is cheap, and produces large increases in
quality of life for the rest of the patient’s normal life span
• Large predicted savings in other health costs, and accident
costs.
• Patients need to remain on treatment to derive such benefits
• There is a large unmet need to treat these individuals with
OSA
• Treatment of OSA represents much better value for money
than many interventions currently funded
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

45. The Bottleneck
• Hospitals and Private Practices establish Sleep
Laboratories in order to treat patients.
• Government introduces NICE Guidelines in order to
provide treatment recommendations.
• UK NHS Sleep Services limited Capacity
• Awareness rising
• Estimated 1 Million untreated patients
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

46. Quote From NHS Sleep Forum:
‘We are a long way short of meeting what will
probably be an increase in demand. Even if
the demand is static, we are actually not
doing very well at the moment.’
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers 28 April 2010 Cambridge Health Network Talk

47. Forum Conclusions
• Funding of services is an issue
• Difficulty meeting increasing demand
• Non-Clinical administration increasing
• Compliance rarely being monitored
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers 28 April 2010 Cambridge Health Network Talk

48. What is MOST?
Patient Support and
Management of Sleep Therapy
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

49. Protocols:
• Defined service protocols
• Comprehensive patient follow up
• Robust troubleshooting guides
• Compliance upload and interpretation
• Full audit trail and patient recording
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers 28 April 2010 Cambridge Health Network Talk

50. MOST
• MOST was designed to work hand in hand with hospitals,
PCT’s and Private Practice establishments in order to
effectively manage patients in the following areas:
• Diagnosis
• Treatment
• Follow up
• MOST works closely with clinicians, nurses, technicians
and other members of staff to ensure patients receive the
best possible therapy.
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

51. MOST Objectives
• Achieve adherence to and compliance with therapy
• Supporting patient and partner to achieve best outcomes
• Pro-active management and timely troubleshooting avoids
failures
• Ensuring the earliest resolution of symptoms (DVLA, return
to work, quality of life) *
• Robust data collection, validation and reporting
• Acknowledging and respecting the need of the INDIVIDUAL
• Service integrity - Clinician confidence
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

52. Clinician Information
• MOST Net.
• Window on the patient for Clinicians
• Patient data can be accessed via a secure internet site.
• Clinicians provided with user name and password.
• Patient notes reveal:
• a comprehensive trail of interactions
• Compliance data and reports for review
• Notes, comments and troubleshooting advice
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

53. MOST Net
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

54. Patient Pathway
MOST provides customer with patient
information form
.
Patient and clinician fill out
prescription form along with
confidentiality agreement
Form sent to Philips Respironics
Philips Respironics contacts patient
Therapy commences
The real work begins!
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

55. Respironics UK Resources
• Dedicated experienced Sleep Support Team providing
support, help and advice
• Five RPSGT Qualified team members available to help
• Onsite training by qualified clinical trainers for staff and
patient groups
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

56. In Summary
• Manage patients needs
• Check and monitor compliance
• Fixed costs with no capital outlay
• Allow more time for clinics
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers 28 April 2010 Cambridge Health Network Talk

57. Who we currently work with….
• Private Practices.
• Companies e.g.. haulage firms.
• Self referred patients.
• Some of the biggest NHS Trusts in the UK.
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers, 28/4/10 Cambridge Network Healthcare Special Interest Group Talk

58. Continued Innovation
• New Sleep platform with embedded TC65i Cinterion
Wireless Module
•Allows wireless, 2 way communication between CPAP
to care provider
•Wireless LAN or Mobile phone network comms
•Live real time data allow therapy adjustment
•Greater standard of care
•Reduced hospitalisation
•Won “Best embedded end to end service award” at
GSMA Embedded Mobile Competition 2010
(Communications sector award)
“This document is the confidential and proprietary information of Philips Respironics and may not be reproduced, disclosed or distributed to any other person or entity without prior permission from Philips Respironics. Philips Respironics makes
no warranty of any kind with regard to this material and it is subject to change without prior notice. Any medical information is provided as a general information service only and is not intended as a substitute for advice from a registered physician
or other health care professional.”
Confidential Darren Umbers 28 April 2010 Cambridge Health Network Talk

59. Your Questions.......