How to Find a Quality Sleep Scoring Service that Does Not Compromise Patient Care – Chad Doucette

Proper due diligence in finding a quality scoring service provider will set the stage for a mutually beneficial relationship. Here are the key questions to ask to avoid quality pitfalls and find a first-rate vendor that can help your laboratory meet the new industry standards and deliver superior patient care.

A Google search for “sleep scoring” will reveal many organizations that purport to offer quality services at low prices and terrific turnaround, often within 24 hours. To many resource and budget strapped sleep laboratories that are dealing with record backlogs, these scoring services offer a compelling proposition. As tempting as these services are, nagging concerns about quality prevents many laboratories from moving forward with a scoring service. This is a legitimate concern: sleep laboratories are literally placing their reputation and patient care into the hands of another company. By erring on the side of caution, these laboratories effectively snooker themselves out of the opportunity to achieve higher levels of efficiency while reducing their operating costs – the key benefits to using a scoring service.

The fact is hiring a reputable industry recognized scoring service in no way compromises quality. If due diligence is given to selecting the right vendor, the quality for sleep record scoring will match or in many cases exceed what a laboratory can do itself. The challenge is to find a scoring company that has put appropriate quality measures in place. What measures should you look for? What can you do to quickly sort the wheat from the chafe? Fortunately there are two key questions that you can ask upfront to quickly pre-screen potential scoring providers and avoid the pitfalls of having quality compromised.

Is the Sleep Scoring Service Following AASM Guidelines?

It is essential to align your sleep laboratory with a scoring service company that has a commanding knowledge and understanding of current industry standards and protocols. The Sleep industry is fast approaching an important deadline. By July 1, 2008 accredited facilities in the United States must be scoring to new standards established by the American Academy of Sleep Medicine (AASM). Credible sleep scoring services will also adopt and follow these same standards. Aligning your laboratory with a scoring service company whose knowledge and understanding of the importance of accurate, industry updated scoring criteria is the best way to ensure you engage a high quality scoring service provider.

Many hospitals and laboratories are concerned about what these guidelines mean for their operations and how best to implement them in time to meet the July 1st deadline. A reputable, forward looking scoring service can actually help you educate your technologists and ensure these new rules and industry standards are implemented effectively and efficiently in your laboratory.

Does the Vendor Have a Quality Assurance Department?

For the best accuracy, sleep studies should be scored manually by a registered technologist since software based scoring has not been perfected and lacks consistency. However, manual scored studies introduce a subjective component. A technologist for example can look at data and interpret it one way while another may interpret it slightly differently. Also, it is not hard to imagine that in 8 hours of sleep scoring one set of eyes might miss something. In addition, poorly acquired records with artifact introduce a possible element for inter-rater differences. For these reasons, a reputable, industry recognized scoring service will practice and have a designated quality assurance department that constantly and routinely oversees the inter-scorer reliability of their scoring technologists. Audits should also be performed on all scoring technologists to ensure that the services you have incorporated into your business practice are keeping with your internal quality standards.

Making sure that a quality assurance standard is practiced by your scoring service is a fundamental way of measuring the efficiency of business processes. A quantifiable benchmark enables problems to be pinpointed and can assist sleep laboratories in identifying ways and means of improving their internal processes and data acquisition.

A quality department can also assist when the medical director has questions regarding the scoring. A designated quality department can review the study in question and evaluate the concerns and either send back a response or if necessary a re-score.

Quality departments can also provide feedback regarding data acquisitions and provide action plans to increase overall quality. Any scoring service that does not have a designated quality department and manager are not placing their scoring quality as their number one priority.

Choosing a scoring service that has an internal quality assurance program is key. When selecting a scoring company without a quality assurance program and department, sleep laboratories run the risk of jeopardizing their relationship with patients and referring physicians through the inability to provide continuously good service and fast and efficient patient care.

Key Follow-Up Questions to Refine your Search

After your sleep scoring candidates get past those two key qualifying requirements – they are incorporating AASM guidelines into their service methodology and they have a viable QA department or practices. Now it is time to move on with a few follow up questions that will help you confidently select a vendor that is a good match for your specific requirements, culture, and needs. Here are the top questions you should ask your short list of potential scoring vendors:

1. How large is the organized? Size goes hand in hand with vendor reliability. Many scoring companies just do not have sufficient capital or enough employees and registered technologists to handle the volume of some of the larger sleep facilities. In addition to the right experience, you are looking for a sleep scoring service that will be able to weather fluctuations in the economy and be a viable business for the duration of your scoring relationship.

2. How much will it cost? Be wary of vendors who quote low prices without even talking to you. Price should be associated with the turnaround time, detailing of the reports and archiving of the studies. A reputable scoring service will customize a pricing schedule based on business objectives, volume, and desired turnaround time. As with most professional services – and things in life – you get what you pay for.

3. What kind of technology are they using? Many of the industry’s top scoring service providers are using the latest technologies to transfer patient files over the internet in a secure online environment that meets and exceeds HIPAA standards. Selecting a vendor that incorporates these technologies will increase your productivity and satisfaction levels. Companies offering courier services for the scoring of patient studies are neglecting the advancements of technology and its ability to increase the turn around times of patient studies. Using the Internet is the fastest and easiest way to transfer files provided that they are using a secure online data transfer system.

4. What references can they provide? It is important to know that the scoring service has the right experience. Ask to see a client roster and references. The company should have experience working with leading hospitals, private sleep laboratories, pharmaceutical companies, home-care organizations and universities. You also want to make sure your scoring service provider has successfully managed clients with similar-sized sleep laboratories to yours before you sign on the dotted line.

5. How will your account be managed? The success of using a scoring service is not just from the level of quality of scoring but also the quality of the management of your account. Making sure that the company has the proper processes in place including an account manager, access to senior technologists and quality managers will ensure that your relationship with the scoring service is a success.

6. Are they using registered polysomnography technologists? For top quality sleep-scoring services, you definitely want to be working with a company that only hires registered polysomnography technologists (RPSGT). Not using registered technologists may result in lower costs – but potentially at the expense of quality and ultimately the reputation of your laboratory.

Sleep Scoring Services Are Here to Stay: Make Sure you Get a Great One!

Since the explosion of the sleep medicine industry almost a decade ago, sleep scoring services have become an “irreversible mega-trend” and is now becoming common practice for leading hospitals and sleep laboratories across North America. This phenomenon has allowed sleep laboratories to provide the highest quality of services while diagnosing and treating patients in record numbers. In addition, this business practice has saved the sleep medicine industry from human resource issues that plague so many other healthcare sectors. Quality has and will continue to be the driving factor in the growth of the sleep scoring industry.

Whether you are currently enjoying the benefits of scoring services or evaluating the proposition for the first time, the guidelines and questions presented in this article will act like a “quick tips checklist” to help you fairly assess your options and get the quality service you need. Like any business partnership, using a scoring service provider will be most successful if you establish beforehand your expectations for the relationship. Asking the right questions to qualify potential vendors will go a long way to helping you find the right fit. This process should be taken as seriously a hiring a full time employee because the work of the scoring company will reflect on your business. If due diligence is given to selecting the right scoring company, you will set the stage for a successful outsourcing program that is based on mutual trust and excellent communication.

Chad Doucette is the V.P Sales & Marketing for Sleep Strategies Inc., a provider of sleep record scoring services for leading hospital, private sleep facilities, homecare companies, pharmaceutical companies and research organizations worldwide. For information on Sleep Strategies, visit www.sleepstrategies.com.

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