Healthy Sleep Solutions: Helping patients with sleep apnea live longer, happier, healthier and more fulfilling lives

Produced by Troy Barker

“Our vision is to help people with sleep apnea live longer, happier, healthier and more fulfilling lives. We do that by delivering innovative, convenient and simple solutions that remove the barriers to their happiness,” said Marjan Mikel, managing director at Healthy Sleep Solutions in a recent interview.

Founded in 2007 with the express purpose of providing primary care doctors and their patients at risk of sleep apnea with appropriate and affordable access to diagnostic, treatment and long-term disease management solutions.  Delivering on these promises Healthy Sleep Solutions quickly became Australia’s largest provider of sleep diagnostic and treatment services.

“At the moment, peoples’ primary medical touch point is their General Practitioner. Extremely busy and time poor these primary care physicians have much to tend to with patient care and, understandably, may not routinely assess patients for sleep apnea. It is estimated that 80% of people suffering with sleep apnea remain undiagnosed. Furthermore, once patients are identified as being at risk of sleep apnea there has often been a rather convoluted and time consuming process for the patient to be definitively diagnosed and then treated. All of this can be very costly,” discussed Mikel. “Our goal has been to eliminate the obstacles and barriers; making it easy for the patient to navigate what can be a confusing and convoluted process. We streamline as much as we possibly can without compromising the medical service.  We also ensure that the independent Sleep Physician is the integral stakeholder of the diagnosis and that the General Practitioner remains the champion of the patient’s care.”

Healthy Sleep Solutions has established a unique disease management and patient pathway that understands the obstacles currently affecting most sleep apnea patients. This included submitting a comprehensive health economic study to the government that helped institute a reimbursed home based sleep diagnostic and continues to cooperate with the Ministry of Health to ensure that these diagnostic investments are delivered to the appropriate patients and delivering the  . This has fundamentally redefined the way key stakeholders can approach the diagnosis issue.

A Unique Approach to Disease Management

The disease management model that Healthy Sleep Solutions follows is one that brings together all stakeholders, eliminating patient pathway inefficiencies that may compromise at risk patients being effectively identified, diagnosed and then appropriately treated and managed.

“What we do is bring all the stakeholders together. That includes patients, sleep specialists, primary care physicians, device manufacturers and technicians to make sure we come up with a simple, highly coordinated solution that overcomes the obstacles that were traditionally inherent in the system. This helps ensure that effective disease management occurs,” said Mikel.

“The typical sleep apnea patient is an obese 50 year old male, who snores and has an identified cardiovascular and/or metabolic disease such as high blood pressure or Type 2 Diabetes. However, they are generally not aware that the quality of their sleep is being severely compromised but rather attribute their tiredness to being older and overweight and not to the possibility that they may have sleep apnea; tiredness becomes an accepted normality for them,” he continued. “Unless General Practitioners proactively manage patients to help them understand that it is sleep apnea that could be the root cause of their fatigued state and also exacerbating their cardiovascular risk profile  then there is little chance of the patient taking steps to address their condition. We work in a way that reinforces that the sleep specialists and general practitioners are the key stakeholders in the identification and management of at risk patients and this helps to proactively search for potential sleep apnea in a medical setting.”

“We also employ a national team of Sleep Service Coordinators who are a key factor in helping to ensure that General Practitioners are more aware of the risk of sleep apnea in their own medical practice as well as the convenience, simplicity and effectiveness of our solution” Mikel explained.

“The effectiveness of Healthy Sleep Solutions and the General Practitioner working together to identify at risk patients can be seen in the fact that normally one in twenty adult Australians are thought to be at risk of moderate to severe sleep apnea, however, working together our diagnostic “hit-rate” is ten out of every twenty referred patients and a further six out of twenty referred patients have mild sleep apnea”

Redefining the Supply Chain Model

The supply chain at Healthy Sleep Solutions involves the provision of medical devices and consumables, but it’s not about machines. It’s about the service and the people involved in delivering that service.

“A landmark clinical study has shown that you only need to treat seven mild to moderate  sleep apnics to prevent two serious or fatal cardiovascular events.  However, in order for this to happen the patients need to have the right treatment solution customized to them and to be adherent and compliant with that treatment.  We therefore co-ordinate the key stakeholders around the patient, General Practitioners, Sleep Specialists, Sleep Technicians and suppliers. We have been successful in redefining what the supply of excellent service and duty of care to sleep apnics really should be,” said Mikel. “It’s not necessarily about the type of machine used in treatment, when one is recommended by an independent Sleep Physician, because they’re all very good. We use all the major brands: ResMed, Philips, Fisher and Paykel. They all work well when they are used properly. That’s not the issue. It’s about the patient, their needs and aspirations. You need to recognize that it’s all about the individual then everything else needs to be redefined and aligned accordingly. So it’s not the device, not the Sleep Specialist, not the General Practitioner, but the sum total of everything that the patient needs.”

Healthy Sleep Solutions partners with market leading organizations and develops relationships with them in order to provide the right solution to the individual patient.

“It's one thing to sit there and have discussions about margins and terms of trade, etc;  and it's another thing completely to work together to develop solutions that are geared towards the real issues and obstacles that limit our patients' access to world class solutions and resulting better health outcomes,” said Mikel. “What we try and do is find organizations to partner with that truly understand that.”

Goals of Expanding in Australia

Healthy Sleep Solutions is focusing heavily on expanding its presence in Australia.

“We’re basically scratching the surface. Despite our success in working with medical practitioners to diagnose tens of thousands of at risk patients 80 percent of individuals with sleep apnea still remain undiagnosed. Many of them will not have access to diagnostics, not just in this country, but globally. We've got a lot of work to do to make sure we make the appropriate services available to the people that really need them and in turn this will continue to fuel growth and continued success,” said Mikel.

“We’re also looking at taking what has worked very successfully in sleep apnea and applying this to other relevant disease states,” continued Mikel. “Most of our patients are high-risk cardiovascular patients and at this juncture we do a very good job of looking after their sleep apnea but then really do have a limited impact on the other cardiovascular risk factors that they have.  What we want to achieve is to provide General Practitioners and relevant Specialists with a partnership to continue to enhance the quality of care patients receive. When you stand still in a dynamic market like healthcare provision,  you invariably go backwards and we intend to stay ahead of the game.  We know that we have been able to achieve very positive outcomes to date with sleep apnics and so we are very confident that we can broaden our care portfolio to address other relevant disease states that typically occur in sleep apnics.”

According to Mikel, 2015 will be a year of local expansion, continued investment in Healthy Sleep Solutions’ patients and developing the IT infrastructure to streamline processes.

“We will continue to look at partnering with our suppliers at a level that is not transactional but more a true partnership where we work together to solve some of the broader issues impacting the most important people in this whole process; the patients,” concluded Mikel. “We will continue to grow our market share in Australia from our current strong position and we have objectives of launching Healthy Sleep Solutions in two or three international markets in the coming 12 months.”