In the past 1+ year since the start of Zzenith Sleep & Respiratory, Medical & Nursing Services Pte. Ltd., we have done close to 250 CPAP trials using the ResMed AirSense 10 AutoSet, which is to date the best Positive Airway Device for close monitoring (i.e. daily, every other day, weekly) in order to maximise patient compliance, which determines patient outcome. What we like about the the ResMed AirSense 10 AutoSet is that it is reasonably small, and it is very quiet. Most importantly, it has an inbuilt 3G SIM card that enables connectivity, wherever my patients are.
However, there was one problem, not everyone could afford a SGD2,000 device, so they would either choose to go for surgery which would be covered by insurance (i still cannot understand why insurance does not cover CPAP therapy in most cases), or to not address their obstructive sleep apnea at all.
In order to enable all patients to receive quality CPAP therapy management, we have had to extend a no-strings attached installment plan for a few of our patients, crossing our fingers and hoping they would pay up as promised. We tried to get a grant to help the less fortunate to be able to receive CPAP therapy. However, before we even applied for it, the staff members at the “consultation” session were already discouraging us, telling us our cause was not significant enough. We were trying to explain that there were many out there who were on the roads all the time and suffered from obstructive sleep apnea. We spoke to a few who said they did doze off at the wheel occasionally, but it was manageable and they did not require treatment. Some of these people were low-income workers who felt that the money could be better spent on food for the family or an outing for the family. Our nagging concern was “what if they knocked someone down and got him/her killed? Or worse, what if they got themselves killed? Will their families not be sucked deeper into the poverty cycle?”
Oh well, the response we got was… “hmmm well… if you really want to, I guess you can try, but I can tell you chances are slim… or why don’t you consider hiring someone who suffers from mental illness?” NO. That was not what we wanted a grant for.
Well, many told us that there were a few other cheaper alternatives these people could instead buy, and that we should forego the need for “connectivity” for the low-income group, as “beggars cannot be choosers”. For the same reason, they felt that the less well-off could do with bigger, noisier devices, without humidifiers, without heated tubes as those would probably cost less. To set the records straight, some of these patients were not poverty-stricken patients but were less cash-rich due to their other financial obligations, and even the less well to do patients never once begged us for anything, so nope they are not beggars. Secondly, why should they have to receive a lower quality of care due to their financial status, which was something they probably did not wish for? Thirdly, was it that impossible for us to find a cheaper alternative, which allowed us to remotely monitor the patients’ progress as often as we wanted, to remotely adjust the settings when it was required, just as we were doing for our patients who were on the ResMed AirSense 10 AutoSet?
We started hunting for our “ideal” CPAP device for the less affluent. We scoured the internet for less heard of manufacturers, we attended medical fairs around the region. We came across many cheaper CPAP devices, some of which looked like rice-cookers and sounded like washing machines. NO. Those were definitely not what we wanted or needed. We thought we had found the ideal product, when a fellow service-provider based in Indonesia brought a sample unit back to her office for a trial, which resulted in a power trip across the whole company. NEXT PLEASE.
Just when we were almost giving up, we came across a stack of brochures from the medical fair held in Dubai, and something caught our eye… hmmm… finally… a CPAP device which was sleek and quiet, had a built-in heated humidifier and a heated tube option, allowed remote monitoring and remote settings, and allowed connectivity via WiFi. They also had an acceptable data management system (nothing fanciful), and came with a reasonable price tag. All these were too good to be true. And since we had learnt through experience that if something was too good to be true, it probably wasn’t true, and primarily due to the skepticism of the quality of made in China products, I decided to book a flight to Shanghai in the midst of my psychology exams, to attend the medical fair to take a peek at the above device. Fully prepared with a license to import these devices for non-clinical purposes, I brought back a couple of units i.e. the Auto CPAP, Auto BiPAP, and the BiPAP, for demonstration to the sleep labs and to some of the doctors. During the recent 18th Asean ORL-HNS Congress, we exhibited these devices, which garnered numerous nods of approval from local doctors as well as doctors from around the region. Some were in disbelief that devices like the range of Hypnus Positive Airway Devices existed, just as I initially was.
We are in the midst of registering the devices with Health Science Authorities, and expect the devices to be ready for sale by the end of September or the beginning of October 2019. Finally, we would be able to reach out to the group whom everyone thought would have to settle for lower quality products with no proper CPAP therapy management programme. These patients are usually the ones who are not “poor” enough to be eligible for help from the Medical Social Workers, but yet are not cash-rich, and may have just enough to get by.
One thing I have learnt is that not all products that are made in China are of inferior quality. They have caught up in terms of the technology, the design, and the durability of their products, and in some cases, may have even superceded the quality of the products manufactured in other more popular regions.
Our CPAP therapy management programme will soon be available at a fraction of what it typically costs.
The time has come for us to make a difference.