Abstract Introduction Care for patients evaluated for sleep apnea is commonly fragmented across referring clinicians, sleep laboratories, therapy providers, and payers, limiting visibility and delaying treatment. A cloud-based operating system for sleep medicine was implemented to place all participants in the patient pathway on a single platform with role-based workflows and status transparency from referral through diagnostic testing and treatment initiation. We evaluated its impact on reliability, throughput, and time to therapy. Methods We conducted a multi-site quality-improvement analysis of de-identified operational metrics from three sleep management programs using the system. The cohort included adults and pediatric patients referred between January 2024 and August 31, 2025 (n = 16 028) from approximately 500 community, academic, and specialty practices. The platform supported referral intake, test scheduling, study completion, interpretation, therapy ordering, and early follow-up. Measures included order validity, scheduling and completion rates, staff time per order, estimated cost per order, and time from order receipt to scheduled test and from diagnostic completion to therapy order. Results were summarized descriptively and compared with United States benchmarks (≈ 50% valid orders, 55% scheduled, 65% completed, ≈ 180 days from test to treatment). Results Programs using the integrated system processed a mean of 1 200 diagnostic orders per month. Valid-order rate was 100% versus the 50% benchmark; 87% of valid orders were scheduled and 93% of scheduled studies were completed, exceeding estimates of 55% and 65%. Overall study completion was 85%. The mean interval from diagnostic completion to therapy order was 43 days, shorter than the ≈ 180-day benchmark. Staff time per order decreased 36%, with an estimated 40 saving per order. Conclusion A single cloud-based operating system for all stakeholders created visibility into the sleep apnea pathway, enabled more patients to move from referral to completed testing and therapy orders, and increased throughput without additional staff. By improving reliability, access to diagnostic evaluation, and time to treatment, integrated workflows may help reverse patterns in which individuals with suspected sleep apnea do not complete testing or therapy. Support (if any) Operational data were provided by the sponsoring company and affiliated sleep-management practices. No external funding.
Lea Desmarteau (Fri,) studied this question.