D102-24 Reducing Bottlenecks in Sleep Services Using a Novel Sleep-Study Device

Abstract Rationale Obstructive sleep apnoea (OSA) is a common but underdiagnosed condition. Over recent years, the sleep service at a central London hospital has experienced a growing number of referrals for possible OSA cases. Without the parallel increase in physicians and technicians, patients are waiting longer for diagnosis and treatment. We piloted the use of a novel sleep-study device in the sleep referral pathway with the view to hopefully improving referral to treatment (RTT) time. Methods A novel pathway incorporated a CE-marked and FDA cleared medical device (AcuPebble SA100), which was sent to the patients’ homes before the initial clinic visit, meaning treatment decisions could be made on the first hospital encounter. It uses acoustics and an oxygen saturation probe to diagnose OSA. The signals transfer to a mobile device and upload to a cloud platform which the clinician can view remotely. RTT time in the novel and standard pathway was then compared. Results In the standard pathway (N = 61), patients waited 173 days for the first clinic. Those then requiring a home sleep study waited a further 65 days to have this performed by a technician, also necessitating travel to the hospital. After study completion, patients waited 104 days for the report and a follow-up consultation to discuss results and management plans. This totals to 342 days for RTT (Figure 1A). In the novel pathway (N = 14), patients waited 9 days from referral to triage and a decision for a sleep study, then 6 days to receive the device. The initial wait to see a clinician was 57 days. The RTT time was 72 days (Figure 1B). Conclusions RTT time in the novel pathway decreased from 342 to 72 days, indicating in this pilot a significant improvement in efficiency for the majority of patients. This novel pathway streamlines the service by reducing demand on resources, saving both clinician time as less clinic attendances are required and technician time by reducing the number of studies they need to perform. A more responsive, patient-centred sleep service allows reduction in pathway delays, reduction in unnecessary travel and expedites treatment decisions. This abstract is funded by: CW+ Charity of Chelsea and Westminster Hospital NHS Foundation Trust