At each quarterly board meeting, the mission and vision of the AASM is prominently displayed to ensure that each decision we make is strategically aligned with our core priorities. At the July 28-29 meeting, the board made several decisions to advance the AASM mission: “The AASM improves sleep health and promotes high quality, patient-centered care through advocacy, education, strategic research, and practice standards.”

Patient-Centered Care

First, we had in-depth discussions focused on addressing the need to improve patient access to care for obstructive sleep apnea. In June I challenged the AASM membership and our field to reduce the number of undiagnosed and untreated patients with obstructive sleep apnea by at least 2 percent every year for the next 5 years. I put that same exact challenge forward to the board of directors at our meeting.

We discussed ways to increase the workforce, especially in rural settings where there is a dearth of board-certified sleep medicine physicians (BCSMP). The board agreed to continue to support AASM SleepTM, as we believe telemedicine can provide access to BCSMPs for millions of patients throughout the country. The board also reviewed a proposed program that would equip physicians at critical access hospitals with the education and training they need to diagnose and manage obstructive sleep apnea. These hospitals would need to have an agreement with an accredited sleep facility in order to refer complex patients for care from a sleep specialist. We will continue to explore this model of care and will be soliciting input from several stakeholders over the next few months.

The board also discussed how advances in technology will impact patient-centered care in the not-so-distant future. Each week, more of my patients are bringing in their wearable devices and insisting that this data be a part of our conversation. In addition, we are seeing increasing reports about the possible applications of machine learning in medicine. This shift is happening in all of health care. With this technology rapidly improving, I believe that the diagnosis of many medical diseases, including sleep apnea, will begin at home with consumer devices in the not-so-distant future. Patients will be able to get an initial diagnosis of a sleep disorder through a wearable device, contactless monitor, smartphone app or over-the-counter test, which then will require confirmation by a physician. The AASM board is discussing initiatives to make sure that we are involved and aware of these advances in technology, so we can provide our membership with the education and resources needed to incorporate these technologies into clinical practice and modify practice models accordingly. I look forward to keeping you informed of our discussions throughout the year.

We also approved the 2017/2018 initiatives of our ongoing public relations campaign. With the help of a PR film – L.C. Williams and Associates – we will implement strategies to increase the workforce, raise awareness of telemedicine, draw attention to the serious health impacts of sleep disorders, and emphasize the importance of seeking care from a board-certified sleep medicine physician and the sleep team at an AASM-accredited sleep center. We also will continue partnering with the CDC on the National Healthy Sleep Awareness Project.

Advocacy

The board agreed to continue our advocacy efforts on two issues that directly impact our members. First, we signed onto the American Medical Association’s Prior Authorization and Utilization Management Reform Principles. The paper, developed by the AMA and a coalition of 16 other organizations representing physicians, hospitals, medical groups, pharmacists and patients, explains a set of 21 principles that are aimed to ensure that utilization management programs are clinically valid and implemented in a way that is transparent, timely, efficient, flexible and standardized. It is our hope that this document will influence utilization management companies and allow physicians to provide patients with the best care based on the individual needs of each patient.

The board of directors also recognizes that many of our physician members feel frustrated and overburdened by the current maintenance of certification (MOC) process. We will continue to support our members by advocating that lifelong learning and CME should be sufficient to meet the requirements for MOC, without the need for a high-stakes examination. We will be reaching out directly to the American Board of Medical Specialties (ABMS) to voice the concerns shared by our board and our members.

Education

To help sleep center personnel who play key roles in the business operations of a sleep center, the board approved a new facility management course that the AASM will offer in fall 2018. It will provide the information that medical directors, office managers and lead techs need to operate a sleep facility successfully and efficiently. This course will provide sessions on topics such as accreditation standards, coding, reimbursement, and telemedicine. It will also incorporate ample time for networking so that attendees can discuss best practices with colleagues from across the country.

Strategic Research

The AASM is in the midst of a $10 million, five-year commitment to support the American Sleep Medicine Foundation awards program. However, we also have been discussing ways to diversify the foundation’s funding base by increasing donations to the ASMF from individuals, industry and institutions. Over the next year, the ASMF, under the stewardship of Dr. Jennifer Martin, will be putting together a strategic plan that will provide the direction we need to guide future fundraising campaigns.

Practice Standards

Promoting the practice of evidence-based medicine is important to every member of the AASM. During the board meeting, we reviewed a draft of the PAP Therapy Clinical Practice Guideline. Dr. Susheel Patil, chair of the guideline task force, attended the meeting and presented the work of the task force. This paper will be available for public comment later this year. I encourage you to review this important document and submit any comments you may have, as input from all stakeholders will only make this paper stronger and more useful.

We also approved a position statement on the use of home sleep apnea testing (HSAT) for pediatric patients. It will be published in an upcoming issue of the Journal of Clinical Sleep Medicine. We are hopeful that this document will provide our members with practical guidance in this area of practice.

Membership

The board of directors is acutely aware that the organization is reliant on our members, and we are thankful for the opportunity to serve the AASM and our field. We voted at our July meeting to make some changes to the dues structure for affiliate members and our younger members. It is our hope that these changes will provide greater access to education and resources for all members of the sleep team. We also were motivated to help younger members gain a foothold in both the organization and the field as they begin their careers in sleep medicine. More details about these initiatives will be available in October.

New Logo & Website

Finally, the board of directors approved a new logo for the AASM, which will be unveiled in September with the launch of the new AASM website. When the current AASM logo was developed in 1999, sleep medicine was still seeking recognition as a medical subspecialty. The logo visually reinforced the identity of sleep medicine as a distinct medical field focusing on the balance that can be achieved through healthy sleep. Nearly two decades later, our field has evolved significantly. Sleep medicine has achieved specialty recognition, there is unprecedented awareness of the importance of healthy sleep, and the next generation of sleep specialists is stepping up to advance the AASM mission. Therefore, it is time for our logo to evolve too. We are confident that this new logo will serve the AASM well in the years ahead, and we look forward to sharing it with you.

In the subsequent pages of this report, you will find information about the work of the AASM’s committees and task forces. The AASM relies on the commitment and dedication of our volunteers to advance the strategic initiatives of the organization.

Accreditation Committee

Alexandre Rocha Abreu, MD – Chair
Mandate: The Accreditation Committee identifies issues with accreditation standards and recommends courses of action to the board of directors. The committee will recommend to the board of directors accreditation status for all forms of accreditation.
Goals for 2017/2018:

  1. Develop a plan to educate site visitors and accredited centers about the changes to the accreditation standards.
  2. Assist in the review of accreditation applications submitted to the AASM.
  3. Evaluate the accreditation/reaccreditation process and make recommendations to streamline and simplify the steps taken by sleep facilities.

Update: In April the AASM launched its expedited accreditation program to help sleep facilities comply with recent changes to Medicare coverage policies for sleep studies. Despite the high volume of applications, the AASM has been able to issue an accreditation decision for some facilities in as little as 1 to 3 weeks after application submission. A facility that is accredited through the expedited program must successfully complete a site visit within the first year of the accreditation term.

Coding and Compliance Committee

Fariha Abbasi-Feinberg, MD – Chair
Mandate: The Coding and Compliance Committee evaluates issues related to existing codes in CPT, HCPCS Level II (DME codes), and code evaluations as determined by the Relative Value Scale Update Committee [RUC] and makes recommendations to the board of directors.
Goals for 2017/2018:

  1. Continue to monitor issues related to the sleep medicine family of codes in the HCPCS Level II and at the CPT and RUC levels.
  2. Identify strategies and opportunities for creating new codes for sleep medicine. This should include a review of all AASM clinical practice guidelines and ICSD-3.
  3. Submit a prioritized list of potential new CPT codes for which to develop CPT code proposals.
  4. Develop resources for members to educate them on how to properly comply with various rules and regulations (e.g. MACRA, navigating the 3% and 4% hypopnea rule, etc.)
  5. Update and maintain coding and compliance FAQs on AASM website.

Update: The committee discussed how to code for sleep studies that are negative and decided that members should be advised to code for signs and symptoms, and not use the diagnosis code, if the sleep study is negative. The committee also recommended the deletion of HSAT code 95801. This code was created for technology that is now considered suboptimal and is not the standard of care. The Board of Directors approved this recommendation, and the AASM CPT advisors will recommend the deletion of this code at the February 2018 CPT meeting.

Education Committee

Lourdes Del Rosso, MD – Chair
Mandate: The Education Committee proposes and develops educational programs, initiatives and products that meet the educational needs of the AASM membership and their patients. The committee also reviews submissions for the Young Investigator Research Awards and ASMF High School Video Contest.
Goals for 2017/2018:

  1. Update AASM products to ensure they align with current standards and guidelines.
  2. Develop a series of educational resources for approved sleep medicine partners outlining a model of care for diagnosing and treating sleep disorders. These resources should provide education that these specialists would need to identify patients who may have sleep disorders.
  3. Implement webinar series developed by quality measures education task force and continue collaboration with the ATS to ensure education and dissemination of sleep quality measures.

Update: In June the AASM launched the APRN/PA online sleep medicine training program, which includes 14 modules. The committee also developed a patient wellness brochure – Healthy Lifestyle, Healthy Sleep – and continues to develop patient education fact sheets. The committee has been instrumental in the updating of the A-STEP online learning modules and development of three advanced-level A-STEP modules, which will be released in early 2018. The committee continues to focus on updating existing AASM products and creating the quality measures webinar series.

Health Policy Strategy Presidential Committee

Chris Lettieri, MD – Chair
Mandate: The Health Policy Presidential Committee identifies emerging health policy, payer and legislative priorities and recommends initiatives to the board of directors.
Goals for 2017/2018:

  1. Identify and prioritize reimbursement issues on which the AASM should consider taking a position.
  2. Evaluate current and potential legislative actions that would impact the practice of sleep medicine and develop a legislative strategy for the AASM to pursue.
  3. Develop resources for the highest prioritized reimbursement and legislative initiatives to educate different audiences about the AASM’s positions on those issues.

Update: The committee is evaluating legislative opportunities for the AASM to pursue by identifying advocacy areas in health care and sleep medicine and prioritizing these opportunities.

Innovative Fellowship Model Implementation Presidential Committee

David Plante, MD – Chair
Mandate: The Innovative Fellowship Model Implementation Task Force will provide oversight and monitor the progress of the ACGME Advancing Innovation in Residency Education (AIRE) proposal.
Goals for 2017/2018:

  1. Monitor the progress of the ACGME AIRE proposal.
  2. Adapt resources for the implementation of the ACGME AIRE proposal, as necessary.

Update: The committee is discussing various innovative competency-based sleep medicine fellowship training models and is pursuing conversations with ACGME, ABIM, ABP and ABPN to clarify details on how to move forward with piloting a competency-based training program.

Lifelong Learning Development Committee

John Park, MD – Chair
Mandate: The Lifelong Learning Development Committee develops educational resources related to lifelong learning in the field of sleep medicine, including the sleep medicine in-training examination and maintenance of certification products.
Goals for 2017/2018:

  1. Update the sleep medicine in-training examination to ensure that it accurately reflects the content areas of the sleep medicine certification examination and has relevant and correct questions.
  2. Develop educational content for Part II MOC to ensure there is one self-assessment module for each content area of the sleep medicine certification examination blueprint.
  3. Update existing Part II MOC modules to ensure they align with current standards and guidelines.
    Review questions and rationales developed for Part II MOC for educational courses.

Update: The committee is developing an online self-assessment examination that aligns with each content area on the recertification examination.

Membership Presidential Committee

Khurshid Khurshid, MD – Chair
Mandate: The Membership Presidential Committee supports the activities of the AASM Membership Department by providing feedback regarding membership benefits, serving as AASM social media ambassadors, and providing recommendations for the AASM Fellow Member program.
Goals for 2017/2018:

  1. Assist in the review of fellow member applications submitted to the AASM and recommend refinements to the fellow member requirements.
  2. Promote the AASM and its products and resources as a social media ambassador.
  3. Solicit submissions to Montage.
  4. Provide suggestions for refinements and improvements to member benefits and the AASM website.

Update: The committee is discussing recommendations for improving the AASM’s fellow member requirements and process, leveraging social media to promote the AASM and increasing the impact and usefulness of Montage.

Occupational Sleep Wellness Presidential Committee

Indira Gurubhagavatula, MD – Chair
Mandate: The Occupational Sleep Wellness Presidential Committee engages various occupations and populations who are at risk for sleep deprivation and provides education on the effects of sleep deprivation and fatigue management strategies.
Goals for 2017/2018:

  1. Identify various occupations and populations that are at risk for sleep deprivation.
  2. Develop key messages and takeaways that can be used by the AASM’s public relations campaigns for those target occupations and populations.
  3. Develop educational resources as needed to enhance Welltrinsic’s Corporate Sleep Wellness program.
  4. Monitor regulatory agencies’ actions related to sleep health and safety risks associated with workers in safety sensitive positions who have sleep disorders.

Update: The committee is developing content for a sleep wellness educational program, drafting a patient education fact sheet for transportation workers, and submitting comments in response to an FMCSA request for feedback on a pilot program to allow commercial drivers to split sleeper berth time.

Payer Policy Review Committee

Neeraj Kaplish, MD – Chair
Mandate: The Payer Policy Review Committee develops recommendations from AASM guidelines for payers to use when establishing policies.
Goals for 2017/2018:

  1. Develop a list of clear, concise and relevant recommendations based off the Diagnostic Testing for OSA and PAP therapy guidelines for payers to use when establishing policies.
  2. Develop a position paper or statement defining high pre-test probability for OSA that can be used by physicians in discussions with payers.
  3. Encourage correct interpretation and adoption by payers.
  4. Create and maintain a public online scoreboard to show committee assessments of which recommendations are followed and which are not by selected insurers according to their published policies at specified time points.

Update: The committee is refining a score sheet for reviewing payers’ guidelines for the diagnostic testing of adult OSA. The score sheet will be used to identify payers that may not adhere to the AASM guidelines and encourage them to do so.

Scoring Manual Editorial Board

Rich Berry, MD – Chair
Mandate: The mandate of the Scoring Manual Editorial Board is to review and update the AASM Manual for the Scoring of Sleep and Associated Events on an annual basis to ensure it is current with AASM practice parameters, clinical guidelines and policy, and addresses the evolution of technology.
Goals for 2017/2018:

  1. Review the current Scoring Manual and submit recommendations for changes to the January 2018 Board of Directors meeting.
  2. Develop a new FAQ section on the AASM Scoring Manual webpage.

Update: This group is discussing edits to the periodic limb movement and slow wave scoring criteria for the next version of the Scoring Manual (version 2.5).

Sleep Technologist and Respiratory Therapist Education Presidential Committee

Scott Williams, MD – Chair
Mandate: The Sleep Technologist and Respiratory Therapist Education Committee recommends and develops educational content that is critical for sleep technologists and respiratory therapists working in AASM accredited sleep facilities.
Goals for 2017/2018:

  1. Develop an educational track for SLEEP 2018 for sleep technologists and respiratory therapists working in AASM-accredited sleep facilities.
  2. Evaluate the AASM’s current educational resources for sleep technologists and respiratory therapists and recommend online educational resources to fill any gaps.
  3. Review the A-STEP educational curriculum to ensure that it is relevant and comprehensive to prepare entry-level sleep technologists for employment in an AASM accredited sleep facility.
  4. Develop a video on the correct placement of electrodes as outlined in the AASM Scoring Manual.

Update: The committee is drafting a survey to send to AASM-accredited sleep facilities to identify the professional education gaps for members of the sleep team. They are developing an education track for sleep technologists and respiratory therapists at SLEEP 2018.

Technology Presidential Committee

Seema Khosla, MD – Chair
Mandate: The Technology Committee monitors and evaluates emerging and evolving technologies that impact the practice of sleep medicine. This includes both patient-focused technologies and practice-focused technologies. This committee is responsible for developing educational resources for members that include best practices for the use of these technologies.
Goals for 2017/2018:

  1. Develop a strategy for continued monitoring and evaluation of emerging and evolving technologies that impact the practice of sleep medicine.
  2. Identify and prioritize these technologies based on how impactful they are to the practice of sleep medicine.
  3. Develop educational resources for members that include best practices for the use of the highest prioritized technology.
  4. Develop a position statement on the use of wearable devices and/or apps that monitor sleep.

Update: The committee is building a plan and structure to assess future disruptive technology.

Young Physicians Presidential Committee

Reena Mehra, MD – Chair
Mandate: The Young Physicians Presidential Committee supports the growth of the field of sleep medicine by providing feedback and ideas for improving sleep medicine training programs and developing resources that are attractive to young physicians in the field.
Goals for 2017/2018:

  1. Review the current structure and training methods for sleep medicine fellowships and recommend changes to make the field attractive to young physicians.
  2. Suggest technologies that the AASM should consider to attract young physicians to the society and field.
  3. Develop resources that will attract young physicians to the AASM and field of sleep medicine.
  4. Develop resources that will help young physicians transition into practice.
  5. Develop a mentorship program for young physicians transitioning into practice.

Update: The committee is reviewing AASM benefits and how they are relatable to young physicians and discussing recommendations for a mentorship program.