The following is a transcript of the speech delivered by then-incoming AASM President Sam Fleishman at the SLEEP 2012 membership meeting:
Good afternoon. It is an honor and privilege to serve as the President of the Academy. It has already been over four years since I was first elected to the Board of Directors. While that time has passed quickly, I certainly have a few more gray hairs to show for it. My time on the Board of Directors has been exhilarating and marked by a true sense of accomplishment – and I look forward to the challenges and opportunities in the year ahead. As the twenty-seventh president of the Academy, I rely on the example of those who have served in this important role before me, and I am especially grateful to Larry Epstein, Mike Silber, Alex Chediak, Susie Esther, Clete Kushida, Pat Strollo and of course Nancy for the strong foundation they set.
As I begin my year as President of the American Academy of Sleep Medicine, I would like to take a moment and recognize my institution, colleagues, friends and family who provide tremendous support to not only me but also the Academy.
First I would like to thank my employer, Cape Fear Valley Health System for being supportive of my roles at the AASM. I especially want to thank my staff and colleagues in the sleep medicine program there and for covering for me while I am working on Academy initiatives.
I would like to thank my colleagues on the Board of Directors for their engagement, their contributions and mostly for making it truly enjoyable to work together. I look forward to this year as there is much for us to accomplish on behalf of the members we represent.
I also thank all of you who volunteer as members of the various committees and task forces of the Academy as your collective and individual contributions have a great impact on not only our association but also the sleep medicine field.
And I also want to thank you, the members, for entrusting this position to me and for providing me with this great opportunity. I look forward to maintaining an open dialogue to address your needs and working together to advance our field.
Most important, I would like to thank my wife Sharon and my daughters Hannah and Maggie. They are my true love and joy. They have been supportive and tolerant of my time away from home while I have served the Academy in various ways over the years. Sharon without you by my side for the past 25 years I am sure I would not be in front of all of these people today in this position. I also want to thank you for making us such a wonderful family and raising our two wonderful daughters sometimes in my absence. As for Maggie and Hannah thanks for tolerating your sometimes pushy and absent father. I promise to make it up in more fishing trips in the years to come.
We just heard Nancy give a wonderful overview of the many initiatives she undertook as President of the Academy, and I now would like to take a few minutes to outline my vision for leadership and objectives for the upcoming year.
Early on in life I knew that I had an intense love for athletics and team sports. If there was any sport that involved a ball I pretty much played it. Unfortunately, I can’t say I am much of an athlete now. Nonetheless, it is from participation in especially organized sports throughout my youth that really helped inform and shape my views on successful leadership. One essential leadership lesson I learned throughout my participation on the football field and basketball court is that the ability to work together toward a common vision is the fuel that allows us to attain results and achieve success.
Teamwork will be a main principle of my presidency as I work closely with the Board of Directors, committees, other stakeholder groups and staff to strengthen the Academy’s mission by focusing on issues that are currently most relevant to our members as the changing nature of clinical medicine affects the daily practice of sleep medicine.
To that end, it is my goal to focus on four primary objectives that I believe will have the greatest impact on the clinical practice of sleep medicine immediately and also serve as part of a blueprint that will guide the future direction of our Academy and field.
The first objective is improving our Standards for Accreditation to ensure patients with sleep disorders receive the highest quality care from accredited sleep facilities.
Over the past year, I have chaired a task force comprised of members of the Board of Directors and Accreditation Committee as well as other experts that is reviewing the current Standards for Accreditation in respect to quality and safety and in respect to an evolving comprehensive and longitudinal care model.
One primary responsibility of this team is reviewing our four accreditation models to address inconsistencies and developed a more uniform approach to standards. Building on the introduction of greater uniformity across the models, the Standards for Accreditation will also be more measurable and quantifiable.
As our focus shifts to a more comprehensive model for patient care, the Standards for Accreditation will include a stronger emphasis on longitudinal management and also address the issue of direct referrals.
These are just a few brief examples of the major areas which the task force has addressed in its efforts to improve the patient care experience and ensure the Academy’s accreditation programs remain the gold standard for sleep medicine. We intend to present our recommendations to the Board of Directors in July for broader conversation, and I will keep you updated on the continued evolution of this process.
The second objective is integrating a comprehensive care model for our patients into current practice.
Health care is transforming and the model is shifting to a patient-centered approach where provider reimbursement is tied to quality metrics. Many of us have experienced this change through our hospital system already, and for others this change is on the immanent horizon. The Academy has taken the lead in developing this new model of care and advocating on behalf of our members for its acceptance.
The Academy assembled a team of leaders to develop a new care algorithm utilizing our accreditation standards – for sleep centers, out of center sleep testing and durable medical equipment – that integrates diagnostic testing and longitudinal care with outcomes-orientated therapeutic measures. Under this new comprehensive care model sleep medicine physicians will manage patient care from the initial consultation and screening through the distribution of durable medical equipment and follow-up.
You may be aware of our efforts to promote this model already, as we have communicated regularly with members about an application the Academy submitted to the Center for Medicare & Medicaid Innovation in January. We have also reached out to CMS and requested a safe harbor for board certified sleep medicine specialists to order and provide DME to Medicare patients. We continue to pursue this carve out with CMS, and I will keep members abreast of our ongoing efforts.
Building on our comprehensive care model and unified accreditation models, the third objective is demonstrating the value of treatment for sleep disorders through the collection of data that tracks set outcomes measures.
As practitioners we all know the value that is realized when patients are treated effectively for sleep disorders. We have all had patients tell us how the quality of their life has improved dramatically because of CPAP. And studies demonstrate the cost savings to insurance companies when a patient is treated for obstructive sleep apnea and their related co-morbidies are managed.
However, we must be equipped with data on outcomes, economics and education to help influence policies related to coverage for sleep services. The Academy is in the initial stages of developing a clinical outcomes database that will demonstrate this effectiveness and efficacy broadly to improve clinical practice and inform policy.
The clinical database will support outcome data, claims data and education data collected at every episode of care, which will help everyone from our members to the Academy’s leadership and policy makers better understand the value that care for sleep disorders realizes.
A collaborative effort to collect meaningful outcomes data that supports the value of our members and the sleep medicine field is increasingly important as health policy undergoes continual changes, and I look forward to leading the Academy in this area.
With the foundations set for stronger Standards for Accreditation, a new care delivery model and meaningful data to promote our value, the Academy will pursue its fourth objective of working closely with insurance carriers to establish policies that are evidence-based and reflect the practice of sleep medicine.
The Academy has worked with influencers that have a role in setting policies that affect the practice of sleep medicine, and in the coming year we will take a more proactive role in meeting with insurance companies. Our Coding and Compliance committee and staff have addressed these policies on behalf of members, and we have worked to establish relationships with insurance companies to maintain a dialogue on existing and new policies that impact the practice of sleep medicine.
As the Office of the Inspector General takes on a greater role in pursuing fraud and abuse to help manage costs, the Academy through our Coding and Compliance Committee will develop new resources on compliance that educate members on best practices including development of a sleep center compliance plan and internal audits.
Certainly, there are serious challenges ahead of us. And through the objectives I just discussed, we are proactively taking on pressing issues that are critical to our members. But I am confident that with the support of leadership, the involvement of members and the expertise of staff, our team approach to these objectives will ensure that the Academy is leading the sleep medicine field in a direction of continued growth and success. I look forward to working with you on our strategic objectives and sharing our success with you.
