“Know Your Number” Campaign
To: Sleep Medicine Physicians and Nurse Practitioners
From: O’Neal Medical – CPAP Plus
Subject: Advancing CPAP Adherence through Standardized, Evidence-Based Measurement
Dear Sleep Provider,
At O’Neal Medical – CPAP Plus, we are advancing a data-driven approach to improving patient adherence with positive airway pressure (PAP) therapy. Our initiative is built on the principle that adherence outcomes can only be meaningfully improved when they are measured consistently and analyzed objectively across a standardized population.
To that end, we have established a closed-system, or “walled garden,” model in which all new patients are equipped exclusively with ResMed PAP devices that feature integrated cellular connectivity to ResMed’s AirView™ clinical platform. This ensures uniform data capture and allows our clinical operations team to evaluate treatment adherence using the exact Centers for Medicare & Medicaid Services (CMS) definition of compliance—≥4 hours of therapy per night on at least 70% of nights during a consecutive 30-day period within the first 90 days.
Our baseline compliance rate across all active PAP users currently stands at 72% (90-day mean). Importantly, we are applying this same CMS-defined compliance metric to all patients—irrespective of payer requirements—to create a normalized dataset for longitudinal analysis. By doing so, we can evaluate adherence trends, identify behavioral or educational predictors of success, and measure the statistical impact of specific interventions over time.
Each patient is systematically onboarded through a standardized educational protocol and encouraged to engage with the ResMed myAir™ digital platform, which provides real-time feedback, daily performance scoring, and reinforcement messages shown in published studies to enhance adherence. The interaction between digital engagement, structured follow-up, and behavioral reinforcement constitutes the core of our continuous quality improvement (CQI) framework for CPAP adherence.
Our objective is to produce a scientifically valid understanding of which combinations of education, technology, and follow-up most effectively increase adherence rates and sustain long-term therapy use. We welcome clinical collaboration and data-sharing opportunities with providers who share this evidence-based vision for improving sleep outcomes.
Sincerely,
Woody O’Neal
ONeal Medical – CPAP Plus
www.onealmed.com
Onboarding
Patient engagement and satisfaction begin at the point of referral:
Patients receive automated notifications when the PAP order is received via Parachute Health - Informs them step-by-step of the referral process
Patients receive a second notification to download and establish their myAir app before arriving
Patient is scheduled for in-office setup which last approximately 30 minutes
Education
A standard CPAP setup educational effort provides patients with a clear understanding of how their therapy works and their active role in achieving compliance.
It includes:
Explanation of Sleep Apnea and Treatment Goals: Simple overview of OSA and how CPAP therapy prevents symptoms and long-term complications.
Device Orientation: Hands-on instruction on how to use, fill, and clean the CPAP device and humidifier.
Mask Fitting and Comfort Tips: Personalized mask fitting, leak prevention, and troubleshooting.
Usage Expectations: Clear explanation of CMS compliance standards (minimum hours and nights) and why consistent use matters for health and insurance coverage.
myAir App Enrollment: Guidance on downloading, linking, and using ResMed myAir to track progress and receive feedback including their AirView Sleep Score Number.
Follow-Up Support: Information on follow-up calls, troubleshooting resources, and how to contact the DME team for assistance.
Together, these steps ensure patients are informed, confident, and engaged—key drivers of long-term CPAP success and compliance.
Follow up
Patients receive an phone call along with a presentation of their 3-Day Progress to identify issues with:
Copy of their 3-Day Progress Report from AirView
Phone call with Q and A with our Care Team
Mask comfort, seal, etc
Pressure intolerance
Device operation
Continued reinforcement of the patient’s responsibility to CMS Compliance Standards
ONeal Medical - PAP compliance
Key Studies / Evidence
Malhotra et al. (2018), “Patient Engagement Using New Technology to Improve Adherence to Positive Airway Pressure Therapy”
This large retrospective analysis compared an active patient engagement (APE) cohort (using myAir + AirView) to a matched usual-care monitoring cohort. The APE group had 87.3% meeting CMS adherence criteria vs. 70.4% in the usual care group (P < .0001).
Average nightly usage was 5.9 h vs. 4.9 h in the matched controls.
Franke et al. (2023), “Effect of a digital patient motivation and support tool on CPAP / APAP adherence and daytime sleepiness”
This prospective RCT (12-week duration) found that patients using a digital support tool (with automated feedback, motivational messaging, and therapy recommendations) had significantly greater adherence (mean usage ~338.8 min vs. 268.7 min; p = 0.002) compared to standard care.
Also, the intervention arm showed significantly greater reductions in daytime sleepiness (e.g. via Epworth Sleepiness Scale).
ResMed / myAir Studies & Reports
A ResMed retrospective white-paper observed that 83.9% of new CPAP users who used the myAir app (along with standard care) achieved Medicare adherence within 90 days; 75.4% achieved it within 30 days; median time to adherence was 23 days.
In one observational analysis of >128,000 PAP users, those using myAir + AirView had >87% compliance compared to ~70% compliance in those monitored by AirView alone (i.e. ~17–24% relative uplift).
ResMed’s own marketing and white-papers cite data showing that pairing myAir with AirView monitoring yields higher adherence, improved mask seal, and longer nightly usage vs. monitoring without myAir.
Lacroix et al. (2023), “Effectiveness of an Intervention Providing Digitally Generated Personalized Education and Feedback on CPAP Adherence”
This study (published in PMC) evaluated a digital feedback + personalized education intervention, and found significant positive effects on CPAP adherence compared to control.
Meta-analytic / Review Evidence (General Digital / eHealth Interventions)
A 2020 meta-analysis (Aardoom et al.) of eHealth interventions in CPAP adherence showed that digital interventions (including reminders, feedback, telemonitoring) were generally effective in improving adherence in adult OSA patients.
A scoping review by Rapelli et al. (2021) looked at motivational and behavioral interventions for CPAP adherence, concluding that such interventions (which may include feedback, coaching, reminders) are more effective than usual care in many trials.
Position Paper
ONeal Medical – CPAP Plus
To: Sleep Medicine Physicians and Nurse Practitioners
From: O’Neal Medical – CPAP Plus
Subject: Advancing CPAP Adherence through Standardized, Evidence-Based Measurement
Dear Sleep Provider,
At O’Neal Medical – CPAP Plus, we are advancing a data-driven approach to improving patient adherence with positive airway pressure (PAP) therapy. Our initiative is built on the principle that adherence outcomes can only be meaningfully improved when they are measured consistently and analyzed objectively across a standardized population.
To that end, we have established a closed-system, or “walled garden,” model in which all new patients are equipped exclusively with ResMed PAP devices that feature integrated cellular connectivity to ResMed’s AirView™ clinical platform. This ensures uniform data capture and allows our clinical operations team to evaluate treatment adherence using the exact Centers for Medicare & Medicaid Services (CMS) definition of compliance—≥4 hours of therapy per night on at least 70% of nights during a consecutive 30-day period within the first 90 days.
Our baseline compliance rate across all active PAP users currently stands at 72% (90-day mean). Importantly, we are applying this same CMS-defined compliance metric to all patients—irrespective of payer requirements—to create a normalized dataset for longitudinal analysis. By doing so, we can evaluate adherence trends, identify behavioral or educational predictors of success, and measure the statistical impact of specific interventions over time.
Each patient is systematically onboarded through a standardized educational protocol and encouraged to engage with the ResMed myAir™ digital platform, which provides real-time feedback, daily performance scoring, and reinforcement messages shown in published studies to enhance adherence. The interaction between digital engagement, structured follow-up, and behavioral reinforcement constitutes the core of our continuous quality improvement (CQI) framework for CPAP adherence.
Our objective is to produce a scientifically valid understanding of which combinations of education, technology, and follow-up most effectively increase adherence rates and sustain long-term therapy use. We welcome clinical collaboration and data-sharing opportunities with providers who share this evidence-based vision for improving sleep outcomes.
Sincerely,
Woody O’Neal
ONeal Medical – CPAP Plus
www.onealmed.com