The future of sleep technology: report from an American Association of Sleep Technologists summit meeting.

The American Association of Sleep Technologists (AAST) Board of Directors hosted a Sleep Technology Summit on September 21, 2013 with the goals of identifying changes in the delivery of diagnostic and treatment services to sleep disorders patients, predicting the impact on sleep technologists, identifying new roles for sleep technologists, and determining appropriate education to prepare technologists for the future. A carefully chosen panel of speakers focused on the business skills necessary to provide care cost effectively and the clinical skills that will be essential for the technologist of the future to help care for patients with sleep disorders. A group of selected leaders, educators, and industry professionals reviewed the current state of affairs and examined opportunities to sustain the profession and define the role of the sleep technologist of the future. Facilitated group discussions of these critical topics followed each session. There was a clear consensus that regulatory and economic pressures are changing the way sleep disorders patients are diagnosed and treated. Private insurers are requiring pre-authorization for laboratory sleep studies and are incentivizing home sleep testing for most patients suspected of obstructive sleep apnea. Reimbursement for home testing will be lower than for laboratory testing, and further reductions in overall reimbursement are anticipated. These factors will almost certainly reduce the need for technologists to perform laboratory diagnostic studies and pressure sleep centers to reduce payrolls. Remaining laboratory patients will have more complicated sleep disorders, have more comorbidity, and require a higher level of care than most of the patients currently tested in sleep centers. Testing these patients will require technologists with a higher level of training, experience, and sophistication. A second area of consensus was that the focus in medicine is changing from diagnosis to outcomes. New models of integrated care will include an increased focus on patient education, monitoring, and follow-up. The most effective treatments will require an individualized, patient-centered approach. A workforce analysis shows that the number of trained physician specialists will be inadequate to provide this care. Well-trained sleep medicine practitioners at many levels will be needed to meet treatment goals, including some roles appropriate for sleep technologists. These factors provide challenges and opportunities for sleep technologists. In order to maintain viability as an allied health profession, the majority of sleep technologists will need to be better educated and demonstrate competency in more roles than overnight monitoring and record scoring. Models for this transition already exist, with several programs moving technologists from night work to days and from diagnosis to patient education, provision of treatment, and monitoring of adherence. The challenge for the professional association is to define new roles for sleep technologists and provide the education that the membership will require to flourish in those new roles.