Home Sleep Apnea Testing

Standards

In January 2021, the College’s DAP Committee approved accreditation standards for home sleep apnea testing.

For enrolled home sleep apnea testing facilities

All enrolled facilities must proceed through the initial assessment process prior to June 2, 2021.

For facilities undergoing significant change in service

An existing accredited facility must report any significant change in service related to: physical location (relocation/extensive renovation), equipment, leadership, interpreting physicians or surgeons, scope of testing and staffing model. Reporting occurs by completing and submitting the following form.

For relocating home sleep apnea testing facilities

All facilities relocating to a new address or within their existing building must proceed through the relocation assessment process prior to service delivery or patient testing.

For service cessation or facility closure

Facilities discontinuing an accredited service or closing completely must provide written communication in the form of a signed letter from the medical director confirming service cessation or facility closure and the effective date. Submit the written communication by email to dap@cpsbc.ca.

Resources

Frequently asked questions

What are the qualifications of the individuals that conduct the accreditation assessment and grant accreditation?

DAP assessors are responsible for conducting assessments. Assessors are selected based on their technical expertise. For HSAT facilities, assessors will include DAP staff for such areas as management assessments plus appropriately qualified physicians and technologists for the medical and technical portions.

The accreditation award decision is made by the DAP Committee, whose members are listed here.

Since HSAT services are provided as an outpatient service, why are the accreditation standards similar to a Level 1 inpatient service instead of an outpatient service such as outpatient spirometry?

Standards for overnight sleep apnea testing would be no different whether provided by an HSAT facility on an outpatient basis or provided by a Level 1 facility on an outpatient basis. The DAP has standards for HSAT for Level 1 facilities, and those same clinical standards apply to HSAT facilities.

Regarding other elements of the standards, such as management standards, the Level 1 standards are more complex than the HSAT standards. HSAT standards are more akin to some of the outpatient service standards like neurodiagnostic imaging.

Why is CPAP therapy included in the standards? 

This is to reinforce that the therapy/prescription of CPAP is under the authorization/order of a physician. This applies to all CPAP providers even those not accredited for HSAT. The enforcement in those cases would be complaint based.

Do you perceive it as a conflict of interest if clinics have CPAP clinics operating within them?

The College has a practice standard titled Conflict of Interest

Are satellite offices who are performing CPAP fitting able to hand out pre-programmed HSAT devices without being accredited?

No.

How will it be determined by the DAP which facilities will be assessed first?

DAP facilities are assessed on a four-year cycle. Once facilities have registered with the program, staff will examine number of facilities and their distribution across the province to determine the most efficient site visit schedule with approximately 25% of facilities assessed each year.

Once accredited (or with provisional accreditation) will there be a technical billing code to provide the testing like there is for other diagnostic services?

MSP billing codes and fees are the responsibility of the Ministry of Health. The DAP does not have input into the process of setting MSP fees. 

Is there a standardized referral form being created for HSAT?

A standardized referral form is being created by the Guidelines and Protocols Advisory Committee of the Medical Services Commission.

Will Level 1 facilities need to use the standardized referral form for HSAT?

The form is designed for HSAT facilities and not Level 1 facilties.

If a standard referral form is created, who will decide which company it goes to?

Any company can receive the standard referral form and physicians can refer to any accredited HSAT facility.

What are our options if we want to appeal DAP decisions?

There are a number of ways that a facility may appeal accreditation nonconformances, award decisions and standards. Documents pertaining to this will be available to the HSAT facilities.