Home Sleep Apnea Testing

Enrolment for accreditation

The first step towards accreditation is for existing home sleep apnea testing (HSAT) facilities to enrol in the DAP HSAT program. Once enrolled, the facilities will be provided with additional information about the initial assessment process to obtain provisional accreditation.

All facilities must enrol here by September 30, 2020 to continue to provide HSAT services in BC.

Standards

The Accreditation Standards – Home Sleep Apnea Testing are currently under development.

For new home sleep apnea testing facilities

All new facilities must proceed through the initial assessment process prior to service delivery. Initial assessment application documents will be available in January 2021. 

For further information, contact dap@cpsbc.ca.

Frequently asked questions

Do we enrol each location or each company with multiple facilities or locations?

The DAP accredits facilities by unique physical address. Each facility with a unique physical address must be separately accredited. The facility must have an address even if it is virtual.

How much are the annual accreditation fees for HSAT?

Annual fees are $2,000 per facility.

If a company is working remotely out of a family physician's office and not linked to an address, how are they expected to enrol?

The HSAT accreditation program is still under development, it is important that all types of facilities enroll with the DAP so that we understand the complete HSAT landscape and develop the program accordingly. The family physician’s address would be used as the facility address.

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.

What date do the proposed standards come into effect?

The target date for the standards to come into effect is February 28, 2021.

The stakeholder feedback for the HSAT standards was due September 30, 2020 and is now being reviewed and collated by the DAP staff and brought to the advisory panel for revisions in October. The revised standards must be approved by the DAP Committee before they come into effect.

Facilities are not expected to meet all standards when they are released. Subsets of standards are to be met by the initial assessment application attestation and by the initial assessment itself.

When we will be receiving the subset of standards to be met?

The attestation standards will be provided as part of the initial assessment application package.

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.

What are the qualifications of the medical director?

Qualifications of the medical director for home sleep apnea testing will be defined and provided to facilities in a medical director guidance document that is currently under development.

Can the medical director also be an interpreting physician?

Yes, the medical director of a facility may also interpret HSAT tests.

What are the credentials required to be an interpreting physician?

The training requirements for interpreting physicians will be including in the credentialing guidance document.

Does each facility require a separate medical director?

A medical director may oversee a number of facilities. This information will be included in the medical director guidance document.

Can the medical director be from out of province as long as they are a registrant of the College of Physicians and Surgeons of BC?

As long as a physician is a registrant of the College in BC, and they meet the qualifications, they will be able to be the medical director of an accredited facility.

What if there is a lack of registrants that agree to be medical directors?

The DAP Committee would need to be advised if this occurs.

When in the process is the deadline for having a medical director for each company?

The attestation must be signed off by the medical leader, therefore a medical leader would need to be in place by February 28, 2021. The DAP Committee would need to be advised if this is not met.

How are facilities to pay for a medical director and who will determine the salary range for the medical director position?

All facilities accredited by the DAP, regardless of funding source, are required to have a medical director. It is the responsibility of the facility to ensure that they meet all standards required for accreditation, including having an appropriately qualified medical director who is a registrant of the College.

Compensation by facilities of medical directors is not addressed by the DAP.  Facilities are free to make their own arrangements for medical director compensation.

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. It will be sent to stakeholders for feedback, hopefully by December, before it is implemented.

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.  

Webinar for home sleep apnea testing facilities

The Diagnostic Accreditation Program and Home Sleep Apnea Testing Accreditation
September 18, 2020 at 3 p.m.