Matt Kaplan is program director for a national sleep testing provider headquartered in the Los Angeles area. For over 20 years his company have been specialists in qualifying patients for sleep therapy. In recent years Sleep Services has been working with dentists providing sleep diagnostic and billing services. I asked Matt recently how outcomes in the dental industry are measured and if there is any way to present this data to the industry to help guide payers and care providers. Matt has written a protocol for a study that will involve dental offices around the country to measure outcomes regionally and help establish best practices based on hard data. Following is my interview with Matt Kaplan.
Randy Clare: How has the medical experience shaped your approach to the dental side of the business?
Matt Kaplan: Originally coming from the medical side of the sleep industry, it’s interesting to see how dental sleep medicine is following a similar path.
Randy Clare: Sleep Apnea diagnostics has recently become very accessible to the dentist and to the primary care physician, how do you think this has affected patient care?
Matt Kaplan: As the Dental Sleep Medicine industry continues to grow we are now beginning to encounter some of the same hurdles that the medical community dealt with. In my own personal experience, I have seen a number of family practice, internal medicine and otherwise non sleep specialty doctors who, incentivized by sleep labs or DME providers, are diagnosing and treating sleep disorders without a complete understanding of the impact they have on their patient. An improperly titrated CPAP machine can make apnea worse, and I personally see sleep study results that show this all the time.
Randy Clare: Dentists are really working hard to care for patients they see as under served by the current standard of care. Do you see dentists treating patients without the proper training? Is this affecting outcomes?
Matt Kaplan: I think the problem is equally prevalent in the dental community, if not worse. I work with a lot of great dentists who educate themselves on sleep and do an excellent job addressing all of the issues that go along with Oral Appliance therapy. However, there are others out there that see OSA as $$$. I deal with hundreds of dentists, and I truly have no idea whether 90% of them have the slightest clue what they’re doing. Unfortunately, I sometimes see indications that a lot of them do not.
Randy Clare: There are over 140,000 dentists in America. It is impossible for them to all be experts in this field. What do you say to dentists just starting out?
Matt Kaplan: I know there are a lot of experts in this group, but everyone had to start somewhere, and I know each of these experts had a first patient. For a new dentist, I like to tell them to do your research, and consult with other people who have the experience that you lack in order to provide a high level of care to those patients you work with before you become an expert in dental sleep medicine.
Randy Clare: There are dental sleep medicine courses every weekend somewhere in America. Do you feel that the knowledge gap is closing? Are the dentists finding it easier to work with sleep specialists?
Matt Kaplan: Because my company, and many others like me, make the administrative aspects of treating sleep apnea easy, we attract a lot of newbies. The truth is, many of them are completely uneducated about sleep, and some have little interest in learning. However, there are others who do ask questions and look for guidance. I obviously spend time reading things on Sleep Scholar, I’ve been involved in a number of education events, and I’ve been very lucky to have spent a fair amount of time working with a variety of sleep apnea experts from the medical and dental community, so I do have plenty of advice to share. But sometimes there is a disconnect between what’s taught in the classroom and what is practical to do in the office. In addition, some of these new dentists simply don’t have access to all the resources that most of us do. There may not be a local sleep specialist who is dental friendly, in fact, there is sometimes no local sleep specialist at all.
Randy Clare: Matt how do you feel we can support the dental community in developing solid guardrails to help provide the best care possible?
Matt Kaplan: I’m currently compiling the “best practices and protocols” from the dentists I work with, along with a few statistics about their treatment outcomes. Basically, I’m tracking what do they actually do, what do they look for, and how effective are they at treating OSA with OAT. I’m a good chunk into the project now but would always be interested in input from other experts as well as the future experts.
Randy Clare: What kinds of questions are you using to establish a common data set to establish best practice?
Matt Kaplan: Other than patients referred to you specifically for OAT, how are you identifying patients in your own practice as OAT candidates? Does it happen in Hygiene, in the front office, a combination? What tools do you use? How do you measure your success in therapy, reduced AHI, subjective patient feedback? What is your trigger for follow up testing? There are hundreds of tiny pieces to the puzzle, and I’m interested in any insight into the practices that I’m not working with to see what others are doing.
Randy Clare: Well thanks for your time today. I am sure looking forward to reading the white paper when all this work is finished. If a dentist wants to participate in this effort how can they get in touch with you?
Matt Kaplan: They can call me at (888) 322-7108 or email at Matt@HSTSleepServices.com our web site is Providers.HSTSleepServices.com I am looking forward to talking to any practitioner that wants to contribute to the data and perhaps change the way the profession approaches this disease.