New York-based Winthrop Sleep Disorders Center made the difficult decision to switch database vendors in an effort to remain a step ahead of progress.
By any measure, the Winthrop Sleep Disorders Center, Garden City, NY, brings a wealth of experience to the relatively young field of sleep medicine. As Associate Director of the Winthrop Sleep Disorders Center, Claude Albertario, RPSGT, has helped the academic facility evolve from modest roots in the late 1980s to its current position as a respected laboratory in the Northeast.
Leveraging their knowledge and experience gained over more than two decades, the hospital recognized the need to expand in 2006. Albertario seized the opportunity to take a long, hard look at equipment needs. The investigation led the 26-year sleep veteran to only consider systems with database constructs that could change with the times.
Expand and Integrate
Later in 2008, the American Academy of Sleep Medicine (AASM) came out with the H5 guideline that requires all patient interactions, even for those not getting a study, to be amassed in a central database. As a result, going beyond a mere “sleep apnea acquisition” system suddenly became a top priority. “As an academic institution, we typically like to keep things in-house, so we did not go with a web-based design,” says Albertario. “However, we did want the ability to interact from the outside through the Internet.”
Narrowing it down to two major database systems was relatively easy, since virtually everything else was cobbled together using third party databases. “We wanted something integrated and cohesive,” says Albertario. “The push over the edge was the solidarity of what the vendor showed us they could provide. The Compumedics Grael High-Definition PSG/EEG system and their nexus Lab Management system had what we wanted, as well as the potential to grow as technology changed.”
As the first accredited and paperless laboratory in the world (1990), Winthrop officials knew early on that patients in the population-dense Long Island region wanted not only the best, but the latest. Cutting edge technology kept people coming back and fueled an expansion from four beds at the turn of the century, to eight beds in their new facility—with all recordings digitally recorded and managed. “Our institution has allowed us to plug into the archiving infrastructure used for Radiology and Cardiology, thereby allowing digitized, seamless, online archiving”, says Albertario.
Keeping the door open for new millennium technology gave Compumedics the slight advantage in a competitive market. Vendor representatives simply could not “fake it” at Winthrop. “They had to know their stuff,” confirms Albertario. Albertario questions vendors with vigor, because he knows that better equipment/database management leads to real-world results, such as decreased turnaround time for patients, while strongly appealing to referral sources. With Compumedics, the idea is to adapt to whatever challenges the industry may throw, while continuing to evolve technologically.
“You have to know sleep, and Compumedics has a good clinical understanding of what we do,” says Albertario. “We have not even finished installing all of the elements, such as digital audio and next-level digital video. The cameras are installed, but the higher-grade software is not written as of yet. I see where they are going with multi-screen video capabilities— one screen zoomed into the face, one into the legs, and all synchronized. They offer it in their EEG platform, so I know it is on the horizon as promised,” says Albertario.
Like a Hotel
Even though the market changes and reimbursement changes with it, Winthrop officials are poised to help the 7.5 million patients on geographic Long Island. Moreover, when these residents show up, the facility they walk into does not look like a laboratory in the slightest. “We literally built a hotel,” says Albertario. “One of the inspectors upon opening the door to a bedroom said, ‘You literally built the Winthrop Hotel.’ And, anybody who visits says the same thing.”
In a state that boasts “The city that never sleeps,” it is appropriate to also open “the hotel” for daytime guests. “We realized that a special segment of our market, and one that not many facilities touch upon, is the shift-worker market,” explains Albertario. “We staff the laboratory around the clock, and every day we have the ability to perform daytime PSGs for patients who sleep and work in this 24 hour New York market.”
Added services and capabilities mean that more in-depth clinical trials are on the horizon for Winthrop, a prospect that officials welcome in the coming years. “We believe we are perfectly poised to help the academic world, and the clinical realm of those New Yorkers who seek treatments and understanding of sleep disorders,” adds Albertario. “In fact, those who have recently visited from Australia and Europe, realize how much thought we have actually put into this facility and comment on our ability to keep all of the technology in the background, thusly allowing the design team’s calming and soothing accents and highlights to shine through. It has truly been a labor of love for all parties involved, says Albertario, a once-in-a-career kind of thing.
Claude Albertario, RPSGT, is associate director of the Sleep Disorders Center, Winthrop-University Hospital, Mineola, NY. Albertario began his career in Sleep Medicine at New York Hospital’s Institute of Chronobiology, after obtaining his undergraduate training in Psychobiology at SUNY Purchase. He obtained his RPSGT credential in 1990. As an early advocate of digital recording methods, he spearheaded the effort to become the first accredited, paperless sleep center in the world (1990). He helped form the New York State Society of Sleep Medicine in 1998, and presently serves as its secretary. His research interests revolve around his invention, z-ratio, a unified metric of sleep/wake (http://www.zzzratio.com). Albertario is also a sleep apnea sufferer.
