EnsoData Blog Post Hero Image - What We're Thankful For in 2021 (1)Learn How the BetterNight Patient Care Plan Optimizes the Experience for the Patient with the Power of Technology throughout the Entire Patient Journey

This month’s sleep physician is a passionate innovator who’s spent more than three decades in sleep medicine, first finding the spark in a Baylor pulmonary sleep lab. Enamored by the equipment they were using, the data being collected, and the lives being impacted, he found his niche in sleep medicine. With SleepData, he helped pioneer cost-effective in-home diagnosis of obstructive sleep apnea (OSA). Currently, he serves as the Chief Medical Officer (CMO) of BetterNight, the national sleep platform that has assisted hundreds of thousands of individuals with their sleep challenges. We’re honored to feature Dr. Dominic Munafo in this month’s sleep story.  

Early Career Development Led to Sleep Medicine 

In the 1980s, Dr. Munafo was working his initial residency at the Baylor College of Medicine, when one day, he stumbled into the pulmonary physiology sleep lab. Immediately drawn to the equipment, he knew that sleep was his calling. In 1988, he finished his residency, then moved on to a yearlong fellowship in sleep, performing research before moving to UCSD (University of California, San Diego) for a pulmonary critical care fellowship from 1989-1993. 

For Dr. Munafo, this first decade in sleep medicine was more than an introduction to a career. Sleep medicine, like other specialty areas, is really just basic science, with new vocabulary. As a physician, Dr. Munafo had all the right training to succeed in many areas of medicine, but it was about opportunities presented, and both the research and medical sides of sleep came calling for Dr. Munafo.  

Transitioning into Private Practice and Starting SleepData

In 1995, Dr. Munafo transitioned into private practice, working for five years as the staff Physician & Director of Critical Care at Pomerado Hospital in San Diego, CA. In the role, he was able to expand the access to care for the local community, but he envisioned playing a bigger role in the world of sleep medicine. He saw first hand how his patient population suffered from sleep disorders and challenges, yet many of them continued to go undiagnosed. He was convinced a better solution was possible.  

In 2000, Dr. Munafo joined the SleepData team, as he realized that their comprehensive in-home care model was a strong next step in increasing access to proper care. Along with a handful of outstanding, pivotal colleagues, Dr. Munafo and the team grew the operation swiftly, expanding to all 50 states:

One of my prouder career moments is that SleepData was the first in-home testing company to be doing HSATs in all 50 states,” said Dr. Munafo with pride. 

Expanding on a Shipped HSAT Model

One reason for the massive growth is the driving mission, a mission that has changed very little over the past two decades, despite the transition from SleepData to BetterNight. That mission is simple: bring access to diagnostic care to a much wider swath of the population. 

In 2005, BetterNight customers began asking the team to expand beyond the HSAT market, specifically asking if they might begin supporting CPAP therapy and adherence. This resulted in the team expanding their operation from diagnostic care to a more end-to-end model that supports each patient from the diagnosis through treatment. In order to properly execute on the therapy and adherence portion of the care continuum, Dr. Munafo’s team created a unique software system named Clarity.

Clarity: Cloud Software to Manage CPAP Adherence

If you’re asking “What is the Clarity patient management system?” Here’s the short version: the Clarity software connects CPAP machine data clouds with BetterNight’s resupply management system and helps make sure patients stay adherent. “Clarity allows us to take a wide variety of objective data inputs, non-proprietary inputs that are accessible to any sleep center, and create something special,” said Dr. Munafo. 

In short, Clarity provides BetterNight with an end-to-end solution. One that starts at screening, using data to better find the patients who are most likely to be at risk for OSA. From there, Clarity will notify the team of the patients who require a telemedicine consultation and/or home sleep apnea test (HSAT). Patients then follow the care plan trajectory that aligns with their diagnosis. After a therapy has been selected, the Clarity system will continue to follow every patient indefinitely for as long as they’re on therapy. 

Clarity allows BetterNight to provide a nationwide, longitudinal care model to patients, giving BetterNight the ability to provide the services to patients at a scale few other operations reach. The extended care model means that as long as a patient uses their therapy, they will have access to the resources BetterNight provides. This creates a better, faster, more accessible patient experience. 

“I think that every patient can benefit from our care plan, from the simple OSA diagnosis to identifying the small number of patients who do need to go to a brick and mortar lab,” said Dr. Munafo. “The reality is that unless you have a more complex form of OSA or another sleep disorder, you can be better treated by our comprehensive home testing approach.” 

Addressing the Vast Undiagnosed OSA Population with Technology

BetterNight’s end-to-end approach to sleep medicine has one big driver of efficiency and success: technology. From the evolution of home testing devices to the Clarity software solution, to the adoption of EnsoSleep AI Scoring, BetterNight has thrived as early adopters of technology. For Dr. Munafo, technology is how to best combat the undiagnosed sleep apnea epidemic. 

“When you look at sleep medicine over the last 30 years, we suffer under the weight of the knowledge that we’ve left 80% of the sleep apnea population undiagnosed,” said Dr. Munafo. “We must leverage technology to be able to better screen and serve that undiagnosed sleep apnea population.”

He went on to describe the relationship between BetterNight and EnsoData, citing the closeness of the two organization’s missions in harnessing the power of data and technology to help sleep professionals bridge the gap in undiagnosed sleep disorders. “The relationship is absolutely integral to our business plan and it’s extremely complementary to EnsoData’s business plan,” said Dr. Munafo. 

National Scale Data is Needed

However, there are still challenges in front of us as we address this audience. Dr. Munafo referenced the January 2020 Emerson Wickwire paper in the Journal of Clinical Sleep Medicine (JCSM) which demonstrates the increased medical costs and added risk of comorbidities for individuals with undiagnosed OSA. Per the report, “beneficiaries with OSA demonstrated increased health care utilization costs and higher mean total annual costs, as well as higher mean annual costs across all individual points of service.”

While this study represents the Medicare population, there are significant costs associated with other OSA populations, as well. This is an important, addressable group of patients Dr. Munafo firmly believes we must reach, but there are still steps to be made, specifically, generating more evidence. We need more data to show that we can bend that curve, and decrease the rate of the rise in costs,” he said.  

Technology Powered by People

As it is for every single customer we support, just having technology is only part of the solution. The people using the technology and caring for patients are the most important aspect of treatment, and Dr. Munafo shared a similar sentiment: 

“Sometimes I get too hung up on the technology we use,” he said. “But it’s vital to emphasize the people using our technology that are crucial. If it weren’t for them, all the data in the world wouldn’t be able to help our patients correctly.” 

That is extremely well put, Dr. Munafo. It’s because of amazing doctors like you and teams like the one at BetterNight that we can help improve peoples’ lives through sleep, one patient at a time.

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