Transcutaneous monitoring in the sleep center - Is this really necessary?
September 8, 2015
Webinar presented by Julie DeWitte, RPSGT, RST, RCP - Asst. Administrator, Sleep Disorders Center Kaiser Permanente Fontana Medical Center, Fontana, CA
Note: You can now join Webex Event Center from iPhones, iPads, and Android devices. Visit the Apple Store or Google Play to install the latest free app on your device.
About this webinar
Traditionally, sleep centers performed overnight polysomnography primarily for the management of obstructive sleep apnea (OSA) which would typically comprise 90% of studies. As home sleep apnea testing use has been increasing and becoming the primary modality for diagnosing OSA, the nature of polysomnography is evolving as it emphasizes the evaluation of patients with complex diseases. In these settings, OSA may comprise only 25% of polysomnography studies while the majority are performed to evaluate patients with respiratory failure, neuromuscular disease, and complex pediatric pulmonary sleep disorders. In fact, there are approximately 90 identified sleep disorders which require therapists to have strong clinical acumen with greater ability to assess a comprehensive set of clinical information and translate them into proper clinical decision making.
Complex sleep patients require monitoring of clinical information beyond that traditionally required by the sleep technologist. Not only are additional cardiopulmonary physiologic parameters necessary such as continuous measurement of CO2, these values must be understood within the context of a greater knowledge of the patient’s underlying pathophysiology, diagnoses, and previous relevant medical testing. For example, performing a polysomnogram in a patient with chronic hypercapnic respiratory failure requires an understanding of the cause of hypoventilation (for example, COPD or neuromuscular weakness), an assessment of whether laboratory values and pulmonary function testing support the suspected etiology, the utilization of this information to develop therapy goals, and the interpretation of CO2 values as a diagnostic tool to determine whether target therapeutic response has been achieved. The ability to provide real-time and continuous capnography monitoring is critical to performing polysomnography properly in the complex sleep patient.
This webinar will review the evolution of sleep medicine and analyze the future of polysomnography. Case studies will be presented to demonstrate the importance of transcutaneous monitoring during polysomnography and illustrate the advantages of transcutaneous monitoring over end-tidal CO2 monitoring. This session will also review the interpretation of transcutaneous monitoring values and describe the method used to recognize improper values.
CE credit for US attendees and Certificates of Attendance for international attendees will be available.
About the presenter
Julie DeWitte has over 25 years’ experience in the field of sleep diagnostics and respiratory therapy. Ms. DeWitte has organized and developed multiple sleep centers and has extensive experience with the management of patients with complex sleep and respiratory disorders including chronic hypercapnic respiratory failure and neonatal respiratory disorders. She is currently an administrator under the direction of Dr. Dennis Hwang at Kaiser Permanente Fontana Sleep Disorders Center. This center is a leader in the field of sleep medicine that manages a large volume of patients with complex sleep and respiratory disorders.
Radiometer is using Microsoft AZURE Active Directory to authenticate users
Radiometer uses Azure AD to provide our customers and partners secure access to documents, resources, and other services on our customer portal.
If your organization is already using Azure AD you can use the same credentials to access Radiometer's customer portal.
- Allow the use of existing Active Directory credentials
- Single-sign on experience
- Use same credentials to access future services
You will receive an invitation to access our services via e-mail when your request has been approved.
When you accept the invitation, and your organization is already using AZURE AD, you can use the same credentials to access Radiometer's customer portal. Otherwise, a one-time password will be sent via e-mail to sign in.
Effective 1 July, 2020
Types of Information We Collect
Information You Provide
You do not have to register for a service or program to receive much of the information available through Radiometer Sites. However, some of our content is available only to registered or identified users and will require you to set up a profile or provide specific information about yourself in order to provide you the service.
Personal Data You Provide When Visiting Radiometer Sites
Radiometer collects Personal Data that you provide on Radiometer Sites. You may do this when purchasing a product, to receive marketing products and information, contact Radiometer customer service, or respond to Radiometer questionnaires or surveys. Such data includes:
- Contact Information such as your name, address, phone number, or email address
- Registration Information such as your username and password
- Remuneration information when you provide a service to Radiometer
- Employment, education and other background information when you inquire about employment with Radiometer
- Payment information (such as banking information, payment card number, expiration date, delivery address, and billing address)
- Content you may provide (for example, when you complete our Online Contact Form or submit other information).
Personal Data You Share During Other Interactions with Radiometer
You may contact Radiometer to ask questions, discuss your concerns, or report issues regarding our products. If you communicate with or request information from Radiometer, you may be prompted to provide your contact information as well as any Personal Data that is relevant to your request. This information includes: e.g., contact information.
Information That May Be Collected Automatically
When you use the Radiometer Sites, we also may collect certain usage and device information automatically as described below. Your IP address and non-identifying information about your use of Radiometer Sites may be collected automatically using tracking technologies, such as cookies. This information includes: e.g., device and advertising identifiers, browser type, operating system, Internet service provider, pages you visit before and after using the Site, the date and time of your visit, information about the links you click and pages you view within the Site, and other standard server log information). Your website browser software can be set to reject all cookies; however, cookies can allow you to take advantage of some of the site’s essential features so they may not work if you reject cookies.
We may record the Internet Protocol (“IP”) address of your computer or other electronic device when you visit the Radiometer Sites. An IP address identifies the electronic device you use to access the Sites, which allows us to maintain communication with your computer as you move about Radiometer Sites and to customize content.
Cookies and Other Tracking Technologies
We also collect information about your use of Radiometer Sites through tracking technologies such as cookies and web beacons. A “cookie” is a unique numeric code that is transferred to your computer to track your interests and preferences and to recognize you as a return visitor. A “Web beacon” is a transparent graphic image placed on a Web site, e-mail or advertisement that enables the monitoring of things such as user activity and site traffic. These technologies help remember your preferences and allow us to bring you the content and features that are likely to be of greatest interest to you on the basis of “clickstream” data that shows your previous activities on Radiometer Sites. Radiometer Sites utilize Google Analytics for tracking purposes.
We may share information about your use of Radiometer Sites with service providers who assist us with personalizing and delivering online marketing and advertising. We may utilize e.g. Google Display Advertising (such as Retargeting with Google Analytics, Google Display Network Impression Reporting, DoubleClick Campaign Manager integration, and Google Analytics Demographics and Interest Reporting) to (1) show you our ads on other websites based on your prior visits to Radiometer Sites, and (2) better understand our ad impressions and use of ad services. In connection with the Google Analytics Demographics and Interest Reporting service, we may use data from Google's interest-based advertising or third-party audience data (such as age, gender and interests) with Google Analytics to understand and improve our marketing campaigns and Site content. Some of our online advertising may take place through Google Display Advertising. As part of this program, we may use Google Analytics features such as Retargeting. In connection with that feature and others offered by ad networks, we and the operators of ad networks, including Google, may use third-party cookies (such as the DoubleClick cookie) – and in some cases first-party cookies (such as the Google Analytics cookie) – to inform, optimize and serve ads across the Internet, based on a user's past visits to Radiometer Sites. We also may show you ads from some of our affiliated companies when you visit Radiometer Sites. When we disclose data for business purposes as discussed above, we disclose the categories of data listed above in Types of Information We Collect.
You can opt out of Google Ads by visiting http://www.google.com/ads/preferences.If you do not want your data used by Google Analytics, you can install the Google Analytics opt-out browser add-on at the Google Analytics opt-out page.
To learn more about cookies and other tracking technologies, including how to disable them, please visit http://www.allaboutcookies.org/. Please note that some cookies are essential to the functioning of our Sites and deleting or disabling them will reduce the site’s functionality.
Some Radiometer Sites are available either as mobile applications or mobile sites that you can use on your mobile device. If you use a mobile device to access and use the Radiometer Sites, we may collect the following mobile-specific information in addition to the other information described above: device or advertising ID, device type, hardware type, media access control (“MAC”) address, international mobile equipment identity (“IMEI”), the version of your mobile operating system, the platform used to access or download the Radiometer Site (e.g., Apple, Google, Amazon, Windows), location information and usage information about your device and your use of the Radiometer Sites.
Information Collected from Other Sources
We may combine information about you from Radiometer Sites with information that you provide offline, for the purposes specified in this notice. Any Personal Data that we obtain offline from you or others will be processed in compliance with notice requirements and other applicable law.
How We Use Your Information
We use your Personal Data to provide you the product and services you request, communicate with you, improve your experience on the Radiometer Sites, generally improve our products and services and for other internal business purposes, including detecting security incidents, debugging to identify and repair errors that impair existing functionality, performing services on our behalf or that you request (such as serving online marketing and advertising), and fulfilling transactions. These uses may also include the recording, organization, structuring, storage, adaptation or alteration, retrieval, consultation, use, disclosure by transmission, dissemination or otherwise making available, alignment or combination, restriction, erasure or destruction of Personal Data. The Personal Data we collect about you will be retained only for so long as reasonably necessary for the purposes set out above and in accordance with applicable laws.
Providing Product and Services You Request
If you choose to purchase a product or receive our services, we use the Personal Data that you provide through Radiometer Sites to manage your orders and invoices, to process payments, to respond to your questions, provide you the services you request and offer an optimal customer experience.
You may also receive marketing information from Radiometer and related affiliates, such as offers regarding Radiometer related products or services, invitations to participate in surveys about our products, or notifications about special promotions. In such cases, we will use your contact and other Personal Data to send you marketing information.
Customized User Experiences
Business and Product Improvement
In order to discover new facts that could help Radiometer better understand customer needs and help improve, develop, and evaluate product, services, materials, and programs. Radiometer analyzes the information that you have provided. For these purposes Radiometer does not use information that can directly identify you.
Site Analytics and Improvement
We may use the information that you provide and the information we collect automatically about your use of the Radiometer Sites to monitor user traffic patterns and preferences for site improvement, analytics and optimization.
Legal Basis for Processing
Consistent with applicable law, Radiometer must have a legal basis to process your Personal Data. The legal basis that applies in an instance will depend on which of the specific purposes described above Radiometer is processing your Personal Data:
- In certain cases, and where required by applicable law, Radiometer may ask for your consent to collect and process your Personal Data. Should you choose to provide your consent, you may later withdraw your consent by contacting us as described in the “Your Privacy Choices” section. Please note that the withdrawal of consent will not affect processing which has already occurred.
- In other instances, the processing of your Personal Data may be necessary in order to comply with an applicable law or regulation or for the performance of a contract to which you are subject. You may not be able to opt-out of this processing, or your choice to opt-out may impact our ability to perform a contractual obligation otherwise owed to you.
- In still other instances, Radiometer may process your Personal Data based on Radiometer’s legitimate interests in communicating with you about our products and services, and about scientific research and educational opportunities. You have the right to opt-out of all such processing of your Personal Data. You may do so by contacting us as described in the “Your Privacy Choices” section.
Information We Share
We may share information about your use of Radiometer Sites for certain business purposes, as follows:
Third-Party Advertising and Online Behavioral Advertising
You may be provided with online advertisements of Radiometer products and services on third-party websites and mobile services that are tailored to you, for example, on the basis of information that you provide to Radiometer or a third-party website you are visiting, or of your browsing activity, purchases, or interests. These types of tailored online advertisements may come through several sources, such as the following:
- We may share with our advertising service providers your non-identifying information that we have obtained from cookies and other tracking technologies on our Radiometer Sites.
Affiliates, Vendors and Suppliers
We have relationships with suppliers and affiliated companies, who help us operate our business and for whom it may be necessary to have access to your Personal Data in the course of providing services to Radiometer. We require these parties to use your Personal Data in accordance with applicable law and reasonable privacy protections.You can find all related affiliates here.
We may partner with other companies to provide you with content or services on a joint or “co-branded” basis. At a co branded site, you will see both the Radiometer logo and the logo of the co-branding partner displayed on your screen. You should read the individual privacy policies of our co-branding partners, as they may differ in some respects from ours. Reading these policies will help you to make an informed decision about whether to provide your information to a given site.
If you contact Radiometer regarding your experience in using one of our products, we may use the information that you provide in submitting reports to the designated government regulatory authority, as required of us by law.
Legal Rights and Obligations
In certain limited circumstances, Radiometer may need to disclose your Personal Data in order to comply with a legal obligation or demand, such as to comply with reporting obligations to our governing regulatory authorities regarding the safety of our products, or in connection with the sale or transfer of one of our product lines or divisions, which includes the services provided through one or more of the Radiometer Sites. In such instances, we will take measures to protect your Personal Data to the extent possible. We also reserve the right to use Personal Data to investigate and prosecute users who violate our rules or who engage in behavior that is illegal or harmful to others or to others’ property.
Change in Organization
In the event Radiometer decides to reorganize or divest our business through sale, merger, or acquisition, Radiometer may share Personal Data about you with actual or prospective purchasers. We will require any actual or prospective purchasers to treat this Personal Data in a manner consistent with this policy.
Radiometer does not knowingly collect or use any Personal Data directly from children on Radiometer Sites (We define “children” as minors younger than 18). We do not knowingly allow children to order our products, to communicate with us, or to use any of our online services. If you are a parent and become aware that your child has provided us with information, please contact us using one of the methods specified below, and we will work with you to address this issue.
Your Privacy Choices
You have the right to be informed about our data practices, as well as about entities with which we have shared your Personal Data and the possibility of denying consent and the consequences of such denial. You also have the right to see and get a copy of Personal Data about you that we maintain as well as to ask us to make corrections to inaccurate or incomplete Personal Data about you. You have the right to receive data you have provided to us in a machine-readable format and to transmit that data to another controller. You may also request the erasure of your Personal Data or the restriction of its processing, or object to the processing of Personal Data about you. We will comply with any other rights you may have under applicable law in addition to those listed above.
Consistent with applicable law, you also may request access to information about the categories of Personal Data we collect, the sources from which we obtain that Personal Data, why we collected it, and with whom we share it. To seek access to Personal Data about you, exercise any other rights, to file a concern, complaint, or request for correction, or to opt-out of particular programs, please contact our Privacy Office by clicking on the “Contact Us” link on the Radiometer Site you are using, by using the Radiometer contact information on the Radiometer mobile application you are using, or by emailing firstname.lastname@example.org. You may also send a letter to the following address:
Radiometer Medical ApS Attn: Legal & Compliance (Privacy office) Åkandevej 21 2700 Brønshøj Denmark
Many countries have a data protection authority to ensure that data protection law is followed. For more information about your privacy rights, or if you are not able to resolve a problem directly with us and wish to make a complaint, contact your local authority.
In all communications to Radiometer, please include your email address, the Web site address, mobile application, and/or the specific Radiometer product to which you provided Personal Data (e.g., Radiometer.com), and a detailed explanation of your request. If you would like to delete, amend, or correct your Personal Data and are contacting us by email, please put “Deletion Request” or “Amendment/Correction Request” in the subject line of the email. We will respond to all reasonable requests in a timely manner and may need to further confirm your identity in order to process certain requests.
Once we receive your request, we may need to contact you to further verify relevant details. You may be entitled, in accordance with applicable law, to submit a request through an authorized agent. To designate an authorized agent to exercise your rights and choices on your behalf, please provide sufficient proof of assignment of authority.
Additional Notice to California Residents
Subject to certain limits under California Civil Code § 1798.83, California residents may ask us to provide them with (i) a list of certain categories of Personal Data that we have disclosed to third parties for their direct marketing purposes during the immediately preceding calendar year, and (ii) the identity of those third parties. This section is for information only, as Radiometer does not share or sell your data.
Radiometer maintains reasonable technical, administrative and physical controls to secure any Personal Data collected through the Radiometer Sites. However, there is always some risk that an unauthorized third party could intercept an Internet transmission, or that someone will find a way to thwart our security systems. We urge you to exercise caution when transmitting Personal Data over the Internet, especially your financial-related information. Radiometer cannot guarantee that unauthorized third parties will not gain access to your Personal Data; therefore, when submitting Personal Data to Radiometer Sites, you must weigh both the benefits and the risks.
Third Party Sites and Social Media Plug-ins
Accessing Our Sites Globally
Radiometer may transmit Personal Data about you to related affiliates worldwide. These affiliates may in turn transmit Personal Data about you to other related affiliates. Some affiliates may be in countries that do not ensure an adequate level of data protection. Nevertheless, all of Radiometer’s related affiliates are required to treat Personal Data in a manner consistent with this policy. We only transfer your Personal Data internationally or to a third party when we are satisfied that adequate levels of protection are in place to protect the integrity and security of your Personal Data being processed, in compliance with applicable data protection laws. Where necessary, including for transfers to affiliates, we use Standard Contractual Clauses approved by the European Union to provide such protection. To obtain additional information regarding the safeguards we have in place for cross-border transfers of Personal Data, please contact us using the information provided in the “Your Privacy Choices” section.
We will carry out the following operations on your Personal Data with and without use of automated means: collection, recording, systematization, accumulation, storage, specification (update, modification), retrieval, use, transfer (provision, access), including cross-border transfers, depersonalization, deletion and destruction.
We share information about your use of Radiometer Site with third parties and transfer your information outside of Russia for certain business purposes. If you would like to get more information on these third parties and the countries to which we transfer your Personal Data, please contact us as described in the “Your Privacy Choices” section and we will provide you with the information on names, locations of those third parties as well as their roles in processing your Personal Data.
Radiometer implements necessary legal, organizational and technical measures to secure any Personal Data collected through the Radiometer Sites, including:
- Restriction of access to the Personal Data on a need-to-know basis, i.e. only to individuals who require such data to perform their respective duties;
- Ensuring physical security of premises where our information systems are located;
- Use of hardware and software information security tools, such as state-of-the-art malware protection and firewalls; and
- Appointment of a Data Protection Officer.