A new white paper from the American Association for Homecare (AAHomecare) defines home mechanical ventilators (HMV) and Respiratory Assist Devices (RAD), while differentiating between the respiratory devices.
Released on June 11, the paper — Choosing the Right Respiratory Support: Ventilators or RADs — noted, “Choosing the right device is critical” in explaining the differences between the two types of devices.
“There are important differences between the types of therapy and support provided by a home mechanical ventilator and a respiratory assist device (RAD),” the paper said. “Both noninvasive ventilation (NIV) delivered via an HMV and therapy from a BPAP [bi-level positive airway pressure] device — also known as a RAD — use positive pressure through a mask or other interface to support breathing. However, the scope and capability of each device vary significantly.”
The paper explained that NIV, a type of HMV, “is considered a life-sustaining device that can operate continuously, whereas RAD is not classified as a life-sustaining or supporting device and cannot operate continuously.”
A chart details the differences between mechanical ventilators and RADs in such factors as alarms and monitoring, application/interface, frequency of use, maintenance requirement, oxygen compatibility, and Medicare payment category. (Example: Mechanical ventilators are under the Frequent and Substantial Servicing/continuous rental payments model, while RADs are 13-month capped rentals.)
The paper also describes the functions of HMVs — to support severe breathing impairment, improve lung function, and reduce the strain on fatigued respiratory muscles — vs. the functions of RADs, which are to deliver two different levels of positive airway pressure. The paper lists the different HCPCS codes for each segment.
AAHomecare concluded that as HMV technology has advanced in the last 10 to 15 years, “we can provide life support to patients with more complex health concerns due to respiratory disease, comorbidities, or a disease of rapidly progressing respiratory failure.” Patients who could be supported and helped include those diagnosed with neuromuscular diseases, spinal cord injury, chronic obstructive pulmonary disease (COPD) with severe hypercapnia, and obesity hypoventilation syndrome.
In contrast, RADs can support patients with obstructive sleep apnea and mild respiratory insufficiency. The paper also includes information on the roles of respiratory therapists.
“By recognizing these differences and aligning device selection with patients’ needs, clinicians and stakeholders can navigate the complexities of respiratory care in home settings more effectively,” the paper said. “Implementing knowledge of the differences between HMV and RAD not only enhances the quality of care, but also contributes to the development of more effective policies and practices in respiratory support.”
