1. How is the SwallowSTRONG device different from its predecessor, the Madison Oral Strengthening Therapeutic (MOST) device?
The SwallowSTRONG device has a touch screen interface allowing users (clinicians and patients) quick and easy access to the enhanced software with the touch of a finger. The enhanced software has an updated look and feel, improved visual cues for guided therapy, and added clinical flexibility (i.e., optional rest periods between presses, sensor specific protocols, easily accessible table quantifying patient adherence and performance). The new mouthpiece design provides increased sensitivity with low pressures, a redesigned sensor shape that is more conducive to successful tongue press (flat rather than rounded top), and an easy-grip handle. The SwallowSTRONG device has the ability to sync with the Swallow Strong Management System (SSMS – see question 6).
2. Should I have a SwallowSTRONG device for each patient?
The answer depends on the healthcare environment and your clinical preferences. In a setting where patients are communal, such as a skilled nursing facility or acute care hospital, one device could be used with multiple patients, all of whom have their own mouthpiece. When their mouthpiece is connected to the SwallowSTRONG device, their customized therapy program automatically becomes available.
In an outpatient or homecare setting, clinicians often have several SwallowSTRONG devices, which they loan to patients for the duration of the protocol. When one patient completes the protocol, the device can then be loaned to another patient. See question 6 to learn about remote patient monitoring using the SSMS.
Patients with chronic disease or patients who are trying to prevent future debilitation (i.e., head and neck cancer patients post-radiation therapy) may use the SwallowSTRONG device for a longer period of time.
3. Do I need to have the mouthpiece autoclaved?
No. The mouthpiece is for use with a single patient and not among patients. To clean between uses by the same patient, disconnect the mouthpiece from the device. Use warm soapy water to clean the mouthpiece, while keeping the plug end dry.
4. I’m worried that if I loan the SwallowSTRONG device to a patient, they won’t return it. Does that ever happen?
There are no reported cases of devices not being returned to the clinic. Patients need to be educated ahead of time that the device is “locked down” and that no other programs will run or can be accessed on the device. Clinicians report that, in general, patients are highly motivated to improve their swallowing and that close communication during the intense therapy protocol either in-person or by phone helps to build a solid clinician-patient relationship supporting responsible device stewardship.
5. Is the SwallowSTRONG device paid for by Medicare or private insurance?
Currently, only the clinician time during therapy is covered by Medicare (i.e., CPT code 92526). There have been individual cases of private insurance paying for the SwallowSTRONG device. Swallow Solutions has written information available to clinicians as they write the justification for insurance coverage. Swallow Solutions is in the process of applying to the Centers for Medicare and Medicaid Services (CMS), but this takes years. Stay tuned as we provide updates via our website and newsletters.
6. What is the SwallowSTRONG Management System (SSMS)?
The SSMS is a secure, cloud-based system that enables clinicians’ full visibility of patient progress and control of therapy settings. The clinician can log into the SSMS from any computer and monitor therapy adherence. Additionally, as patients transfer through the continuum of care, their customized therapy plan may be accessed from the SwallowSTRONG device at their new healthcare destination by simply connecting their mouthpiece to the next device. The SSMS provides appealing, quantified graphic displays of therapy and facilitates QA/QI and utilization review efforts by tracking patient outcomes at multiple facilities within an organization.
7. What are the prices for the SwallowSTRONG device and SSMS?
Price is dependent on a number of different factors. Please call our office at (608)-238-6678 for a customized quote.
8. I’m convinced that the SwallowSTRONG device is useful clinically, but how can I convince our administrator that this is a worthwhile purchase?
The SwallowSTRONG device was designed based on clinical research. Published evidence in peer-reviewed journals supports the effectiveness of lingual strengthening therapy. Swallow Solutions is happy to provide references to clinicians to facilitate the discussion with administrators.
Most recently, results from patients at the William S. Middleton Memorial Veterans Hospital in Madison, WI, were presented at the Dysphagia Research Society Conference in Nashville, TN, in March 2014 by Nicole Pulia, PhD. Dr. Pulia reported that Penetration-Aspiration Scale Scores (a quantified measure of airway invasion) decreased for thin liquids; maximum isometric lingual pressures increased; swallowing-specific quality of life questionnaire subscale scores improved, and Functional Oral Intake Scale scores improved overall, demonstrating that patients moved to less restrictive diets. Several patients progressed from feeding tube dependency to full oral intake.
Additionally, Dr. Pulia reported that patients who completed I-PRO therapy using the Swallow Solutions device, showed an 88% decrease in pneumonia diagnoses and a 79% decrease in hospital admissions. These data represent the enormous cost savings facilitated by the SwallowSTRONG device considering the average charge for a hospital admission to treat pneumonia is $17,000.