Kieran Gallahue
Management
First of all I think there are certain home sleep testing pilots that we’re involved with and there are many that are ongoing that are really led by the customers themselves and experimenting. So, as we expected throughout this year there is going to be activity really across a wide range of customer types. Seeing primary care physicians try their hand at it, the independent diagnostic testing facilities, or the IDTFs that are getting involved, sleep physicians, other types of specialists, so there are a number of different types of customers or healthcare providers that are getting involved in understanding what their role in home sleep testing could be, or should be, and you are almost seeing the first echo, if you will, in that process where there has been a learning and an iteration in it. What I mean by that is there are certain groups that seem particularly interested in it and I would say the IDTFs working with the HMEs seem particularly interested and capable of providing support and very encouragingly we see more and more sleep physicians, who we certainly enjoy working with in this category, who are beginning to understand the benefit of integrating home sleep testing along with their traditional diagnostic techniques. And, you see many of the sleep physicians who maybe a few months ago, and I mean that literally, just a few months ago may have been quite reticent to think about the adoption are beginning to learn a bit more, experiment a bit more, and to gain substantially more comfort with the idea of home sleep testing in their professional hands being able to be administered quite well and in a quite balanced way. In addition, you are seeing more and more payers get engaged in this. We, on a regular basis, get feedback from payers, local payers, national payers, of their interest in either supporting customers that have been working in home sleep testing or somehow encouraging the use of home sleep testing and much of this we get from feedback from the physicians themselves who have been working with those payers. So, it is progressing. I would say that the effect on results to date is not yet material. We hadn’t expected it to be material and in fact is not material and that is sort of the way that you would expect these things to roll out, which is to have people gain comfort, understand the three Ps, process, payment and politics. The process and payment have been progressing quite well. Then as I note that the politics, which were probably a bit more intense six, nine months ago, are beginning to ease a bit, but certainly by no means have disappeared and I wouldn’t expect that to happen over night. So, good progress and I would say nothing has happened yet that is different than we had anticipated and articulated certainly earlier in the year.