---
title: Clinical CV
updated: 2026-11-02T03:55:08-05:00
canonical: https://waltspence.com/cv/clinical
---

**Walter Spence, RPSGT**
Richmond, VA · [walt@waltspence.com](mailto:walt@waltspence.com) · [LinkedIn](https://linkedin.com/in/waltspence) · [GitHub](https://github.com/waltspence)

Registered Polysomnographic Technologist with more than 20 years in sleep medicine and over 15,000 studies of every type, focusing on alternative therapies, with a specialty in pediatrics. I lead the hypoglossal nerve stimulation (HGNS) program at St. Mary's Hospital, with nine years of hands-on Inspire HGNS experience, from overnight titration through long-term follow-up. I also build and run AI agent systems and the software around them.

Open to clinical and engineering roles, remote preferred.

## Clinical experience

### Registered Polysomnographic Technologist, Daytime
Bon Secours Mercy Health, Richmond, VA · July 2025 to present

- Leads the hypoglossal nerve stimulation (HGNS) program at St. Mary's Hospital.
- Daytime testing operations and physician workflow, including study readiness and documentation.
- Also covers overnight Inspire titration studies and implanted-patient follow-up.
- Lab-side clinical reference for implanted patients: device education, comfort and adherence troubleshooting, and escalation to the implanting team.

### Overnight Registered Polysomnographic Technologist
Virginia Commonwealth University Health, Richmond, VA · 2024 to 2025

- Returned to pediatric sleep medicine, which I had worked in early in my career.
- Overnight testing in a high-acuity academic medical center, including pediatric patients with complex neurological, genetic, respiratory and behavioral conditions.
- Accurate physiological data collection, real-time monitoring and protocol compliance for vulnerable patients.
- Trained and mentored new technologists in electrode application, study protocol, scoring criteria and EMR use.
- Tracked, calibrated and troubleshot diagnostic equipment.

### Daytime Registered Polysomnographic Technologist
Pulmonary Associates of Richmond, Richmond, VA · 2024

- Multiple Sleep Latency Tests and reports for physician review.
- Patient education on PAP compliance and long-term therapy, and follow-up for Inspire patients.
- Scoring and interpretation workflow, including DME setup.

### Overnight Registered Polysomnographic Technologist
Community Health Systems / Bon Secours Mercy Health, Richmond, VA · 2020 to July 2025 (PRN from 2024)

- Overnight Inspire titration studies and implanted-patient care across the full follow-up cycle.
- Electrode application and overnight monitoring, with attention to scoring protocol and patient comfort.
- Technical operations of the sleep lab, including equipment readiness and data quality.

### Overnight Polysomnographic Technician
Sleep Clinics of America, Richmond, VA · 2017 to 2020

- Inspire titration studies and implanted-patient follow-up alongside standard diagnostic polysomnography.
- Diagnostic accuracy and patient comfort across high-volume overnight studies.

### Earlier sleep laboratory roles

- Sleep 360, Austin, TX · 2016
- Virginia Medical Group, Colonial Heights, VA · 2014 to 2016
- Bon Secours Health Source, Richmond, VA · 2010 to 2014
- River City Sleep Medicine (Neurological Associates), Richmond, VA · 2008 to 2010
- Sleep Disorders Center of VA, Colonial Heights, VA · 2003 to 2008

## Certifications

- RPSGT, Registered Polysomnographic Technologist (Board of Registered Polysomnographic Technologists)
- BLS, Basic Life Support
- Licensed in Virginia and North Carolina

## Skills

- **Clinical:** polysomnography of every study type (adult, pediatric, high-acuity), hypoglossal nerve stimulation (HGNS) titration and follow-up with Inspire, MSLT, PAP therapy and compliance education, AASM scoring
- **Technical:** neurostimulator titration workflow, electrode application and troubleshooting, diagnostic equipment calibration and maintenance
- **Software:** Ruby on Rails, Python, JavaScript and Vue, Shell, PostgreSQL, Redis, Docker, Linux and macOS administration, LLM integration and agent systems

## Engineering and business

### Independent web developer and consultant
Web and AI agent systems · 2004 to present

- Contract web development since 2004; for the last five years, consulting and individual-contributor work on web and AI agent systems alongside sleep medicine.
- [zap](https://github.com/waltspence/zap): a terminal-native app uninstaller for macOS and Linux. On its first run on my own machine, it freed over 20 GB.
- Helix: a multi-node fleet of AI agents across Linux and macOS, with a scheduled loop that finds recurring failures, tests fixes and ships them behind a rollback. See [Supposed to Run Itself](/notes/supposed-to-run-itself).
- [Knowfer](/projects/knowfer): a Rails knowledge base that agents read and write over MCP.
- [Talkify](/projects/talkify): a Rails and Vue 3 dashboard for running agents.
- [waltspence.com](/projects/waltspence-com): this site and its publishing desk, on Rails, Vue 3, Redis, and Python and Node workers.

### Founder and CEO
EnLab, LLC · 2010 to 2016

- Founded a startup focused on a WebRTC meeting project.

## Education

- Coursework, Richard Bland College of William & Mary, Petersburg, VA
- High school diploma, Dinwiddie County High School, Dinwiddie, VA