“...performing cEEG saved money by shortening intensive care unit length of stay in those found to have nonconvulsive seizures—this savings more than offset the overall cost of performing cEEG.” [1]
There are a few noteworthy cases that show a failure to make a timely diagnosis of nonconvulsive status epilepticus led to a $1.25 to $1.5 million judgment against a hospital because of long-term cognitive impairment in the patient. [4], [5]
Hospital Administration
What is the Impact of Continuous EEG for Hospital Administration?
Financial challenges again ranked No. 1 on the list of hospital CEOs’ top concerns in 2012, making it their No. 1 concern for the last nine years, according to the American College of Healthcare Executives’ (ACHE’s) annual survey. Patient safety and quality ranked second. Unfortunately the No. 1 challenge has a direct impact on the No. 2 challenge. The last thing that hospital administration wants hear about is another program that is touted to increase the quality of patient care but once again...it come at increased capital costs.
When you focus specifically on neurocritical care patients in the intensive care units of your hospital (ICU, PICU, CICU, NICU, neuroICU, EMU – a questions is now raised, “How can a hospital increase the quality of neurocritical care, while increasing physician satisfaction, and optimizing the existing investment in health information technology infrastructure?”
One Answer is...
Outsource cEEG monitoring and Remote EEG Reading Services
In a study from University of California, Los Angeles, by Vespa et al. “found that cEEG accounted for only one percent of the total hospital costs of 100 patients with TBI and helped guide clinical decisions in 90% of the patients.”[1] Commenting on a study Dr. Lawrence Hirsch points out that cEEG in the ICU lead to changes in therapy over 50% of the time[2] – typically due to the discovery of non-clinical seizures and non-convulsive status epilepticus, which both represent medical emergencies and if left untreated can cause permanent irreversible neuronal damage.
When considering cEEG cost one center presented a non peer–reviewed financial projections on the costs of cEEG. They estimated that “performing cEEG saved money by shortening intensive care unit length of stay in those found to have nonconvulsive seizures—this savings more than offset the overall cost of performing cEEG.” [3]
CortiCare has the goal to provide hospitals an outsourced neurotelemetry service that offers their patients constant cerebral monitoring to protect against neuronal damage using registered technologists and neurophysiologists without incurring the higher cost of maintaining an in-house, round the clock neurodiagnostic monitoring staff.
We have succeeded in providing reliable neurophysiologic monitoring services to hospitals across the country, eliminating the worrisome problem for critical care physicians and hospital staff who have to arrange for continuous EEG monitoring on short notice which often results in settling for unattended EEG recording by untrained monitoring staff and unsatisfactory service for your reading neurologists. There is limited value in a continuous EEG “recording” if no one is looking at the real-time information and intervening in critical patient care that improves outcomes and decreases mortality.
Although malpractice cases seldom reach public record, and are often settled out of court, there are a few noteworthy case that show a failure to make a timely diagnosis of nonconvulsive status epilepticus led to a $1.25 to $1.5 million judgment against a hospital because of long-term cognitive impairment in the patient. [4], [5]
In addition to having cases settled against them, these hospitals now have another thing common – they all have a continuous EEG monitoring program staffed 24/7 and 365 days a year.
If your hospital is in need of reliable on-call neurodiagnostic monitoring staff, CortiCare can help. We understand the frustrations of paying for over-time to have have EEG staff on-call at nights, or over the weekend in order to provide quality care to your patients and clincial services to your neurocritical physicians that are requesting them. We will work with your clinical staff, whether you have a current system in place and only need supplemental gap coverage using registered technologist to fill in temporarily, or you are looking for a permanent solution to your continuous EEG monitoring problem. CortiCare can provide reliable, cost effective EEG monitoring and reading services. Our monitoring technologists are available around-the-clock, part-time, full-time or anytime you need real-time EEG information to provide quality neurocritical patient care.
CortiCare offers many advantages over in-house cEEG staffing:
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We are on-call 24 hours, 7 days a week, 365 days a year – when your patients arrive – we are a phone call away and ready to monitor for your physician staff - just like we were at the patient bedside.
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We are dedicated to high quality and use nly registered R.EEG T monitoring technologists.
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Our monitoring technologists are experienced reading in multiple departments and for patients from adult, pediatric, to the new born ICU.
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We offer comprehensive remote monitoring and reading services, unrestrained by geography, and can be there whenever you need us.
We solve difficult monitoring challenges for your hospital and increase the utility of your IT investment to get real-time neurocritical information to the clinicians that need it to make patient care decisions.
If you need monitoring support, or EEG reading services, contact CortiCare to open a dialogue about your specific needs and requirements.
[1] Vespa P. EEG cost analysis. Presented at the Noncritical Care Society Annual Meeting, Las Vegas, October 31–November 3, 2007.
[2] Jordan KG. Continuous EEG monitoring in the neuroscience intensive care unit and emergency department.J Clin Neurophysiol 1999;16:14–39.
[3] msnbc.com, updated 4/8/2008 8:28:26 AM ET, Before Code Blue: Who’s minding the patient? http://www.nbcnews.com/id/24002334/#.UgLoQWRASIV
[4] Friedman D, Claassen J, Hirsch LJ. Continuous electroencephalogram monitoring in the ntensive care unit. Anesth Analg. 2009 Aug;109(2):506-23
[5] Epilepsy Currents, Vol. 10, No. 4 ( July/August) 2010 pp. 82–85
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