With patients and potential patients across the country being advised to avoid hospitals and to cancel or delay elective procedures, telemedicine and other remote digital health services are being touted as alternative options. Unfortunately, some specialties are better suited than others for such an approach. And, as a result, some patients may be missing important diagnostic procedures or treatments.  

Like other specialties, neurology has been forced to deal with these difficult and unusual circumstances. Across the country, EMUs and EEG departments are reducing services or suspending them altogether. In its list of resources for managing requests for neurodiagnostic testing, the American Clinical Neurophysiology Society (ACNS) stated, “In keeping with national directives to limit elective admissions to optimize bed availability for potential COVID-19 patients, many institutions cancelled elective EMU admissions.” 

The coronavirus crisis comes at a time when EEG services were already operating under strain. The ACNS also noted, “Many hospitals are experiencing staffing difficulties due to illness, lack of childcare and self-quarantine directives. In addition, many neurodiagnostic technologist (NDT) staff experience considerable anxiety about frequent and prolonged exposures to potentially infectious patients, and the impact that their illness could have on themselves and their family. Furthermore, most institutions have been operating with minimal NDT staffing even prior to COVID 19 due to a national technologist shortage.” 

In the near past, this current, taxing environment would effectively eliminate most EEG services. However, modern advances in ambulatory EEG are affording neurological providers alternative options. Ambulatory EEG has already been gaining momentum as studies continue to recognize its advantages to common inpatient procedures. Such advantages include lower cost of service when compared to a hospital EMU and higher likelihood of capturing epileptic events in a natural home environment. Combine that with the timely circumstances of unavailable hospital facilities and CDC guidelines against inpatient procedures, and ambulatory EEG stands as the optimal option.  

In fact, the ACNS, in its aforementioned recommendations, suggests that aEEG can provide successful alternative in both outpatient or “routine” EEG and for elective EEG monitoring. In both circumstances, the ACNS points out that information from aEEG procedures can potentially avoid ED visits.  

Consider that as critical care patient admissions increase, a significant number will involve altered mental status, with some experiencing non-convulsive seizures requiring cEEG monitoring to detect and manage. Furthermore, some “elective” procedures aren’t necessarily all that elective. Critical patient assessments that shouldn’t be postponed could instead consider evaluations using an extended, home-based video-EEG study with remote monitoring. 

Ambulatory EEG with remote monitoring now provides neurologists with options once only available in hospital settings, and advanced providers of outsourced aEEG can fully provide: 

• Insurance pre-authorization and scheduling  

• In-Home patient set-up by qualified EEG technologists, following CDC infection control guidelines 
• Full EEG montage with additional ECG electrodes and digital audio/video capabilities  
• Routine EEG with patient stimulation and activation when requested  
• Real-time remote monitoring of the patient study to ensure high quality EEG data by experienced staff with 24/7 live patient support  
• Local technologists for EEG set-up and equipment collect at the end of study  

• EEG review and annotation by experienced and trained technologists  
• Cloud-based study storage with secure portals for access and reporting  

New challenges to our operational environments call for new solutions. High-quality aEEG with remote monitoring is one of those solutions. Outpatient EEG and EMU testing can both be shifted to home-based, monitored video-EEG with the right partner and provider behind you. 

Click here to find out how CortiCare can help provide the needed EEG services to your patients.