NEURO

The world of neurodiagnostics got a rude awakening about infectious disease 30 years ago. That was when the largest outbreak of Hepatitis B in history was linked to 6 outpatient EEG clinics . Since then, EEG labs and clinics have adopted more stringent infection control measures. It hasn’t been enough, though. Researchers have continued to find contamination. The most recent example includes two papers by Albert et al., published in 2018 and 2019 , that found 25 percent of cleaned, reusable EEG cup electrodes and lead wires had bacterial growth. And no two labs followed the same cleaning process. “That was really alarming, because you would think that 30 years later we would be in a better position,” says Anna M. Bonner. Bonner is a neurodiagnostic technologist and author of “ Infection Prevention: 2020 Review and Update for Neurodiagnostic Technologists ,” published in the Neurodiagnostic Journal. This is the fifth iteration of infection control guidelines provided by ASET-The N

One of the key goals of marketing your neurology or PM&R practice is to become known as a likable expert in your community. One of the best ways to achieve this is by becoming a media expert that news outlets can turn to when they need subject-matter expertise for a story. It may seem as if Dr. Oz and that ilk have that role locked up, but it isn’t quite as difficult as you might think to carve out a media niche for yourself. Whether in print, online, or onscreen, journalists need medical professionals to provide accurate information and to lend an air of legitimacy to their reporting. Here are a few steps you can take to be top of mind for the reporters in your area. Make yourself available . There are several websites that connect reporters with experts for their stories. Sign up for services such as Help a Reporter Out, ProfNet, or Expert Engine to receive emails about, or to be found in searches for, your specific area of expertise. Pitch a story. You don’t have to wai

As with just about everything you’ve done for your career as a neurodiagnostic technologist, asking for a raise works best with advance preparation. You want to receive consistent pay increases during your career, so you should always be laying the groundwork that will allow you to successfully ask for your next pay bump. Here are five tips to help you do that: 1.     Set goals. Your goals should include both plans for improving your skills as a healthcare professional as well as advancing within your organization. Share these goals with your supervisor, then ask for feedback to help you refine your goals and identify steps you can take to achieve them. Go in with a plan, and don’t expect your supervisor to do all the work for you. Instead, be open to suggestions and criticism of your plan – it’s a great way to show that you are a team player and can be flexible. 2.     Communicate your successes. Make sure the people who can make decisions about your career are aware of your a

Marketing specialists have been recommending doctors get on YouTube for years now,   Today, users can “meet” their doctors, watch medical procedures, and get many of their healthcare questions answered. As more medical information crowds into YouTube, physicians need to find ways to stand out on this platform. The best way to do this? Do what physicians have always done to make their mark: deliver at the highest level of quality possible. After Google, YouTube is the second-largest search engine on the internet, a place where people increasingly seek out medical information.  YouTube is primarily an entertainment medium, however, and as a result medical professionals need to be careful not to get pulled into the click-bait mentality that prevails there. In addition to content produced by healthcare providers, there is also medical information from a wide variety of other sources, including patients, alternative medicine providers, media, and parents. Sometimes this information is

Since the AIDS epidemic became widespread in the 1980s, sharps handling procedures have taken on a much greater significance for healthcare practitioners. Along the way other bloodborne pathogens, such as hepatitis B and C and at least 20 other less common pathogens, have only heightened the importance of needle safety. As a result, robust protocols have been established for many common needle uses in a healthcare setting over the years. However, for those who provide intraoperative neuromonitoring (IONM), needlestick injury is a unique risk, as they place multiple subdermal needle electrodes during a single procedure. These needles can easily be misplaced among the surgical waste. Best practices have not always been evident, and research on the topic is limited. A 2014 study found that neurodiagnostic technologists who provide IONM, as well as other operating room personnel, were at risk for needlesticks from these needles. The study concluded that steps to minimize needlesticks

For the last couple of years now, the personal coaching sessions offered at the annual American Academy of Neurology meeting have filled up within hours of opening. This program has grown so much, they have added three times the number of coaches to this year’s slate. We spoke with one of the coaches, Keri Bischoff, to find out why these sessions are so popular, and what they can do for neurologists. By focusing on individual strengths instead of weaknesses, she sees people physically change in these sessions – they sit up taller, they smile. “We’ve had people come into our coaching sessions and they’re in tears because they’ve never had the opportunity to sit and understand why they feel the way they do,” says Bischoff. “It’s like a breath of fresh air for them.” These kinds of reactions highlight the level of professional ambivalence and burnout now rife in the field of medicine , and among neurologists in particular. It was in reaction to this problem that the AAN first created

Skin irritation and even injury are all too common in long-term EEG monitoring. Some argue they are simply inherent to the procedure, but new research has zeroed in on some key risk factors. With this information in mind, EEG technologists will now be able to identify their most vulnerable patients and implement enhanced safety measures, decreasing their rate of injury. Understanding the Research The authors of the study , published in the most recent issue of The Neurodiagnostic Journal , looked at patients undergoing ambulatory electroencephalography (AEEG) monitoring. The 251 patients studied fell into two groups, those monitored for two to three days and those monitored for four to five days. As expected, the longer patients wore the electrodes, the more skin inflammation was observed, especially between the second and fourth or fifth days.Inflammation was also greater in patients with the following characteristics: Increasing age Fair skin color Dry skin texture Fine hai

Fifty million people around the world have epilepsy, and the vast majority – 80 percent – live in the developing world. In many low-income countries, the disease is poorly understood and there’s a huge diagnosis and treatment gap. EEG technologist Trei King is one of a growing number of healthcare providers in the U.S. dedicated to closing that gap. He hopes that by sharing his passion for this work, he’ll motivate other techs to get involved. According to the World Health Organization (WHO), three-quarters of epileptics living in low-income countries do not get the treatment they need. This treatment gap causes incalculable and unnecessary personal suffering and impacts social and economic development. Misinformation about the disease also abounds – epilepsy, for example, is often thought to be contagious and it carries great stigma, resulting in human rights violations. These issues have led to the development of the WHO Programme on Reducing the Epilepsy Treatment Gap , which i

The latest coronavirus to make the jump from animals to humans, COVID-19, has dominated recent news cycles. As a result, you may be getting a number of questions from patients who aren’t sure how serious the threat is or how it may affect them with regard to their specific health conditions. This is an excellent opportunity for you to create a piggyback article or post for your medical practice website. A piggyback post is an article you write “on the back” of a highly publicized news item. Whenever there is a hot health topic in the news, it’s an opportunity for you to use your platform to share the most current, evidence-based information on that issue. The topics can come from a number of sources. Current Events:  The death of a celebrity may have people curious about the disease that caused the death. Providing factual information without focusing on the celebrity is a safe way to do it without seeming opportunistic. It’s even more effective if you provide resources for physical

A new study comparing the addition of outpatient palliative care to standard care alone for patients with Parkinson’s disease and related disorders found that the additional care brought benefits to the patients without adding to caregiver burden. This is significant because the level of care required for many with advanced Parkinson’s disease is considerable. Even when the standard of care is met, the patients may still struggle – and the burden on caregivers only grows. Parkinson’s disease affects 1 to 2 percent of the population over 65. In addition to motor dysfunction, patients also suffer from non-motor symptoms such as pain, dementia leading to poor quality of life, and high nursing home placement. Palliative care , once belonging primarily to the realm of oncology, has become an important tool in managing these difficult symptoms and issues. But until now, no systematic evidence has been collected about its efficacy. This study, published February 10 in JAMA Neurology , wa

In any professional career, an up-to-date, polished resume is an important item to have, even in a field facing a workforce shortage – as is the case for EEG technologists . If you are actively looking for a new position, the need for an excellent resume is obvious. But employers aren’t the only ones who look at resumes, so even if you are perfectly happy where you are, it is to your benefit to keep that document current and ready to go. You never know what kind of opportunity may present itself – committee leadership positions, speaking engagements, or seats on nonprofit boards, for example. These are all ways you can expand your skills and grow your network, and you may need to submit a resume to be considered. We’ve compiled a list of tips to help you get that all-important document in tip-top shape. Start with a working document. This resume will list everything you can think of that could be valuable for any opportunity – work experience, education, volunteerism, special cred

This is the story of how one neurology practice dialed up efficiency, shortened wait times, and increased profitability, all while increasing the opportunity for patient eye contact and decreasing physician burnout. We first heard this story at a talk given at the 2019 annual meeting of the Academy of Neurology. We later spoke with one of the presenters, Dr. Enrique Alvarez, director of outpatient adult neurology services at the University of Colorado Hospital, where this share-worthy program is in place. Like many neurology practices, Alvarez and his team were dealing with EHR issues and greater-than-three-month patient wait times. They also had efficiency challenges: rooms often standing empty and medical assistants sitting around waiting for their next assignment. Then, in 2017, they implemented a pilot program adapted from a primary-care efficiency model out of the University of Utah. The program took six months to a year to put in place and involved greater use of MAs. “Norma

Mavidon, the maker of collodion, one of the most commonly used EEG electrode adhesives, issued a product recall at the end of December 2019 due to possible contamination. This had techs across the country scrambling to find a substitute until the recall was amended in January 2020. Still, the recall and subsequent update underscored concerns expressed by Connie Kubiak, President of ASET the Neurodiagnostic Society , just days before the recall was reversed: EEG techs and their departments aren’t always first in line to receive important product information like this. This, she told Neurology Insights, is because EEG techs aren’t always on the radar of hospital administrators – they often don’t know the difference between EEG and ECG techs. “We’re the people in the basement who nobody knows, and people don’t really understand what we use and what we do. If you’re part of a huge corporate entity, did [this news] trickle down to where you were?” she wondered. “Did they assume that b

Facial paralysis can occur at any time in an individual’s life. It may be present at birth due to a congenital disorder such as Moebius syndrome or birth trauma. It may also occur later due to issues such as Bell’s palsy or stroke. Either way, it’s reasonable to assume that this type of condition has an impact on mental well-being – the inability to use facial expression to communicate and the social stigma that accompanies the disorder make such an impact inevitable, according to new research. This socioemotional impact was the topic of recent work by researcher Kathleen Bogart of Oregon State University’s College of Liberal Arts. Her survey of adults with either acquired (n=434) or congenital (n=112) facial paralysis revealed that those with facial paralysis are indeed more likely to experience depression or anxiety than the general population. The research, published in Health Psychology , also revealed surprising differences between the congenital and acquired groups. Bogart l

Lumbar puncture is an important part of any neurologist’s toolkit. But patients who need an evaluation of their CSF are already struggling with symptoms of some kind that necessitated the procedure. No one wants to add to their discomfort. This is why understanding the etiology of post-dural puncture headache (PDPH) is so important to the field of neurology. PDPH, which occurs in 32 percent of cases, can last for days and may be incapacitating. This makes understanding the cause important for obtaining the best diagnostic information while avoiding morbidity. Young adults and females are at greatest risk for PDPH as are those with lower body mass or undergoing procedures with larger needles or multiple punctures. According to the International Classification of Headache Diagnoses, 3 rd Edition (ICHD-3), PDPH is a subcategory of ICHD 7.2: “Headache attributed to low cerebrospinal fluid pressure.” It can only be diagnosed if it occurs within five days of the procedure with document

When Connie Kubiak R. EEG/EP T., CNIM CLTM talks to physicians about who should be performing EEG studies, the first thing she does is ask about family. “If your family member needed to have an EEG done, would you have them come to this office and do it? Are you confident that your staff would give you the best quality study for your family member? And if you can’t say absolutely , then your staff is not trained well enough.” Kubiak is the current president of ASET the Neurodiagnostic Society and her group is lobbying hard to make sure the most qualified professionals are the one’s performing EEG studies. “There should not be people monitoring your epilepsy patients who are not credentialed and who do not have at least three to five years of experience,” she said in a recent phone interview. Physicians may or may not realize just how unregulated the field of neurodiagnostic technology is. Currently there is no state that requires EEG techs to have any formal education, or to be li

“It used to be that medical records were just about remembering treatments and what the patients said, and passing along info to colleagues. Today it is about so much more,” said Isabelle Bibet-Kalinyak, JD, MBA. “Medical records are now a major source of risk and compliance traps.” Bibet-Kalinyak, a healthcare attorney from Ohio, spoke at the most recent meeting of the Medical Group Management Association , sharing insights into the changing role of medical records. It was no surprise to find the importance of good charting at the top of her list. Most Common Charting Pitfalls With the widespread use of EHRs “We think errors and omissions in medical records should be a thing of the past, but no,” she emphasized. Studies are still showing that two of the biggest failures in medical records are failing to 1) put in required information or 2) amend relevant  information. “We also see a lot of inaccurate data and we still see issues of professionalism.”  And that is not all. Below is

As you think about your practice in 2020, you may be considering how to maximize your Medicare payments through the Merit Based Incentive System (MIPS). At the 2019 Annual Assembly of the American Association of Physical Medicine and Rehabilitation (AAPM&R), Mark Huang, MD, and Robert Jasak, JD, presented a session titled MIPS 2020: Preparing Your Practice for Reporting and Strategies to Improve Performance . According to them, most Physiatrists will report under MIPS which has a direct impact on future Medicare payments. The program is updated annually, and 2020 performance will adjust Medicare payments anywhere from a 6.2 percent increase to a 9 percent decrease in 2022, so this is a long game. It’s also important to remember that MIPS is not an all or nothing proposition, so there is value in completing what you can and reporting it, even if you can’t achieve all of the benchmarks. Who Is Excluded from MIPS? First things first: are you even required to report for MIPS? Jasa

Whether practice growth is one of your new year resolutions or not, now is a great time to put some energy into your public-facing spaces. From decluttering your office to refreshing your website and social media, our fall lineup of posts included a whole bunch of helpful tips and tricks. Take a moment now to read up, and get ready to usher in a more profitable 2020. POST #1 You Are Creating Marketing Content, and You May Not Even Know It! Lack of time may truly be the biggest roadblock for the neurologist who wants to create digital content to help build their neurology practice. But in today’s online world, digital content is marketing currency. It can be shared on your website, and on social media channels to connect with potential patients and referring physicians. In this post you can learn how to make use of content you probably already have. READ MORE > POST #2 Referral Development Is Key to Practice Growth: Here’s How to Nail It Referral sources want two things from

“It’s important to remember that the alternative to telehealth for many is not in-person care, it is no care because of barriers.” —Marla Kaufman, MD Dr. Marla Kaufman, Medical Director & Clinical Associate Professor, Puget Sound VA Hub Site, Telerehabilitation Enterprise Wide Initiative (TREWI), picked up the AAPMR session on teleRehab where Dr. Tapia left off, emphasizing some of the nuts and bolts of an actual teleRehab visit. The most obvious question is how the physical exam can be completed. In such a hands-on specialty, it can be hard to imagine how video medical visits can work. Some physiatrists have found ways to modify the exam, while others use a telepresenter—a medical professional such as a nurse or physical therapist who can conduct the physical tests on video. But when patients require frequent visits, particularly with mental health or pain issues in play, these visits can improve patient experience and compliance. She also emphasized the importance of havin