High-Density EEG in Practice

Improving Patient Care and an Already Successful Practice with High-Density EEG

Whether you call him an early adopter or an innovator, it is clear that Butte, Montana, neurologist Dr. Carlos Sullivan has long been on the cutting-edge of neuroimaging technology. For example, when he opened his first private practice in California in 1974, he purchased a CT scanner that was among the first three on the West Coast. In the early 1980s, he was instrumental in bringing one of the nation’s first MRI scanners to routine clinical use. It may be surprising, then, that he considers his recent purchase of the neurologists’ old standby—an EEG system—the tool that most revolutionized his practice.

“Since we switched from a cap-based EEG system to the EGI system, I’ve not had a single patient display even the mildest of negative reactions,” Dr. Sullivan said. “Instead, the response to the EGI system has been extremely positive! Our patients love it. They literally, on a daily basis, tell us ‘It’s the only way to go!’

“I can’t begin to express how much this means to the men and women we treat. For the little kiddies, it’s that much more important!”

Since installing an EGI 32-channel Geodesic EEG System, Dr. Sullivan’s practice has experienced a 22% increase in its total billing dollars (compared to a comparable time period in which he used a capbased EEG system). The unique, patented HydroCel Geodesic Sensor Net and Net Amps 300 technology has cut the preparation and clean up time for a single routine EEG recording by as much as one hour. That time savings means that Dr. Sullivan can now run at least twice as many recordings as he could with his old cap-based system, or that he can gather an extra hour of EEG data on a single patient in the same time period.

These changes have also made it possible for those patients who need an EEG recording to be tested on the same day of their first appointment to his office. Prior to the installation of the EGI GES 300, it was not uncommon for his patients to wait two or more weeks for the recording. And although many neurologists must refer their patients to a hospital or clinic for EEGs, Dr. Sullivan is now taking referrals from other doctors and a hospital. In fact, he is often able to perform immediate EEG exams on patients referred from the hospital’s emergency department.

“I’ve not had to increase a single fee, and I am experiencing a marked increase in my income,” Dr. Sullivan noted. “I want to make this very clear: I am making more money, and that increase has not come at the slightest cost to my patients. Most importantly, the product I offer my patients has changed, and it is a far better one. My ability to diagnose, treat, and refer for treatment is more accurate, reliable, and efficient.”

In addition to an increase in his productivity level and bottom line, the increase in billing has allowed Dr. Sullivan to hire another full-time employee—all of which, he said, has dramatically increased his ability to spend extra time with his patients. Dr. Sullivan insists that it is “imperative” that doctors get to know their patients because, just as patients must live with the consequences of their doctor’s medical decisions, so, too, does the doctor. When doctors know their patients on a personal level, Dr. Sullivan believes they then act with a sense of responsibility that curbs any tendency to act in their own financial interests.

“You really hate for it to come down to dollars and cents. Myself, I’m not much of a capitalist when in comes to medicine, and tend to favor a more socialist approach,” Dr. Sullivan explained. “But this is the real world, where money matters. What the EGI system has meant for me is that I am able to perform many more EEGs in less time. [And] despite the initial investment in the system, the system literally pays for itself in no time at all!

“For my patients, the EGI technology means that they don’t have to wait for weeks to schedule the exam. It also means that for the same cost as a traditional EEG recording, they are getting a much more comfortable experience, in less time, and a better end product.”

Additionally, because there is no need for scalp abrasion or the use of noxious collodion glue, Dr. Sullivan noted that the EGI system has lowered his malpractice risk. It is quite common to draw blood with traditional EEG systems, which is not only uncomfortable for many patients, but introduces an infection risk. According to Dr. Sullivan, the ability to completely avoid that risk and discomfort to his patients “helps us all breathe a lot easier.”

The data quality, visualization capabilities, and analytic tools available with his EGI system have also given Dr. Sullivan “far more confidence in [his] expertise in interpreting the EEG.” For example, since installing the EGI system Dr. Sullivan has had two patients for whom all clinical observations pointed to an epileptiform disorder. In both cases, however, Dr. Sullivan performed routine EEGs using the EGI system, and his interpretation of the EEGs indicated the recordings were normal.

Fearing he had missed something, he referred those patients to Harborview Medical Center (Regional Epilepsy Center in Seattle), where the neurologists agreed that the EEG recordings conducted in Dr. Sullivan’s clinic were normal. They then ran their own EEG recordings (using a 256-channel EGI system), and, once again, the tracings were absent of pathology.

“It is because of cases such as these, coupled with the beautiful data I see on the EGI recordings, that my confidence in my clinical ability grows every day,” Dr. Sullivan said.

Dr. Sullivan and his patients are not the only ones benefiting from the new EGI system. According to Dr. Sullivan, his EEG technician (who has 20+ years experience working with several types of traditional EEG systems) insists that no amount of money would convince her to use anything other than EGI technology. “Everyday she sees, firsthand, the spectacular response from our patients,” Dr. Sullivan said. “She is absolutely spoiled, and enjoys her work so much more than ever before.”

Despite his already “exasperatingly busy” schedule, he is currently making plans to add a second EGI system to his practice, and to perhaps upgrade the channel count on one of the systems from 32 to 64 or 128 channels. As a neuroimaging pioneer, Dr. Sullivan has continually bolstered his medical training with courses in mathematics and physics. Although he was first skeptical about the need for high-density EEG, when his review of the high-density EEG literature revealed that the mathematics were “virtually identical” to that in other imaging technologies (such as MRI) he was convinced that higher channel counts were necessary.

“Not only does the switch to high-density EEG satisfy my academically minded ego, it is obvious that, just as with CT and MRI, EEG benefits tremendously from higher resolution,” he said.

Dr. Sullivan remarked that the only drawback to the new EGI system is that he has not yet had an opportunity to take full advantage of all of the features of EGI’s Net Station software.

“Quite frankly, I’d take a position as a janitor at EGI if it meant that I would have the opportunity . . . to learn a little more from all your wonderfully talented scientists and support engineers,” Dr. Sullivan quipped.

According to Dr. Sullivan, to ensure the best possible diagnosis and treatment for their patients, neurologists must be immediately introduced to the merits of EGI’s technology.

Return to Routine EEG in Clinic or Private Practice page.