In Phase Neuro

Why In Phase Neuro? To be in phase means to be in alignment. For the past two years, we have grappled with existential crises that inescapably require that we pivot from many of our old ways of being and doing. The visionary fiction of Octavia Butler challenges us to be in alignment with the change we aspire to see in the world, to embody and to enact it. In our case, we are working in the technical space of EEG and other digital diagnostics, but we are also very intentionally people forward. And not just individual people but communities of people, within and outside of our organization. This manifests in the work we accept, the values we advance, the partnerships we forge, and the goals we co-create. #digital #people #partnerships Follow our journey!

Expert consensus agrees that there is amortality and functional benefit in treating silent seizures in critically ill patients. 10-20% of critically ill patients may experience these silent seizures. Like for stroke, time is brain. The longer we wait to treat, the more difficult it can be to control seizures. And in many cases, the greater the seizure burden the poorer the clinical outcome. If the purpose of real time monitoring of EEGs in critically ill patients is to reduce time to definitive therapy, it makes sense to monitor in real time. But this goal also relies on robust processes for communication and mutual expectations for rapid response between managing physicians, remote EEG consultants, and EEG monitoring services. How many EEG monitoring companies prioritize process and quality control? How do they choose the limit for the number of studies a single EEG technologist monitors simultaneously? How do they choose the limit for the number of studies a single clinical neurophysiologist reads simultaneously? Are these choices made to optimize volume (read: profit) or patient safety? Are you setting up or revamping an EEG program at your hospital and seeking to build with integrity? You’ve landed at the right place. Reach out for guidance. #EEG #quality #process #patient #safety

Here's a bit of the inside scoop on 8-channel #EEG, which is apparently taking the world by storm. This is coming from someone who not only spent six years as the Medical and Scientific Director of an EEG diagnostics company and continues to consult in EEG in clinical services and clinical trials. I also founded and run a large (400+) EEG specific neurologists group for virtual peer-to-peer consultation (EEG is still an inexact science and benefits immensely from consensus)... AND I try rigorously to live a person over profits centered life (talk to me about life choices and advocacy pertinent to immigration, voting rights, language justice, health equity)... Using 8-channel EEG as a replacement for a full 10:20 to save money when localizing seizures or determining whether drugs are seizurogenic is completely inappropriate. This reduced montage option is reasonable as a stop gap measure for determining whether someone is actively in generalized nonconvulsive status epilepticus. Furthermore, the 8-channel system should be used only where there is expertise to set up a high quality study and interpret the results for clinical decision making and/or where remote consultants are working lockstep with clinical decision makers on the ground who know what to do with the data, and there is clear accountability. But often, this technology is simply plugged into a workflow bereft of appropriately trained professionals with the misguided notion that it can in some ways replace them. For first in human (safety) trials, we are looking for subtler findings (focal, episodic discharges) that may be entirely missed with only 8 channels. In both clinical and clinical trials contexts, decisions about whether to implement this technology would result in very different outcomes if rooted in what is best for delivering timely and relevant information rather than in maximizing returns. When an 8-channel EEG is used to avoid indicated transfers/referrals in resource poor settings or to double bill with a routine 10:20 or continuous study in a way that makes no sense to EEG experts/clinicians and has health and economic costs for patients, we should take issue. 8-channel EEG is a technical solution that attempts wrongly to address an adaptive problem. Its utility is limited, but tech is so $exy, isn't it?