healthcaretechoutlook

CortiCare: 'Eyes-on Monitoring' to Detect Non-convulsive Seizures

 Tim Innes, Exec. Vice President of Business Development
Non-convulsive seizures (NCSzs) are increasingly recognized as common occurrences among ICU patients today. According to published surveys of the current US standard-of-care—most continuous EEG (cEEG) studies are examined at 12 hour intervals. Patients with continuous seizures lasting for longer than 10 hours have an 85 percent mortality rate. “The ACNS and NCS guidelines set 12 hour retrospective review of cEEG as the bare minimum standard for patient EEG surveillance. They also define status epilepticus as 5 minutes of continuous seizures requiring physician intervention in one hour. This makes it difficult to meet Association guidelines for EEG neuro-clinical care,” expresses Tim Innes, Exec. Vice President, CortiCare. Every physician takes approximately 30 minutes to one hour to review 24 hours of recorded electroencephalographic (EEG) data. “If one physician has more than one or two cEEG patients to review each morning, patient care surveillance quickly becomes unsustainable,” adds Innes. There is no doubt that reading neurologists become overwhelmed by the labor intensive process of detecting seizures.

Neurotelemetry using Continuous Electroencephalographic (cEEG) monitoring is the newest telemedicine tool to protect patients from critical care brain injury. cEEG serves as the gold standard for seizure identification in critically ill patients. CortiCare—an EEG monitoring solution provider, enhances the neurologic assessment of ICU patients.

“Our goal is to monitor the neurocritical care patient in real-time with registered EEG technologists and alert the reading physician immediately if there are any remarkable events, so that they can intervene in real-time–not 12 or 24 hours later,” asserts Innes. CortiCare uses HIPAA compliant RDP (Remote Desktop Protocols) technology to connect with the existing hospital EEG equipment or we can supply new equipment, to remotely link the registered EEG technologists with the instrumentation at the patient bedside. Just like Cardiac Telemetry, which was used for decades in the Cardiovascular Intensive Care Unit to monitor a patient’s cardiac function, Neurotelemetry can be used to remotely monitor brain function in real-time to provide critical care patient surveillance.

Our goal is to monitor ICU patients in real-time with registered EEG technologists and alert the reading physician to prevent or reduce neurological injury and deterioration


“This connectivity allows us to monitor raw EEG waveforms and patient video 24/7 and alert the adult or pediatric neurophysiologist of any notable events.”

There is a nationwide shortage of qualified neurophysiologists available to read cEEG studies across the country. The situation is worse internationally, even for countries with advanced health technology such as the EU, UK, and Japan. This telemedicine service will allow any hospital ICU that treats neurological injuries such as, traumatic brain injuries, stroke, cardiac arrest, metabolic diseases, status epilepticus and acute illnesses that provoke silent, non-clinical seizures to access technical and diagnostic neurophysiological expertise required for their patients. Now any hospital worldwide with EEG equipment, electricity and a broadband connection can monitor their ICU neurocritical patients in real-time.

In one instance, Providence Health and Services in CA deployed CortiCare’s neurotelemetry services in their Neonatal Intensive Care unit (NICU) to monitor newborn babies with acute brain injury to alert the on-site neonatologist of any nonconvulsive or otherwise clinically indiscernible seizures or actionable changes in brain activity.

CortiCare's pilot Cloud platform provides physicians with access to more patient data from across institutions for seamless seizure management consultations. “We are also developing disposable EEG Cap, which can be put on by the nurses or other allied healthcare professionals—without the need for EEG technologists for set up. “CortiCare's secure technology solution for remote EEG monitoring and instrumentation, network of on call EEG technologists, board certified adult and pediatric neurophysiologists, and disposable EEG cap all comprise parts of a comprehensive solution for monitoring any patient for seizures virtually anywhere,” concludes Innes.