OVER 110,000 IONM CASES ANNUALLY.
Intraoperative Neuromonitoring (IONM) Services
SpecialtyCare is the largest provider of intraoperative neuromonitoring (IONM) services in the nation, with 110,000 cases every year. Our people work alongside the world’s leading surgeons to help identify any early signs of neurological injury. Our surgical neurophysiologist clinicians are backed by a skilled team of IONM physicians, who provide additional support with real-time monitoring through telecommunication, enabling timely interventions to avoid long-term neural problems. At SpecialtyCare, the health of the patient always comes first. As a partner in IONM, we are your insurance policy against risk and the high cost of patient injury, even during the most complex procedures like spine surgery, brain surgery, cardiac surgery, vascular surgery, and general orthopedic surgery. You can rely on our expertise in IONM to reduce risk and help ensure patient safety.
What is Intraoperative Neuromonitoring or IONM?
Intraoperative neuromonitoring (IONM) is the continuous surveillance of a patient’s nervous system (the brain, spinal cord, and nerves) when it can be at risk of injury during surgery. The purpose of IONM is to protect the nervous system.
Depending on the procedure, a variety of tests can be used to measure nervous system function. Usually, IONM works by delivering electrical impulses to the nervous system and measuring their effect. To gather this information, electrodes are attached to the wrists, ankles, scalp, and sometimes to specific muscle groups, depending on the type of surgery.
A trained clinician (surgical neurophysiologist), under the supervision of a qualified IONM physician, constantly monitors the information from the tests. When significant neurophysiological change is detected, the IONM team provides immediate feedback to the surgeon, anesthesiologist and nurses who can respond quickly to minimize the chances of long-term post-operative injury.
IONM provides an extra layer of safety for both the surgeon and most importantly, the patient.
A patient’s insurance carrier may pay for a portion of the costs associated with IONM. This amount depends on the specific carrier and insurance plan. Patients can contact their insurance provider to find out about coverage for IONM. Patients and surgeons should consider the advantages of preventative IONM services compared with the risks and costs of serious neurological complications.
A Brief History of IONM
Intraoperative neurophysiological monitoring is currently used in thousands of surgical procedures every year across the United States. The first use of IONM dates back to the 1930s, when direct stimulation of the brain was used to identify the motor cortex of patients with epilepsy undergoing intracranial surgery. Later on, it was the introduction of new monitoring tests and the invention of the commercial IONM machine in the early 1980s that allowed for the widespread use of the technique.
The 1990s saw transcranial electric motor evoked potentials (tceMEPs) introduced as a method for monitoring spinal cord activity and for predicting postoperative motor problems. Technological advances in the last 20 years have allowed monitoring techniques to continually evolve.
The widespread availability of computer networks and communication systems has allowed IONM to be performed even from remote sites. This has made the technique even more popular in the last decade.
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What SpecialtyCare Provides
SpecialtyCare’s clinical staff has a proven history of research and innovation in IONM. We were among the first to introduce the common use of transcranial motor evoked potentials in monitoring spine and intracranial surgery. We’ve also customized techniques for monitoring nerve root function during spine surgery, brachial plexus function during shoulder reconstruction, and sciatic nerve function during pelvic surgery. We provide the industry’s most advanced clinical neuroscience services, including neurophysiological mapping during deep brain stimulation surgery, monitoring during interventional neuroradiology, transcranial doppler evaluations in the intensive care unit, and support of long-term EEG monitoring.
We support most complex surgical procedures including:
- Spine surgery
- Interventional neuroradiology
- General orthopedic surgery
- Vascular surgery
- Cardiothoracic surgery
SpecialtyCare’s IONM keeps hospitals and surgeons on the forefront of innovation without the huge cost associated with hiring and equipping an advanced team of clinicians.
IONM Accreditation and Certification
Our surgical neurophysiologists have eight years of experience in IONM on average. We also have the most staff with Certification in Neurophysiologic Intraoperative Monitoring (CNIM) and the most diplomats certified by the American Board of Neurophysiologic Monitoring (DABNM) in the industry. SpecialtyCare’s neurophysiologists are thoroughly evaluated and granted clinical privileges based on performance in specific surgical procedures. Clinical competency is reviewed on an annual basis, fostering continuous improvement and advancement of skillset. SpecialtyCare holds both accreditation and certification from The Joint Commission (TJC), and we are the first IONM clinical services provider to have a neuromonitoring training program that is formally recognized by ABRET, the Neurodiagnostic Credentialing and Accreditation Board.
Our surgical neurophysiologists work alongside the world’s leading surgeons, tracking nervous system activity in real time to identify and act on any early signs of evolving neural injury. We’ve got the patient’s back. Always.
Surgeons expect skilled, familiar people in the OR who they can trust and rely on to monitor their cases. Maintaining a highly competent hospital-based program can be difficult. Our experienced clinicians and monitoring physicians step in to serve as an extension of the OR team, ensuring both patient safety and surgeon satisfaction.
Our IONM Training
Our training program welcomes up to 25 new students across four training cohorts each year. In order to be considered, candidates must have a bachelor’s degree and display a commitment to core values like clinical excellence, integrity, and customer service. The year-long program includes classroom learning, supervised clinical training, and clinical oversight until competencies are demonstrated.
In January 2018, the Neurodiagnostic Credentialing and Accreditation Board (ABRET) formally recognized SpecialtyCare’s Intraoperative Neuromonitoring (IONM) Training Program.
With approval as a recognized program, our surgical neurophysiology trainees gain Pathway IV test eligibility for ABRET’s Certification in Neurophysiologic Intraoperative Neuromonitoring (CNIM). ABRET recognition is an important milestone, and it shows our ability to meet the primary goal of our program, which is to provide surgeons and their teams with highly trained and certified clinicians who can contribute to patient safety, improved patient outcomes, and reduced healthcare costs.
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Trainees learn critical thinking skills in different diagnostic techniques, are exposed to literature review activities, and participate in OR communications training in a simulated operating room, all of which are focused on development of clinical acumen. This extensive training and our dedicated CNIM test preparation have resulted in impressive first-time CNIM test pass rates that far exceed the national average each year.
This confirms that our program provides substantial and effective preparation for both certification and high-quality patient care. NIOM program status makes SpecialtyCare the first clinical services provider to achieve this recognition. With approval as a recognized program, our surgical neurophysiology (SNI) trainees gain Pathway IV eligibility for ABRET’s Certification in Neurophysiologic Intraoperative Neuromonitoring (CNIM) testing. ABRET recognition is an important milestone for our training, and it shows our ability to meet the goal of our program, which is to increase patient safety, improve patient outcomes, and reduce healthcare costs by providing surgeons and their teams with highly trained and certified clinicians.
In recent years, ABRET has shifted away from exclusive reliance on on-the-job training, focusing more on formalized preparation of clinicians by requiring nationally recognized coursework for exam eligibility. SpecialtyCare’s structured curriculum and rigorous clinical training fosters consistency and a high level of performance.
We believe that great performance begins with great training, so we created a strong educational foundation and have built upon that foundation since the beginning. The result has been a training program that differentiates SpecialtyCare and the performance of our surgical neurophysiologists in the operating room.
Our IONM Services Cost Savings
Standing as a leader in outsourced clinical services, SpecialtyCare is a one stop shop for your needs. Our IONM team saves you the cost of hiring, training, and obtaining support that may not suit your surgical needs. And our buying power all over the country provides you with top-of-the-line equipment and products at competitive rates from leading manufacturers, such as:
- Rochester Electro Medical
Innovation in IONM
SpecialtyCare brings a proven history of research and innovation to surgical teams and hospitals across the country. We were among the first to introduce routine use of transcranial electric motor evoked potentials (tceMEP) in monitoring spine and brain surgery. We have developed numerous tceMEP innovations, such as customized anesthesia protocols for optimizing neurophysiological recordings and techniques for monitoring nerve root function during spine surgery, brachial plexus function during shoulder reconstruction, and sciatic nerve function during pelvic surgery.
At SpecialtyCare, our goal is to help you build an operating room team based on excellence and to provide the best outcomes, always. Our approach is founded on the belief that a combination of clinical excellence, compliance, and dedicated personal service is needed to ensure the very best in patient care and cost management. Reach out to us today for more information.
IONM Training Program
In January 2018, the ABRET Neurodiagnostic Credentialing and Accreditation Board recognized SpecialtyCare’s Intraoperative Neuromonitoring (IONM) Training Program with formal Neurophysiologic Intraoperative Monitoring (NIOM) program status. With approval as a recognized program, our surgical neurophysiology (SNI) trainees gain Pathway IV eligibility for ABRET’s Certification in Neurophysiologic Intraoperative Neuromonitoring (CNIM) testing.