Making surgery safer.

SpecialtyCare is the largest provider of intraoperative neuromonitoring (IONM) services in the nation, with 110,000 cases every year.


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 neurophysiologists are backed by our 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, cardio 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 monitoring of a patient’s central nervous system (the brain, spinal cord, and nerves) when it can be at risk during surgery. Depending on the procedure, a variety of tests can be used to measure the nervous system.

A trained clinician, under the supervision of a qualified surgeon, constantly monitors the information from the tests. If there are any changes or potential problems, our clinicians can immediately alert the surgeon and nurses.

The purpose of IONM is to protect the nervous system. The real-time information of IONM can often prevent neurological injury (damage to the brain, spinal cord, or nerves).

When neurological injury does occur, the immediate feedback from IONM allows the surgeon, anesthesiologist and nurses to quickly respond to minimize long-term post-op damage. IONM provides an extra layer of safety for both the surgeon and most importantly, the patient. Usually, intraoperative neurophysiologic monitoring (IONM) works through measuring and creating electrical impulses and determining their effect on the nervous system. To gather this information, electrodes are attached to the wrists, ankles, scalp, and sometimes to specific muscle groups, depending on the type of surgery.

The electrodes record the response of the nervous system to an electrical stimulus and can see if any changes have occurred. If there are significant changes, the clinician will immediately alert the surgeon and, the intervention happens right then and there if necessary.

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. Please check with your insurance carrier to find out about coverage for IONM. But remember, you should consider the relatively inexpensive cost of IONM services against the high cost of postop long-term care (including rehab) for possibly experiencing neurologic complications as a result of surgery.

A Brief History of IONM

Intraoperative neurophysiological monitoring is now a big part of thousands of surgical procedures every year across the United States. The first use of IONM testing dates back to the 1930s, when direct stimulation was given in order to identify the motor cortex of patients with epilepsy. Later on, it was the invention of the commercial IONM machine in the early 1980s that the technique became widely popular.

The 1990s saw transcranial motor evoked potentials (TcMEPs) become mainstream as a method for monitoring spinal activity and also for predicting postoperative motor problems. Technological advances in the last 20 years have allowed monitoring techniques to evolve.

The widespread availability of computer networks and communication systems have allowed IONM to be performed even from remote sites. This has made the technique even more popular in the last decade.

Promoting IONM

SpecialtyCare offers IONM specialists a way to promote the amazing work that they do. We offer exclusive lifestyle options that appeal to a much larger audience. Browse our store and see the items we offer, from scrubs, t-shirts, totes, backpacks, and more!

IONM Services T Shirt
Perfusion Services Shirt

Intraoperative Neuromonitoring (IONM) Podcast

Scrubbing In, powered by SpecialtyCare, is a medical podcast about innovation in the OR. In these discussions, we will be speaking to industry leaders in IONM and those making a positive impact on health care, in the operating room, and in the IONM industry. This medical podcast is designed to reach all of those within the medical field specifically those in the OR, including; surgeons, nurses, perfusionists, surgical assistants, hospital management, neurophysiologists, supply chain associates, medical researchers, and all those that assist in making surgery safe and successful.


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 electric motor evoked potentials (tceMEP) 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 neuroscience services and treatment therapies, including monitoring for deep brain stimulation and interventional neuroradiology, ICU doppler evaluations, and support of long-term EEG monitoring.

We support most complex surgical procedures including:

  • Spine surgery
  • Neurosurgery
  • Interventional neuroradiology
  • General orthopedic surgery
  • Vascular surgery
  • Otolaryngology
  • 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 around eight years of experience in IONM on average. We also have the most certified and advanced staff in the industry, with the Certification for Neurophysiological Monitoring (CNIM) and the Diplomate, American Board of Neurophysiologic Monitoring (DABNM). SpecialtyCare’s neurophysiologists are thoroughly evaluated and granted clinical privileges based on performance. They are then reviewed on an annual basis, fostering constant improvement and even more advanced skills. We hold both accreditation and certification from The Joint Commission (TJC), and we are an IONM clinical services provider with a NIOM Training Program recognized by ABRET’s Neurodiagnostic Credentialing and Accreditation Board.

Our surgical neurophysiologists work alongside the world’s leading surgeons to review and interpret data in real time and identify the early signs of evolving neural injury. We’ve got the patient’s back. Always.

The surgeons expect skilled, familiar people in the OR who they can trust and rely on to monitor their cases. Maintaining a highly competent internal program can be difficult. Our experienced clinicians and monitoring physicians serve as an extension of the OR team, ensuring both patient safety and surgeon satisfaction.


Our IONM Training

Our program welcomes around new 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 excellence, integrity, and customer service. The year-long program includes classroom learning, supervised clinical training, and eventually, indirect oversight. A trainee must complete many learning stages and demonstrate competency on a clinical level.

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.


Trainees learn critical thinking skills in different diagnostics, are exposed to literature review activities, and participate in simulated OR communications, all of which are focused on development of clinical sharpness. The bulk of our training and our dedicated CNIM test preparation have resulted in impressive first-time CNIM 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 more recent years, ABRET has shifted away from exclusive on-job training and focused more on formalized training by requiring nationally recognized coursework for exam eligibility. Knowing that just on-job training alone isn’t enough, SpecialtyCare also focuses on formalized training that brings consistency in the quality of our graduates.

We believe that great performance begins with great training, so we created a strong educational foundation and have build upon that foundation since the beginning. The result has been a training program that separates us and our performance of our surgical neurophysiologists in the operating room.

Learn more by visiting our IONM Careers page for current opportunities.


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:

  • LivaNova (formerly Sorin)
  • Terumo Cardiovascular Systems
  • Medtronic
  • Haemonetics

Innovation in IONM

SpecialtyCare brings a proven history of research and innovation to surgical teams and hospitals all across the country. We were among the first to introduce routine use of tceMEP, which stands for transcranial electric motor evoked potentials in monitoring spine and brain surgery. We have developed numerous tceMEP innovations, such as customized anesthesia protocols for better recording 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 of excellence and to provide the best outcomes, always. Our approach is based 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.



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