When the Best does not Exist, What is the Alternative?

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Author: Christine Scott Blodgett, MA, R. EEG/EP T., CLTM, FASET

Working for an EEG solutions company, I am privy to the inside workings of many hospitals around the country. It is clear that each faces challenges in meeting the demand for EEG services. Whether the limitations are staffing, equipment or a combination, hospitals are struggling to deliver testing for their patients. A significant number of facilities are forced to send their patients out to other hospitals for testing or monitoring, thus delaying appropriate treatment for the patient as well as losing revenue.

With these issues in mind, I have been reflecting on the future of our profession and the evolving demands of our healthcare systems. Can we continue to follow the traditional path we are on? Something we honor as a hallmark skill of Neurodiagnostic Technologists is head measurement and application of the 10-20 system. During training, these skills are paramount, and you cannot advance until they are mastered.

This has always been the gold standard and it is understood that without an initial quality setup, you will not get the quality test we all strive to provide for our patients. However, while we hold this skill sacred, we also recognize the number of highly skilled and trained technologists is inadequate to the demand, with those who are registered being even more scarce. We see that many hospitals do not have access to trained techs and the majority that do, have no coverage after daytime hours or on weekends. Therein lies the problem of needing this critical skillset to deliver our EEG services – when the trained technologist is not available. When the best does not exist, what is the alternative?


Several products have come to market, or will soon, with the express purpose of filling this skill gap in some situations. Dry electrodes, rapid response EEG systems, electrode caps and templates were all developed to help initiate EEG recordings when a trained technologist is not readily available. One of these, the electrode cap, has had great utility in research applications, but has been historically viewed by skilled technologists as a threat rather than a tool, which could never meet the accuracy requirements or signal quality of a traditional electrode setup. Recently, a paper by McKay, et al.1, indicated that an electrode cap could be applied by residents or other healthcare staff when an EEG tech was not available and still provide clinically acceptable recordings. In the absence of resources – would you rather have no test for your patient, or an alternative that will help provide them with the care they need?

If the last few years have shown us anything, it is that there is a need for us to evolve. We no longer need to hang our hats on just the skills of measurement and application. If we commit to growing and expanding our skillsets, we can move forward with confidence knowing there are tools to help us and we can accomplish more if we look beyond the traditional definition of tech. Advanced technologists are already monitoring live studies to alert physicians to acute changes and generating preliminary reports. The advanced practice level technologist is something that we can all strive to be, which will ultimately advance the profession. It may be that an alternative approach to applying electrodes is one of those ways to propel us into the future.

Christine Scott Blodgett is the Director of Clinical Quality Assurance for CortiCare, Inc. a nationwide EEG Services company. She was previously Chief Technologist, Neurophysiology at Massachusetts General Hospital, Boston and Senior Clinical EEG Specialist for Physicians Ancillary Services, LLC. Christine serves as adjunct faculty in the Neurodiagnostic Technology programs for Laboure College of Healthcare and Baptist College of Health Sciences.

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