For Hospital Administrators

Neurophysiologist CNIM

Understanding Neuromonitoring

This page is to provide essential information and resources for hospital administrators to ensure they are making a well informed decision regarding their choice of neuromonitoring service providers,

Administrators must be aware of the wide range of quality and competency of neuromonitoring service providers. Strict quality assurance measures should be employed to ensure each individual surgical neurophysiologist that practices in your hospital is qualified and competent.

Administrators are often enticed by low-cost options but should understand that using poorly trained and inexperienced neuromonitoring personnel can have disastrous effects for the patient, surgeon and hospital.

Research has shown that surgical outcomes are directly related to the experience of the surgical neurophysiologist.


"Literature suggests that least experienced neuromonitoring teams may have a neurologic deficit rate that is twice as high  as the rate of the more experienced teams."
– Nuwer et al: Clinical Neurophysiology 1995;96:6e11

One of the world's most experienced and respected spine surgeons discusses the importance of quality neuromonitoring in spine surgery.

How Important is the Quality of the Neuromonitoring?

Intraoperative neuromonitoring is an essential clinical service that ensures the safety of patients undergoing surgical procedures that place the brain, spinal cord and nerves at risk.

It takes many years of training, study and experience to become competent in surgical neuromonitoring and even more to become truly proficient. It is important for hospital administrators to understand that there is great variability in the education, experience and skill levels of surgical neurophysiologists.

Hospital Liability & Risk Management Considerations

Statistics regarding surgical medical malpractice are staggering. The annual cost of the medical malpractice liability system has been estimated to be $55.6 billion-2.4% of the total healthcare system.'

  • The median award for plaintiffs in actions involving the spinal cord is $2.9 million, and the median value for settlements is $1.45 million.

  • A neurosurgeon will spend approximately eleven years of his or her career with outstanding malpractice claims.


The Baltimore Law Review Publication:

Litigating Intraoperative Neuromonitoring (IOM)Neuromonitoring Litigation

Neuromonitoring Supply & Demand

Administrators Beware:

Dangerous Trend in Neuromonitoring

Neuromonitoring has been proven to improve surgical outcomes and the demand for these services is outpacing the supply of qualified practitioners. Over the last decade, there has been a disturbing trend of corporate acquisitions of smaller companies that provide neuromonitoring services. Currently, the majority of neuromonitoring service providers are employed by a small number of large national corporations that generate their primary income from selling other hospital products or services.

Profit-driven corporations that offer neuromonitoring services often employ low-cost personnel that are often poorly trained and unqualified to provide neuromonitoring services. It is not uncommon to find that the quality of patient care suffers when corporate profits are prioritized.

Administrators should appreciate that neuromonitoring is a clinical service, and they must carefully assess the training, knowledge, experience and competency of any surgical neurophysiologist who will be permitted to practice in their hospital.

While low-cost neuromonitoring options can be enticing for an administrator, a single bad surgical outcome can be disastrous for the patient, surgeon and hospital.

Contact us for more information about empowering your surgical program with cost-effective, high quality neuromonitoring services.

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Contact us for more information about empowering your surgical program with  high quality neuromonitoring.

211 Crestview Drive
Orinda, CA 94563
Phone: (678)