HP33: A global survey of intraoperative monitoring: Needs and availability

Abstract

Introduction: Results from a multi-factorial global survey regarding the awareness of, need for, and availability of Intraoperative Neurophysiological monitoring in a cross-section of populations and socio-economic conditions will be presented. A statistical analysis of the responses will be given. Conclusions from these data will be discussed. Intraoperative Neuromonitoring (IOM) is a proven technology for reducing iatrogenic sequelae and improving patient outcomes. Unfortunately, its availability is not universal, leaving many populations without access to this beneficial service. In order to target IOM resources most efficiently, thereby maximizing its availability to under-served patients, an understanding of the current state of IOM delivery in the global market is necessary. To establish a representative “cross-section” of respondents, we surveyed 12 countries across North and South America, Africa, Europe, and Asia. Respondents included surgeons, neurologists and clinical neurophysiologists. Of primary interest in the Survey was the demand for IOM, and the availability of trained Neurophysiology clinicians to meet that demand. Other critical factors examined included surgeon awareness of IOM, non-standardized delivery models, the relative paucity of education curricula or training resources for the IOM clinician, real-time physician oversight for the interpretation of the IOM data, and budgetary constraints related to reimbursement and capital equipment purchases. We are able to draw several conclusions from this survey. Demand for IOM far exceeds the available trained clinical staff, particularly in emerging economic regions. Increasing surgeon advocacy through awareness and education will drive improved opportunities to deliver this critical patient care.