Abstracts

Rationale: Although the fundamental principles of recording an EEG have been unchanged for decades, the technology in that surrounds the acquisition and interpretation has greatly advanced the field. The greatest example of this is the development of digitized EEG allowing for post-recording manipulation of the EEG, magnifying interpretation abilities. The next frontier of technology has been the invention of wireless technology and mobile devices. Like digitization, "going wireless" will change the way in which we are able to practice clinical EEG. Methods: Mayo Clinic Department of Neurology has recently implemented EEG reading services at three other institutions across the state of Arizona, termed "tele-EEG." The epilepsy division then has four institutions where they have remote access to EEG interpretation. There are two different EEG acquisition systems (Natus and Nihon-Koden) and two different methods to provide remote access (VMWare and Citrix). Please see table 2 for details. Ease of access is instrumental in managing the complexities of multiple systems, therefore the iPad devices were compared to a standard laptop (HP EliteBook 2540p) and on-campus desktop access. Results: Table 1 summarizes the technical specification of each of the devices. Table 2 summarizes the speed of access from each type of system that is used. The laptop used in this study is a relatively small laptop; however it is still larger and heavier than the iPads, with a higher cost. The advantage is that it has a larger screen. The time it takes to open an EEG measured showed no significant difference between the devices, with a trend toward being slightly slower with the laptop. The boot-up time is significantly longer for the laptop and desktop. In addition, the 4G access appears essentially no different than wifi. Subjectively consultants who are using the iPad as compared to the standard laptop feel that it has the advantage of the larger screen and easier to input data. However, the iPad has significant advantages as it gives the reader more freedom to leave their home/hospital despite being on call, as well as feeling that it is faster and easier to use. Cost is also significantly less. There have been times that were noted that the laptop would loose connection, where this would not happen with the iPad. Testing this in alternate conditions, such as in a moving vehicle, did not decrease the ability to access remote systems. Conclusions: With high volumes of EEGs to read and multiple systems and facilities to read from, the efficiency of technology is essential to many physician practices. Despite the marginally smaller screen size; the ease of use, accessibility, and reliability make the use of the iPad a viable option for its integration into the tele-EEG practice. At this time, iPads can be best used as a complementary to the laptop that EEG readers are using at their home wifi networks. It is reassuring, however, that with an increasingly busy practice, tablet-style devices can keep electroencephalographers connected wherever they may be.