Purchasing new technology for high-acuity patient care can be complex. The process is typically more difficult if the technology being considered is neither required nor a “standard of care.” Level of consciousness (LOC) or BIS™ brain monitoring technology during surgical procedures falls into this category.
Our goal is to provide you with the cost and financial benefits to help you make your decision. This blog highlights the factors that help you determine the cost of brain monitoring solutions and how that cost can impact your practice. Before you buy, consider the following primary components:
- Cost of the monitor
- Cost of the patient sensors
- Cost per patient
- Potential reduction in cost of patient care through enhanced recovery
What’s the Total Cost of a LOC Monitor?
There are several components to consider in your estimation of the total purchase and installation cost of LOC brain monitoring in your OR:
- Monitor cost
- Specialized mounting needs
- Electronic medical record (EMR) interface requirements
There are three manufacturers of LOC brain monitors available in the United States:
- Masimo SEDLine™ system
- GE Entropy™ * system
- BIS™ system
These monitors range in cost from about $4,000 to more than $5,500. Cost of mounting options, like pole clamps, are minimal and are often included with each monitor. We recommend mounting our BIS™ monitor to optimize the visibility of the display and to secure the monitor in typically crowded workspaces.
Connecting a stand-alone monitor with your hospital electronic medical record system is often required and should be considered on the front end of your purchase.
Not all EMR systems have established interface solutions, because LOC monitoring isn’t a standard monitoring parameter. The more common EMR systems (EPIC and Cerner) have active interface solutions. The cost to interface can vary and depends mostly on the EMR system.
What Are the Costs of Patient Sensors?
Sensors vary in costs depending on how they will be used. Typically, sensors from the three manufacturers range in cost from about $12 to $25 each.
The most common BIS™ sensor can costs from $13 to $18. The less commonly used BIS™ bilateral sensor costs anywhere from $25 to $28 per sensor.
Are There Recurring Maintenance Costs?
New BIS™ monitors come with a standard five-year parts and labor warranty. The warranty covers the monitor and the LOC module. A replacement of the back-up battery is recommended after five years and costs approximately $500.
There are no maintenance costs associated with the BIS™ system, and all necessary software updates are provided free of charge. Extended multi-year service programs are available and provide full coverage of BIS™ monitors — including accidental damage and cable replacement. The cost can run from $300 to $1,000.
What Is the Potential Cost Benefit of Monitoring Patients with LOC or Brain Function?
Numerous publications have demonstrated the clinical benefits of individualized anesthetic management with the BIS™ system — although few studies include a cost benefit analysis.
It’s reasonable to consider rough cost benefits based on reported avoided adverse events and increased length of stay (LOS).1 Several investigators have reported a potential reduction in cost of care by avoiding adverse events associated with BIS™ brain monitoring technology.1, 2
One example of this potential economic impact is the demonstrated 35 percent reduction in postoperative delirium (POD) associated to BIS™ system guided anesthesia.3 POD is associated with significantly longer and costly hospital stays. On average it adds around 13 days to the LOS.2, 4 Consider these factors as you decide what to purchase for your OR.
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1. Gan TJ, Glass PS, Windsor A, et al. Bispectral index monitoring allows faster emergence and improved recovery from propofol, alfentanil, and nitrous oxide anesthesia. BIS Utility Study Group. Anesthesiology. 1997;87(4):808-815.
2. Deiner S, Silverstein, JH. Postoperative delirium and cognitive dysfunction. British Journal of Anaesthesia. 2009; I03 (Suppl. L): i41 – i46.
3. Chan MT, Cheng BC, Lee TM, GinT; CODA Trial Group. BIS-guided anesthesia decreases postoperative delirium and cognitive decline. J Neurosurg Anesthesiol. 2013 Jan;25(1):33-42.
4. Ansaloni L., Catena, F., Chattat R., Fortuna D., Franceschi C., Mascitti P., and Melotti R.M. Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery. British Journ of Surg. 2010; 97:273-280.
TOPIC: BIS™ Brain Monitoring, Operating Room