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Optimizing the operation of an electrodiagnostic laboratory during the COVID-19 pandemic: A 6-month single-center
K H Vincent Lau1, Michelle C Kaku1, Ariel Marks1
1Department of Neurology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
Insights
Electrodiagnostic (EDx) laboratories can safely resume operations following COVID-19 guidelines. Reopening EDx labs under American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM) guidance achieved pre-pandemic patient volumes and billing without staff or patient COVID-19 transmission.
Area of Science:
- Neurology
- Clinical Electrophysiology
- Infectious Disease Control
Background:
- The COVID-19 pandemic caused widespread cancellations of elective medical procedures, including electrodiagnostic (EDx) studies.
- Reopening of EDx laboratories was guided by recommendations from the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM).
Purpose of the Study:
- To evaluate the safety and operational outcomes of an EDx laboratory during its reopening phase.
- To determine necessary workflow adaptations based on real-world reopening experience.
Main Methods:
- A retrospective review of clinical volumes, billing data, and diagnosis distributions was conducted.
- Rates of COVID-19 exposure and transmission among patients and staff were monitored.
- Adopted AANEM guidelines and other consensus statements were detailed.
Main Results:
- During the first 6 months of reopening, 816 outpatient studies were completed, achieving 97% of 2019's volume and billing.
- Inpatient study completion reached 83% of requested procedures.
- No known COVID-19 transmissions occurred between patients and staff.
Conclusions:
- Safe operation of EDx laboratories is feasible under AANEM guidance.
- Clinical volumes and billing can return to pre-pandemic levels.
- Workflow adaptations enabled successful reopening and sustained operations.
Introduction/Aims:
The initial surge of the coronavirus disease-2019 (COVID-19) pandemic in early 2020 led to widespread cancellation of elective medical procedures in the United States, including nonurgent outpatient and inpatient electrodiagnostic (EDx) studies. As certain regions later showed a downtrend in daily new cases, EDx laboratories have reopened under the guidance of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM). In our reopening experience guided by the AANEM, we measured relevant outcomes to determine further workflow adaptations. We aimed to detail our experience and share the lessons learned.
Methods:
We reviewed the clinical volumes, billing data, diagnosis distributions, and rates of COVID-19 exposure and transmission among patients and staff in our EDx laboratory during the first 6 months of reopening, starting on June 1, 2020. For context, we detailed the recent AANEM guidelines we adopted at our laboratory, supplemented by other consensus statements.
Results:
We completed 816 outpatient studies from June 1 to December 1, 2020, reaching 97% of the total volume and 97% of total billing compared with the same time period in 2019. The average relative value units per study were similar. There were no major shifts in diagnosis distributions. We completed 10 of 12 requested inpatient studies during this period. There were no known COVID-19 transmissions between patients and staff.
Discussion:
Our experience suggests that it is possible to safely operate an EDx laboratory under the guidance of the AANEM and other experts, with clinical volume and billing rates comparable to pre-pandemic baselines.
