There are less than three thousand board certified intraoperative neurodiagnostic technologists in the United States. Of those, only a few have 30+ years experience and quad credentialed. I am one of this nation's elite Neurodiagnostic Technologists.

Autobiography

When I graduated High School in 1976 I was not sure what I wanted to do.

My Aunt (an RN) posed the question, "did you ever consider a career in healthcare"? She offered to facilitate a tour of some healthcare departments. While touring New York-Presbyterian, Columbia University Medical Center I entered their famous Neurology Department where I encountered a patient with wires on their head and brainwaves being written to paper. I was mesmerized.

The recording and analysis of neurophysiologic signals has become my life study. The application of the neurosciences in the Operating Room and Clinical Laboratory my vocation.

The wonderful folks there directed me toward an accredited school of electroneurodiagnostic technology administered by the Lewin's and Dr. David Doniger through United Hospitals of New York.

After graduation I completed my internship at Bronx Jacobi and the Albert Einstein Medical School in the South Bronx. In the late 70's the South Bronx was a war zone. I will always remember the subway trips there every day and the walk through the ER past the morgue to the Neurology Department.

My first full-time position (1980) was as a staff Technician at Overlook Hospital in Summit, New Jersey. It was part of the Atlantic Health System. Upon my arrival, Overlook only performed routine clinical electroencephalography. At this time Evoked Potentials were rapidly evolving from the research phase and entering the clinical environment.

I am proud to have been offered the opportunity to develop their evoked potential and intraoperative spinal cord monitoring program. I assembled the proposal and business plan, worked with architects and designed the physical plant, selected the instrumentation (GRASS Model 10), supervised the clinical trials and performed the normative analysis. I also assisted in the development of their epilepsy and Ambulatory-EEG monitoring program.

Some of the distinguished physicians I worked with included:
Henri Liss, Neurosurgeon Henry R. Liss M.D. was a Pioneer in Neurosurgery who in 1965 performed New Jersey's first stereotactic neurosurgery with his partner, Dr. George Zazanis, and served as senior vice president of medical affairs at Overlook Hospital in Summit for 10 years.
George Zazanis, Neurosurgeon
Joseph Altongy, Orthopedic Surgeon
Roy Nuzzo, Orthopedic Surgeon

In 1982 I had a rare opportunity for a brief fellowship with Dr. John Knott. Dr. Knott created the EEG Laboratory at the University of Iowa in 1939, one of the first in the nation. In so doing, he was instrumental in developing, and later defining, the position of EEG technician/technologists that we have inherited. Dr. Knott led and shaped the electroneurodiagnostic profession in many ways through countless hours of dedicated scientific endeavors in electroencephalography and in service to EEG technology. Dr. Knott worked throughout his career for the betterment of EEG technologists. He was co-editor of the American Journal of EEG Technology from 1966 through 1973. He served as member and chair of the Joint Review Committee on Education in EEG Technology (JRC/EEG). He co-authored Fundamentals of EEG Technology. He was the moving force behind the formation of ABRET, traveling across the entire United States, organizing regional examinations and convincing technologists that, through ABRET, there was a road to increased professional status. Dr. Knott was one of this nations most renowned experts in electroneurodiagnostic technology. It was a pleasure and honor to meet him and spend time learning the art and practice of our science.

While I was in Summit, NJ I was approached by a group of Neurologists who were interested in building their own diagnostic center with MRI, CT, and END capabilities. They were interested in obtaining my assistance in developing their program. Again I had an opportunity to work with architects, engineers, builders, medical instrument vendors, and business management software solutions. Although I was not the chief orchestrator, I did play a key role in the overall project. That venture went well until the Federal STARK regulations affected physician owned diagnostic centers.

I also did some per diem work at Morristown Memorial and Fair Oaks Hospital in New Jersey.

I spent 10 years in Summit, NJ primarily at Overlook, Morristown and the Neurodiagnostic Group of NJ. I really loved the area. I purchased my first house and boat and found I enjoyed water skiing more than fishing. I will always remember the holiday season in Summit as a magical time.

Early in 1990 an opportunity presented itself to take a leadership position at Jersey Shore University Medical Center in Central New Jersey as Manager, Diagnostic Imaging. The facilities Division of Diagnostic Imaging included: General Radiology, Cat Scan, MRI, Ultrasound, Interventional Angiography, Nuclear Medicine, and the Neurodiagnostic Department.

The position appealed to me because it offered excellent opportunities to expand my knowledge and experience into other areas of healthcare delivery. So I put together a five-year plan to redesign the Neurodiagnostic department. That plan would change the organizational structure, physical plant, work flow, policies, procedures and clinical protocols in an effort to improve revenue, reduce expense, achieve regulatory compliance and improve overall customer satisfaction. That plan was endorsed and I accepted the position of Assistant Manager, Diagnostic Imaging/Supervisor, Neurodiagnostic Services. The plan was completed in 4 years and resulted in 40% improvement in revenue, reduced manpower by 30%, and reduced physical space by 20%.

In 1992 Jersey Shore University Medical Center began an initiative to replace its enterprise wide healthcare information management system. The project included replacement of the current Diagnostic Imaging System. The Company signed with Shared Medical Systems (SMS) Shared Medical Systems Corporation (SMS) is a leading provider of computer-based information processing systems and associated services to the healthcare industry in North America and Europe. The company provides various data processing and management services to hospitals, clinics, physician groups, and miscellaneous healthcare corporations. SMS helped to pioneer the industry during the 1970s and was still enjoying heady gains in the mid-1990s. of Malvern, PA. (Now Siemens Medical Solutions) SMS had a subsystem known as the Radiology Management System (RMS). RMS was a proprietary relational database application running on an Open VMS operating system on a DEC Alpha box. This system provided capability for order entry, billing, patient tracking, inventory management, and digital image management. Around 1994 I was offered and accepted the responsibility for the installation, upgrade, maintenance, management, auditing, and access control of the digital hardware, software, and communication network that resides within the Department of Diagnostic Imaging & Therapeutic Services. I took several courses and learned all that I could on DEC VMS systems and networking. The Department had approximately 55 terminals, 30 printers, 150 users, processing 6,000 transactions per day, generating about 150,000 historical records per year. The RMS was the primary information management system for the division.

Some of the distinguished physicians I worked with included:
Paul Silbert, MD, Neurologist
Leonard Zawodniak, MD Radiologist
Alan Colicchio, MD, Neurologist
Alan Deutsch, DO, Neurologist
Michael F. Lospinuso, MD, Orthopedic Surgeon

Around 1995 managed care was having quite an impact on health care. Many Medical Centers in the state were taking a hard look at healthcare delivery costs. I was inspired to start my own business. I located a federally subsidized SBA course that was done with the assistance of SCORE at Brookdale College. It was a very enjoyable course that provided education in almost every aspect of starting a business including obtaining startup capital, bookkeeping, tradename registration, payroll, incorporating, and the NJAC. That knowledge coupled with my standing knowledge of CPT & ICD coding, DOH regulations, JCAHO guidelines, and HCFA regulations positioned me well to start my own business. However, I still felt a little gray in the arena of employee relations so I found a course on employee management and wage/hour issues that provided education on FLSA, FMLA, and HIPAA/HITECH compliance. Now I felt I had the knowledge I needed to venture into private practice with confidence. I partnered with several area technicians, a lawyer, accomplished business executive, and physician. I developed a business plan, performance improvement plan, employee relation plan, and standard service agreement. I put on my best salesman suit and ventured forth, seeking customers. Over the course of the next few years, ENDS of CNJ secured long-term agreements with several area healthcare providers including the NJ State Department of Health and Human Services, Long Term Care Facilities and Deborah Heart & Lung Center, and Monmouth Neurological Associates. ENDS of CNJ did not develop into a very large venture, but it did OK for me. I am very proud of this, it was not large but it was a fully functioning business compliant with all regulatory agencies.

I spent 13 years on the beautiful Jersey Shore. I had an opportunity to work with many brilliant people. I rebuilt the JSUMC Neuro Lab, expanded their service line, installed a medical management system and started a successful private enterprise.

On April 2, 2007 my wife and I sold our property, submitted our resignations, liquidated our business, loaded what was left in a truck and hit the road. Why? Our little suburban paradise became urbanized. Traffic was intolerable, quality public education nonexistent. Even our trash pickup was problematic. My daughter was 3 years old. We saw an opportunity to take a trip, a big trip. We were off to see America.

About one-third of the way across the country we unloaded our truck into storage in Indiana. Then in Carthage, Missouri we felt a little cramped in our PT Cruiser and saw a sign for Mid America RV, "the largest Motor Coach dealer in the mid-west". We left in a 35 foot Class A with our PT in tow. Over the next one and one half years we traveled 23,543 miles. Like the wind we just blew about the country, listening to our heart and following our whimsy. My family and I got to visit 26 states, exploring all the great places we always wanted to visit and doing many of the things we had only dreamed of. Our journey strengthened us and reaffirmed my life purpose, duty to work and love of family. Unfortunately, all good things must end and so must our great adventure. In October 2008 I accepted a full time position in Sacramento, California at the Sutter Neuroscience Institute.

I spent about 1 year at the Sutter Neuroscience Institute in Sacramento, California. The Neuroscience Institute is one of our nations top ranked neuroscience centers performing all facets of applied clinical practice. I enjoyed working with the distinguished Dr. Robert Burgerman, MD in his epileptology program including phase II - Electrocorticography (ECoG) and foci ablation.

My family and I truly loved Sacramento. The weather, the trees, the downtown areas, all the pleasures of a city without the big city problems.

In September of 2009 an opportunity presented itself to take a leadership position as Regional Director with the private sector neuromonitoring company IntraNerve. This position would place me in Los Angeles, California with overall responsibility for all regional operations. This position also came with the provision of developing an educational program that could take an individual with general education in the neurosciences and prepare them for board certification in intraoperative neuromonitoring.

I rebuilt all instrument setups. Nowadays all our instrumentation is digital. When we start our neurodiagnostic instrument we select and the instrument loads a “setup” that is appropriate for the procedure. These setups contain all the system variables that will configure the device to perform a particular service in a particular way. The setups may contain upwards of 2,000 variables. These new setups are designed to achieve several goals: provide the tech in the field a basic starting setup, facilitate teaching, accommodate professional interpretation, provide similar performance and appearance between manufacturers, and meet certain national standards of practice.

I installed and set up a browser based regional management solution with modules for...

• A Posting board for announcements.
• E-Learning Solution
• Capital Equipment Manager
• Time and Attendance Manager
• PTO Request Manager
• Daily Service Audit tool
• Instrument setups
• Company Policies
• Clinical Resources
• Clinical Protocols
• Frequently used documents
• A Library
• Preference Cards
• CPT Code Lookup Tool
• UPIN/NPI Code Lookup Tool
• Contraindications
• Nomograms
• Myotome & Dermatome Maps

The intranet E-learning solution provides a mechanism to provide the employees relevant study material and a user-friendly examination process that can evaluate competency with documentation of demonstrated competency. This process can be used for company policy procedure and protocols, clinical knowledge base development, and Board preparation.

The intranet Capital Equipment Management solution provides a user-friendly interface to track and establish a "state of readiness" by identifying what equipment we have, where is it located, any custodianship if applicable, it's state of readiness, and an issue and repair history.

There are less than three thousand board certified intraoperative neurodiagnostic technologists in the United States. Of those, only a few have 30+ years experience and quad credentialed. I am one of this nation's elite Neurodiagnostic Technologists. Coupled with my experience and expertise in:

• Team Building and Project Management
• Leadership and Supervision
• Education and Training
• Capital and Operating Budget Management
• Supply and Inventory Management
• Quality Assessment Programs
• Personnel Relations
• Scheduling and Resource Management
• CPT, ICD, HCPCS, DRG coding
• HCFA, HIPAA/HITECH Regulations

places me at the forefront of my profession.