Zeto's wireless EEG machine

Blog

Blog

Zeto ONE Billing: Expanded CPT Codes for 24+ Hour EEG Monitoring

Full-Montage EEG with video capabilities

Understanding the appropriate CPT codes for EEG services is essential for accurate billing and reimbursement. With the introduction of Zeto ONE, our latest EEG headset for continuous monitoring, Zeto now has a product that can support both routine and longer-duration EEG studies. Following proper billing practices, Zeto now aligns with the expanded set of EEG CPT codes to ensure accurate documentation and billing.

In addition to our WR19 system for routine EEG collection, Zeto ONE enables extended monitoring up to 24+ hours with video, enabling clinicians to perform longer studies that may align with long-term EEG CPT codes.

Please note: The information provided in this article is for educational purposes only. This content is not intended as billing, coding, reimbursement or financial advice. Healthcare providers are advised to consult legal counsel and billing and coding specialists to determine appropriate CPT codes based on specific procedures, payer requirements, and patient needs.

Introducing Zeto ONE

Zeto ONE is our latest advancement in EEG monitoring designed for long-term, continuous EEG monitoring in acute care settings. Zeto ONE is a user-friendly full-montage headset and a portable recording device that provides reliable bedside seizure detection*, accompanied by video, audio, and live remote monitoring and interpretation service. 

* enabled by encevis

WR19 vs. Zeto ONE: Enhanced Capabilities

Note: The devices shown in this comparison image are for illustrative purposes only. In clinical practice, the Display Unit (DU) is mounted on bedside stands, not held by patients during monitoring.
WR19Zeto ONE
Monitoring DurationUp to 6 hours24+ hours
Primary Use CasesRoutine EEGTriage, Routine, Stat, and Continuous EEG
Video IntegrationYesYes
Billing Codes RangeRoutine EEG codesFull spectrum including extended monitoring

Expanded CPT Code Coverage with Zeto ONE

For standard routine EEG billing codes (studies up to 2 hours), refer to our blog: Billing for Zeto: Zeto EEG Billing CPT Codes.

Long-Term Video EEG Monitoring (2-12 Hours)

VideoMonitoringCPT Code Technical ComponentCPT Code Professional Component
Without VideoUnmonitored9570595717
Without VideoIntermittent9570695717
Without VideoContinuous9570795717
With VideoUnmonitored9571195718
With VideoIntermittent9571295718
With VideoContinuous9571395718

Professional component codes include 95717 for studies without video and 95718 for studies with video. Zeto ONE’s advanced multi-stream video capability enables providers to utilize the video EEG codes when clinically appropriate.

Long-Term Video EEG Monitoring (12-26 Hours)

VideoMonitoringCPT Code Technical ComponentCPT Code Professional Component
Without VideoUnmonitored9570895719
Without VideoIntermittent9570995719
Without VideoContinuous9571095719
With VideoUnmonitored9571495720
With VideoIntermittent9571595720
With VideoContinuous9571695720

Technical Component for 24-Hour Monitoring

Technical component billing includes several options for extended monitoring:

  • 95950 for seizure-focused monitoring for each 24-hour period, 95951 covers each additional 24-hour period. 
  • 95953 applies to computerized portable 16+ channel EEG monitoring for each 24-hour period
  • 95956 covers portable EEG monitoring for each 24-hour period.

Video EEG: Enhanced Clinical Value and Reimbursement

Zeto ONE’s multi-stream video capability captures patient behavior, environmental factors, and seizure activity, enabling complete clinical assessment during long-duration EEG recordings. These integrated capabilities are designed to support robust documentation and assist clinicians in demonstrating medical necessity during the payer review process.

Key Documentation Requirements

Successful reimbursement for extended monitoring requires thorough documentation of medical necessity for monitoring durations exceeding routine timeframes. Clinical indications must clearly support the need for continuous versus intermittent monitoring EEG recordings. When billing video EEG codes, documentation should include specific rationale for video recording as well as the duration of the EEG based on clinical presentation and diagnostic requirements.

For 24+ hour studies, seizure detection protocols and safety monitoring procedures should be clearly documented to support medical necessity and appropriate code selection.

Conclusion

Healthcare providers can utilize Zeto ONE’s comprehensive monitoring range, from routine diagnostic studies to extended seizure monitoring with synchronized video capture.

For individualized guidance on EEG billing, several third-party consulting service providers are active in the market. For questions or an introduction to a consultant familiar with Zeto, complete the form below.


    Disclaimer

    Zeto, Inc. does not provide billing or coding services and does not offer advice, guidance, or recommendations regarding billing, coding, reimbursement, or claims submission. The information presented in this article is intended solely for general informational purposes and should not be construed as legal, compliance, coding, reimbursement, or financial advice.

    It is the sole responsibility of each individual or organization to ensure the accurate selection and application of codes, modifiers, coverage, and documentation, as well as to establish medical necessity and submit claims in full compliance with all applicable federal, state, and local laws, regulations, and payor policies, including those of Medicare, Medicaid, and commercial insurers. To mitigate potential legal, financial, or regulatory risks, it is strongly recommended to consult with qualified legal counsel and experienced coding or reimbursement professionals. Requirements should also be independently verified with relevant payers and authoritative sources, prior to making any billing or coding decisions. This article is not a substitute for professional guidance or independent verification.

    Zeto, Inc. makes no representations or warranties regarding the accuracy, completeness, or applicability of the information provided and expressly disclaims any liability for any losses, damages, or other consequences that may result from reliance on this content. Use of this information is at your own risk.

    EEG in Supine Position: Making Bedside Monitoring Truly Bedside

    Zeto ONE enables rapid, full-montage EEG while patients remain comfortably lying down – no gels, no electrode wires, no repositioning. ICU and ED teams now have a solution that matches the pace and complexity of real-world care.

    Why Supine EEG Access Matters in Critical Care

    In critical care and emergency environments, most patients are not sitting up. They’re post-surgical, unconscious, intubated, or in a medically complex state that makes repositioning impossible.

    Being able to conduct high-quality EEG while lying down is more than a convenience. It’s a matter of life-saving speed.

    Zeto ONE: Built for the Bedside

    In most hospitals today, traditional EEG is still the standard of care – but that doesn’t mean it’s easy. These systems offer the full-montage data neurologists rely on, but they come with significant logistical hurdles. Setup takes 20–30 minutes, requires a trained EEG technologist, involves abrasive skin prep, messy gels, and a maze of wires. Especially for patients in critical conditions, with limited ability for re-positioning, preparing the scalp and gluing down traditional gel-based electrodes can take even longer than usual. 

    In response to these challenges, a new category of “rapid EEG” systems has emerged. But while these devices promise speed, they often sacrifice quality. Unlike some rapid EEG systems that are bulky or uncomfortable for patients lying down, the Zeto ONE is designed with a low-profile form that makes it easy for patients to rest comfortably on a pillow—no neck towel or special positioning required. The headset can be applied in under five minutes and removed just as quickly if a CT or MRI is needed. It’s gel-free and paste-free, so there’s no mess to clean up, and unlike many limited-channel systems, Zeto ONE delivers a full-montage 21-channel EEG, giving clinicians the diagnostic quality they need without compromising patient comfort.

    Remote EEG Monitoring Without Compromise

    Zeto ONE is more than just a rapid setup. It also supports real-time, cloud-based EEG streaming and integrates AI-powered seizure detection. Zeto comes closest to a traditional full montage EEG with all its benefits and seamless integration with the cloud.

    Here’s what that means in the field:

    • Remote neurologists can begin interpreting EEG as soon as the recording starts.
    • The system provides automatic notifications for seizure activity and status epilepticus.

    That means faster intervention. More accurate diagnosis. And fewer unnecessary patient transfers.

    What Makes It Different From Traditional EEG?

    FeatureTraditional EEGZeto ONE
    Patient Comfort Gel dries, wires interfereSleek design makes it comfortable.  
    Setup Time15–25 minutes  ~ 5 minutes
    Specialized Technologist RequiredYesNo – any trained staff member
    Gel / Paste RequiredYesNo
    Patient Clean-up RequiredYesNo

    Zeto ONE has been used to record over clinical 150,000 EEGs, many of them in high-stakes emergency and ICU environments. Providers using the system report faster workflows, better patient experiences, and a major reduction in unnecessary transports.

    Ready to See It in Action?

    Request a demo of Zeto ONE and learn how you can implement rapid, full-montage EEG at the bedside, in the ICU, or anywhere care happens.

    EEG for Nurses: A Rapid Full EEG When Every Minute Counts

    Zeto ONE makes it possible for nursing staff to initiate high-quality EEGs—no gel, no wires—when EEG technologists are unavailable.

    In many hospitals, especially in emergency departments, intensive care units, and rural facilities, nurses are often the first clinicians to respond when a patient shows signs of a neurological emergency—such as nonconvulsive seizures, status epilepticus, or post–cardiac arrest encephalopathy. But traditional EEG systems are generally not deployed by nurses. They require EEG technicians – critical practitioners who unfortunately may not be always available in rural settings or off-hours. 

    Zeto ONE offer Rapid FULL Montage EEG for the ICU

    It is the first FDA-cleared, full-montage EEG system that can be applied by trained nursing staff when EEG techs are unavailable—without requiring gels, glues, or specialized tools. The system is intuitive and wireless, enabling clinicians to initiate EEGs within minutes, even in critical care environments.

    EEG technologists remain the gold standard in the administration of EEG studies. Zeto ONE offers EEG techs, and when they’re not available, other front-line staff such as nurses, an invaluable and easy to use tool when time to treatment is critical, and expert personnel are not immediately on-site.

    Why Fast EEG Access Matters

    EEG plays a vital role in diagnosing seizures—especially nonconvulsive seizures and nonconvulsive status epilepticus, which can be difficult to identify through clinical observation alone. In neurocritical care and emergency medical settings, delayed EEG access can delay treatment, particularly for patients in altered mental states following epileptic seizures or cardiac arrest.

    Traditional EEG systems require:

    • Specialized EEG technologists for setup and monitoring
    • 15–20 minutes or more for electrode placement
    • Gels, wires, and post-procedure cleanup

    In the absence of an EEG tech, clinicians must either wait until they are available, which could be days, or transfer the patient— a time-intensive and resource-draining process.

    With Zeto ONE, trained nurses can initiate EEGs in under five minutes, helping reduce diagnostic delays and supporting earlier intervention.

    Zeto ONE: A Nurse-Friendly EEG System, Not a Replacement for Technologists

    Zeto ONE is user-friendly enough to be deployed by neuro-ICU nurses, emergency teams, or critical care staff with minimal training. When EEG techs are unavailable, it enables immediate EEG acquisition that can be reviewed by physicians or EEG personnel remotely.

    Key features include:

    • Full-montage high-quality EEG
    • Application in under 5 minutes—no gels, wires, or prep
    • Comfortable for supine patients in ICUs or emergency bays
    • Portable, compact headset fits seamlessly into crowded units
    • Quick to remove and reapply

    Once applied, Zeto ONE begins recording immediately, sending data to a secure cloud-based platform that enables remote access for neurologists and EEG staff for interpretation.

    Built-In Seizure Detection with NeuroPulse AI™

    Zeto ONE includes NeuroPulse AI™, an AI-powered seizure detection tool trained on more than 21,000 hours of EEG recordings across over 800 patients. It continuously monitors for abnormal brain activity and automatically alerts care teams.

    If seizure activity is detected:

    • Nurses receive a notification at the bedside
    • Physicians and EEG techs can be notified remotely

    This capability empowers nursing staff to identify and respond to neurological deterioration, even in the absence of on-site specialists.

    Streamlining Workflow for Nurses in Critical Care

    Zeto ONE is designed to work within the constraints of busy, high-acuity units:

    • EEG studies are immediately available to remote neurologists
    • NeuroPulse AI™ generates real-time summaries and insights
    • No need to transport patients only to get EEG or coordinate external EEG services

    It’s especially valuable during night shifts, weekends, or in smaller facilities without 24/7 neurology or EEG coverage.

    Additionally, the system is:

    • Quick to remove and reapply for imaging procedures
    • Compact enough to store and charge within neurocritical care units
    • Non-disruptive to existing care protocols

    Easy to Clean: A 5-Minute Protocol 

    Zeto ONE is also easy to maintain, with cleaning protocols that meet infection control standards without consuming staff time.

    Our happy customer at Huntsville Memorial Hospital (HMH) in Texas, shared with us that their staff follow a 5-minute cleaning process that has passed routine inspections by their infection control nurse.

    The process:

    • Step 1: Remove the headset—no gel, no residue, no skin irritation
    • Step 2: Wipe down the device using hospital-approved SaniWipes
    • Step 3: Use 70% isopropyl alcohol

    “Cleaning takes about five minutes. We use hospital-approved wipes to reach all areas. Infection control inspected and approved the process.”
    — Joe Schorre, Director of Cardiopulmonary and Emergency Management, HMH

    Additional notes:

    • Cleaning is performed by respiratory techs or nurses immediately after use
    • Devices are stored in designated, upright positions for charging and longevity

    The result is a workflow-friendly process that supports rapid turnover between patients.

    Conclusion: A Critical Tool for Emergency Gaps

    EEG techs are indispensable, and Zeto ONE is not a substitute for their expertise. But in moments when rapid neurological insight is needed—and a tech isn’t available—Zeto ONE gives nurses a fast, accessible solution.

    By empowering nurses to apply EEGs in urgent moments, Zeto ONE helps prevent treatment delays, reduce unnecessary transfers, and improve outcomes in emergency and intensive care settings.

    Want to see how Zeto ONE fits into your neurocritical care workflow?

    Schedule a demo or explore our quick-start training resources.

    EEG in Healthcare Transformed: Zeto Makes EEG Accessible Everywhere

    While EEG in healthcare is the main use of the technology, EEG is no longer confined to hospital rooms. With Zeto’s cutting-edge technology, brain monitoring has become accessible in places you wouldn’t expect. From concert halls to ambulances, our portable, gel-free EEG systems empower researchers, clinicians, healthcare providers and caregivers to rethink where and how EEG can be used to improve lives.

    At Zeto, we’re driving a new era of accessibility in EEG, transforming patient care and expanding its reach beyond traditional settings. In this blog, we explore real-world examples of how portable EEG is making an impact in diverse environments.

    Join us in discovering how brain monitoring is becoming a seamless part of everyday life.

    Bring EEG to ICUs and EDs

    Our latest innovation, ONE, is making emergency EEG faster and easier, especially for hospitals that don’t have dedicated EEG resources. With full 10-20 electrode placement, video and audio recording, AI-powered triage tools, seizure activity monitoring, and remote reading services, ONE brings real-time brain monitoring right to the bedside.

    Huntsville Memorial Hospital successfully implemented ONE for bedside brain monitoring, enabling nurses to apply the EEG headset in just about 5 minutes. The system provides real-time notifications for patients with suspected non-convulsive seizures, supporting faster and more informed clinical decisions around brain function.

    Why It Matters:

    In emergency settings, every second counts. Traditional EEG systems often require specialists and lengthy setups, delaying critical care. Zeto changes that.

    Key Benefits

    • Eliminates the need for costly and time-consuming patient transfers to larger hospitals.
    • EEG setup can be performed by non-EEG technicians.
    • Rapid data collection decreases the period of time it takes to get faster diagnosis and intervention.
    Zeto-ICU

    EEG is Everywhere: Even Rural Hospitals

    EEG in healthcare can be found in services in rural hospitals across the U.S. are often limited due to a shortage of trained EEG technologists and neurologists.

    Zeto addresses this challenge by enabling any healthcare provider or member of the medical staff to initiate EEG when needed, with seamless access to remote EEG reading services through our cloud platform.

    Greenwood Leflore Hospital, a small community hospital in Greenwood, Mississippi, has been using Zeto EEG for routine EEGs. One of the key benefits they have noted is the significantly faster turnaround time for reading and interpreting EEG tests, with results now available the same day.

    Zeto at GLH-2023

    Why It Matters:

    Patients in remote areas often face long commutes for advanced neurological care. Zeto’s portable EEG bridges the gap by bringing diagnostics directly to them.

    Why are rural hospitals choosing Zeto EEG:

    • Expands access to advanced neurological care for rural patients in emergency (such as post brain injury) and non-emergency settings.
    • Reduces financial and logistical burdens associated with patient transfers.
    • Promotes healthcare equity by enabling local hospitals to provide specialized care.

    “The biggest challenge of getting EEGs done in small community hospitals is the lack of EEG technologists. This lack of EEG technicians incentivizes ordering physicians to just send patients to a metropolitan hospital for EEG testing.” – Steven Robinson, director of cardiopulmonary care, Greenwood Leflore Hospital.

    Bring EEG to Neurology Offices and Clinics

    Zeto is commonly used in neurology offices due to its ease of use, with many customers noting shorter wait times for testing and improved patient experience. Dr. Randy Baculi from RHB Neuro shared his experience:

    “In the short term, we quickly cleared a backlog of 100+ patients, including new ones, within just a few weeks. In the long term, the system’s ease of use means we’re no longer limited by the availability of specific staff members, ensuring essential diagnostics are completed on time..”

    Full story: Case Study: Zeto’s Modern EEG at RHBNeuro | ZETO

    Why It Matters:

    Outpatient EEG procedures are often delayed due to complex setups and staffing shortages. Zeto simplifies the process, making it feasible to conduct more EEGs in less time and on an outpatient basis.

    Key Benefits:

    • Gel-free headset for increased patient comfort.
    • Quick setup reduces appointment durations and increases throughput.
    • Can be operated by medical assistants, freeing neurologists for more critical tasks.

    Watch how RHB uses Zeto at its clinic:

    Bring EEG to Pediatric Neurology

    Children often find traditional EEGs in healthcare settings uncomfortable due to gel applications and restrictive equipment. Zeto’s design prioritizes comfort, making EEG sessions more child-friendly. Pediatric neurologists who implemented Zeto report that the setup is fast and easy.

    Key Benefits:

    • Gel-free electrodes eliminate the need for hair alterations.
    • Reliable data capture, even for active or restless children.
    • Faster setup reduces waiting times and anxiety.

    Read our interview with Dr. Christina M. Patterson, Director of Epilepsy and EEG Services at UPMC Children’s Hospital of Pittsburgh, on how her team incorporates Zeto into pediatric EEG care.

    Bring EEG to Ambulances

    There is currently no effective way to assess brain injuries or perform brain monitoring in an ambulatory environment. However, early diagnosis during transport can significantly improve patient outcomes. Zeto’s latest EEG system, ONE, enables emergency responders to begin neurological assessments to the ambulance or helicopter, on the way to the hospital.

    Key Benefits:

    • Portable EEG system can be used inside ambulances.
    • Provides high-quality data capture during transport.
    • Enables pre-hospital interventions that can save lives.

    FDA Cleared: ONE is FDA-cleared for use in both air and ground transport, setting a new standard for mobile neurological care.

    EEG in Concert Halls: The Music-in-Medicine Initiative at MD Anderson

    Zeto EEG has been used to study the neurological effects of music therapy on patient recovery and well-being. We see this study with the pioneering work of Dr. Mei Rui, Director of Music-in-Medicine at MD Anderson Cancer Center, who used Zeto EEG to explore how classical music influences brain recovery. She believed that by capturing brain waves and their activity during performances, clinicians can unlock new therapeutic pathways for a range of neurological conditions.

    Research has shown that music can significantly impact brain activity via neuroplasticity and emotional regulation. By bringing EEG into live music therapy sessions, researchers can better understand these neurological responses in real time.

    Why MD Anderson Chose Zeto’s EEG:

    • Portable, gel-free design makes for ease of use and wearing for unconventional settings like music halls.
    • Non-invasive, quick setup that doesn’t interfere with the therapy session and can be easily set up by any healthcare provider.
    • Real-time data collection on brain activity for more impactful research outcomes.

    Bring EEG to Research Labs – University of Rochester Medical Center

    EEG systems are employed in research to study neurological activity and electrical patterns in experimental settings. Dr. Ram Haddas, a  director of UR Medicine Motion Labs at the University of Rochester, shared how Zeto’s EEG enabled them to conduct more seamless studies on brainwave activity without subjecting participants to traditional EEG discomfort.

    Dr Ram Haddas

    Why It Matters:

    Research labs require reliable data without cumbersome setups. Zeto enables researchers to focus on their experiments rather than technical issues.

    Key Benefits:

    • High-quality, reliable data collection to support robust research.
    • Portable and easy-to-use system with no need for gel or extensive preparation.
    • Compatible with all hair types, ensuring inclusivity in participant recruitment.

    Click here to see Dr. Ram Haddas in action.

    Bring EEG to Neurofeedback Clinics

    Neurofeedback sessions often require multiple visits. A quick, comfortable EEG setup ensures patients can seamlessly fit sessions into their schedules.

    Key Benefits:

    • Gel-free, quick setup minimizes patient discomfort.
    • Portable design enables for frequent, non-disruptive sessions.
    • Perfect for lunch-break appointments.

    Bring EEG to Senior Living Communities

    Early detection of cognitive decline can improve quality of life for seniors. However, EEG tests can be uncomfortable for older adults. Zeto’s gentle design addresses this challenge.

    Zeto EEG Headset B9994282

    Key Benefits:

    • Soft-tipped electrodes are gentle on hair and scalp.
    • Quick setup without gel or skin abrasion reduces stress and discomfort for patients.
    • Enables routine cognitive assessments without disrupting daily routines.

    Bring EEG to Contract Research Organizations (CROs)

    Clinical trials require consistent, reliable data across various sites and patient populations. Zeto provides an efficient solution for brain monitoring in research.

    Key Benefits:

    • Reliable, high-quality data collection.
    • Simplified workflows for research teams.
    • Compatible with diverse hair types and patient profiles.

    Bring EEG to Sports Arenas – Monitoring Athletes’ Brain Health

    Real-time brain monitoring can help protect athletes from long-term neurological damage by providing immediate insights during games.

    Key Benefits:

    • Portable systems for on-site brain health assessments.
    • Real-time data collection supports safer sports practices.
    • Reduces the risk of undiagnosed concussions.

    Breaking Boundaries in Brain Monitoring

    Zeto is making EEG more accessible than ever – bridging the gap between advanced technology and everyday care settings. Our innovation and commitment to accessibility empower practitioners and researchers to break new ground in brain health.

    Take the Next Step: Explore how Zeto can transform your approach to brain monitoring or collaborate with us to pioneer new applications.

    Whether it’s in hospitals, research labs, or unexpected places like music halls, Zeto’s EEG technology is reshaping the future of brain health and neuroscience.

    Interested in learning more about this topic?

    Stay tuned for upcoming articles. If you haven’t already, subscribe to our newsletter or follow us on LinkedIn. Interested in a demo? Click here to schedule yours now.

    Simplifying Routine EEGs: Zeto Improves Care for Neurology Practices

    Routine EEGs are one of the cornerstones of neurological care[1], yet traditional EEG systems often create unnecessary hurdles. It enables non-emergency diagnosis, extended follow-up of many types of neurological conditions, and the performance of non-emergent EEGs.

    For practices with limited resources there can be significant scheduling constraints (and no possibility of scheduling many consecutive patients) to messy gels, sticky pastes, and time-consuming set-up processes, the old way of doing things isn’t just inefficient—it’s inconvenient for patients, eeg technicians and medical providers.

    Enter Zeto WR19 EEG headset: a wireless, no-gel EEG solution that’s reshaping how neurologists approach routine testing.

    Here’s how Zeto transforms the routine EEG experience and contributes to improving outcomes for doctors, patients, and practices:

    1. EEG Solutions When Techs Aren’t Available

    EEG Technicians are considered the gold standard for EEG performance, but they’re not always available. Zeto offers flexibility to EEG workflows, enabling medical assistants (MAs) to perform tests when needed. This can help practices reduce reliance on strict scheduling, making it easier to conduct EEGs without waiting for technician availability.

    Benefits of Zeto for Routine EEG include:

    • Reduced scheduling complexity: Patients can have their EEG performed during regular office visits without the need to schedule several weeks out. Due to the ease of set-up and lack of cleanup needed, an office can schedule consecutive EEGs, maximizing their resources.
    • Enhanced flexibility: EEGs can be offered on-demand, streamlining workflow and reducing delays in diagnosis.
    • Improved patient compliance: By eliminating scheduling barriers and increasing patient comfort during the recording, patients are more likely to follow through with testing.

    “I love it because our MAs (medical assistants), who were trained by the Zeto team, can set up and run the EEG studies. If they ever have issues, I step in to troubleshoot, but this is really rare. We have been able to work more efficiently with the limited resources we have, which is important because I am in a multispecialty private practice group.” – Dr. Komal Rastogi, Granger Medical Clinic.

    2. Five-Minute Setup and Ease of Use

    Zeto’s wireless, rapid EEG system is designed for efficiency in routine EEG use. The headset enables quick and easy setup in about 5 minutes, meaning less time preparing for the test and more time focusing on the patient. The no-gel electrodes eliminate the hassle of cleanup, and removal is just as simple, taking only one minute.

    Why Ease of EEG Setup Matters:

    • Faster setup means less time preparing for the test and more time focusing on patient care.
    • The streamlined process enables practices to serve more patients in a day, improving patient care and speeding up clinical diagnosis.
    • Faster testing means patients spend less time in the office, which they appreciate.

    “The setup for routine EEG has decreased to 5-10 minutes from previous durations of 30 minutes to 1 hour. Quality of both EEG and video is very impressive.” – Dr. Raj Gupta, San Jose Pacific Neurology Center PC.

    3. No Gel, No Mess, More Patient Comfort

    Gone are the days of sticky gels and lengthy cleanup times. Zeto’s no-gel system[2] makes EEGs more comfortable for patients and easier for staff.

    Patient benefits include:

    • Comfort: Without messy gels, patients don’t have to deal with the discomfort and inconvenience of washing their hair after the test.
    • Convenience: Patients can resume their day – whether going back to work, school, or home – immediately after the procedure.

    This improved patient experience increases compliance with testing, making it easier for neurologists to provide timely care.

    “Patients find the experience quicker and more streamlined, resulting in shorter visits compared to traditional setups. Overall, they respond positively to the technology. I have personally worn the Zeto headset for extended periods and can attest to its comfort.” – Dr. Christina M. Patterson, UPMC

    4. Remote Access for Results, Anytime, Anywhere

    Zeto’s cloud-based platform enables neurologists to access EEG results remotely[3], providing flexibility. This makes it possible for tests to be performed in one location while neurologists review the results if needed in real time from another, facilitating faster diagnoses and streamlined workflows.

    Benefits for neurologists:

    • Efficient workflows: No need to be physically present to review results and make a diagnosis.
    • Faster diagnoses: Immediate access to EEG studies speeds up the diagnostic process.

    “I’ve been remotely reading EEGs done by the Zeto EEG headset for one of my local colleagues through Zeto’s EEG cloud platform since the beginning of 2022. How it works: EEGs are done in the clinic here in San Diego by trained staff. The EEG is streamed and saved in real-time to the Zeto cloud and I receive a notification when the recording is finished. At that point, I go online, read the EEG study, and prepare the report. Overall, the process is easy, fast, and straightforward.” – Dr. Boris Khamishon, Neurology San Diego

    5. Transforming Neurology Workflows

    By integrating Zeto into their practices, neurologists have found their workflows become more efficient, patient-friendly, and seamless. The ability to offer on-demand EEGs keeps things running smoothly and increases the speed of care.

    Key impacts include:

    • Increased patient compliance: Patients are more likely to follow through with testing when it’s convenient and hassle-free.
    • Streamlined care: On-demand EEGs eliminate bottlenecks, enabling for faster diagnoses and improved outcomes.
    • Improved patient care: Timely EEG testing ensures patients receive the diagnostics they need without unnecessary delays, enhancing treatment planning and overall care quality.

    “In the short term, we were able to quickly address a backlog of 100+ patients (and incoming new ones) within just a few weeks. In the long term, with how easy the system is to use, we are not bottlenecked to only certain staff members and their availability to utilize the device and ensure essential diagnostics were getting completed in a timely manner.” – Dr. Randi Baculi, RHBNeuro

    6. Perfect for Solo Neurologists: Ease of Use That Saves Time and Costs

    For solo neurologists, Zeto’s intuitive design makes performing EEG studies seamless. The headset is easy to apply with minimal artifacts[4], enabling practitioners to focus on patient care without the need for additional staff or complicated scheduling.

    Benefits include:

    • Increased efficiency: Solo practitioners can perform EEGs independently without needing to rely on additional staff, and use the time between studies for administrative tasks or patient care.
    • Flexibility: Ideal for part-time neurologists or those performing a limited number of studies per week.
    • Accessible support: Zeto offers easy access to technical assistance for troubleshooting when needed.

    “I’m my own technician. I work part-time and perform 2 to 4 EEG studies a week, or about 12-15 studies a month. Technical assistance is easy when I have questions. It’s easy to use and maneuver. I usually read the results immediately after seeing patients and share the results in near real-time.” Dr. Virginia Thornley, Elite Neurology

    7. Cloud-Based Software: Seamless and Up-to-Date Technology

    Zeto’s cloud platform ensures that its software is always up-to-date, requiring minimal IT expertise or budget.

    Benefits include:

    • User-friendly interface: The intuitive design makes reading EEGs straightforward and accessible.
    • Cross-device compatibility: Works effortlessly across laptops, phones, tablets, and desktop computers.
    • Streamlined accessibility: The cloud system provides reliable access, eliminating the need for complex setups or maintenance.

    “The cloud interface is truly wonderful – user-friendly, easy to access, and visually appealing. I’ve used it on various devices, and it has consistently provided a seamless and headache-free experience.” Dr. Christina M. Patterson, UPMC

    Zeto’s cloud-based platform meets stringent data security standards, such as HIPAA compliance, ensuring patient data is safe, accessible, and protected.

    8. Report Writer: Designed with Neurologists in Mind

    Zeto’s report writer features customizable templates that meet the specific needs of neurologists, enabling easy adjustments.

    Benefits include:

    • Time-saving templates: Streamlined templates reduce the time spent on documentation.
    • Accessibility: Reports can be reviewed and adjusted from any device with internet access using the same login credentials.
    • Flexibility: Neurologists can adapt templates to align with individual practice preferences or patient needs.

    “The biggest advantage is the Zeto report writer. The template features for the report are designed perfectly for a neurologist’s needs, and it’s very easy to make adjustments. The program is also easy to maneuver, and you can read the EEGs from any computer or device with a stable internet connection using the same login credentials.” – Dr. Boris Khamishon, Neurology San Diego

    9. Accommodates All Hair Types

    Zeto’s innovative electrode design eliminates barriers for patients with thick, curly, or styled hair, such as braids or dreadlocks.

    Benefits include:

    • Patient comfort: No need for patients to alter or remove hairstyles, reducing stress and preserving dignity.
    • Cultural inclusivity: Accommodates protective hairstyles often tied to culture and identity.
    • Unique electrodes: Zeto’s patented electrodes can move past braids, cornrows, twists, or dreadlocks up to 1 inch thick and even work with thicker hair bundles.

    We’ve written an entire blog on this topic: Textured Hair EEGs: Accessibility for All Hair Types 

    10. Signal Quality on Par with Traditional EEG Systems

    Zeto is committed to delivering high-quality EEG brain monitoring results. With full-montage 10-20 electrode placement and advanced technologies such as Active Electrode Technology (AET) and Dynamic Noise Cancellation (DNC), Zeto provides data that is non-inferior to traditional EEG systems.

    Benefits include:

    • Reliable results: Signal quality is the same as traditional EEG systems but the setup is easier and faster and no gel is included.
    • Evidence-backed performance: Clinical studies across 50 subjects demonstrated parity between Zeto EEG (zEEG) and clinical EEG (cEEG) systems.

    “I like the idea of quick setup using soft gel electrodes like Zeto. It’s an easy & efficient way to do quality routine video EEGs”. Dr. Jaivir S. Rathore, Falcon Advanced Neurology Center.

    For a deeper dive into Zeto’s signal quality, read our article, “Comparison of Dry Electrode EEG System with Conventional EEG System,” or review the abstract, “Technical Validation of the Zeto Wireless, Dry Electrode EEG System,” presented at the American Epilepsy Society.  

    Zeto’s signal quality meets the performance and technical standards outlined in EEG Guidelines provided by American Clinical Neurophysiology Society (ACNS).

    The Future of Routine EEGs is Here

    Zeto’s WR19 EEG system is more than a technological upgrade — it’s a practical solution that addresses the inefficiencies of traditional EEG workflows. By making EEGs faster, more comfortable, and more accessible, Zeto is helping neurologists provide better care for their patients.

    Take advantage of Zeto’s end-of-year offer for neurology practices: upgrade your routine EEG workflow with our wireless, no-gel EEG system by the end of the year and enjoy the . Don’t miss this limited-time opportunity to revolutionize patient care and streamline your practice — offer ends December 20th, 2024!

    References:

    1. Worrell, G. A., Lagerlund, T. D., & Buchhalter, J. R. (2002). Role and Limitations of Routine and Ambulatory Scalp Electroencephalography in Diagnosing and Managing Seizures. Symposium on Seizures, 77(9), 991–998.
    2. Sensors (Basel). (2014, July 18). Dry EEG Electrodes – PMC, 14(7), 12847–12870. doi: 10.3390/s140712847
    3. Reider-Demer, M., & Shah, V. (2019, October). Telemedicine & Epilepsy: Your Smartphone Is Not Just for Communication – It Can Be Your Medical Care on the Go! Practical Neurology.
    4. Lopez-Gordo, M. A., Sanchez-Morillo, D., & Pelayo Valle, F. (n.d.). Common Artifacts During EEG Recording. In Electroencephalography (EEG): An Introductory Text and Atlas of Normal and Abnormal Findings in Adults, Children, and Infants. NCBI Bookshelf.

    Interested in learning more about this topic?

    Stay tuned for upcoming articles. If you haven’t already, subscribe to our newsletter or follow us on LinkedIn. Interested in a demo? Click here to schedule yours now.

    Textured Hair EEGs: Accessibility for All Hair Types

    Getting an EEG shouldn’t be a hassle – no matter your hairstyle. For most patients, an EEG test typically requires no special preparation. However, for individuals with curly hair, textured hair or specific hairstyles, such as braids, dreadlocks, cornrows, twists, hair extensions or coily/kinky curly hair, the setup process can be more challenging than it needs to be. Thanks to innovative technology by Zeto, there’s a solution that makes textured hair EEG accessible and efficient for everyone.

    Understanding Hair Types

    Before addressing the challenges and solutions, it’s important to understand that hair types vary widely based on texture and curl patterns. The commonly recognized Andre Walker Hair Typing System classifies hair into four main types:

    Andre Walker Hair Typing System

    Type 3 and Type 4 hair, in particular, tend to be thicker, curlier, or kinkier, which can present unique challenges for textured hair EEG setups. Additionally, protective hairstyles such as braids, cornrows, and dreadlocks further complicate traditional EEG setups. For many patients, even getting a test can be difficult or uncomfortable, creating unnecessary barriers to essential healthcare.

    EEG and Hair Diversity: The Urgent Need for Inclusive Solutions

    For decades, EEG technology has not been inclusive of everyone. Traditional EEG electrodes are designed to sit flat on the scalp, which is especially challenging for people with thick, curly hair or dreadlocks. The process can become even more difficult, requiring technologists to ask patients to alter or remove their hairstyle to achieve quality EEG data.

    Imagine being told that you need to take down intricate braids or cut your dreadlocks – hairstyles often deeply tied to culture, identity, and personal expression – just to undergo an EEG. What may seem like a minor inconvenience to some can become a major obstacle to others, delaying critical diagnostic tests and adding stress to an already daunting medical experience.

    This issue has disproportionately impacted patients whose natural hair types and protective hairstyles are often incompatible with the rigid requirements of traditional EEG technology. As a result, many patients have encountered frustrating barriers to accessing the care they need.

    Zeto Offers Textured Hair EEG: EEGs That Work for All Hair Types

    The good news is that Zeto EEG technology is removing these barriers. Zeto’s wireless textured hair EEG headsets are designed to accommodate all hair types, from straight and wavy to curly and coily, including protective styles like dreadlocks, cornrows, and braids.

    Unlike traditional EEG systems, Zeto headsets do not require the use of abrasive pastes or applications of messy electrolytes to obtain accurate readings. Instead, it sits comfortably on the head, regardless of hair volume, texture, or style. This ensures that patients with textured hair or complex hairstyles no longer need to worry about altering their hair for the test.

    With Zeto, EEGs are no longer a stressful ordeal but a straightforward, accessible solution for all patients.

    The photos  illustrate the flexibility of dry electrodes used in the Zeto EEG system. Any of the three bristles touching the skin would provide sufficient skin-to-electrode contact for stable signal recording.

    Zeto’s Unique Electrodes

    Zeto’s textured hair EEG electrodes are designed to work with a wide variety of hair types and densities. Flat electrodes are ideal for areas without hair, such as the forehead. Taller electrodes with legs are designed to navigate through thicker hair, allowing for easy placement on the scalp, even with complex hairstyles.

    Zeto’s patented electrode tips seamlessly move through hair and braids without leaving behind any sticky residue. The electrodes are capable of moving past braids, cornrows, twists, or dreadlocks up to 1 inch thick, and can even work with thicker hair bundles, depending on the style.

    Zeto offers EEG solution for protective hairstyles

    Convenient for EEG Technologists

    Zeto makes life easier for EEG technicians by eliminating time-consuming skin preparation and messy gels. The setup is quick and efficient, even for patients with type 4 kinky/coily hair, taking just 5-10 minutes at most. Zeto’s headsets come with handy light-based signal quality indicators  built into each electrode that lets users know when the electrodes have a good connection (green light) or if they need a little adjustment (Red, orange, or yellow ). The adjustment is made by rotating and repositioning the electrode, to make sure they’re properly touching the scalp.

    Comfortable for Patients

    Zeto provides a significantly better EEG experience for patients. The setup is faster and more comfortable, with no sticky gels or adhesives to wash out afterward. There’s no need for special preparation or skin abrasion, which minimizes the risk of irritation or discomfort. Additionally, Zeto’s electrodes are single-use, eliminating the risk of cross-contamination. Patients enjoy a hassle-free experience with precise and reliable results, all without being asked to change or remove their hairstyle.

    Many patients have shared that after their Zeto EEG test, they could go about their day as planned, without the need to wash or restyle their hair.

    Remaining Limitations

    While Zeto’s EEG technology works with most hairstyles, blocking the electrode tips from contacting the scalp may still prevent accurate recordings. However, weaves or sew-ins that allow scalp contact are generally not an issue for Zeto’s electrodes.

    EEGs should be accessible to everyone, regardless of hairstyle. Zeto is proud to offer a solution that makes brain monitoring more inclusive, comfortable, and efficient. By offering innovative EEG headsets with unique electrodes, Zeto ensures that no patient is left behind due to their hair type or style.

    From WR19 to Zeto ONE: Inclusivity and Reliability Across 100,000 Studies

    Zeto has two innovative EEG headsets: the WR19 for EEG studies up to 6 hours and the Zeto ONE for continuous  monitoring for 24+ hours. Both headsets use the same electrode technology and work seamlessly with textured hairstyles, ensuring reliable and high-quality EEG recordings.

    Zeto EEG headsets, WR19 and Zeto ONE, offer EEG solutions for all hair types.


    Zeto’s commitment to accommodating various hair types and styles began with the clearance of our first-generation WR19 device in 2018. From the outset, the WR19 was capable of recording EEGs on patients with diverse hairstyles and hair types without requiring additional effort or compromising signal quality. This dedication to inclusivity and performance was carried forward into the design of our next-generation device, the Zeto ONE EEG system, launched in 2024. 

    Out of the 90,000 EEGs conducted using Zeto’s EEG system across over 200 healthcare facilities in the U.S., there has not been a single complaint or failure related to hair type.

    Preserve the Style, Skip the Paste

    To find out more about Zeto’s patient-friendly EEG technology and how it can work for you, explore our website or schedule a consultation with our team. Zeto is committed to making brain monitoring accessible for everyone, no matter your hair type or style.

    We explored the compatibility of Zeto EEG with different hair types, including braids, cornrows, and kinky/coily hair, in a recent webinar. During the webinar, we also conducted live demos with various hairstyles to demonstrate how well Zeto EEG works. Be sure to check it out! 

    Interested in learning more about this topic?

    Stay tuned for upcoming articles. If you haven’t already, subscribe to our newsletter or follow us on LinkedIn.

    Zeto Offers Reliable FDA Cleared Seizure Detection Software

    Advancements in seizure detection technology provide essential tools for precise diagnosis and management of neurological conditions. Zeto integrated a full suite of FDA cleared EEG Trending, Seizure, and Spike Detection tools from encevis into the Zeto cloud platform for quick and seamless assessment of full montage EEG signals in the ICU, inpatient and outpatient environment providing more capability vs. competitors.

    Zeto’s cutting-edge EEG solutions are designed to enhance patient care and streamline clinical processes. Encevis is powered by the AIT Austrian Institute of Technology, a renowned research and technology organization in Europe, and their EEG analysis software is widely utilized and peer reviewed by physicians across the world.

    Zeto Offers:

    Zeto EEG Setup Time< 5 minutes after only 2 hours training
    Full Montage EEG19 channels, non-inferior to traditional EEG[3]
    Time to Seizure Detection < 2-3 minutes
    Seizure Detection [4]High sensitivity at low false alarm rates. Proven by three independent clinical trials to get a reliable system that will provide a detailed overview of seizures and suspicious EEG activity. [2, 4]
    Spike Detection [5]Detects spikes and sharp waves with a very high sensitivity combined with a high specificity. Sensitivity of 89% was measured together with a specificity of 70%.[1, 5]
    EEG Trending [4,5,6]Graphically visualizes the results of several hours of EEG to allow a quick assessment of the state of the patient. The software works in near real time and allows reading of trends in the functional state of the patient’s brain in one glimpse.[1]
    Amplitude-Integrated EEG  [6]General amplitude and symme­try can be read easily in the quantitative EEG panels and in the amplitude-integrated EEG. This al­lows a quick assessment of the state and trend of the patient
    Burst Suppression [6]Burst suppression events and the relative amplitude attenuation including suppression time of the bursts.
    Artifact Reduction: PureEEG [1,2]PureEEG removes artifacts automatically. It removes artifacts such as electrode movements, muscle contractions, line noise and head movements, etc. 
    Notification FeaturesOne-time setup enables notification templates (email or text) to be shared automatically with a select group of stakeholders (physicians, nurses, techs) when programmable seizure thresholds are exceeded. This is not a seizure alarm but a notification infrastructure that informs decision makers about the results of the Encevis seizure detection tool.

    Seizure Detection Technologies and Their Impact

    EEG trending plays a pivotal role in patient assessment, allowing clinicians to view near real-time data and react swiftly to patient needs. Innovations such as amplitude-integrated EEG and burst suppression analysis provide deeper insights, while PureEEG technology effectively reduces artifacts, ensuring cleaner and more accurate readings.

    Integrated EEG Trending, including Burst Suppression, Seizure Detection and Load:

    Zoom-In of the EEG Trending Panel:

    Enhancing Clinical Efficiency

    The integration of seizure detection features streamlines clinical workflows and enhances communication among healthcare professionals. This is achieved through effective notifications  that alert clinical staff about critical patient developments, improving decision-making and patient care.

    Seizure Detection vs Seizure Burden

    Seizure detection and seizure burden are two critical but distinct concepts in epilepsy management. Seizure detection focuses on the immediate identification and recognition of individual seizure events using technologies such as EEG monitoring systems, which can pinpoint abnormal brain activity in near real-time. This allows for timely intervention and management during an episode. On the other hand, seizure burden refers to the cumulative impact of seizures over time, encompassing the frequency, duration, and severity of the episodes. While seizure detection aims to identify seizures as they happen, seizure burden assesses the broader, ongoing effects of the condition. 

    Zeto offers an FDA-cleared seizure detection tool compared to competitors that only perform seizure burden.

    AI-enabled Notifications for Seizure

    AI-enabled notifications provide near real-time notifications enhancing timely intervention and patient management. It works by continuously analyzing EEG data in near real-time using advanced algorithms, instantly notifying healthcare providers when abnormal brain activity indicative of a seizure is detected.

    FeatureBenefit to Clinicians
    Rapid EEG SetupMinimizes patient discomfort and maximizes clinical efficiency
    Full Montage EEGProvides comprehensive brain activity analysis
    High Sensitivity with Low False PositivesEnhances diagnostic accuracy
    Amplitude-Integrated EEGSimplifies interpretation of EEG data
    Burst Suppression AnalysisCrucial for assessing severe neurological conditions
    Artifact Reduction with PureEEGEnsures clarity and accuracy of EEG readings

    Zeto’s advancements in EEG technology mark a significant milestone in neurological care, promising improved patient outcomes and operational efficiencies. The future of EEG monitoring looks bright, with ongoing innovations poised to further revolutionize the field.

    To learn more about Zeto’s wireless, dry-electrode, full-montage EEG headset with remote monitoring and seizure detection, please contact us to schedule a chat and a demo.

    References:

    [1] PureEEG: Automatic EEG artifact removal for epilepsy monitoring, Hartmann, M.M., Schindler, K., Gebbink, T.A., Gritsch, G., Kluge, T., Neurophysiologie clinique/Clinical Neurophysiology, November 2014

    [2] https://www.accessdata.fda.gov/cdrh_docs/pdf17/K171720.pdf

    [3] https://www.accessdata.fda.gov/cdrh_docs/pdf17/K172735.pdf

    [4] Seizure detection

    [5] Spike detection

    [6] EEG monitoring in the intensive care

    EEG in the ICU: Brain Monitoring in Critical Care Settings and Emergency Departments

    EEG in the ICU offers unparalleled insight into the neurological status of patients. Facilitating ease of use is a cornerstone of making sure this vital marker is not overlooked.

    In the fast-paced world of healthcare, where every moment can be crucial, monitoring a patient’s neurological status is often overlooked in emergency situations. However, research findings suggest that integrating EEG (electroencephalogram) monitoring into critical healthcare settings can have profound benefits, especially for patients requiring prompt neurological evaluation

    EEG in the ICU

    In Intensive Care Units (ICUs), where vigilant monitoring of patient health is crucial, traditional focus areas like heart rate, blood pressure, and oxygen levels are routinely scrutinized. EEG monitoring in the ICU is often used for continuous, long-term monitoring of brain activity in critically ill patients. It’s particularly crucial for detecting non-convulsive seizures, assessing the depth of coma, and monitoring for changes in brain function in patients with severe brain injuries, stroke, or those at risk of neurological deterioration. The second biggest neurological emergency after stroke is Status Epilepticus, defined as “A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minute period, without returning to a normal level of consciousness between episodes is called status epilepticus. This is a medical emergency that may lead to permanent brain damage or death.” For more info see here. 

    Unfortunately, the monitoring of brain activity doesn’t receive the same level of attention. This is despite various critical care and neurophysiology societies providing guidelines for EEG indications in the ICU. This oversight can be critical, especially since conditions like non-convulsive seizures can go unnoticed without proper EEG monitoring. Research indicates that timely access to EEG monitoring is vital for effective patient management, and any delays can have significant impacts, not just on patient outcomes but also on hospital operational efficiencies.

    Challenges in the ICU

    The Neurocritical Care Society guidelines advise that patients suspected of having Nonconvulsive Status Epilepticus in ICU should get an EEG test within 15 to 60 minutes.

    The primary challenge in intensive care unit is the lack of specialized EEG or neurology staff, which can lead to delays in detecting and treating critical neurological conditions.

    The complexity of traditional EEG equipment also poses a challenge, as it requires time and expertise to set up and interpret. This can be problematic in the ICU, where rapid response and treatment are often necessary. Non-convulsive seizures, for instance, are common in critically ill patients but can be difficult to detect without proper EEG monitoring. Studies suggest that delays in EEG access can extend hospital stays, emphasizing the need for more accessible EEG solutions.

    A pressing challenge is accurately assessing brain activity, especially in post-cardiac arrest patients. While vital signs like heart rate and blood pressure are meticulously monitored, determining the status of the brain remains a complex task. In the case of patients who have experienced cardiac arrest, assessing neurological function without EEG is nearly impossible. These patients may exhibit varying degrees of consciousness to comatose, making it difficult to discern subtle neurological changes. Traditional methods often fall short in providing a comprehensive understanding of brain activity, highlighting the critical need for accessible and efficient EEG monitoring solutions like that of Zeto EEG.

    Additionally, a key factor with EEGs in the ICU is timing. Even large academic hospitals offering 24/7 coverage of conventional EEG have reported a median delay of four hours to initiate EEG monitoring. Additionally, the process of applying EEG leads on a patient’s head using a traditional EEG system further contributes to these time delays, impacting the speed at which critical monitoring can begin.

    Another major barrier to effectively leveraging EEG in the ICU is the lack of bedside diagnostic capabilities. Live, remote interpretation by a physician is simply a must, to ensure that an expert is on hand to diagnose and treat in a timely manner. Live video and continuous monitoring by remote techs would provide the highest quality of care in these situations. 

    Solving the Problem of EEG in the ICU, With Zeto

    Zeto’s EEG system is designed to meet the unique demands of the ICU. Zeto’s EEG headset is full-montage with single-use electrodes. Additionally, it is wireless and portable, eliminating the need to wait for a cart to be brought into the ICU. It offers a rapid setup and user-friendly interface, making it accessible to healthcare professionals who may not have specialized training in neurology. This ease of use is a significant advantage in the ICU, where time and accessibility are crucial. The system’s design allows for quick application and immediate monitoring, facilitating faster response times in critical situations.

    With Zeto EEG, bedside diagnostics becomes possible, with remote, continuous real-time monitoring by EEG techs and interpretation services from neurologists available, Zeto EEG facilitates high quality care. 

    The Zeto EEG system also addresses the challenge of interference from other medical devices in the ICU with its state-of-the-art active electrode technology, noise shielding and noise cancellation technology.  

    Benefits and Features of Zeto EEG in the ICU

    Zeto’s EEG system offers several key features that make it particularly suited for the ICU environment:

    • Bedside Diagnostics with Accurate Seizure Detection: Timely detection of non-convulsive seizures is crucial for patient care. Zeto’s system integrates FDA-cleared seizure detection with notifications, ensuring that these critical events are not missed. Learn more about seizure detection tool here.
    • Live video through the cloud: Zeto is compatible with any integrated or USB-enabled camera. The cloud’s live/remote capabilities allow for real-time observation of patients during suspected seizures. 
    • The portability and ease of setup of the Zeto system mean it can be quickly deployed and used across different patients, adapting to the dynamic and fluid nature of the ICU. 
    • Special response service for Stat EEG (Status Epilepticus): If you do not have neurologists available to interpret your EEGs, you can easily order this service through our cloud platform. 
    • Remote monitoring by EEG techs
    • Remote monitoring by board certified neurologists

    EEG in the ED

    In Emergency Departments (EDs), EEG is typically used for acute diagnostics rather than long-term monitoring. It may be employed to differentiate between epileptic seizures and other conditions (like syncope, psychogenic nonepileptic seizures, or coma) or to confirm status epilepticus when a seizure is not visible.

    While ED staff excel at providing immediate care for life-threatening conditions, brain activity monitoring is not always a routine part of the process. However, research findings suggest that

    integrating EEG monitoring into the ED’s toolkit can have far-reaching benefits,

    especially for patients with conditions requiring prompt neurological evaluation. 

    Challenges with EEG in the ED

    One of the primary challenges in the ED is the limited time available for comprehensive assessments. Research shows that this constraint can lead to missed opportunities for detecting critical neurological conditions, such as non-convulsive seizures or non-convulsive status epilepticus. Patients in the ED may not exhibit obvious seizure symptoms, even after injuries that would seem to typically present them, such as traumatic brain injury, making EEG monitoring even more essential for timely diagnosis.

    Furthermore, EDs typically lack specialized neurology staff, and the complexity of traditional EEG equipment can hinder its utility in this fast-paced environment. The need for quick setup and interpretation is evident, given that delays in EEG access can impact patient outcomes. Numerous research findings emphasize the critical role of EEG monitoring in emergency department (ED) settings, highlighting the potential risks associated with overlooking neurological conditions.

    Zeto’s Solution for the ED

    Zeto’s EEG system is tailored to address the unique challenges of the ED. It offers a streamlined setup process that can be quickly implemented by ED staff, who may not have specialized neurology training. This ease of use is vital in an environment where every minute counts, and rapid response can be a matter of life and death.

    The Zeto EEG system also features advanced seizure detection capabilities, aligning with the need for timely diagnosis in the ED. Seizures will be automatically detected and marked in the EEG for review. Near real-time detection notifies medical staff about patients with ongoing clinical seizures. This capability is particularly valuable in the ED, where rapid neurological assessments are essential.

    Benefits and Features of Zeto in the ED

    Zeto’s EEG system offers several key features that make it a valuable tool in the ED:

    • Quick Setup: In the high-pressure environment of the ED, simplicity is paramount. Zeto’s full-montage headset is designed for quick deployment without any preparation needed, enabling ED staff to initiate EEG monitoring rapidly (the average time is 5 minutes). 
    • Ease of Use: If EEG techs are not available, any ED nurse or medical assistant can be trained to do EEG with Zeto. Wireless and portable, Zeto headset enables straightforward setup at a patient’s bedside, facilitating immediate EEG monitoring using a laptop.
    • Video EEG via cloud: Zeto is compatible with any integrated or USB-enabled camera and the cloud’s live/remote capabilities allow for real-time observation of patients during suspected seizures.  
    • Single-use disposable electrodes: Zeto’s electrodes are dry and soft, and designed for convenience and patient comfort, requiring no paste, gel, or cleanup. 
    • Fast turnaround time: Zeto’s EEG system facilitates a swift turnaround time, allowing for instant EEG monitoring and rapid decision-making, essential for prompt diagnosis and treatment in emergency scenarios.
    • Remote EEG Reading: Zeto offers a Remote EEG Reading Service accessible through the Zeto Cloud Platform. A team of remote, certified, and specially trained adult and pediatric epileptologists provides real-time or retrospective EEG interpretation across all 50 states, the District of Columbia, and Puerto Rico.
    • Remote EEG monitoring: Zeto provides real-time remote video EEG monitoring by registered EEG technologists (R.EEG.T) when such personnel are unavailable on-site. This service is available in real time upon request with a 30-minute notice 24/7/365, at no extra charge during nights, weekends, or holidays.
    • These features collectively enhance the ED’s ability to provide comprehensive care, including neurological assessments, to patients who may present with complex medical conditions. The Zeto EEG system’s adaptability and efficiency align with the dynamic nature of the ED, where quick assessments and decision-making are critical.

    Contact us to learn more and to schedule a demo or consultation. You’ll discover how our technology can advance your hospital’s neurodiagnostic capabilities. Join us in leading the change towards better, more efficient patient care.

    How Digital EEG Filters Impact EEG Signal Morphology

    Filters are commonly used during clinical assessment of EEG brainwaves. They are recommended in the ACNS guidelines¹ to reduce electrical noise and improve EEG data quality. The basics of filter theory are part of the training curriculum for physicians and EEG techs² alike, yet the impact of filters on interpreting data is not always apparent to everyone in the day to day clinical operations. This blog summarizes the issues, explains what filters exist, and what effects they can have on the morphology of the EEG waveforms. Selecting the right filter settings can help improve readability and reduce misinterpretations.

    Why We Filter and Why It’s Appropriate

    A considerable amount of raw data in EEGs are contaminated by noise and artifacts. This noise originates from various sources such as the environment, recording instruments, or from within the body that are not of interest to analyzing the EEG (i.e. “physiological noise”). The problem arises when these noise sources mask the target EEG signal or interfere with its assessment. Oftentimes, however, the artifact noise and target EEG signal occupy different spectral regions, and selectively filtering out specific frequencies may improve the overall signal-to-noise ratio (SNR).

    For example, a direct current (DC) or baseline offset of the amplifier system or slow fluctuations induced by sweat artifacts may be removed with a high-pass filter. Electrical power line noise in the recording environment can be attenuated by using a notch filter at 50 or 60 Hz. And, unwanted high-frequency components from muscle artifacts can be removed by “smoothing” the data with a low-pass filter. The advantages of filters are that they can help increase the SNR of target signals especially in situations in which the target EEG signals are in a limited band.

    Filters are applied selectively to exclude frequencies from further evaluation. Three main types of filters used to accomplish this for EEG are i) high-pass filters (also called low-cut-off filters), ii) low-pass filter (also called high-cut-off filters), or iii) band-reject filters (or also called notch filters) – See Figure 1. Most EEGs evaluated in clinical day to day operations have a combination of these filter types applied before a reviewer assess clinical characteristics for triaging or diagnosis.³

    Figure 1: A Low pass filter is a filter that passes low frequency components and blocks high frequency signals. A High pass filter is a filter that passes high frequency signals and blocks low frequency signals. Bandpass filter is a filter that passes a certain range of frequencies and blocks both lower and higher regions. A Band Reject filter is a filter that passes most of the frequency except a very narrow range of the frequencies.³

    Because of their useful properties, filters are found at all stages during the EEG recording and review process. EEG amplifiers often contain an analog low-pass filter ahead of the analog-to-digital (AD) converter to address aliasing artifacts that are otherwise introduced due to the discrete sampling rate. However, most filters in EEG processing are digital and take place after the AD conversion. That makes filters omnipresent when working with EEG data and their settings will affect the look and shape of the EEG tracings on a reader’s screen. More in-depth analysis of filter times and filter theory.⁴

    Wanted and Unwanted Effects of Filters on EEG Morphology 

    The way that many filters operate is to apply a weighted average of consecutive data points of the raw signal to obtain a smoothed, output (filtered) waveform. Depending on the type and width of this averaging window, specific frequency components disappear from the output waveform. The filtered signal may not show excluded frequencies anymore, but this was made possible after having created a causal relationship with the surrounding data segments. Figure 2 illustrates this principle.

    Every sample of the output depends on multiple samples of the input, as illustrated.

    Figure 2. Every sample of the output depends on multiple samples of the input, as illustrated in Figure 2 (top).  Conversely, each sample of the input impacts several samples of the output (Figure 2, bottom). As a result, the signal that is being filtered is smeared along the temporal axis, and temporal relations between filtered and original waveforms are blurred.

    Top: each sample of the output y is the sum of samples of the input x weighted by the impulse response h. For a causal filter, only past or present samples of the input make a contribution (black). For an acausal filter, future samples too can contribute (gray). Bottom: another way of describing this process is that each sample of the input x affects multiple samples of the output y, with a weight determined by the impulse response h.⁴

    Filters that lead to this kind of temporal smearing are called causal filters and are frequently used in EEG assessments. However, causal filters are known to create ripples in the EEG data that will show up as slow waves in the EEG data. These causal filters create a phase shift but have the advantage that they can be applied in real-time to ongoing EEG data streams.

    To avoid phase shifts and to get outputs much closer to the true biological signal, so-called forward/backward filters (or zero phase) filters are another option. Zero phase shift filters first run the filter in one direction and again in the other direction. As a result, any phase shift is mitigated and no temporal smearing occurs. However, the disadvantage of these zero-phase filters is that they can only be applied in real-time recordings with a significant delay because they have to wait for data to be recorded before they can run backwards.

    Figure 3 illustrates the output of a causal (blue) or zero phase filter (green) when applied to a test signal (black). The output of the causal filter (blue) creates a well visible phase shift and relevant filter ripple along with a long overshoot. In contrast, the zero phase shift filter keeps the integrity of the main signal peak intact and only creates minor symmetrical ripples around the peak.

    Temporal Response Function Estimated from Simulated Stimulus-Response Data

    Figure 3. Temporal Response Function Estimated from Simulated Stimulus-Response Data. Black: “true” TRF. Thick blue: TRF estimated using response data that has been filtered by a causal filter (Butterworth band pass 1–10 Hz, order 4+4). Green: same with acausal filter (MATLAB’s filtfilt).⁴

    Examples of Causal and Zero Phase Filters in EEG 

    The most noticeable difference between causal and zero phase shift filters on actual EEG data occurs for high pass filters in the delta range (<1.5Hz) because they can visibly alter the appearance of commonly occurring biological signal components of the EEG such as vertical or horizontal eye movements (i.e., blinks and saccades), sweat artifacts, and even specific epileptiform discharges (e.g. absence seizures). For an overview, see Figure 4.

    Effects of causal filters in higher frequencies (>50Hz) certainly exist as well but these are much less noticeable due to much faster oscillations that have smaller amplitude and are harder to pick out visually.

    Effects of causal filters in higher frequencies (>50Hz) certainly exist.

    Figure 4 – Here an example of two channels (FP1, FP2) filtered with a 1Hz causal filter (black tracings) or zero-phase filter (gray tracings) – causal filters introduce relevant slow wave filter ripples.

    Implementation of Causal and Zero Phase Filters on the Zeto Cloud Platform

    Most clinical EEG hardware or software manufacturers have filter master-settings that pre-determine the exact type and properties of the filters available in their products. That can result in situations in which the same biological signal may appear slightly differently depending on the manufacturer’s default digital filter settings. Zeto is improving the tradition by introducing features that enable users to easily switch between different filter types and settings to optimally control the use of filters while reviewing EEG data.

    As a result, users can configure their filter preferences to match their individual viewing and training history, resulting in filter outputs that match their expectations. Instead of retraining themselves on a new system’s filter settings, they can now adjust filter attributes and reduce the time to a confident read significantly.

    With Zeto, EEG data is saved in raw unfiltered (DC) formats that do not distort the original signal attributes. Subsequent digital filtering can then be used to match desired filter attributes. For example, Zeto can display data after running causal or zero phase shift filters and switch between these filter settings more easily, making it possible to compare which setting is preferred on the spot.

    Figure 5 illustrates this filter switch approach on different data samples. The tiles on the left are filtered using zero phase filters and tiles on the right show the same data using causal filters of the same cut-off frequency. Switching between these filters reveals signal ripples, most noticeable for the blinks but also in other signal components.

    1Hz Filter – left: zero phase; right: causal filters.

    With Zeto, EEG data is saved in raw unfiltered (DC) formats that do not distort the original signal attributes. Subsequent digital filtering can then be used to match desired filter attributes.
    With Zeto, EEG data is saved in raw unfiltered (DC) formats that do not distort the original signal attributes. Subsequent digital filtering can then be used to match desired filter attributes.
    With Zeto, EEG data is saved in raw unfiltered (DC) formats that do not distort the original signal attributes. Subsequent digital filtering can then be used to match desired filter attributes

    The benefits that filters provide are crucial to enable a confident clinical read that is not skewed by unwanted signals. However, filters can introduce artifacts on their own. The well trained EEG reader will need to be vigilant about possible filter artifacts in EEG signals and how these may affect the clinical assessment of the patient’s brain states. As Zeto, we encourage our users to match the available filter settings to their preferences to ensure a fast and efficient diagnostic process. For questions about how to best match your Zeto filter settings and establish adequate default settings, please contact our customer success team at support@zetoinc.com.

    References:

    1. Sinha, S. R., Sullivan, L., Sabau, D., et al. (2016). American Clinical Neurophysiology Society Guideline 1: Minimum Technical Requirements for Performing Clinical Electroencephalography. Journal of Clinical Neurophysiology, 33(4), 303-307. DOI: 10.1097/WNP.0000000000000308
    1. ASET Board of Trustees. (2021, March 20). National competency skill standards for performing electroencephalography (EEG). ASET Website. Retrieved from https://www.aset.org/wp-content/uploads/2022/11/EEG_Competencies_FINAL.pdf (Page 4, Section 2.3)
    1. ShareTechnote. (n.d.). RF – Filter. Retrieved from https://sharetechnote.com/html/RF_Filter.bak
    1. De Cheveigné, A., Nelken, I. (2019). Filters: When, Why, and How (Not) to Use Them. Neuron. DOI: 10.1016/j.neuron.2019.02.039

    EEG Techs Face Challenges: Portable EEG Creates Solutions

    EEG Techs continue to be the gold standard for EEG administration, their training and expertise is crucial for meeting the neurodiagnostic needs of hospitals. Unfortunately, there is a massive nationwide shortage of EEG techs in the United States, and this significantly impacts the delivery of essential neurodiagnostic services throughout the country. This shortage not only strains healthcare systems, and causes delays in diagnosis and treatment, but also places an immense burden on EEG techs.


    Zeto’s portable full-montage EEG headset offers a solution to this crisis. By simplifying and streamlining the EEG process, Zeto helps hospitals and medical centers to deftly navigate staffing shortages or a lack of availability of EEG techs on nights and weekends.


    Zeto offers an EEG solution with seizure detection, video, and remote monitoring services, enabling hospitals and outpatient settings alike to maintain high-quality neurodiagnostic services even in the face of such staffing constraints.

    Enhancing Productivity and Hospital Service Capabilities for EEG Techs

    There is a massive nationwide shortage of EEG techs in the United States

    In hospital settings, where the demand for EEG services is often high and continuous, the presence of a skilled EEG tech is invaluable. However, the current shortage of these professionals creates significant challenges. Zeto’s portable EEG headset is designed to address this gap, providing solutions that significantly enhance the efficiency and effectiveness of EEG services in hospitals.

    Efficiency Improvements for EEG Techs:

    Zeto’s headset simplifies the EEG setup and operation process. By reducing the time and effort required for placing electrodes and setting up, Zeto enables EEG techs to manage their workload with more ease.

    EEG Techs can Delegate:

    One of the key advantages of Zeto’s system is its ease of use, allowing EEG techs to quickly train other healthcare staff, such as nurses or other types of techs, such as respiratory therapists. If EEG tech is not available, support staff can step in. This capability is crucial for providing EEG services, especially during off-hours such as nights and weekends, or in the critical care and emergency departments.

    Techs can Focus on Higher Level Duties:

    With Zeto’s user-friendly system, EEG techs can dedicate more time to monitoring and annotating EEG readings, which are vital for accurate diagnoses. This shift in focus from setup to analysis enables EEG techs to apply their expertise where it matters most.

    Upskilling for the Future:

    As the healthcare industry evolves, there is a growing need for EEG techs to adapt and upskill. Technologies like Zeto not only provide immediate solutions to current challenges but also pave the way for techs to enhance their skills in areas like data analysis, remote monitoring, and advanced neurodiagnostic techniques.

    Remote Validation of EEG Studies with Zeto’s Cloud Platform:

    Zeto’s cloud platform enables EEG techs to remotely monitor EEG studies when the setup is performed by non-technical personnel. Utilizing live video, EEG techs can oversee EEGs in real-time from anywhere, ensuring the quality of each study. This remote capability is essential for maintaining high standards in EEGs, regardless of who performs the initial setup.

    Use of Zeto’s portable EEG headset for hospitals is a significant step forward in managing the current EEG tech shortage. By enhancing efficiency, facilitating skill development, and ensuring continuous high-quality EEG services, Zeto helps hospitals to better manage their challenges, and to deliver excellent healthcare.

    Improve Outpatient EEG Services Using Portable EEG 

    In outpatient settings, the EEG tech shortage presents unique challenges, particularly in terms of efficiency and patient throughput. Zeto’s wireless EEG headset addresses these challenges head-on, contributing to improvements in how EEG services are delivered in outpatient clinics.

    Reduction in Setup and Cleanup Time:

    Traditionally, EEG setup and cleanup can take up to an hour, burdening both the EEG tech and the patient. Zeto’s portable EEG system reduces this to just a few minutes.

    Minimal Space Requirements and Increased Flexibility:

    The need for a sink and extensive setup space, as required for conventional EEG, is eliminated with Zeto’s portable EEG headset. Clinics can conduct EEG tests with just a bed or chair, making better use of available space. This compact setup allows a single tech to manage multiple EEG sessions simultaneously, with EEG data accessible via the cloud.

    Enhanced Patient Throughput:

    With Zeto, the primary limit to conducting EEGs is the number of headsets available. This capability to run multiple sessions concurrently significantly increases patient throughput, a vital factor in busy outpatient settings.

    Streamlined Data Management:

    Zeto’s cloud-based system means that data transfer concerns are a thing of the past. EEG techs no longer need to spend time ensuring data is properly transferred and stored, as it’s automatically synced to the cloud and accessible for whomever needs it, instantaneously.

    Focus on Value-Added Patient Care:

    Freed from time-consuming setup and data management tasks, techs can focus more on direct patient care, education, and comfort. This shift not only enhances the patient experience but also provides more job satisfaction for techs.

    Patient Satisfaction and Comfort:

    Zeto offers a more comfortable, shorter, and cleaner experience for patients. The use of no-residue electrodes that do not use gels or pastes, means there’s no need for a patient to wash their hair afterwards. It works perfectly with different hair types, including kinky, coil, and braided hair.

    Expanding EEG Setup Skills Across Your Team with Zeto:

    In outpatient settings where EEG techs might not always be available, Zeto’s system offers a practical solution. Any staff member, such as a medical assistant, can be trained to do the EEG setup. This flexibility allows clinics to utilize their resources more efficiently, ensuring that EEG services are readily available when needed. With Zeto, clinics can schedule patients for EEGs swiftly, enhancing patient care and operational efficiency even with limited staffing.

    Zeto’s portable EEG headset addresses the critical challenges posed by the EEG tech shortage. By enabling more efficient use of time and resources, reducing the need for extensive physical infrastructure, and enhancing the quality of patient care, Zeto is setting a new standard in outpatient neurodiagnostic services.

    To learn more about Zeto’s wireless, dry-electrode, full-montage EEG headset with real-time remote monitoring and near real-time seizure detection, please contact us to schedule a chat and a demo.