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But Don’t Take My Word for It.


As the Chief Medical Officer at a leading provider of in-home, video-EEG (VEEG) monitoring services, I know that outpatient monitoring can save money while providing comparable quality as inpatient monitoring. I know that outpatient VEEG often offers better access for patients. I know that for many patients it makes the most sense in this age of value-based health care. But don’t take my word for it.

See for yourself.

A study published in the June 2019 issue of the Journal of Medical Economics reveals that epilepsy-related healthcare costs among patients who receive a VEEG are significantly lower in an outpatient setting versus an inpatient setting. The study, “The real-world economic impact of home-based video electroencephalography: the payer perspective,” reveals a number of benefits:

  • The epilepsy-related cost of the index diagnostic event in an outpatient setting was 30% the cost of inpatient VEEG.
  • The 12-month, post-index epilepsy-related healthcare costs for patients who had an outpatient VEEG were 48% of the cost of those who had an inpatient VEEG.
  • The time from referral to having the index VEEG was 12 days shorter for patients who had an outpatient VEEG compared to an inpatient VEEG.

A retrospective cohort study design was used in the research, which included almost 50,000 patients. Epilepsy-related costs were defined as the costs of medical claims with a primary diagnosis of epilepsy or epilepsy-like conditions and the costs of pharmacy claims for epilepsy treatments.

The study was published on the heels of research published in Seizure: European Journal of Epilepsy in 2018 on the “Outcome of ambulatory video-EEG monitoring in a 10,000 patient nationwide cohort.” The first to look at such a large group of patients, the study supports previous research that shows the value of outpatient VEEG in providing comparable results while avoiding the high-costs, reduced access, and inconvenience associated with inpatient VEEG.

There are patients for whom inpatient VEEG is clearly indicated, such as those undergoing a work-up in anticipation of possible epilepsy surgery. However, for the majority of patients, the belief that only an inpatient VEEG study will provide the needed data is not supported by the latest research. All the players in healthcare, including government, private payors, physicians, patients, and industry continue to seek opportunities for value-based care. The push to reduce costs while providing equal or better quality shows no signs of slowing. In this environment, outpatient VEEG is a logical option for many patients. But don’t take my word for it; study the evidence for yourself.



Jeremy Slater, M.D., has worked in the field of epilepsy for more than 27 years and currently serves as the Chief Medical Officer for The Alliance Family of Companies. He served as the director of the Texas Comprehensive Epilepsy Program from 2004 through 2017, growing the center from a single neurologist and neurosurgeon to one of the largest epilepsy surgery programs in the country. Dr. Slater earned his medical degree at the University of Pittsburgh School of Medicine, in Pittsburgh, Pa. He completed his residency in neurology followed by a fellowship in epilepsy and clinical neurophysiology at the University of Miami School of Medicine in Miami, Fla.


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