Featured Post from ChristianaCare

Innovative EEG Brain Monitoring Program Provides Optimal Care for Critically Ill Patients

May 2, 2024

3 min

Kimberly Gannon, M.D., Ph.D, F.A.H.A

ChristianaCare has launched an innovative electroencephalogram (EEG) brain monitoring program that represents a significant leap forward in the diagnosis and management of neurological conditions. The easy-to-use EEG program is the first of its kind that can be performed at the bedside to measure the electrical activity of the brain, providing a vital sign for brain function to help diagnose seizures more quickly.


ChristianaCare is the first hospital system in Delaware to use the Ceribell point-of-care EEG monitoring system, which can reduce the time it takes to diagnose certain neurological conditions from hours to mere minutes. Using the system, clinicians have immediate access to EEG information so they can triage at-risk patients in just five minutes and monitor patients for treatment optimization.


“With this new program, our team of expert clinicians will have the diagnostic information they need to provide high-risk patients with the right care at the right time, ensuring the best outcomes for our patients and their families,” said Kim Gannon, M.D., Ph.D., service line leader for Neurosciences at ChristianaCare.


New technology detects ‘silent seizures’


Critically ill patients are at high risk of harmful brain electrical discharges called seizures. Some of these patients experience a type of “silent seizure” with no noticeable symptoms (non-convulsive) that can only be detected using EEG. If prolonged, non-convulsive seizures can lead to permanent brain injury and higher risk of morbidity and mortality.



Demonstration of EEG device on patient at ChristianaCare Newark Campus.

As a result, guidelines from the Neurocritical Care Society recommend EEG should be initiated within 15-60 minutes when these seizures are suspected.


Meeting these guidelines has proven difficult due to the limitations of conventional EEG systems, which were not designed for use in emergency situations. Even top academic centers that have 24/7 EEG capabilities may experience wait times of four hours or more for conventional equipment. When relying on clinical judgement alone while waiting for these conventional EEG systems, diagnostic accuracy has been shown to be only slightly better than chance (65%).


The value of this new technology for patients is that it provides accurate results quickly so that the care team can intervene early.


“The neuroscience and critical care teams at ChristianaCare believe that ‘time is brain’ not only applies to stroke but also when dealing with seizure,” Gannon said.


Gannon is referring to the fact that for every minute that passes when someone is having a stroke, 1.9 million brain cells are lost, increasing the chance of disability or death. That same kind of speed and urgency can now more easily be brought to bear for patients when a seizure is suspected.


“This monitoring system is easy to use and can be set up in about five minutes,” said Richard Choi, D.O., medical director of the Neurocritical Care Unit at Christiana Hospital. “It consists of a simple headband, pocket-sized recorder with intuitive software and an on-line portal for remote viewing. Using the system, we can review EEG data, assess response to treatment and optimize care, all in real-time.”


Neurosciences at ChristianaCare


ChristianaCare’s multidisciplinary neurosciences team provides comprehensive and advanced care for neurologic illnesses across the acute and ambulatory settings. As the largest and most comprehensive neurology practice in Delaware with more than 55,000 patient visits last year, ambulatory subspecialties include stroke, epilepsy, multiple sclerosis, movement disorders, neuromuscular disorders, headaches/migraines, pediatric neurology and Botox specialists. The inpatient team of experts includes neurosurgeons, neurointerventional surgeons, neurocritical care physicians and vascular neurologists. The Newark Campus serves as the only comprehensive stroke center in the state and includes the only Epilepsy Monitoring Unit in Delaware.

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Kimberly Gannon, M.D., Ph.D, F.A.H.A

Kimberly Gannon, M.D., Ph.D, F.A.H.A

Medical Director of Comprehensive Stroke Program, Physician Executive of Neurosciences Service Line

Dr. Gannon combines the expertise of clinician with doctorate research to improve both patient and population health in neurological care.

Stroke CareVascular NeurologyNeurologyPhysiologyNeurological Diseases

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First in Delaware to Offer MR-Guided Ultrasound for Treatment of Essential and Parkinson’s Tremor

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2 min

Wilmington Campus Receives $1 Million Donation From the Rocco A. and Mary Abessinio Foundation

ChristianaCare has received a $1 million gift from The Rocco A. and Mary Abessinio Foundation Inc. in support of ChristianaCare’s Wilmington Campus. “All families and communities deserve the excellent care that Wilmington Hospital and ChristianaCare provide,” said Rocco and Mary Abessinio. “It is an honor for our family to support the health and wellbeing of the Wilmington community.” The funds will support areas of greatest need, including the expansion of patient care initiatives aimed at reducing disparities in screening and treatment for cancer and cardiovascular disease in the city of Wilmington. “We are tremendously grateful to the Rocco A. and Mary Abessinio Foundation for their continued, generous support of the Wilmington Campus – a vital resource serving the greater Wilmington community,” said Janice Nevin, M.D., MPH, ChristianaCare president and CEO. “With their help, we are closing gaps in health disparities and improving health for everyone, including some of Delaware’s most vulnerable populations.” The Rocco A. and Mary Abessinio Foundation provided a $1 million gift in 2014 for the redesign and renovation of the health center, which was then named the Rocco A. Abessinio Family Health Center at Wilmington Hospital. The health center is home to three primary care practices and other programs and services that offer high-quality health care, wellness and preventive health visits for people of all ages, regardless of their income or ability to pay. “As a result of the Abessinio family’s longstanding partnership and investment in our mission of service, we are making significant progress in addressing disparities and building strong and healthy communities,” said LeRoi S. Hicks, M.D., MPH, FACP, campus executive director of ChristianaCare’s Wilmington Hospital. A Wilmington landmark in the heart of the city, the ChristianaCare Wilmington Hospital has been serving the diverse medical needs of the city and surrounding region for over 125 years. “Philanthropy is essential to ChristianaCare’s mission of service to our community, and we extend our heartfelt thanks and appreciation to Rocco and Mary Abessinio for their inspiring and visionary philanthropic leadership in support of the Wilmington Campus,” said Dia Williams Adams, MPA, vice president of philanthropy at ChristianaCare. “Their gift is a legacy that not only allows us to increase our ability to make a positive impact on patients and community, but honors the incredible work that our caregivers do every day.” For more information about ways to support ChristianaCare’s mission of service to the community, visit: https://christianacare.org/us/en/make-a-gift.

5 min

This Is a Critical Moment: Delaware Must Not Go Backward in Health Equity

The proposed Delaware House Bill 350 is well-intended but would have terrible consequences for Delaware’s most vulnerable populations. There is a better way. By LeRoi S. Hicks, M.D., MPH, FACP As a Black physician who has dedicated his 25-year career to understanding and addressing health equity, I am deeply concerned about Delaware’s proposed House Bill 350, which aims to address rising health care costs by establishing a body of political appointees that would oversee the budgets of Delaware’s nonprofit hospitals. While the goal of bending the cost curve in health care may be well-intentioned, this bill will have horrific consequences for Delaware’s most vulnerable populations, including Black people, Hispanic people and other groups that have been traditionally underserved in health care. We can and must work together to solve this problem and provide the right care, in the right place, at the right time. A tale of two cities To borrow a phrase from Charles Dickens, Delaware, like much of America, is a tale of two cities. The experience of life—including a healthy, safe environment and access to good-quality health care—is vastly different depending on where you live and your demographic background. In the city of Wilmington, for example, ZIP codes that are just a few miles apart represent more than 20 years difference in life expectancy. This is not OK—it’s a sign that we have serious structural problems in our communities that are causing harm to people and making their lives shorter. Importantly, chopping $360 million out of Delaware’s hospital budgets, as House Bill 350 would do in year one, is not going to help this problem—it’s going to make it worse. And in doing so, it would ultimately make health care in Delaware more expensive—not less expensive. The key to lowering health care costs is to improve quality, access and equity Data show that about 5% of patients in the United States account for more than 50% of all health care costs. These are primarily patients who have complex and poorly managed chronic conditions that cause them to end up in the most expensive care settings—hospitals, operating rooms, emergency departments. The key to driving down health care costs is to improve quality and equity so that everyone is supported in achieving their best health, and these high users of the most expensive kinds of care are better supported in managing their health conditions such as diabetes or heart failure in the appropriate way. In doing so, they prevent the need for costly emergency or “rescue” care. Let’s do more—not less—of what we already know works Health care is not a one-size-fits-all industry. The delivery of care for patients across a diverse population requires multiple interventions at the same time. These interventions are designed not only to improve the quality of care but also to close the gap in terms of health care disparities. That’s important, because when we improve care and outcomes for the most vulnerable populations, we tend to get things right for everyone. One type of intervention is about doing exactly the right things for a patient based on the evidence of what will help—and doing nothing extra that will cause harm or generate additional costs without providing additional benefit. An example of this might be ensuring that every patient who has a heart attack gets a certain drug called a beta blocker right after their heart attack, and they receive clear guidance and support on the actions they must take to reduce their risk of a second heart attack, such as regular exercise and good nutrition. The second type of intervention is for the highest-risk populations. These are patients who live in poor communities where there are no gyms and no grocery stores, and people commonly have challenges with transportation and lack of access to resources that makes it difficult—sometimes impossible—to follow their plan for follow-up care. They lack access to high-nutrient food that reduces their risk of a second heart attack. They also live in areas where there are fewer health care providers compared to more affluent areas. These interventions tend to be very intensive and do not generate income for health systems; in fact, they require significant non-reimbursed investment, but they are necessary to keep our most vulnerable patients healthy. The medical community has developed interventions for these populations that are proven to work. A local example is the Delaware Food Pharmacy program, which connects at-risk patients with healthy food and supports their ability to prepare it. The program helps patients improve their overall health and effectively manage their chronic conditions so they can prevent an adverse event that would put them back in the hospital or emergency department. When we work together, we succeed We’ve seen incredible examples of how this work can be successful right here in Delaware. Delaware was the first state in the country to eliminate a racial disparity in colorectal cancer, and we did this by expanding cancer services, including making it easy for vulnerable people to get preventive cancer care and screenings. This is an incredible success story that continues to this day, and it was the result of thoughtful, detail-oriented partnerships among the state and the health care community. The work continues as we collaborate to reduce the impact and mortality of breast cancer in our state. Unfortunately, these kinds of interventions are the first thing to go when health care budgets get slashed, because they don’t generate revenue and are not self-sustaining. These kinds of activities need to be funded—either through grants or an external funder, or by the hospitals and health care systems. By narrowly focusing on cost, we risk losing the progress we have made Delaware House Bill 350, as it’s proposed, would cause harm in two ways: First, it would compromise our ability to invest in these kinds of interventions that work. Second, it increases the risk that higher-cost health services and programs that are disproportionately needed by people in vulnerable communities could become no longer available in Delaware. In states where the government has intervened in the name of cutting costs, like Vermont and Massachusetts, we see the consequences–less quality and reduced equitable access to much-needed services. House Bill 350 will widen the gap between those who have means and those who are more vulnerable. These changes will lead to increased disease burden on these populations. They will end up in the emergency room more and hospitalized more, which is by far the most expensive kind of care. That’s not what anyone wants—and it’s the opposite of what this bill was intended to accomplish. At this moment, in Delaware, we have an opportunity to put our state on a sustainable path to better health for all Delawareans. House Bill 350 is not that path. However, the discussion that House Bill 350 has started is something that we can build on by bringing together the stakeholders we need to collaborate with to solve these complicated problems. That includes Delaware’s government and legislators, the hospitals and health centers, the insurance, pharmacy and medical device industries, and most importantly, patients and the doctors who care for them. LeRoi Hicks, M.D., is the campus executive director for ChristianaCare, Wilmington Campus.

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