Patient Compliance

Patient Compliance VNG Testing

Help patients successfully prepare for VNG tests

Preparation and patient compliance are vital elements for completing a successful series of VNG tests. Many practices distribute pre-appointment paperwork with information such as timing for the following:

--Medications to temporarily discontinue

--Medications to continue

--What to wear: comfortable clothes, flat shoes

--Eye prep, such as not wearing eye makeup or contact lenses

--When to avoid eating food and drinking caffeine or alcohol prior to testing

--What to expect regarding induced dizziness, the possibility of not driving oneself home

The preparation sheets are a helpful reference for patients who have no experience with vestibular disorders or VNG testing. There is quite an extensive list of do's and don'ts, which can be quite overwhelming.

To further improve patient compliance, practices who distribute papers and/or web information with Q and A's of what is actually involved with the VNG testing can go that much further to assist their patients. Most people are already feeling nervous about a doctor visit, especially when they are undergoing tests that they have no idea of what is involved. I know I was completely caught off guard when I learned that a full battery of VNG tests involves a series of eighteen tests and that it would take up to 30 or 45 minutes.

The information doesn't have to be clinical or complex, just keep it simple such as:

What to Expect for Your VNG Testing

Overall Objective

The overall objective of your VNG testing is to stimulate and visually record your eye movements under various circumstances. This is very likely to make you feel dizzy. Be prepared for dizziness and even the possibility of feeling nauseous or even throwing up in some cases. Both are common reactions during VNG testing. Your technician will help you as much as possible.

First Phase of VNG Testing

--The first portion of the tests, you will be asked to wear head gear consisting of goggles that have built in camera/s

--One eye will be shielded with a cover and the other one will be video recorded

--Keep your eyes wide open so the camera can record the movements of your pupil

--You will be asked to look at a dot on a monitor and follow the dot with your eyes

--Don't try to anticipate the pattern of the movements of the dot

--Each eye will repeat the same testing sequences and will be video recorded, one eye at a time*

--Please let your technician know if you are experiencing any adverse reactions to the testing procedures

*Unless your practice has a binocular VNG, in which case the eyes will be recorded at the same time

Second phase: Caloric Irrigator Tests

--A medical device called a caloric irrigator will be used for the second phase of testing

--A caloric irrigator is used to evoke your inner ear response to a stimulus

--You will be asked to wear headgear: goggles with the camera/s and lie down on an exam table

--A lighted tip connected to the caloric device will blow warm and cool air into your inner ear

--Keep your eyes wide open so the camera can record the movements of your pupil

--The camera/s will record the movements of your eyes, one at a time

--Expect a sequence of caloric testing, including physically changing movements while lying on the exam table

--You may need to lie on the exam table for a few minutes once testing is complete in order to recover from the dizziness you may experience

--Do not attempt to sit up, stand up, walk or drive unless you do not feel dizzy

--Please let your technician know if you are experiencing any adverse reactions to the testing procedures

For practices who are using ENG or older, outdated VNG testing equipment, consider upgrading to premium VNG devices and caloric irrigators manufactured by Difra Instrumentation. Difra's software is designed to reduce the time consuming aspects of testing. Difra software eliminates the need to mark up tests during during the testing procedures and therefore allows technicians to accurately test more patients with less labor for the tech and less time for the patient as well. For more information about Difra products, please contact Secure Health or review the product information contained on this web site.

If you have questions or just want to talk about this post or you have any other questions, please contact Secure Health, Inc.  We look forward to hearing from you.

Lana Scherer
Marketing Director, Secure Health, Inc.
260-418-6835 / [email protected]

Secure Health, Inc. is the exclusive US agent for Difra Instrumentation, a world's leading manufacturer of diagnostic balance disorder technology for more than 48 years.


The opinions and information contained in this website are for general information purposes only. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products or services contained on the website for any purpose. Any reliance you place on such information is therefore strictly at your own risk.In no event will we be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from or in connection with, the use of this website.


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When is the right time to upgrade your VNG Device? 

When is the right time to upgrade your VNG device? 

Like anything else, VNG devices have a lifespan.  How long that is may be difficult to say? Much depends on the manufacturer and how well you have maintained the device.  It is entirely possible with proper care a VNG device should last at least 7 to 10 years.  

As with any technology, the older it gets, the more it becomes outdated. It may be lacking new

Difra HeadStar VNG equiment

features and in the case of VNG devices, expensive to repair.  There comes a time with any device to look at replacing yours with new technology. So consider the following major points regarding the decision to upgrade or replace your VNG device.


You start noticing an increasing amount of down time due to malfunctions with your VNG.  No one wants to reschedule patients due to technology failures. Will they return for the rescheduled visit?  You hope so, but we know that not all will. How much patient care is lost and what does that equate into lost revenue?  Plus, what will the repairs cost you?

Reliability problems can be caused by old worn out cameras, aging circuitry, worn out cables, loose connections, improper handling and so much more.  

What if your VNG manufacturer is no longer in business?  Do you have a company that can properly repair your aging VNG equipment?  Older board circuitry components can be difficult to find and replace. Some manufacturers charge a premium for replacing the main circuit boards, often times reaching $10,000.  That’s nearly one half the price of a new VNG device, depending on features and manufacturers. 

Worse yet, after replacing the boards, you are still left with an old computer, unsupported operating system, aging cameras, and little guarantee that next week you don’t encounter another problem, costing even more money, lost time, patients and revenue.  It can turn into a spiraling, out-of-control expense and frustration.

Outdated Computer Operating Systems

Here's another problem.  As long as your computer is working, it isn't an immediate concern, but suddenly, your old VNG computer crashes.  Now what? 

Chances are high your old computer ran an unsupported Windows XP or Windows 7 operating system. Microsoft no longer supports Windows XP and soon will stop supporting Windows 7.  If you need to replace the computer, the VNG software of your older system may not be compatible with new operating systems such as Windows 8 or 10.  Not all VNG manufacturers have kept up with software upgrades to be compatible with current operating systems.

If you can’t update the software from the manufacturer, then your VNG device is rendered useless.  

Data Collection and Output Quality

We covered the reliability and computer problems with your aging VNG device.  Now let's consider the quality and accuracy of your data acquisition.  In other words, are eye tracings and nystagmus accurate and clear?  Are results repeatable and reliable?

It’s a simple fact that current technology for image quality is far superior to older VNG devices.  High-definition cameras allow good eye capture and data tracing.  Eye-tracking technology is much better with today's software technology than your old system.   The end result is more accurate reports and improved diagnosis.  The old adage of “Garbage in, garbage out” is still relevant today.  New VNG technology is increasingly better and more user-friendly than your old VNG is.  

Here's a great example of the benefits of new VNG technology.  Some older VNG devices required your technician to manually “mark” the data after a VNG test. That means the technician would need to scan through the VNG results and "manually" select the extremes of nystagmus.  This takes a fair amount of time, as much as 5 to 10 minutes per test, costing you thousands of dollars over the course of a year in labor costs.  Further, if your technician is really busy, the likelihood of inaccurate marking increases, resulting in an inaccurate report.  

A good VNG device will offer automatic data marking that is incredibly accurate, which provides fewer chances of technician error as well as consistency in reporting.  Plus, automatic marking eliminates the cost of labor for manual marking.  It may seem small, but over the course of a year, you save a ton of money utilizing automatic data marking.  

Remote Access Tech Support

If your clinic has a software problem of any sort, does your older VNG system provide online tech support? There are countless times I have personally assisted clinicians and technicians with remote access tech support that was easily resolved. Not only does it save time, it provides quick, accurate assistance to avoid delays due to downtime, which I already mentioned is not good for patients nor the staff.

Additional Considerations

There are so many other considerations when looking to replace old for new.

Certainly cost is always a factor.  Just always keep in mind what your total costs are, including labor, so you make an accurate assessment. The initial investment in a new VNG system may be less than you think due to many lease and finance options, as well as tax advantages.

Don't forget to check with your accountant on your ability to use the Accelerated Depreciation, one-year write off on your new VNG equipment.  Depending on your tax rate, you can save a significant amount by writing your new VNG device off in the first year of use.  That equates to a cash discount worth thousands of dollars.

All of us know that reimbursement rates are as critical as cost.  So again, specifically ask your billing and coding specialist to ensure you are getting the latest information on reimbursements in your area.

Quality and longevity in business is a huge consideration. Just as with buying a new vehicle, everyone knows the manufacturer, product and price are all reflective of the quality. The same holds true for VNG devices.

Finally, who you choose to work with as your VNG vendor is of the utmost importance.  Are they easy to contact?  Do their actions follow their words?  Do you feel as if they are honest? Are they giving you a fair price? Do you have confidence they can handle your support issues?  All of these are extremely important questions to consider when making any kind of buying decision, not just replacing your old VNG.

I'm always happy to speak with you about VNG old or new.  We are experts in VNG technology with 14 years of experience.  I want you to be happy with your buying decision so feel free to comment, call or write to me if you want to discuss your options.  I would enjoy the opportunity to hear from you.


--Dan Scherer, CEO

Secure Health, Inc.

260-804-4041 or [email protected]

Secure Health, Inc. has assembled the finest vestibular and balance products in the world. Our Better Balance™ technology is comprised of proven systems that identify, diagnose and treat vestibular and balance disorders. An essential component of our Better Balance™ technology is premium VNG diagnostic equipment manufactured by Difra Instrumentation. Difra Instrumentation is a global leading manufacturer of diagnostic balance disorder technology for more than 48 years. CALL 260-804-4041 FOR MORE INFORMATION or via email: [email protected]

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