Point-of-care ultrasound, also known as POCUS, has transformed the field of medical imaging in the past decade. Gone are the days of relying solely on large, bulky console units confined to ultrasound departments. Instead, the advent of portable ultrasound devices has revolutionized healthcare by bringing this technology directly to the patient's bedside.
Point-of-care ultrasound has become the preferred diagnostic tool for healthcare providers across various specialties. Its portability and ease of use has expanded its utility beyond radiologists, enabling physicians from different disciplines to harness its benefits. By collecting data at the point of care, POCUS plays a vital role in helping improve patient outcomes.
As POCUS continues to evolve and embrace digitalization, its widespread impact on healthcare providers becomes increasingly evident. The transformative potential of point-of-care ultrasound is still unfolding, promising to shape the future of medical practice in remarkable ways.
An Impact on Clinical Decision Making
The integration of POCUS into clinical decision-making processes can lead to a significant impact on patient care and outcomes. Recent research supports the effectiveness in achieving these goals.1 When used at the bedside, POCUS has been seen to:1
- Change in the main diagnosis or the addition of a relevant diagnosis in up to 18% and 24% of cases, respectively
- Impact plan management in 37 percent to 52 percent of cases
- Reduce the length of stay by one day
The Streamlining Effect of POCUS
POCUS also offers significant benefits to providers. When implemented across departments or facilities, it can help to modernize workflow and connect providers involved in patient care.
Workflow Modernization
Current ultrasound workflow is antiquated, says Brian Green, IT connectivity leader in ultrasound at GE HealthCare, citing the need for providers to submit orders for scans through the electronic medical record (EMR), prior to beginning an exam. POCUS reshapes workflow by allowing providers to scan patients at a moment's notice. With probes that can capture high-quality images and wireless connectivity, POCUS can help to accelerate care.
"Physicians can step outside the orders-based, scheduled workflow," he says. Speaking about VenueTM family systems, he continues: "Now, you have an encounter-based workflow where you can pick up the probe like you would a stethoscope and use it. Removing the shackles of orders, EMRs, and PACS and implementing a solid point-of-care workflow can save lives."
Provider Connection
POCUS can revolutionize the way healthcare is delivered across the entire hospital system. Although POCUS has traditionally been a cardiology and obstetrics tool, it's quickly become a go-to device for multiple specialties, including emergency care, critical care, NICU, PICU, MSK and anesthesia.
"Ultrasound technology has gotten to the point where it can be deployed—at very little cost—pretty much anywhere," says Lee Kryszewski, connectivity leader for GE HealthCare's Point of Care Business. "We're going to see almost every physician carry it, particularly in smaller clinics, physician's offices, urgent care centers, and emergency rooms."
Compared to other diagnostic tools, ultrasound data at the point-of-care is readily shareable. POCUS-captured images can be recorded and stored in the EMR, the cloud, a vendor-neutral archive, or in a reporting and workflow solution like ViewPointTM 6, making them accessible throughout a facility for faster diagnosis or more informed treatment decision-making.
A Partner for Efficiency and Cost Control
By modernizing workflow, POCUS can help to produce time and cost savings. This digitalization can help providers work smarter.
For example, bedside POCUS can be performed in intensive care or the emergency room, eliminating the need to transport a patient to the radiology suite. Providers can get the information they need faster, and radiology resources can be reserved for other patients. And the instaneous accessiblity for providers allows them to look at medical trends that can reveal emerging problems or compare a patient's current and previous status, helping to lead to faster and more effective care delivery.
Having these scans accessible across the hospital system may also reduce duplicative imaging. Wherever a patient goes, their scans are readily available for evaluation.
The Role of POCUS in the Emergency Department
Given the clinical value POCUS offers, extending it to the emergency department has been a natural evolution. Every moment counts, so a growing number of providers are embracing these portable devices to boost care, Kryszewski says.
"Rather than sending patients to radiology for an imaging study, emergency providers conduct ultrasounds themselves," he says. "The insight and diagnostic decisions they can make are so much richer when they're doing the ultrasound. They can make decisions in the moment."
Additionally, paramedics can use some POCUS devices such as Vscan Air™ and Vscan Extend™ to scan patients in an ambulance. Sending these images ahead to the emergency department can help to prepare providers to more easily continue care.
The Value of POCUS in Other Healthcare Settings
The utility of POCUS extends beyond the emergency room. In recent years, providers in several other specialties have recognized the benefit of using this portable technology.
- Pediatrics. As a non-radiation-based modality, ultrasound can be a helpful diagnostic tool for assessing children. Pediatricians today use it for musculoskeletal, cardiac, and lung evaluations, as well as gastrointestinal problems.
- Critical care. Dual-trained emergency medicine and critical care physicians use POCUS for cardiopulmonary and blood flow monitoring.
- Field use. POCUS plays a role in assessing victims of natural disasters, including earthquakes, hurricanes, tornadoes, and more. With minimal training, providers can capture vital patient data in locations where X-Ray, CT, and MRI imaging may be limited.
- Military sites. Combat hospitals are outfitted with POCUS equipment that helps field doctors make informed decisions about moving wounded soldiers for more intensive care.
Assessing the Investment
Merely implementing POCUS isn't enough, however. Hospitals must assess their investment to ensure it's being maximized. Stored data reveals how often providers use the devices, the ways they're using them, and whether they're billing correctly for services. Providers need to be trained and credentialed, and hospitals require an asset management program for portable units—as well as a plan for reporting and reimbursement, Kryszewski says.
"We're seeing point-of-care ultrasound is being used much more than it's being billed for. Facilities aren't looking at what it's being used for, how often doctors use it, and what the clinical outcomes are," he says. "So far, these tools aren't being managed and integrated well into the larger enterprise imaging infrastructure. We need to concentrate on that infrastructure."
To set the stage for success, he says, hospitals ask their vendors to help with a cost/benefit analysis to ensure their implementation of POCUS will make the biggest impact for both providers and patients, and that they'll get the maximum return on their investment.
Learn more about capturing, storing, and accessing imaging data with Point-of-Care Ultrasound on the Healthcare IT Talks podcast.
REFERENCES:
1. Cid-Serra X, Hoang W, El-Ansary, et al. Clinical impact of point-of-care ultrasound in internal medicine inpatients: A systematic review. Ultrasound in Medicine & Biology. February 2022; 48(2):170-179. doi: 10.1016/j.ultrasmedbio.2021.09.013.
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Venue, ViewPoint, Vscan Air and Vscan Extend are trademarks of GE HealthCare. GE is a trademark of the General Electric Company used under trademark license.
