By John Martin, MD, Chief Medical Officer, Butterfly Network
Twitter: @ButterflyNetInc
At HIMSS22: Visit Butterfly Network at #HIMSS22 in Booth 2135 in Orlando
An evolved state of point-of-care ultrasound (POCUS) is transforming diagnostics across many care settings by delivering powerful imaging insights to close information gaps and drive better care decisions. Such an affordable, efficient means of gathering critical data at the bedside is not only engaging a growing number of clinicians and specialists, but is also touching vast underserved geographies.
Combined with the power of artificial intelligence (AI) to guide bedside image acquisition and interpretation, an emerging application of POCUS promises a revolution in point of care assessment and provides a glimpse toward healthcare’s future standard of care. In addition to surfacing information faster by accelerating when and how imaging happens, this evolved approach to ultrasound can also meaningfully address a portion of healthcare’s mounting waste —reaching upwards of $935 billion annually—by reducing unnecessary imaging costs and referrals. Here are four leading values associated with an evolved approach to imaging, happening from the bedside, powered by an AI-enabled, handheld ultrasound device:
- Economic Value. For decades, ultrasound machines have cost anywhere from tens to upwards of several hundred thousand of dollars. While newer POCUS technology is no competitor against machines used for high-end ultrasound work, it does provide a tectonic shift in the foundations of imaging as a practical diagnostics advisor at the bedside. Today, POCUS devices are available for approximately $2,000 and have evolved from bulky cart-based offerings to pocket-ready, handheld portable, stapler-sized scanners that can easily be linked to smartphones to view output.
The benefits of a lower price point are significant. The availability of POCUS at scale throughout an enterprise means more practitioners across departments can have access to powerful imaging insights, compounding the opportunities to improve more informed decision making and eliminate waste. For instance, use of POCUS has been shown to significantly reduce patient imaging costs, including expensive diagnostic tests such as echos, Chest CT and traditional abdominal ultrasounds. It’s even reduced the odds of a chest x-ray being ordered by 87%. Moreover, its value in primary care is increasingly being proven: One study found an almost-50-percent reduction of secondary referrals and a change in diagnosis in up to 49 percent of patients, likely reflecting the added value of new diagnostic precision.
- Portability. POCUS puts advanced imaging in the pocket of practitioners everywhere to inform point of care assessment and to guide the differential, the diagnosis, the treatment, and follow up plan. And, since POCUS devices can be easily transported and linked to smartphones, the value is not only in accessibility at the bedside, but in transcending some of healthcare’s most ingrained geographic barriers. For example, for 2/3 of the world medical imaging is absent altogether, because it is either unaffordable, too far away, or both – a single probe that enables whole body, handheld ultrasound is not just about closing information gaps fast, it’s enabling access to a care modality that does not otherwise exist. This is true in low-mid income nations and in parts of higher income countries in rural settings. With such a pocket-based tool, imaging can be accessible anywhere, fitting easily and affordably in the pocket of every clinician, so they can see what they need to know. Such portability unlocks tremendous potential to advance global health equity, close gaps in rural care settings, and enhance what’s possible across other low-resourced as well as home care scenarios.
- Speed. Practitioners often call upon imaging modalities to confirm a diagnosis and treatment plan. With POCUS, care teams can introduce imaging as part of the initial assessment, speeding the timeframe for appropriate, optimal care. And thanks to cloud technology available to securely capture, transport, and store diagnostics from clinicians even hundreds of miles away, POCUS can easily deliver key imaging data to existing infrastructures housing patient data, enabling more thorough analysis across stakeholders. The new technology doesn’t operate in a silo, but integrates fully with existing enterprise systems, workflows, and EMRs, expanding the collaborative reach of the enterprise and supporting the sort of data-sharing required between hospitals and government agencies such as Health and Human Services (HHS).
Traditionally, ultrasound diagnostics have been performed by radiologists or sonographers who are not always readily available. That can lead to extended wait times that slow diagnostic delivery. For instance, today some states have 25% fewer radiologists than Medicare patients at a time when the population of Medicare beneficiaries has outpaced the number of radiologists entering the workforce over recent years. This leaves some states with nearly 30% fewer providers compared to patients who require imaging services—and the gap is growing.
- Diagnostic precision. Today, billions of people lack access to medical imaging and very often clinical decisions are made with incomplete information. In the majority of clinical scenarios, across a variety of care settings and geographies, clinicians base diagnostic decisions on how the patient describes symptoms, their history, a physical examination and vitals. But often, this limited information can only narrow assumptions of the diagnosis.
POCUS vastly expands access to powerful imaging insights that can drive better diagnostic decision making. And, when powered by AI to offer guidance and surface statistical wisdom from a vast database of cloud-based medical information—diagnostics are much more likely to be accurate.
New POCUS technology is becoming available at a very opportune time, and is likely to help hospitals establish a better standard of care both nationally and globally. Today’s ultrasound technology barely resembles that of the cart-based past. Rather, it’s a tool for the 42 million healthcare practitioners around the globe, those focused on the full spectrum of care delivery – from hospital to specialty, from acute to home-based, from primary care to value based care to chronic care and more.
All these factors combine to make POCUS today a story of optimism and hope in a healthcare industry that sometimes seems ever more burdened with bureaucracy and expense. Smaller, more portable devices combined with advanced analytics infrastructures are delivering critical insights across disparate environments of a health system, and empowering better decisions and outcomes. That’s good news for everyone. In time, these tools will prove value across the ecosystem, reducing time to diagnosis, accelerating treatment, driving efficiency, enhancing patient experiences, and enabling higher quality care. With such clear value and growing momentum, it’s only a matter of time.