POCUS Uses You Need to Know
July 28, 2021
No doctor joins the medical field to spend copious amounts of time performing documentation. In 2021, doctors spent an average of 15.6 hours per week on paperwork and other administrative tasks. That was a dramatic increase from the experience of 70% of doctors in 2018, who reported that they spent about 10 hours per week on those same tasks. This leads to burnout for physicians, headaches for administrators, and most importantly, inconsistent care for patients.
Point-of-care ultrasound (POCUS) reduces the administrative workload for physicians so they can focus even more on providing the best care for their patients. So, what exactly is a POCUS ultrasound machine and where is POCUS used? In this article, we’ll provide an overview of POCUS medical devices and how you can use them to improve patient outcomes even further.
What Is POCUS?
POCUS technology brings the insights of an ultrasound machine to the point of patient care. Using pocket-sized, handheld, or cart-based transducer devices, POCUS technology often connects with smartphones and tablets to display images dynamically in real-time. That’s right, point-of-care ultrasound with an iPhone can have all the functionality of a stationary machine.
Why Is Point of Care Ultrasound Important?
When comparing point-of-care ultrasound vs an ultrasound that’s stationary, physicians gain:
- Convenience: POCUS technology is portable. That means you don’t have to send your patients off to another location, possibly at a later time or date, to get examined. You can perform the ultrasound immediately, document the results, and act on them.
- Funding: How much does a portable ultrasound cost? The POCUS ultrasound price can be as little as $2,000, while a standard machine can cost $30,000 or more.
- Patient Safety: Ultrasounds are preferred over many other imaging methods because they don’t expose the patient to ionizing radiation. POCUS takes safety one step further by allowing you to examine patients immediately, so you can diagnose your patient faster. In many situations, every second counts. POCUS gives you more of those seconds (and sometimes hours).
- Time: Platforms like Exo Works™ connect your ultrasound devices to your workflow system, so you can record your patient encounter in seconds. You can also send out results for feedback or to PACS and EMR remotely.
- Positive Patient Outcomes: The limiting nature of standard ultrasound machines leaves patients choosing not to follow up on appointments, and when they do, rushed documentation may lead to results getting overlooked. POCUS provides you with the autonomy to find and document the information you need to give your patients the best care possible without the wait.
What Is POCUS Used For?
POCUS can be used for early diagnosis, emergency examinations, procedural guidance, and to make patient care more efficient. A well-designed POCUS workflow is also able to complement POCUS exams to overcome many of the disadvantages of on-site ultrasound machines, such as scheduling complications and inconsistently documented results.
What Can POCUS Diagnose?
Point-of-care ultrasounds can provide real-time imagery to aid diagnosis for a variety of conditions, ranging from joint and tissue health to high-risk pregnancies. The following list is a very short example of the many conditions that can be identified and/or diagnosed with POCUS:
- Abdominal Aortic Aneurysm
- Deep Venous Thrombosis
- Acute Decompensated Heart Failure
- Ectopic Pregnancies
- Rotator Cuff Tears
POCUS technology is not only efficient, but it is also highly accurate. In two separate studies, POCUS yielded a 100% accuracy rate when screening for abdominal aortic aneurysm. For deep venous thrombosis, POCUS informed diagnosis with 97% accuracy. When examining shoulder injuries, POCUS can identify full-thickness rotator cuff tears just as accurately as magnetic resonance imaging (MRI) can. For monitoring pregnancies, physicians can detect masses outside of the uterus which can indicate an ectopic pregnancy in obstetric patients. POCUS can also be used to identify appendicitis; however, it cannot confirm the absence of the disease.
The case for POCUS accuracy is made more impressive by how easy the technology is to use. The American Academy of Family Physicians (AAFP) reports research that found that “a medical student was able to identify 15 out of 16 aneurysms in 57 patients after three hours of training.” The AAFP also reports a case in which after only two hours of training, primary care physicians were able to diagnose deep venous thrombosis with 90% sensitivity and 97% specificity.
Increased access to exams with POCUS not only enables earlier diagnosis, but it also helps patients feel like they are being taken seriously. In fact, 58% of patients who received a POCUS exam reported that they felt their concerns were heard, and 86% of patients trusted their physician more after a POCUS exam. More trust means that patients will open up more about their symptoms, so you can get to an accurate diagnosis faster.
How Can POCUS Help Emergency Cases?
POCUS can help emergency cases by making accurate, real-time imaging as accessible as a stethoscope. For many emergency cases, delayed diagnosis can result in a higher risk for complications and longer hospitalization. Appendicitis, for example, can be treated with an appendectomy if diagnosed in time. However, if left undiagnosed, appendicitis can cause the appendix to burst and spread a possibly life-threatening infection through the patient’s abdomen. Other emergency use cases that POCUS can improve patient outcomes for include:
- Chest and Abdominal Trauma
- Pregnancy Complications
- Abnormal Cardiac Activity
- Respiratory Distress
- Soft Tissue Infections
- Musculoskeletal Damage
- Bowel Obstructions
Point-of-care ultrasound technology is crucial in emergency cases because it gives results faster than a standard machine and eliminates the need to transport patients who are in critical condition. POCUS also reduces the amount of no-shows for scheduled ultrasound appointments. Patients have a variety of reasons for skipping examination appointments, even if they are facing a potentially serious condition. They may fear that they’ll receive bad news, or bulky ultrasound machines may give them anxiety. Furthermore, patients could run into scheduling conflicts, have trouble keeping track of when and where their appointment is, or feel frustrated that they didn’t receive results right away.
POCUS solves these blockers to care by eliminating the need for scheduling appointments at another time and/or location. Instead, you can conduct the ultrasound at the point of care and interpret and deliver the results. You’ll be able to move forward, and your patient will know what they’re up against instead of imagining the worst.
Can POCUS Guide Procedures?
Point-of-care ultrasound technology can be used to guide both musculoskeletal and non-musculoskeletal procedures, including the following:
- Nerve Blocks
- Carpal Tunnel Injection
- Knee Injection
- Glenohumeral Joint Injection
- Placement of Central Venous Catheters
- Fluid Drainage from Body Cavities and Lumbar Punctures
- Skin and Soft Tissue Abscess Incision and Drainage
- Internal Jugular Central Line
In many cases, POCUS can reduce complications and improve patient outcomes when used for guidance. For example, AAFP reports that “In central venous catheter placement, ultrasound guidance reduces complications, arterial puncture, and time to completion, and improves success.” When used to guide lumbar procedures, ultrasound guidance reduces instances of traumatic lumbar puncture. And, when used to guide superficial skin abscess drainage, POCUS increases treatment success.
POCUS can also reduce procedural pain when guiding musculoskeletal procedures. For example, ultrasound guidance has been found to reduce pain by 50% when used during knee arthrocentesis and knee injections. In bicep tendon sheath injections, POCUS guidance reduces average pain scores by 1.9 points out of 10. And, point-of-care ultrasounds help alleviate pain by 0.6 points out of 10 during glenohumeral joint injection procedures.
For its convenience and accuracy, point-of-care ultrasound is becoming the standard of care for many procedures.
With POCUS technology, it’s easier than ever to:
- Conduct exams at the point of care and eliminate scheduling headaches
- Immediately document results
- Report exams for billing
- Access and distribute information securely through the cloud
Insufficient POCUS Workflow Can Hinder POCUS Adoption
All too often, scheduling delays and complications lead to results going undocumented, patients not being billed, and loss of revenue. Improved workflows aren’t just good for your sanity and for administrators’ accounts payable statements. They also result in better care. When a patient’s results aren’t documented properly, you won’t have all the information you need to prescribe the best treatment plan. Point-of-care ultrasound devices when combined with an efficient workflow allow you to quickly document findings, so you can make the most informed decisions.
You can see even more benefits when pairing POCUS technology with a point-of-care ultrasound workflow solution.
Exo Works™: Your POCUS Workflow Solution
To physicians and their patients, more time means healthier outcomes. With POCUS technology, you can detect irregularities earlier, which gives you more time for treatment. At Exo, it’s our mission to improve patient outcomes even further. That’s why we developed Exo Works™—to give you even more time to work with your patients.
Exo reduces the administrative burden that takes vital time away from physicians. With Exo Works™, you can:
- Scan with any DICOM-enabled ultrasound machine
- Review and record findings in seconds
- Automatically save to EMR and PACS for storage and billing
- Securely distribute and access ultrasound exams through the cloud
Interested in learning more? See Exo Works™ in action.