What Is Point-of-Care Ultrasound and What Can It Do?
January 14, 2023
What Is Point-of-Care Ultrasound and What Can It Do?
Point-of-care ultrasound (POCUS) describes a type of ultrasound machine that emphasizes the care for patients at the bedside (or wherever treatment occurs), rather than requiring patients to move to the ultrasound machine’s location. POCUS devices are usually more portable and more cost-effective than traditional console machines.
With a portable ultrasound machine, physicians can move the machine to patients instead of the other way around. This improves patient comfort and outcomes. Yet, cart ultrasound machines aren’t always the best type of portable ultrasound. In this article, we’ll go into more detail about which pain points POCUS solves for patients, physicians, and administrators, as well as how to get the most out of your POCUS process.
What Is Point of Care Ultrasound (POCUS)?
Point of care ultrasound (POCUS) technology enables physicians to benefit from imaging where the patient is. This cuts down on the extra time and risk associated with transporting patients, especially those in critical care. When it comes to POCUS, you have two primary options:
- Cart-Based: Cart-based POCUS devices offer more flexibility than stationary machines, but they are still more costly and restrictive than handheld devices.
- Handheld: Handheld devices offer the most for mobility and cost-effectiveness.
However, care centers should compare devices on the market to ensure they obtain the best ultrasound for the price, durability, image quality, and overall value.
A handheld point-of-care ultrasound machine only requires two small devices: the scanner and a computing device, such as a smartphone or tablet. This means you can get results quickly for your patients, whether they’re in the emergency room, a private practice, or even an ambulance. With the right ultrasound workflow, you can also make consistent billing a breeze and relieve financial pressure from across departments. In other words, getting the most out of your point-of-care ultrasound requires both the right devices and the process to scan patients, communicate their results, store information, complete billing, and continue care.
How Does Point of Care Ultrasound Work?
Point-of-care ultrasound works similarly to other types of portable ultrasound machines. The physician uses a transducer device to scan the patient. The transducer then sends images to a screen for the physician to examine. The key differences between POCUS and traditional portable ultrasounds are:
- Handheld POCUS equipment is smaller and more mobile
- Physicians, rather than radiologists, usually read the scanned images
With reduced equipment also comes reduced costs, which we’ll cover later on.
Are There Point of Care Ultrasound Guidelines?
- Competency-based point of care ultrasound training that requires knowledge on when to conduct exams, how to scan patients, how to interpret images, and how to document findings for further patient management.
- Centralized requirements for POCUS certification that qualify practitioners based on a standard set of core competencies.
- Quality assurance measures that recommend reviewing 5-10% of an institution’s POCUS records to ensure that users are following best practices.
Typically, the care center’s POCUS program implements and tracks these guidelines.
Who Performs Point of Care Ultrasound?
Trained clinicians can perform point-of-care ultrasounds. One of the key advantages of POCUS over other imaging methods is that POCUS does not need to be performed by a sonographer. By enabling one person to scan, interpret, and document images, POCUS makes the ultrasound process quicker and more efficient, which is great for:
- Patients, who receive faster care
- Physicians, who can quickly gain key insights
- Administrators, who can accurately complete billing and meet compliance
What Is Point of Care Ultrasound Used For?
Point of care ultrasound is a versatile solution, and POCUS uses include:
- Emergency examinations
- Procedural guidance
What Can POCUS Diagnose?
Point of care ultrasounds can be used reliably to detect many conditions, including:
- Abdominal Aortic Aneurysm
- Gallstones and Cholecystitis
- Bowel Obstruction and Perforation
- Decreased Cardiac Ejection Fraction and Presence of Pericardial Effusion
- Deep Venous Thrombosis
- Elevated Intracranial Pressure
- Hydronephrosis (caused by renal blockage)
- Intraperitoneal Bleeding in Trauma
- Obstetric and Gynecologic Conditions (such as Ectopic Pregnancy)
- Respiratory Distress
- Retinal Detachment
- Skin and Soft Tissue Infections
Point of care ultrasound not only offers ease of use and efficiency for physicians, it does so without sacrificing accuracy. For example, findings published by the American Academy of Family Physicians (AAFP) report that POCUS has a 98-100% sensitivity when screening for abdominal aortic aneurysm.
In addition to diagnostics, physicians can also use POCUS to guide the following musculoskeletal and non-musculoskeletal procedures:
- Nerve Blocks
- Knee Injection
- Carpal Tunnel Injection
- Glenohumeral Joint Injection
- Central Venous Catheter Placement
- Fluid Drainage from Body Cavities and Lumbar Punctures
- Skin and Soft Tissue Abscess Incision and Drainage
- Internal Jugular Central Line
When used to guide procedures, POCUS can improve patient outcomes. For example, the same AAFP report referenced above found that when used to guide internal jugular central line procedures, POCUS can help physicians reduce complications and procedure time by 30 minutes.
How Can You Improve POCUS Workflows?
The advantages of POCUS become even more clear when you combine the portable
hardware with an intuitive workflow solution like Exo Works™. POCUS workflow software can help your team overcome common and frustrating pain points.
Knowing where gaps in documentation help connect patient care to billing and compliance. Care centers strive to provide excellent care for their patients. However, if an institution’s processes, finances, and compliance aren’t in order, care providers may need to cover for gaps in these areas, which takes attention away from patients. In many cases, a lack of time causes gaps in documentation. POCUS workflow reduces these gaps by taking
users from scanning to billing with four steps:
- Scan patient with a DICOM-enabled device.
- Review images and document findings.
- Automatically save images and findings to EMR and PACS for simplified billing.
- Store data in the cloud to enable secure distribution.
Is POCUS Cost Effective?
POCUS is cost-effective both as an initial investment and an ongoing cost-saving process. Typically, you’d expect a larger investment to yield better returns, so why is this different when it comes to ultrasound machines? To start, let’s look at initial costs.
How Much Does an Ultrasound Unit Cost?
Hospitals can purchase ultrasound machines that range from $40,000 to $200,000 or even more. So, how much is a point-of-care ultrasound? According to the American Academy of Physician Associates (AAPA), the average point-of-care ultrasound price is 1/15th of the cost of a traditional ultrasound machine. With lower initial costs, care centers can invest in more devices, which leads to our next point: cost savings through improved processes.
Ultrasounds—especially when used in emergency settings—can be a financial and legal liability. When multiple physicians need access to the same ultrasound equipment, bottlenecks form in an environment that’s already extremely time-sensitive. This leads to cut-corners, such as a lack of documentation because physicians need to prioritize acting on findings above recording them. While doing so is often necessary to deliver effective care in the short-term, documentation gaps lead to more problems down the line.
Some of the most common issues are:
- Reduced Patient Outcomes: Incomplete documentation can make it more difficult for follow-up care providers to take the best course of action because they are missing important information.
- Legal Liability: When poor documentation compromises care, or when procedures have complications and lack the proper documentation to justify that procedure, care centers can be held legally responsible.
- Financial Strain: Without proper documentation, care centers can’t consistently process billing. Other departments are then pressured to make up for lost revenue, which can lead to similar problems in more departments.
POCUS devices enabled with workflow software help alleviate these pain points because:
- Physicians can quickly access ultrasound devices, so they don’t lose time transporting patients or waiting for cart machines.
- POCUS devices can fill in documentation gaps by automatically recording, saving, and reporting findings to billing.
Essentially, POCUS helps documentation work for care providers instead of against them, the way it’s supposed to. By helping to provide more efficient care and improving billing procedures, POCUS saves money at every step.
What Is the Best Portable Ultrasound?
The best portable ultrasound device is one that’s enabled with end-to-end workflow software. Here’s why. Point-of-care ultrasound benefits include improved patient care, better legal compliance, and increased revenue. However, without the right software, physicians will face many of the same challenges as they would with console machines.
Physicians may be able to perform scans more efficiently, but they will still be pressed for time when documenting findings, resulting in the familiar issues of missing information and lost revenue.
Exo Works exists to take the chaos out of ultrasound workflows. Care centers are hectic enough, and physicians do what they can to deliver the best care possible. Ultrasounds shouldn’t be an obstacle. By enabling physicians to scan and record findings in seconds, Exo puts the focus back on patients.
Ready to see it for yourself? Schedule a demo today.