Why Dr. Arun Nagdev Uses POCUS to Improve Patient Care

Arun Nagdev, M.D., the Senior Director of Clinical Education at Exo, works closely with a variety of physicians, from experienced attending physicians to fellows, residents, interns, and medical students. But no matter whom he works with in the medical community, he advocates for utilizing point-of-care ultrasound (POCUS) to deliver improved patient outcomes.

In his ultrasound fellowship year at Highland Hospital in Oakland, California, he was learning the basic skills of POCUS from emergency physicians who literally wrote the first book on the topic. Pioneers in the emergency department at Highland Hospital taught him the basics and allowed him to grow as a clinician, learning how to incorporate this new technology into his medical practice. By the time he moved back to Brown University for his first attending job, he had become the young doctor who was bringing POCUS to the emergency department. He would push the one and only cart-based ultrasound system all over the emergency department as he checked in on patients. “I was the young guy out there,” Dr. Nagdev recalls in an episode of the Mastering Medical Device podcast. “I was off ultrasounding everybody, and the nurses would laugh at me because I carried that machine with me.”

His memory is filled with numerous cases: a young woman who came to the emergency department for chest pain and the bedside echocardiogram showed that she had a large pericardial effusion; a young pregnant woman who came to the emergency department in shock, and with the help of ultrasound, was diagnosed in under five minutes with ectopic pregnancy; the sick-appearing eldery man who almost passed out at home and during the intial evaluation on ultrasound was noted to have an abdominal aortic aneurysm that was leaking.

Over the next three years as the POCUS director, Dr. Nagdev realized the importance of point-of-care ultrasound integration into patient care, and how imperative it was to teach the next generation of clinicians. Since then, Dr. Nagdev has been on a mission to increase clinical POCUS education for all physicians, “We have the opportunity to train different generations of physicians on this new advancement in POCUS and improve efficiency in patient treatments.”

Growing with Point-of-Care Ultrasound

POCUS has advanced significantly since Dr. Nagdev first started using ultrasound at the bedside. Many companies are working to improve the ultrasound systems; making the image quality better, smaller and more mobile. The expensive, cart-based ultrasound machines of decades past are evolving into handheld probes that physicians can always have, wherever they are located. This allows for ease of use in bedside imaging and improved patient care.

According to Dr. Nagdev, the main drivers for portable point-of-care ultrasound originated from physicians, “The point-of-care market evolved because of clinicians who were using it wanted companies to build systems around them. They changed the user interface. They made them smaller. They made it easier for us to use and they made it possible for us to go from patient to patient, rather than the patient coming to us.”

“The technology continues to improve rapidly because new physicians want portable ultrasound systems. Internal medicine is training healthcare professionals how to use ultrasound, as is hospitalist medicine and orthopedics — almost every field is now touching the imaging space and using ultrasound as a modality to improve patient care,” Dr. Nagdev remarks.

The user experience of POCUS is also enticing physicians, as it runs on familiar devices, such as a smartphone or tablet. But Dr. Nagdev remarks that hurdles are still preventing widespread POCUS adoption. For too many hospitals, outdated workflow software hasn’t evolved in tangent with handheld POCUS devices, which makes performing and documenting an ultrasound exam at the bedside a convoluted process.

Dr. Nagdev compares Apple’s success as a great example of user experience and how the same approach could change point-of-care ultrasound: “Apple recognizes their product is useless unless people love using it. If I have a great system that shows me great imaging, but my novice user or new medical student is really uncomfortable using it, the adoption is going to be low and they're not going to want to use it.”

The good news is that companies like Exo have recognized this POCUS workflow pain. Exo recently launched an intuitive ultrasound workflow solution, Exo Works™, so that physicians can now easily document ultrasound findings, review exams for quality assurance, and seamlessly send exams for billing, all from a single mobile application in seconds. Learn more here.

Empowering Physicians with POCUS

Dr. Nagdev sees the next generation of physicians utilizing point-of-care ultrasound even more, and Exo couldn’t be more than excited to have him leading the way to help more clinicians adopt POCUS in their practice to improve patient outcomes.
“I think once you give people—in any age group, with any skill set—the opportunity to do procedures with ultrasound, it just happens. They get it,” says Dr. Nagdev. “I think this is something that every clinician can do comfortably and safely.”

Listen to the entire interview on The Mastering Medical Device Podcast.