Increasing system efficiency using POCUS

Point of Care Ultrasound (POCUS) is the use of an ultrasound imaging device at the bedside ofHeadshots of Dr. Amer Johri and Dr. Julia Herr patients and Dr. Amer Johri from the Department of Medicine at Queen’s University says it could become as common as the stethoscope. “These devices can be small, hand-held devices that may connect to mobile phones, tablets or may be laptop-sized machines. POCUS is able to provide a quick and accurate picture of the internal organs, such as the heart and lungs, and is therefore a powerful tool in the management of patients from Emergency Departments to Family Medicine offices,” he says. 

Recently, hand-held POCUS devices have made the technology more portable and widespread, and the integrated video-streaming software into their operational features now provides the ability to live-stream an ultrasound exam to another physician, such as a cardiologist, for consultation purposes. “POCUS is portable, quick, safe, and affordable compared to standard ultrasound machines. Ultrasound uses soundwaves to image internal organs, and as such, does not expose patients to harmful radiation. POCUS in the hands of primary care providers can enhance the physical exam,” Dr. Johri says. “POCUS can decrease the time to a correct diagnosis and appropriate treatment and can reduce the number of incorrect diagnoses by making imaging equipment available sooner. While a POCUS exam is not a substitution for a full, formal ultrasound exam by a sonographer on a full-size machine, a quick POCUS exam can help a physician determine what additional tests are needed or do not need to be ordered.” 

For specialists, POCUS has the ability to bring imaging services to otherwise underserved areas due to its portability. Specialists can use Tele-POCUS to communicate with care providers in remote areas, and to see live ultrasound imaging of their patients through this portable streaming technology, bringing expert knowledge to areas that may otherwise be lacking in it. Dr. Johri says, “The implementation of ‘Tele-POCUS,’ as developed by our group (the Cardiovascular Imaging Network at Queen’s [CINQ]), may be particularly useful for Indigenous and remote northern care centres, where access to professional cardiopulmonary services is limited or not possible. The issues associated with lack of care are compounded by the well-known and growing disparities in cardiovascular disease which disproportionally impacts the vulnerable Canadian Indigenous population.” 

Julia Herr, MSc is a CINQLab researcher that has been instrumental in the research into POCUS. Studies at the CINQLab and elsewhere have shown that integrating POCUS education into the medical school curriculum improves the students’ understanding of anatomy and recognition of simple disease pathology. “The addition of a standardized POCUS training curriculum to medical schools would ensure that future physicians would have an additional resource and skill available to them. We envision a “Hub and Spoke” model where Tele-POCUS conducted in remote settings, or by non-conventional users, is supported by experts in high-volume centres, thereby improving quality of care for patients over large geographic and regional areas,” Dr. Johri says. “This model has the potential to improve appropriateness of downstream imaging and increasing system efficiency.”