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Handheld Ultrasound Education.

Embrace Handheld Ultrasound Training to Expand Patient Engagement

Handheld ultrasound may present the opportunity to help physicians further engage their patients, which is why some are evaluating adding it to their practices. After all, having another diagnostic tool is appealing to providers looking to improve patient care. However, bringing in this new technology requires training to get the most out of it. 

Many technologies have been presented as solutions, but few offer the accessibility, results and efficiency of hand-held ultrasound. For example, a study in Clinical Cardiology demonstrated "that the pocket-sized [portable transthoracic echocardiography (pTTE)] provides accurate detection of cardiac structural and functional abnormalities beyond the [electrocardiogram]." It also found that "the use of pTTE as an initial screening tool prior to [standard TTE] is cost-effective." And yet, the benefits don't stop there.

An Exceptional Patient Experience
The majority of patients most likely appreciate fewer tests, more convenience and reduced complications in their billing and financial experiences. Reducing unnecessary tests is important, and point of care ultrasound may be a practical step toward achieving that goal. According to Heart, "[Hand-held cardiac ultrasound] performed at the point of care by [family doctors] with remote expert support interpretation using a web-based system is feasible, rapid and useful for detecting significant echocardiographic abnormalities and reducing the number of unnecessary echocardiographic studies."

Increased Physician Engagement
Put simply, becoming a more confident user of handheld ultrasound gives physicians another way to engage their patients. According to the Journal of Ultrasound in Medicine, "By implementing pocket-size ultrasound examinations that took less than 11 minutes to the usual care, we corrected, verified or added important diagnoses in more than 1 of 3 emergency medical admissions. Point-of-care examinations with a pocket-size imaging device increased medical residents' diagnostic accuracy and capability."

Empowerment Through Ultrasound Training
Giving physicians access to the benefits of these new approaches to ultrasound and the physical examination requires training that is adaptable and that empowers physicians to optimize their results and maintain their skills over time.

On-Demand Training
The benefits of portable ultrasound training shouldn't be limited just to residents. Physicians who are advanced in their careers need flexible training methods to maintain and refresh their ultrasound skills over time.
Comprehensive, on-demand options facilitate continuous education and are accessible to physicians ranging from novice users who are just learning the technology to experienced practitioners who want to keep their skills sharp. These options include the following:
  • Focused courses.
  • Online videos and tutorials.
  • Point-of-care technology courses.
  • Point-of-care preceptorship courses.
  • Third-party training options.
  • Coaches.
  • Webcasts and webinars.
Learning Online
Online training now offers flexibility and continuous education that wasn't possible in the past. GE's POCUS FocusClass by 123 Sonography may help doctors gain confidence in performing basic ultrasound studies and interpretation. Physicians have access to modular options that can be tailored to training budgets, schedules and learning styles. These include common applications involving the following:
  • Heart.
  • Lung.
  • Obstetrics.
  • Kidney.
  • Vascular (abdominal aorta and deep vein thrombosis).
  • Biliary tract.
This type of training is designed specifically for primary care physicians and their busy schedules so that proficiency can be developed with maximum efficiency.

Today's ultrasound training options offer a wide range of benefits, including providing opportunities for physician champion projects, patient interaction initiatives and overall engagement goals. Clinical leaders invested in keeping their teams up to date in a fast-changing clinical technology landscape should keep ultrasound training on their shortlist of priorities.
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Handheld Ultrasound Education.

How Handheld Cardiac Ultrasound Aids in Diagnosis

Handheld cardiac ultrasound does not aim to replace routine comprehensive echocardiography, but its use may decrease the frequency of comprehensive scans. As a result, it might not only make clinicians' lives easier, but it may also lead to better patient experiences and outcomes.

Making a Cardiology Diagnosis
There are many applications for handheld ultrasound in making a cardiology diagnosis. For example, it may be used specifically to assess cardiac chamber size and function and valvular regurgitation. An article in Clinical Cardiology reported that "the pocket-sized [portable transthoracic echo (pTTE)] provides accurate detection of cardiac structural and functional abnormalities beyond the [electrocardiogram (ECG)]. In addition, the use of pTTE as an initial screening tool prior to [standard TTE] is cost-effective, suggesting that the pocket-sized pTTE is poised to alter the current diagnostic strategy in clinical practice."

Non-cardiologists may use handheld ultrasound as a tool for aortic stenosis and mitral regurgitation. This means that the ultrasound may be an adjunct to clinical examination in patients where a murmur is heard. Wiener Klinische Wochenschrift reports, "Pocket-size ultrasound imaging devices without continuous and pulse wave Doppler modalities can, even in the hands of a non-cardiologist with limited cardiac ultrasound instructions with high sensitivity and specificity, be a useful tool for detecting more than mild aortic stenosis and more than mild mitral regurgitation."

Handheld ultrasound may also be used to assess the volume status of the patient, via the inferior vena cava (IVC) diameter, as an indicator of progression of heart failure. As discussed in the American Journal of Cardiology, this use of ultrasound "is associated with an increased risk of heart failure admission and may provide clinically useful information at the point of care to guide heart failure management."

Augmenting Workflow
Handheld ultrasound may be used by primary care physicians to detect cardiovascular disease, and this may decrease the number of unnecessary formal echocardiograms. One study, published in Heart, used remote expert support to help interpret the handheld ultrasound images and found it to be "rapid and useful for detecting significant echocardiographic abnormalities and reducing the number of unnecessary echocardiographic studies."

Having repeat formal transthoracic echocardiograms (TTEs) to detect problems such as impaired ventricular function, pericardial effusion and IVC collapse is common. Using handheld, focused ultrasound scans of the heart may reduce the need for so many follow-up TTEs in a short space of time. A paper in the Journal of the American Society of Echocardiography concluded that "[t]he judicious use of expert focused cardiac ultrasound in place of repeat inpatient TTE has the potential to deliver quality cardiac imaging at reduced cost."

In some patients who are acutely unwell, moving them into a good position in their bed for a formal echocardiogram could be challenging. Handheld ultrasound may have an advantage as it can be used on patients in a semi-recumbent position. An article in Acta Anaesthesiologica Scandinavia concluded that "[t]he apparatus is well-suited for performing a [focus-assessed transthoracic echocardiography] examination in a one-day surgery setting and could very well also be applicable in almost any situation involving patients with acute illness."

Streamlining Care
What's more, handheld ultrasound may be used by cardiologists on their ward rounds. Being able to do a bedside ultrasound may reduce the number of formal echo studies that need to be done. As described in the American Journal of Medicine, "For hospitalized patients, [t]his finding could shift the burden of performing and interpreting the echocardiogram to the examining physician and reduce the number and cost associated with formal echocardiography studies."

In emergency departments, handheld ultrasound may reduce the time to diagnosis in patients presenting with shortness of breath. Herz reported, "One-third of patients had significant findings on the scans to possibly aid diagnosis and prevent misdiagnosis. This has the potential to reduce time to diagnosis in the [emergency department]."

Handheld ultrasound may be used by a broad range of healthcare professionals in different specialties to help streamline patient care, improve diagnosis and direct therapy — and it might be a beneficial adjunct to formal echocardiography.
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