Ultrasound: making waves where it has never gone before

by Gus Iversen, Editor in Chief | July 06, 2015
Population Health Primary Care Ultrasound Women's Health
From the July 2015 issue of HealthCare Business News magazine

“One village had a health house that didn’t even have doors and windows, they had electricity that would go on and off and they had no running water,” says Nordgren. Using smartphones and tablets donated by Sony, they encrypted and transferred the images via a 3G network to consumer tablets, where physicians reviewed them and sent back diagnoses within 24 hours. Out of 575 women imaged, they discovered
94 high-risk pregnancies and were able to take appropriate measures to ensure those women received medical care when it was time to give birth. The other 481 expecting mothers were cleared to give birth in the customary fashion of the culture.

Goodbye stethoscope, hello PUPEDs?
Ultrasound has not always had the luxury of mobility. “When it started, the systems were quite large, like a refrigerator,” says Mount Sinai’s Narula. Patients had to be brought to a lab much the way they would for an MR or a CT scan. The growth of handheld ultrasound has allowed the procedure to take on a more fundamental role in patient evaluation. Incorporating handheld ultrasound into general examinations could reduce the overall cost of imaging care while also providing better outcomes and improving doctor-patient relationships, says Narula. “It is one of the most important ways of bringing medicine to the bedside, being able to get an accurate diagnosis, avoiding unnecessary imaging studies, and ensuring that what we identify is worthy of further investigation.”

Narula points out that the Greek origin of stethoscope can be translated as, “look inside the chest,” – and he believes it’s time to update the medical dictionary. “Ideally the ultrasound should be called stethoscope and the stethoscope should be called stethophone or something like that,” he says.

Philips Healthcare has initiated a consortium of health care leaders to drive the creation and implementation of mobile ultrasound solutions, and it counts Narula among the inaugural members. “One of the things we’re working on is credentialing for these handheld systems,” says Vitor Rocha, CEO of Philips Ultrasound. “How do you extend the use of these systems while ensuring high-level care?”

Narula says he has seen firsthand the ease with which student doctors can adapt to handheld ultrasound, “This is the generation of Playstation and they know how to handle gadgets.” On the other hand, he says, it’s the art of using a stethoscope that is being lost. “I don’t think the people from the Western countries have any talent left in terms of identifying the heart sounds and murmurs the way we used to do in the previous years,” says Narula. “We used to get significant one-on-one training with stethoscopes but that doesn’t happen anymore and our students today are incompetent at making diagnoses with it.” Instead he says they’re more likely to suggest imaging exams.

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