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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

“Teaching someone to do ultrasound is not that tricky, I’ve become pretty good at it myself,” says Nordgren with a laugh. “It’s reviewing them and reading them, and making the diagnosis – that’s where the scarcity comes in.” Rocha and Narula both stressed that in a primary care setting, ultrasound would be intended for conducting a better initial examination – not replacing ultrasound as a specialty imaging modality.

Narula calls his ultrasound-as-stethoscope a “portable ultrasound as a physical examination device (PUPED)” and believes the cost of the imaging should be included in the exam itself. Medical students would be trained on the PUPEDs the same way they were once trained with stethoscopes, says Narula. He breaks down the schooling as follows: First year students would learn what normal looks like, in their second year they would contrast that vision of normal with examples of what is abnormal. By the third and fourth year they would start using PUPEDs for algorithms where, “If I look at these five things I can make a diagnosis in 95 percent of cases right at the bedside without requiring a full-fledged imaging exam,” says Narula.

For the remaining five percent, more advanced imaging may be called for. “The echocardiography laboratories are afraid this will decrease the number of scans going to them – which it will,” says Narula, “but only the unnecessary ones.”

Premium systems: A different ballgame
While handheld ultrasound may take the spotlight, premium ultrasound systems are ensuring better outcomes for the most complex patients. These high-end systems also continue to hold the largest share of the market, according to Jon Brubaker, an industry analyst from MD Buyline. Most of the quotes he sees pertain to the premium systems. “Cost-wise they are multiple times more expensive than hand-held systems,” says Brubaker, adding that the price can sometimes reach upward of $300,000. Cardiology and radiology accounted for over 25 percent of the overall ultrasound market in 2014, making them the largest individual segments.

Carestream, a leader in digital X-ray, announced at RSNA 2014 that it was going to delve into the ultrasound market. The company’s first two Touch Ultrasound systems received FDA approval this June. Its entry into the market is unusual, according to Brubaker, because where most newcomers target the lower-end segment, these are decidedly high-end offerings.

“Carestream is an innovator,” says Andrew Hartmann, the company’s general manager of global X-ray solutions, by way of explanation. “Innovation is cutting-edge, and cutting-edge is typically at the high end of imaging performance.” Premium ultrasound systems – a segment dominated by companies such as Philips, GE, Siemens, Acuson, Terason, and Toshiba – provide better quality images than their handheld counterparts. They are also more useful to unique departments within the hospital, having specialized transducers that make them capable of highly specific configurations.

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