ACEP ID:

Emergency Ultrasound

Industry Roundtable Update

EUS Section Industry Subcommittee
Matthew Flannigan, DO, FACEP, Director, Advanced Emergency Medicine Ultrasound Fellowship. Spectrum Health / Emergency Care Specialists, Grand Rapids, MI

Jason Nomura, MD, FACEP, Director, Advanced Emergency Medicine Ultrasound Fellowship; Director, Institutional Clinical Ultrasound. Christiana Care Health Systems, Newark, DE

Rachel Liu, MD, FACEP, Director, Advanced Emergency Medicine Ultrasound Fellowship; Director, Point-of-Care Ultrasound Education. Yale School of Medicine, New Haven, CT

 

Background

Each year the ACEP Industry Roundtable leadership seeks to engage industry vendors to improve their products (hardware, software, service). This partnership and ongoing communication led to significant improvements in ultrasound equipment and workflow.

ACEP ultrasound leaders have assisted vendors with prioritizing their research and development efforts. Our discussions have stimulated innovative ideas that address our community’s main points with performing, documenting, reviewing, and sharing our ultrasound images and interpretations.

This year’s discussion and future projects were guided with input from the survey sent to our section’s ultrasound leadership this Fall.

US Leadership Survey

Demographics

    • 94 respondents; 57% ultrasound directors; 75% leadership roles
    • Most Used Vendor: Fujifilm 47%; Mindray/Zonare 34%; GE 12%; Philips 7%
    • EMR: Epic 64%; Cerner 17%; Meditech 9%; Other < 10%
    • QA Software: QPath 50%; No Workflow Solution 32%; Other 10%; Custom 8%, Butterfly 2%

 

Requested Areas to Focus:

1. Workflow Networking and Connectivity- 48%
2. Ability to Scale Workflow Across Machines / Departments / Hospitals - 22%
3. Hardware / Disinfection- 17%
4. Standardized Reporting-16%
5. Artificial Intelligence/Telehealth- 11%

 

Future Project Ideas

Patient Wristband Barcode

1. Physicians expressed difficulty having an appropriate barcode to scan. Each system is different. Barcodes might represent the patient’s FIN, MRN, or pharmacy number.

2. Vendors are willing to assist physicians identifying correct barcode

      • Action: gather multiple health system wristbands to identify patterns.
        • Group by EMR
        • Details
          1) One wristband without labels
          2) Second wristband with labels (MRN, FIN, Pharmacy, etc)
          3) Label health system, department, and patient volume represented by wristband type

Workflow Standard

1. Vendors want direction 

      • Ask: Physician leaders to create a white paper. Features that would broadly represent our community.

2. New equipment models have increased features to support modality worklists, ldap, regex, barcode

3. Modality Worklists

      • Assemble peer references available through QA software vendors/EMR
      • Ask: Request vendors to assist clinicians with identifying “role model” institutions that exemplify ideal workflow integration.

4. RFID

      • Achieve improved workflow if able to access machine via LDAP (local directory access protocol / single sign on) and then record physician performing the exam (one-step process)
      • Integrated with machine or via peripheral (JADAK)
        • Setup meeting with Jadak to explore workflow with barcode /RFID scanner
          • Ability to customize cord length
          • Ability to create holders specific for vendors/models

5. EPIC / QA Software Interface

      • Setup meeting
        • Ability to send QA notification to inbox?
        • Batch notifications for incomplete exams?
        • Contact: Ashley Singletary

6. Create POCUS Dashboards 

      • Exams clinically - indicated vs. educational (QA Software)
      • % Appropriately Documented (QA Software)
      • % Billing (EMR/QA Software / Other)
      • % Reimbursed (Billing Dept)
      • LOS with POCUS vs. RADUS (EMR)

 

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