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Solving revenue capture for POCUS - The importance of workflow management

Gus Iversen, Editor in Chief | November 30, 2020
Ultrasound

The formal QA process governing residency was also extremely cumbersome with our old workflow system. When a resident sees any patient, they have to have an attending physician attest to being present for key components of the visit as well as all procedures—including ultrasounds. Another person then reviews the ultrasound scan for quality assurance, asking: Did the resident and the attending pick up all the findings? Could they have adjusted their technique a bit for a better scan? Removing barriers to locating scans and communicating feedback improves the learning curve of both residents and attendings.

For attendings, too, credentialing is a relevant issue: every two years they have to prove that they’ve accomplished a certain number of studies, for instance. With our old system this was extremely difficult to prove, and required Excel spreadsheets and a ton of painstaking labor. Now we can easily generate an administrative report simply by inputting the provider name, specific date range, and exam type. You can imagine how much better the staff responsible for that recredentialing feels about the new system.

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HCB News: Are there any other QA or credentialing issues that fall to your point-of-care ultrasound workflow solution? Anything around your trauma center status, for instance?
Dr. Hipskind: Absolutely. It’s not exactly credentialing, but we do undergo an American College of Surgeons trauma accreditation . One thing they look at is what’s called an eFAST ultrasound, which is widely used to initially evaluate a critically ill patient. Emergency medicine physicians are obviously very facile with this—but the problem for us was that our surgeons were avoiding these scans. What we eventually learned was that they knew how to use the machine fine—it was the storage of the images, putting the images in PACS, and doing the QA that they found so difficult that they were avoiding it altogether. Our new system makes all of that intuitive and clear. Its ease of use is just amazing—which is important for evaluations, of course, but also because trauma centers depend on different specialists working closely together. Our patients deserve the best coordination, so if we can remove any unnecessary barriers, we should.

Let me share a brief story to illustrate how elegant our new Sonosite Synchronicity system is. Recently I was walking through how to do a scan on a stable trauma patient with a resident. He actually already knew how to do the scan, but he hadn’t yet stored the exam for QA and for the EMR, so I showed him how to do that on the new system. Two hours later we had a moderate trauma patient come in—and the resident said “Let me see if I can do this myself”—and on first pass he easily completed the documentation and actually made a really nice diagnosis. None of that would have ever happened with our old system.

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