Point of care ultrasound reduces the impact on departmental radiology and echocardiography services: results of 1 year service evaluation.

Abstract

Point of care ultrasound (POCUS) is becoming an increasing part of the assessment and management of patients within internal medicine. There is ample evidence confirming the diagnostic accuracy of POCUS in acutely unwell patients, but very little focus has been placed on the resource implications of introducing a POCUS service to a department. We provide here a complete evaluation of one year of reported scans in a district general hospital Acute Internal Medicine department, analysing the impact on departmental imaging requests following a POCUS scan. Between January and December 2023 a total of 467 scans yielded 572 individual reports, comprising thoracic, abdominal, urinary tract, deep vein thrombosis, echocardiogram and musculoskeletal scans. Of these reports, a departmental imaging request followed in only 154 (26.9%) of cases. Even when excluding thoracic ultrasound (which typically is not performed within radiology services), 188/321 cases (58.6%) did not require a subsequent departmental imaging request. For all individual scan types, in at least 45% of cases a departmental scan request did not follow. Where departmental requests were placed, in 34/154 (22.1%) cases they were for outpatient imaging rather than inpatient scans, meaning in total in only 120 (20.1%) instances did a POCUS scan lead to a subsequent inpatient imaging request. These data show that a dedicated internal medicine POCUS service will lead to significant reductions in inpatient radiology and echocardiography requests, rather than increasing the burden as previously hypothesised. They provide support to those departments considering setting up such a service.