Family-med POCUS is growing strong, but problems aren’t solving themselves
Close to 90% of family-medicine departments at U.S. medical schools employ one or more faculty members trained in point-of-care ultrasound, including 7% that are presently training at least one (or one more).
So report researchers at the University of Michigan who analyzed around 100 survey responses from family-medicine chairs.
The survey was conducted in August 2021 by the Council of Academic Family Medicine’s Educational Research Alliance (CERA), and the results are described in a study published online July 27 in the Journal of the American Board of Family Medicine [1].
Lead author Juana Nicoll Capizzano, MD, senior author Diane Harper, MD, MPH, also found 32% of family-medicine departments running an established POCUS curriculum and 28% actively working to create one.
Just two years prior, they note, only 6% of family-medicine programs offered an established POCUS curriculum.
The authors suggest the teaching trends are following patterns in clinical utilization.
“POCUS is rapidly becoming recognized as one of the most effective, cost and time-saving bedside tools of the 21st century,” Capizzano and colleagues comment. “POCUS has utility for assessing patients, providing real-time diagnostic and monitoring information, and it plays a key role in optimizing many procedures with direct visualization.”
Frustrating Forays Into Image Management, Radiological Billing Codes
At the same time, the present survey shows practitioners struggling to reckon with major obstacles hindering broad adoption.
Not least among these are means of confidently billing for, and thus reliably getting paid for, the clinical use of POCUS.
For example, even though 80% of the surveyed department chairs have at least one faculty member trained in POCUS, only 6% are currently billion for POCUS use in ambulatory clinical care.
“This is broadly in line with data from a retrospective Medicare claims study that reported 9.2% of primary care physicians billed for POCUS during 2012 to 2017, with approximately half of this by family physicians (4.8%),” the authors write.
Further, 73% of survey respondents indicated they’re having a hard time establishing billing systems for clinical POCUS use.
Doing so is difficult, the authors point out, because most family physicians and primary-care administrators are unfamiliar with processes like capturing and storing imaging data, documenting reports and fulfilling other criteria for billing specific radiologic CPT codes.
Indeed, such duties represent “arguably the key steps currently preventing the expansion of POCUS use into ambulatory clinical care,” Capizzano and co-authors remark.
More:
Significant initial costs for POCUS training, equipment and secure software packages could be offset if departments can learn to successfully bill for clinical POCUS use. Collaborating with the 6% of departments that have successfully implemented billing for POCUS use in ambulatory care may be one avenue that could be explored to address these difficulties.”
‘Implications for Educational, Scholarly and Clinical Missions’
Meanwhile the highest hurdle to establishing a POCUS curriculum in academic family-med departments turns out to be a lack of time for faculty to receive training, the researchers ascertained.
Not far behind are purchasing equipment and “sharing notes” on training with unaffiliated family-medicine departments.
“POCUS use in family medicine is significantly expanding across the U.S. with implications for educational, scholarly and clinical missions,” Capizzano et al. conclude. “Academic family physicians trained in POCUS, the rapid development of POCUS curricula in family-medicine departments, and the emerging dissemination of POCUS use into ambulatory clinical care across the United States [all] continue to rise.”
As the growth continues, they add,
it is imperative to create a more efficient and less hindered road to growth. Collaboration across departments to share best practices in training, purchasing equipment and billing for POCUS will be important to facilitate high-quality POCUS access for our patients.”
The study is posted in full for free.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.