Healthcare Anywhere: Handheld Ultrasound Improves Access Around the Globe

In Zambia, Africa - a cost-effective, real-time imaging tool

When it comes to providing care to their patients, almost every clinician can vividly recall the moment they fell in love with their trade, with each hallmark moment after that fueling their passion.

For Sister Miriam Cibale Mushoda, nurse practitioner at the Chilanga District Health's Center in Zambia, Africa, this moment came in a deceivingly small package. One that allowed her to not only improve how she cared for her patients, but also see inside the body in ways she wasn’t able to before.

"I used to use my hands to tell if a baby was in breech,” Sister Miriam said. “The first time I held the ultrasound probe and was able to see the fetal heart and cardiac activities--and the presentation of the baby--was the greatest day of my life.”

With ultrasound now at the health center, Sister Miriam and her team can care for expecting mothers with improved diagnostic confidence by seeing what they could once only feel and hear. The ultrasound system provides portability, cleanability, and quick information for clinical users.

The nurse practitioner now sees 30 women a day--more than double the previous number as a result of using handheld ultrasound--transforming care for women in their country. If the patient can’t come to the clinic, she simply takes the portable ultrasound in her backpack and travels by bicycle to the patient’s residence.[1]

Like many rural and remote parts of the world, Sister Miriam’s patients used to travel several kilometers to have access to ultrasound technology. This challenge is not unique to Africa. The World Health Organization (WHO) reports that two-thirds of the world's population has no access to basic X-ray or ultrasound examinations, and if they are available, quality and safety can be questionable or dangerous.[2]

No matter the location or care circumstance, handheld ultrasound has proven an invaluable tool for many clinicians as a cost-effective, real-time tool to triage and determine patient care. The device's portability, ease of use, and connectivity make it an indispensable and critical tool for primary care providers around the globe.

In Southern France - an extension of the clinical examination

Approximately 11,000 kilometers away in the commune of Les Vans in Southern France—population 2,600 with approximately 10,000 in the surrounding area—general practitioner Dr. Francis Pellet said the GE Healthcare Vscan Extend handheld ultrasound and cloud connection are "the ideal, if not the best tools in primary care, an extension of the clinical examination."

Although he also works in a remote location, he still manages the same complex cases as his fellow physicians in Paris. The handheld ultrasound allows him to conduct the same diagnostics as they do, and to collaborate virtually with them there and anywhere.

Handheld ultrasound is especially useful for diagnosing lung inflammation, allowing doctors to determine which patients are at risk, he said.

During the COVID-19 pandemic, from a local pool of 2,000 people with pulmonary inflammatory symptoms, his team tested everyone with ultrasound and identified 10 to 12 patients per day, or about 10 percent, who needed special follow-up or different monitoring.

The handheld ultrasound also provided information that allowed him to diagnose a severe case of cardiac decompensation that required surgery 15 days later, and a surprising, serious case of advanced cardiomyopathy in a 20-year-old male.

"Ultrasound examination can guide a clinical response, meaning it can help assert, or on the contrary, exclude a diagnosis," Dr. Pellet said.

Dr. Pellet said handheld ultrasound has proven very efficient because it:

• Facilitates early, reliable and accelerated diagnosis in binary response echo-clinical situations;

• Improves clinical evaluation, management, patient follow-up and referral to competent specialists or emergencies;

• Reduces referring a patient to second-line medicine when it provides evidence of no increased risk; and

• Reduces emergency room congestion and delays in obtaining appointments in radiology centers.

In the United States - expanding care and increasing patient face time

For family medicine physician Dr. David Flick, an early user, there’s been "seemingly endless benefits from adopting a handheld ultrasound," including saving time for diagnosis and significantly reducing costs when used at the bedside—so patients needn't be referred to a specialist.[3]

"It’s as accessible as the stethoscope around my neck," said Dr. Flick, now associate director of advising at MedSchoolCoach and a flight surgeon for the U.S. Army.

He attended the Family Medicine Residency Program at Tripler Army Medical Center in Hawaii where he established a residency ultrasound curriculum and taught point-of-care ultrasound to residents and employees at nearby clinics. Then he encouraged the first family medicine residents to join the Army's Emergency Medicine Ultrasound Fellowships.

"Giving medical personnel this experience from the start of their education will only benefit their professional careers in the long run," he said.

Like Dr. Pellet and Sister Miriam, Dr. Flick believes use of the handheld ultrasound strengthens patient relationships.

"It both increases the amount of face time individuals have with us and expands the type of care we are able to provide," he said. Plus, the incorporation of artificial intelligence (AI) adds the extra element of increased overall speed in workflows.

In Zambia, Sister Miriam and her team know the handheld ultrasound has not only helped minimize distance challenges for patients, but also reduced pregnancy risks and mortality rates.

"I am smiling, people in the community are smiling," said Sister Miriam. "I feel like it will be with me until death do us part."

[1] The device has been verified for limited use outside of professional healthcare facilities. Use is restricted to environmental properties described in the user manual. Please contact your GE Healthcare sales representative for detailed information.

[2] Accessed on 1/5/2021: https://web.archive.org/web/20121023154427/http://www.who.int/eht/en/DiagnosticImaging.pdf

[3] Accessed on 1/5/2021: https://www.dotmed.com/news/story/49035?p_begin=0