Intelligent Network for Point-of-Care Ultrasound

Throughout 2020–2021, IN PoCUS made great strides towards its goal of expanding the use of handheld ultrasound devices across BC. Fifty devices have now been purchased and sent to rural communities in all health authorities, including the First Nations Health Authority. Additional rural physicians, who have purchased their own handheld ultrasound devices, have also been recruited into the project and are eager to participate in its innovative roll-out to extend the rural IN POCUS community of practice.

Despite ongoing pandemic restrictions, which curtailed in-person learning opportunities throughout the year, IN PoCUS was able to continue its handheld ultrasound training for rural healthcare providers. The team successfully completed its first virtual course for novice users, which, although challenging, enabled practitioners from across the province to participate. Individual expert ultrasound educators also engaged interested physician participants in one-on-one training throughout the year via the Clarius application, or Zoom. In addition, relationships cultivated with the University of British Columbia’s Coaching and Mentoring Program enhanced educational opportunities and support for the IN PoCUS project.

Evaluation of IN PoCUS is crucial for demonstrating the need for greater access to handheld ultrasound assessments and diagnostics in rural areas, and to improve the project. Dr. Jude Kornelsen, Co-director for Rural Health Research, was hired to perform an evaluation of IN PoCUS with the intent of publishing the findings in the coming year. As the evaluation continues, the IN PoCUS team is collecting qualitative feedback from participating practitioners who described how handheld ultrasound improves patient care, increases patient satisfaction, and reduces or expedites transfers:

“We had a febrile patient with shortness of breath come into our isolation zone. There was nothing specific on work up: An elevated white count, a bit of an elevated C-reactive protein, but the chest x-ray was clear. With the Clarius, I was able to see some isolated inferior B-lines. I remember thinking, ‘That’s weird’. I admitted for pneumonia, just in case, and kept in isolation until we got our COVID-19 swab back, which was positive. So, the Clarius PoCUS assessment did directly help raise clinical suspicion for COVID, and helped keep that patient properly isolated. If they went home, or out of isolation, there very easily could have been an outbreak.”
—Dr. Kevin Fairbairn, Nelson, BC

“…I was the “street doc” in Campbell River this week and saw a woman who had not yet presented for any care. I was able to see her at the request of the mental health team and, because I could do an ultrasound, could get a sense of where we were at regarding gestational age. Seeing her baby’s heartbeat and movements also likely helped her to agree to engage in care. She got to the lab for her bloods minutes after leaving my care.”
—Dr. Jennifer Kask, Campbell River and Port Hardy, BC

“I had a totally healthy 75-year-old, on no medications, who lives with his wife, come in at midnight. He had an onset of belly pain earlier in the day that was persisting. I was able to see him within minutes. On PoCUS exam, there was a 7 cm AAA. I called the tech in and had him in scanner 15 minutes. He had a leaking aneurysm. Yikes … Talked with vascular and he was on the road to Victoria a little over an hour after he came in. He did fine.”
—Dr. Aaron Fitzpatrick, Vernon, BC

In the coming year, IN PoCUS will continue its work to expand access to handheld ultrasound devices and training to more practitioners in remote BC communities. The team will also work with practitioners to continue to develop PACS, which is integral to a province-wide rural POCUS community, and dovetails with other efforts to implement province-wide electronic medical records.