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John R. Fischer, Senior Reporter | April 11, 2022
From the April 2022 issue of HealthCare Business News magazine
Modern-day uses
In addition to imaging patients in real time, the miniaturization of cardiac ultrasound, plus its ability to complete scans fast makes it cost-efficient and less time-consuming compared to MR. It is also nonionizing, unlike CT, and is noninvasive, compared to open heart surgery. “It is on the scale of cardiac imaging. It's still relatively cheap to perform. It's portable. There's no radiation. There are very few clinical contraindications to get a cardiac ultrasound study,” said Little.
Little expects the technology to “merge” with other modalities in the future. “We have trans thoracic imaging. We have trans esophageal imaging. And more recently, we have intracardiac imaging with ultrasound, crystals on the end of an intravascular catheter. And at some point, those different modalities will start to talk to each other, and perhaps a single user will be able to pick and choose between modalities to create a different kind of image.”
But the solution is highly operator-dependent and needs experienced and skilled users who can acquire images at the right angles and personalize exams for individual patients. Blaivas says that automation is the key here. “What we need to do is take someone fresh out of medical school who has very little training in ultrasound but the same capability to diagnose things in the heart that I have after practicing with ultrasound for 28 years. The only way to do that is with AI. It isn’t happening as fast as we would like it to and can’t seem to happen as fast as we need it.”
Sengupta says AI will speed up image acquisition and reading in cardiac ultrasound but also help extract more unused information about the heart from images. He says that advances like MELODY and telemedicine can improve day-to-day operations and help compensate for the lack of available personnel. “Technical and sonographer shortage is a big problem. Now, sonographers can be brought into the picture from a remote location to help the workforce. In the middle of the night, they will not have to travel.”
Experts like Goldman say that greater investment in training and compensating skilled expertise is also essential for expanding access to echocardiography and for ensuring AI and telemedicine are used properly to make accurate diagnoses. “Salaries need to reflect skill and experience. A skilled sonographer or physician doing imaging recognizes that their acquisition may vary depending on their real-time interpretation as they are acquiring the images. With COVID, there were many referrals coming in every day. Sonographers were exposed and jeopardized their own and their family’s health to provide care and yet, they didn't get hazard pay.”
According to Lee, more research and development is needed to overcome certain limitations with new techniques in Intracardiac echocardiography (ICE). But she adds that innovations like these and the pandemic are changing the role and scale of echocardiography. “We are looking at the use of technology more universally. Not just isolating advances in imaging to use on one organ or system but expanding how we use technology to image the heart and the body's systems. The use of emerging technology has improved patient care and outcomes.”
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