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杰斐逊医疗系统中床旁超声(PoCUS)的实施情况。

Implementation of Point-of-Care Ultrasound (PoCUS) in Geisinger Health System.

作者信息

Adams William, Chukwuemeka Ene C, Kiniale Calvin, Bekker Jennifer, Johnson Hugh, Rajaram-Gilkes Mathangi

机构信息

Medical Education, Geisinger Commonwealth School of Medicine, Scranton, USA.

出版信息

Cureus. 2024 Oct 16;16(10):e71621. doi: 10.7759/cureus.71621. eCollection 2024 Oct.

Abstract

Background Point-of-care ultrasound (PoCUS) is an imaging modality with many inherent benefits, such as increased patient satisfaction, cost savings, and elimination of delays in diagnosis. The popularity of this bedside imaging technique has increased in recent years, and its scope of use for diagnostics and procedures has expanded in many specialties. Research question Can increased implementation of PoCUS within the Geisinger Health System (GHS) reduce the need for other more expensive, time-consuming, and potentially harmful imaging techniques? Methods Investigations were carried out on the uses of PoCUS established in the literature as a bedside diagnostic tool for specific pathologies such as pneumonia, nephrolithiasis, and various fractures. The SlicerDicer tool from Epic was then used to quantify diagnostic tests that could be replaced with PoCUS. Data collection focused on the number of other imaging modalities (CT, MRI, X-ray) that could be substituted with PoCUS. Data regarding the existing use of PoCUS within GHS could not be collected due to the limitations of SlicerDicer. Results Between January 1, 2019, and December 31, 2023, 121,057 imaging studies, including 38,838 CT scans, were recorded in SlicerDicer, where PoCUS could be implemented as an alternative diagnostic tool for specific pathologies. The largest portion of PoCUS-replaceable scans was chest X-ray at 61,684, followed by CT of the abdomen and pelvis at 36,204 scans in the five-year study period. Conclusions Our review of SlicerDicer data from GHS revealed substantial numbers of imaging scans that could be substituted with PoCUS. Expanding the use of PoCUS within GHS would be advantageous to both patients and providers, and we recommend that providers take advantage of opportunities to incorporate PoCUS into their clinical practice.

摘要

背景 床旁超声(PoCUS)是一种具有诸多固有优势的成像方式,如提高患者满意度、节省成本以及消除诊断延迟。近年来,这种床旁成像技术越来越受欢迎,其在诊断和操作中的应用范围在许多专业领域都有所扩大。

研究问题 在盖辛格医疗系统(GHS)中增加PoCUS的应用能否减少对其他更昂贵、耗时且可能有害的成像技术的需求?

方法 对文献中确立的PoCUS作为肺炎、肾结石和各种骨折等特定病症的床旁诊断工具的用途进行了研究。然后使用Epic公司的SlicerDicer工具对可用PoCUS替代的诊断测试进行量化。数据收集集中在可用PoCUS替代的其他成像方式(CT、MRI、X射线)的数量上。由于SlicerDicer的局限性,无法收集GHS内PoCUS的现有使用数据。

结果 在2019年1月1日至2023年12月31日期间,SlicerDicer记录了121,057项成像研究,包括38,838次CT扫描,其中PoCUS可作为特定病症的替代诊断工具。在为期五年的研究期内,PoCUS可替代的扫描中最大部分是胸部X射线,为61,684次,其次是腹部和骨盆CT,为36,204次扫描。

结论 我们对GHS的SlicerDicer数据的审查显示,大量成像扫描可用PoCUS替代。在GHS内扩大PoCUS的使用对患者和医疗服务提供者都将是有益的,我们建议医疗服务提供者利用机会将PoCUS纳入其临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8392/11566340/4ef808452c95/cureus-0016-00000071621-i01.jpg

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