The Picture is Clear: Pocket-Sized Ultrasound Devices Offer
Economic Value in Optimizing Resources
While there’s mounting evidence that Pocket-sized Ultrasound
Devices (PSUDs) provide clinical value to cardiologists in
cardiology clinics, it’s becoming clear they also offer the
potential for significant savings at the department level when
used by highly experienced echocardiographers as an adjunct
to standard physical examination.
Often, cardiologists turn to Standard Echocardiography (SE)
whenever a physical examination is inconclusive or for further
evaluation of a known disease’s severity1. And while SE helps
enable more accurate diagnosis than physical examination alone,
it requires highly skilled personnel, and may not be performed
until days after the initial cardiology evaluation; thus resulting
in potential further delays in diagnosis and increased economic
costs due to the need for additional patient–doctor encounters
to discuss results and possible revisions to treatment.
Studies suggest positive economic impact
In recent years, the use of PSUDs, such as Vscan, have proven to
be reliable tools for physicians to rapidly assess the presence of
cardiac and non-cardiac abnormalities1. A study conducted by
Cardim et. al2 showed the use of PSUD directly impacted patient
treatment costs by reducing the number of diagnostic tests
needed (see story on page 18). Additionally, further cost savings
were realized with an early discharged group because these
patients no longer required further consult or treatment. The use
of PSUD also has the potential to deliver indirect cost savings
and lower downstream costs.
It also saves physicians time because follow-up visits may no
longer need to be scheduled or conducted for patients who no
longer need to be seen2. Additionally, the study conducted by
Cardim and his colleagues concluded that the downstream time
savings recognized through the clinical benefits and efficiencies
of using the PSUD offset the initial time it took to use it during
the physical exam workup.
Evidence also supports that implementing bedside
echocardiograms into cardiology units improves workflow3, 4.
Performing echocardiograms in the admissions department of
an inpatient clinic improved sonographer productivity by 34% 3
and echocardiography lab productivity by 41%1.
These improvements in productivity coupled with reductions in
porter and staff time, hospital costs, and scanning and reporting
times, decreased the average cost of each echocardiography
exam by approximately 29% 4. Similar findings from another
study confirm that the use of hand-carried ultrasound reduced
both the number of echocardiography exams and follow-up
visits, which led to overall cost savings of € 2,142 per 100
patients referred for SE in Italy1.
The use of PSUDs may also help improve the patient experience.
In particular, the efficiencies of Vscan use reported above led to
reductions in waiting times and follow-up visits among patients
who do not require further evaluation2, 4. These savings imply
potential additional indirect cost savings for patients by reducing
travel time and time missed from work due to unwarranted
doctor appointments. The bottom line points to overall cost
1. Trambaiolo P, Papetti F, Posteraro A, et al. A Hand-carried Cardiac Ultrasound Device in the
Outpatient Cardiology Clinic Reduces the Need for Standard Echocardiography. Heart 2007;
93 ( 4): 470–475.
2. Cardim N, Golfin CF, Ferreria D, et al. Usefulness of a New Miniaturized Echocardiographic
System in Outpatient Cardiology Consultations as an Extension of Physical Examination.
Journal of the American Society of Echocardiography November 2010; 24( 2): 117-24.
3. Badano LP, Nucifora G, Stacule S, et al. Improved Workflow, Sonographer Productivity, and
Cost-effectiveness of Echocardiographic Service for Inpatients by Using Miniaturized Systems.
European Journal of Echocardiography February 2009; 10( 4): 537–42.
4. Gianstefani S, Catibog N, Whittaker AR, et al. Pocket-size Imaging Device: Effectiveness for
Ward-based Transthoracic Studies. European Heart Journal Cardiovascular Imaging May 2013.