Axis Imaging News recently sat down with Stuart Nissell, senior manager of medical informatics at Fujifilm SonoSite, about the importance of using point-of-care ultrasound (POCUS) workflow software solutions, especially in fast-moving environments. With scans properly captured and documented, Nissell asserts that users can expect improved workflow efficiency, revenue capture, and a host of other benefits. 

Axis Imaging NewsPoint-of-care ultrasound (POCUS) scanning often takes place in some fast-moving clinical environments where care can be unplanned, such as in the ER and ICU. We understand that capturing the scans and organizing them can bring order to what can seem like chaos. What level of need is there to fix this?

Stuart Nissell: There is an enormous need, which customers have shared with us over the years. In the past, we addressed part of POCUS workflow challenges with software solutions, though not comprehensively. Fujifilm Sonosite Synchronicity is our comprehensive workflow solution, which addresses the administrative challenges that clinicians said were badly needed.

POCUS workflow is different than the traditional radiology workflow, with those systems unable to adequately provide an appropriate interface for ultrasound provided at the point of care. Therefore, an investment in a specific point-of-care workflow solution is necessary to ensure all ultrasound exams are captured and there is documentation to support billing and possible reimbursement, along with other metrics, such as exam recall, quality assurance (QA), and credentialing.

AXIS: How does Synchronicity work to facilitate better workflow and how is this different from current POCUS workflow solutions?

Nissell: The system enables program managers and users to access pre- and post-scan documentation, and then manage and track quality assurance, coding and billing, and credentialing. At different points in the workflow process, program managers and users interact with the workflow system, starting with the ability to complete documentation at the bedside via downloadable worksheets on the ultrasound device. Then, with a computer log-in, they provide and receive QA information, along with viewing reports and analytics in Synchronicity. Users can also track the workflow process. Plus, clinicians can generate a wide range of reports, and the system is set up to allow for customized user notification features depending on preferences.

I mentioned earlier that POCUS workflow is different from radiology workflow, which is important to distinguish conceptually. There are several features on our system that are distinct including that it is encounter-based, and our clinically indicated and designated educational POCUS exams are available in a single environment. In addition to the ability for users to customize exam worksheets at any point, Synchronicity has been designed to reduce the number of steps or decisions that physicians are required to make because of a built-in study workflow.

AXIS: With the systems being out in the marketplace for a couple of years now, what kind of feedback are you getting from the earlier users?

Nissell: Certainly, we have heard consistently that they have been able to capture billable scans that historically were not recorded. This has resulted in significant revenue gains. So that has been quite big, but not surprising. Reports are coming in from one of our customer sites indicating a 206% increase in POCUS reimbursement due to exam capture for coding and billing purposes.

Customers have also shared that workflow has been appreciably optimized allowing them to be more efficient and address patient needs in a timelier manner and increase volumes and throughput. They have also been quite pleased with how the system has automated and streamlined the QA and credentialing process—so significant improvements have been made there as well.

AXIS: What about IT and clinical system integration? 

Nissell: Of course, everyone is worried about having a hard-to-integrate system and then clunky interaction and work-arounds post implementation. Synchronicity interoperability with EMRs, and other systems have gone very smoothly for our customers in part because our professional service group is with them every step of the way. The larger part has been that the system is so well thought out and designed for smooth interoperability. This has enabled POCUS exams to populate the EMR very quickly, with scans captured and turning into patients’ electronic medical records reliably. The result is the more effective use of point-of-care ultrasound. 

Synchronicity can also help maximize customer investment because it can connect with any DICOM-enabled ultrasound devices, allowing for seamless integration with the facilities IT ecosystem. Synchronicity was designed to provide scalability from a single departmental solution to an enterprise integrated delivery network.