The University of California, Irvine presented each member of the class of 2023 a handheld/smartphone portable ultrasound device. This represents a considerable upgrade for the stethoscope treasured by so many neophyte physicians. No longer would the treasured stethoscope hanging from the neck of students, nurses and nurse practitioners be the status symbol.
Ultrasound machines are usually those large instruments wheeled around from room to room with a large display. It required a physician order to have an ultrasound technician to perform the test. Now the ultrasound will become ubiquitous. For most diagnostic purposes it will be carried in a pocket by the physician for immediate use. And for most studies, it will be adequate. If a more advanced ultrasound is needed it can be ordered. In 90 % of cases, it will be used to rule out serious problems in an emergency department, urgent care center, nursing home or even at home.
Normally $2,000, the devices were free for the 104 newly-minted members of the class of 2023.
In 1966 when I was a junior at George Washington University School of Medicine we were gifted a Welch Allyn Diagnostic set in a zipper case. It was a moment like that I am sure the UCI medical students experienced. This gift measures the strides we have taken since 1968. Very few would imagine a hand-carried ultrasound would take the place of the ‘stethoscope’ which had become an icon about physicians.
Nine years ago, the University of California at Irvine Medical School became the first medical school in the country to equip each of its 104 incoming students with their own iPads.
This month, at the same White Coat Ceremony where that announcement was made back in 2010, Dr. Michael J. Stamos, the school�s dean, surprised the class of 2023 with another gift: Butterfly handheld ultrasound devices.
The devices are the students� to keep, and it’s no small investment on the school�s part � each device retails for just under $2,000.
�When our faculty director caught wind of Butterfly coming into existence, we had talked about this being a big game-changer for us,� Dr. Warren Wiechmann, UCI�s associate dean, told MobiHealthNews. �Historically, we had been using a lot of laptops and cart-based ultrasounds, which are technically portable but they�re not handheld and they are still a little bit limiting for our students. So when we heard about Butterflies, that really opened up the possibility that we could move toward this idea of having every student with an ultrasound machine in their pocket.�
An additional important feature of this device is that images can be uploaded to a cloud and also interface with the electronic health record for permanence. Incorporated in the network software is a provision for reimbursement coding (CPT) and diagnostic information. (ICD)
WHY IT MATTERS
Butterfly Network�s device, which secured FDA clearance two years ago, uses a novel ultrasound-on-a-chip technology to make handheld portable ultrasounds cheaper and more accessible. The mission is not just to make it easier to use ultrasounds in the ways they are already used, but also to change the status quo � using ultrasounds in areas of medicine where they might be useful but formerly would have been impractical.
�From the very beginning, it�s an affirmation of this device and the role it could play in the transformation of healthcare,� Dr. John Martin, chief medical officer at Butterfly, said. �If you look across the practice of medicine, two-thirds of medical dilemmas can be solved with simple imaging devices. In the past, I had to order that test. Now, as a physician I don�t have to order that test; the test is in my pocket. I can communicate with my patients, I can share that information with them instantly, I can make rapid decisions, and that puts this school far out front of others across the country.�
Martin and Wiechmann hope that students will take the technology and treatment methodologies it enables with them after they graduate.
�The fundamental purpose of good medical schools and good residency programs is they help people develop the knowledge and skills and then seed the rest of the planet with those people and then they take that knowledge to those institutions,� Martin said. �I�m pretty confident that�s what�s going to happen.�
Members of the class of 2023 said they are excited at the prospects of the device for patient engagement and for bringing care to lower-income, lower-infrastructure parts of the globe.
�I think it�ll help me connect with my patients, which is pretty much essential to establishing continuous care of a population,� Leonardo Alaniz, an incoming student, said. �It will enhance my abilities as a physician, and it will also give me the opportunity to share what I see. Patients aren�t always committed to sticking with the health plans we put them on, and I think that [better communication] ultimately can lead to better outcomes.�
�I�m looking at doing a program for ultrasound initiatives, global outreach around the world, in the summer between first and second year,� said Christina Grabar, another student. �I think having my own Butterfly and being able to use it well before the program starts is not only going to enhance my research but then when I�m going to teach other physicians about this technology, I�ll feel even more comfortable with it.�
THE LARGER TREND
UCI�s cultivated reputation for training the next generation of digital-savvy doctors goes beyond iPads and ultrasounds. The school has also experimented with Google Glass and AliveCor�s ECG device, as well as investing in high-fidelity simulations.
In 2013, the school boasted that the first class to receive iPads saw a 23% boost in their test scores.
�I think it�s important that we prepare our students to become the best 21st-century physicians and not necessarily be held to the classic constructs of how medicine is practiced and how medicine�s delivered now,� Weichmann said.