Butterfly iQ ultrasound?

[Bobblehead]

It seems like a lot of the old ultrasound equipment threads started here so I figured I'd ask if anyone here is on the waiting list for the Butterfly? The website description of their probe states that since they're using a semi-conductor instead of a piezoelectric crystals you'd only need a single probe for any of the frequencies commonly in use. It looks like they opted for the form factor of a linear probe and the videos they show on the website look like they generate a pretty high quality image, at least on a healthy model. For the supposed price of "under $2000" (I'm guessing $1999.99) you couldn't even buy a single used probe for any of the current generation cart based ultrasounds.

Meet Butterfly iQ - Whole body imaging, under $2k

The issues I see so far are:
1. Actual availability as so far it's just a website and publicity blitz.
2. Form factor as sometimes it's nice to have the far wider spread of a curvilinear probe or the compact square phased-array head depending on where on the body you're imaging.
3. If you're using this for a central line placement or other sterile procedure you're either going to need to buy a stand which defeats the purpose of having such a portable device or have someone hold the phone for you or figure out how to prop it against something near the sterile field.
4. They're not specific about whether their cloud service is mandatory for operation which could create information security issues.
5. I'm guessing it'll have its own battery which hopefully will be replacable.
6. It's only compatible with iOS although I'm assuming eventually they'll release an Android supported model.

---

Members don't see this ad.

 

[partydoc]

I'll buy one when I can. I don't know about all those issues, but I guess that depends on where you are and how easy it is to find an ultrasound

 

[norwood]

- Not blown away with the samples I see of the image quality.
- The cable from the phone to the transducer does not look to me like something that's going to have a long service life. Looks like it's made out of the same stuff as your standard issue USB cables... You know, the ones that work for a year or two and then get flaky.
- As you alluded, all that portability can help or harm. Where do you keep the probe when you're not doing an ultrasound, anyhow?

 

[anbuitachi]

Very unimpressed with the OS that it is compatible with

 

[nimbus]

Or you can get this for $8k. My cardiologist buddy has one. Image quality is incredible.

Philips Lumify | Portable Ultrasound Machine

I personally plan to get the Butterfly. Think it’ll be good enough for our purposes and I’ll find uses for it.

 

[Bobblehead]

We're currently using dual-probe Vscan units. They're good for quick looks but the image quality is still inferior to the larger GE ultrasounds we have. Still, with a Vscan you can walk up the stairs. With the cart you're definitely less mobile.

 

[anbuitachi]

Or you can get this for $8k. My cardiologist buddy has one. Image quality is incredible.

Philips Lumify | Portable Ultrasound Machine

I personally plan to get the Butterfly. Think it’ll be good enough for our purposes and I’ll find uses for it.

You are dropping thousands post tax for this yourself? Thats a lot of money

 

[nimbus]

You are dropping thousands post tax for this yourself? Thats a lot of money

No I’m waiting for the butterfly.

 

[Bobblehead]

Is anyone going to SCCM that wouldn't mind reporting back from the dinner they're sponsoring? If it's going to be released this year I may wait for it to come out before submitting a request for replacement US machines at work.

Society of Critical Care Medicine

 

[OldGregg]

Is anyone going to SCCM that wouldn't mind reporting back from the dinner they're sponsoring? If it's going to be released this year I may wait for it to come out before submitting a request for replacement US machines at work.

Society of Critical Care Medicine

Dinner was nice, it seems like an impressive enough device. Resolution looks much better than V-Scan (we carry em at VA, I’m not a huge fan). We carry a lumify at our mothership. Interface for the Butterfly on iPhone seemed a little bit better for one-handed use.

These guys are going to come show off the Butterfly to us later this year. Based on what I saw, I’d be in favor of our fellowship picking up a couple. My 2¢.

 

[T-burglar]

I’m curious about the image handling details. Where do the images go and how do we get them into the chart and is it a hundreds of dollars per month charge for the cloud service

 

[OldGregg]

I’m curious about the image handling details. Where do the images go and how do we get them into the chart and is it a hundreds of dollars per month charge for the cloud service

I think they’re still ironing details out (i.e. couldn’t give me a battery life/phone battery demand estimate). Their image handling looks proprietary, but I’m told they can be beamed in to Xcelera & Epic (what we use). There is an unspecified subscription fee for their cloud and image exportation, but they indicated you could still buy the probe for ~$2K, forego the cloud and just use it as a triage device without formal image handling.

I’ll post an update when we get the in-house demo. Thinking I’d personally just use it in a pinch to eyeball things on the floor, intraop, etc. before doing a formal exam with a real echo machine.

Also FWIW I have no financial links to these guys. Just the five or six free drinks I nabbed at the demo. I just like tech and use a lot of portable diagnostic ultrasound in CCM fellowship. Passing along info for the greater good since y’all asked and I’m at SCCM.

 

[T-burglar]

Yeah I think I would do the same but I’m wondering about medicolegal issues with scanning but not saving images when investigating undifferentiated instability

 

[Bobblehead]

Dinner was nice, it seems like an impressive enough device. Resolution looks much better than V-Scan (we carry em at VA, I’m not a huge fan

Thanks, that's quite promising. We use the dual probe Vscans and they have worked out pretty well so far.

There is an unspecified subscription fee for their cloud and image exportation, but they indicated you could still buy the probe for ~$2K, forego the cloud and just use it as a triage device without formal image handling.

This is also good news as the cloud image storage was going to be a hard stop for us I think due to our medical records policies.

Yeah I think I would do the same but I’m wondering about medicolegal issues with scanning but not saving images when investigating undifferentiated instability

This has been a pretty hotly debated topic so I'm sure others will chime in. I think in part it has to do with what you're billing the insurance company and what you're credentialed to do. For example, while I'm perfectly capable of doing a thoracic US I'm neither credentialed to document one in our radiology system nor would I bill insurance for it. However I would be able to bill either E&M or critical care time for it depending on the circumstances. We've settled on documenting findings just like we would any other part of our physical exam, sans the imaging.

That's different than when we do US guided lines or thoracenteses, etc. when there is an insurance requirement to save an image. We've ended up saving those to some hard drive or we've also been printing them out and then having them scanned into the chart which has been easier than getting either IT or radiology to have us access the PACS.

 

[Bobblehead]

I received an email from the manufacturer today indicating they will begin to take orders for up to 10 units "this fall". The unit itself is listed for $1999 which is lower than what we paid for our VScan units which have held up really well in the 3 years since we put them into use. I do expect we'll need to replace the batteries on some of them relatively soon though.

A one year subscription to their cloud service is mandatory. After that you can cancel per the email. Therefore the price for the device really is more like:
$2419 (individual, $35/mo billed up front for the first 12 mo)
$3619 (up to 10 users, $100/mo billed up front, also $20/mo for each additional user for larger groups)

I think I'm going to pass on the Butterfly given its subscription model until there's more real-world data on how it holds up, etc. The cost is very comparable to any of the existing handheld ultrasounds in existence and the fact that it needs to link to either your phone or other mobile device creates a lot of privacy, data security and HIPAA issues. If you're planning on saving studies beyond the first year to the cloud you will soon be looking at a device that's more costly than any of the existing handhelds. It's unclear whether there's an ability to do off-line transfers directly to your hospital's image servers.

I expect most hospital's HIPAA offices won't even know how to address this device if you tell them you are purchasing one for personal use and then taking electronic medical records off-site to upload into the company's servers. I suppose you could not upload anything to the cloud service but it's unclear whether you can physically block the device from transmitting any data off-site.

 

[bronx43]

I received an email from the manufacturer today indicating they will begin to take orders for up to 10 units "this fall". The unit itself is listed for $1999 which is lower than what we paid for our VScan units which have held up really well in the 3 years since we put them into use. I do expect we'll need to replace the batteries on some of them relatively soon though.

A one year subscription to their cloud service is mandatory. After that you can cancel per the email. Therefore the price for the device really is more like:
$2419 (individual, $35/mo billed up front for the first 12 mo)
$3619 (up to 10 users, $100/mo billed up front, also $20/mo for each additional user for larger groups)

I think I'm going to pass on the Butterfly given its subscription model until there's more real-world data on how it holds up, etc. The cost is very comparable to any of the existing handheld ultrasounds in existence and the fact that it needs to link to either your phone or other mobile device creates a lot of privacy, data security and HIPAA issues. If you're planning on saving studies beyond the first year to the cloud you will soon be looking at a device that's more costly than any of the existing handhelds. It's unclear whether there's an ability to do off-line transfers directly to your hospital's image servers.

I expect most hospital's HIPAA offices won't even know how to address this device if you tell them you are purchasing one for personal use and then taking electronic medical records off-site to upload into the company's servers. I suppose you could not upload anything to the cloud service but it's unclear whether you can physically block the device from transmitting any data off-site.

I just recently picked up a Clarius wireless ultrasound, which is larger than what I would like, but it does provide substantially better image quality than the Lumify. It's more costly than the Butterfly at$8900, but you can upload to your own PACS or their cloud, which is free up to 5 Gb. It also has a battery pack which is only good for about 1 hour of continuous scan time, but in my clinic, I can use one while charging another.

 

[dhb]

I tried the Lumify recently and it was ok. Image quality is inferior to a proper machine but it' probably sufficient if you are proficient in US and for easy blocks/anatomy.

 

[DM27]

I am big on the Butterfly hype train and have been impressed by what I have seen. However, when I received the email about the mandatory subscription service it really turned me off as well. I was initially in the camp of definitely buying, but I am now somewhat in between on if I am going to pull the trigger or not.

 

[kmurp]

There seems to be a number of wireless ultrasound products coming to market now( though the one in this thread seems unique). We just saw a model from Angiodynamics that sells for $4000. It seeemed fine for central line type things. Now the nurse manager of our ortho center is encouraging me to take a look at the product from Arthrex. She saw it during a visit to Arthrex this week.

So my question is; do any of you have any experience to share regarding the use of these new wireless devices for regional blocks?

 

[midazzoler]

A new iPhone ultrasound device, whose chief medical officer used it to diagnose his own cancer, just raised $250 million — Business Insider

 

[sevoflurane]

Interesting they removed the piezo from the unit which is very expensive to produce.

I’m happy with my Phillips, but am curious of this technology.

 

[T-burglar]

I would buy one of these maybe if
1. Could see it demonstrated
2. No mandatory cloud service.

 

[Guillemot]

They made the cloud service mandatory for a year because they weren't able to keep the cost under 2k as initially claimed, and the launch date still isn't solidified. Price could potentially increase further in such ways as not including a battery/case/cable with this thing and selling the necessary a proprietary components as mandatory accessories. Frustrating, but this thing is still cheaper than its competitors... so far at least.