Portable ultrasound devices logistical issues

[ethilo]

After the recent thread about the butterfly iQ ultrasound probe, I just got my trial Phillips Lumify linear probe in the mail today. So excited.

When playing around with it at home, I found that one of the problems I'm going to face in the OR is how to set up the screen. If I use my cell phone for PIVs I can just lay it on the patient. If I use a tablet that might be a little harder. And if I do PNBs that could make the resting spot for the screen a little difficult. Does anyone have any experience with this? I'm thinking of rigging up some way to hang the screen from the IV pole as my best bet.

Also, how are people getting images off the device to help bill for the procedure? We normal print them on the ultrasound machine and scan the image into the patient's chart but you can't really print on the tablet or phone. I'm especially interested in people that have Epic EMR.

Are there any other logistical problems people have run into? I'm really excited to use this thing.

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[Psai]

Have the patient hold the screen for you

Email the picture to your billing people so they can upload the image

 

[drmwvr]

Are there any other logistical problems people have run into? I'm really excited to use this thing.

Heard of a guy that ran into trouble with his hospital biomed department...got the brass to tell him he couldn't use it because it wasn't one of theirs.

 

[deleted59964]

I'm thinking of rigging up some way to hang the screen from the IV pole as my best bet.

.

Joby GripTight GorillaPod Stand Pro

and can't you get someone to use the tablet to take a screenshot?

 

[caligas]

Can you reliably see LV function and rule out major valve pathology with these?

 

[2010houston]

I'm especially interested in people that have Epic EMR.

We use epic Haiku (mobile app) to take a screenshot of the image on the u/s with our phones; either as the block /line is being placed if someone’s hands are free, or of a saved shot on the u/s later. Uploads directly to patient’s chart, very easy.

 

[DM27]

I find what usually works well, mainly for upper extremity blocks, is I have the patient hold my phone with the arm I am blocking. It gives me a good view of the screen since it isn't too far, and when they drop my phone I know the motor component is setting in. I haven't had any patchy blocks since starting this process, but I have gone through about 8 cell phones.

 

[nimbus]

We use epic Haiku (mobile app) to take a screenshot of the image on the u/s with our phones; either as the block /line is being placed if someone’s hands are free, or of a saved shot on the u/s later. Uploads directly to patient’s chart, very easy.

The issue is that Haiku only lets you upload camera pics, not screenshots. It’s a problem if you have Haiku and the ultrasound app on the same device. You either need to print the screenshot, then upload it with Haiku. (Or you need 2 devices....one for Haiku and one for ultrasound.)

 

[2010houston]

The issue is that Haiku only lets you upload camera pics, not screenshots. It’s a problem if you have Haiku and the ultrasound app on the same device. You either need to print the screenshot, then upload it with Haiku. (Or you need 2 devices....one for Haiku and one for ultrasound.)

Yes that’s absolutely true.

 

[cchoukal]

Has anyone run into patient privacy issues? I could envision the hospital being worked up about putting PHI (are images PHI?) on a phone/network that isn’t secured by the hospital.

 

[Velefunt]

You can hang your tablet around your assistant's neck (tech or circulator) a la Flavor Flav.

 

[ethilo]

Can you reliably see LV function and rule out major valve pathology with these?

I got a linear probe which I'm evaluating exclusively for nerve blocks. From the looks of the software, I think the curvilinear or phase array probes would be stellar. I'm really happy with the image quality - I especially notice a better resolution at depth. At 8 cm the resolution is much better than our US at work.

The issue is that Haiku only lets you upload camera pics, not screenshots. It’s a problem if you have Haiku and the ultrasound app on the same device. You either need to print the screenshot, then upload it with Haiku. (Or you need 2 devices....one for Haiku and one for ultrasound.)

That's the exact work-around I'm dealing with but don't have a solution for. It would be nice if you could port it directly into the patient's chart but then you might be having to manage PHI. Speaking off PHI...

Has anyone run into patient privacy issues? I could envision the hospital being worked up about putting PHI (are images PHI?) on a phone/network that isn’t secured by the hospital.

I really don't know how it could be a patient privacy issue since I haven't put any patient identifiers into the image. When you use the Epic Haiku app to take a picture of the tablet / phone, that is done WITHIN the safety of the Haiku app. There is no identifying patient data.

You can hang your tablet around your assistant's neck (tech or circulator) a la Flavor Flav.

I'm thinking of getting the assistant who pushes medication to hold the screen.

The other thing I am noticing is how easy it would be for someone to walk off with the probe or for me to leave it somewhere accidentally, and it's like $8000. Since it's micro USB, it would be super easy to lift this thing if you wanted and sell it off to anyone with a tablet.

 

[pjl]

Can you just get an iPod type device that is always with the ultrasound for the haiku? It is a pain. Please add your voice to mine asking epic to fix this.

 

[AdmiralChz]

Can you just get an iPod type device that is always with the ultrasound for the haiku? It is a pain. Please add your voice to mine asking epic to fix this.

That’s 2 devices practically begging to walk away, unfortunately. It’s much simpler to have an ultrasound with a printer, which is what we use at our sites.

And not everywhere uses Epic, so a solution for that system would help many but not all. I’m not sure I agree with their own proprietary server hosting the files, seems sketchy at best. A better way (for Epic users) would be for Haiku to access your camera’s saved pictures for upload but I definitely see potential (or definite) HIPAA violations there for sure.

Also, our hospital system clinical affairs committee isn’t a fan of personal tech being applied on site. Everything has to be cleared through them and if it plugs into the wall their engineering folks have clear it. This was an issue a few years ago when the paramedic ED techs brought in McGrath laryngoscopes without approval and there was some major snafu... not sure of the details.

 

[Psai]

That’s 2 devices practically begging to walk away, unfortunately. It’s much simpler to have an ultrasound with a printer, which is what we use at our sites.

And not everywhere uses Epic, so a solution for that system would help many but not all. I’m not sure I agree with their own proprietary server hosting the files, seems sketchy at best. A better way (for Epic users) would be for Haiku to access your camera’s saved pictures for upload but I definitely see potential (or definite) HIPAA violations there for sure.

Also, our hospital system clinical affairs committee isn’t a fan of personal tech being applied on site. Everything has to be cleared through them and if it plugs into the wall their engineering folks have clear it. This was an issue a few years ago when the paramedic ED techs brought in McGrath laryngoscopes without approval and there was some major snafu... not sure of the details.

Thats because the mcgrath isnt as good as a pentax