Camille Baxter:
Hello and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Camille Baxter. And today we are thrilled to welcome to the podcast, Dr. Davinder Ramsingh. Dr. Ramsingh is the Vice President of Clinical Research and Product Development at Butterfly Network. And Professor of Anesthesiology at Loma Linda Medical Center and the author of the first whole body point of care education curriculum for training anesthesiologists in the US called FORESIGHT. In today's episode, Dr. Ramsingh will be talking about why point of care ultrasound should be the standard of care for lung assessment in place of chest x-ray. He'll also talk about what's being done to make it feasible for mass adoption across health systems. Thank you so much for being here today.
Dr. Davinder Ramsingh:
It's my pleasure, Camille. Thanks so much for having me.
Camille Baxter:
Well, this is a very exciting topic and I'm really interested in learning about this, so let's jump in. So ultrasound has been around for more than 50 years, and specifically point of care ultrasound has been around for more than 10 years. What's different now that could accelerate change in clinical practice?
Dr. Davinder Ramsingh:
Camille, it's a really exciting time on a topic of point of care ultrasound. The technology of putting ultrasound on a chip as developed by Butterfly has made ultrasound more accessible, affordable, and scalable. This innovation puts a whole body ultrasound system that historically had been on a system that required a corner of a room to then even cart based systems. Now you're getting that same amount of functionality in a device that truly fits in your pocket. On the evidence side, the number of research articles demonstrating the clinical value of POCUS has grown exponentially. In fact, every five years, it's an exponential curve of the thousands of articles showing its clinical value in a variety of different clinical settings. That puts us to where we are today. With half the medical schools in the country adopting it, some of the largest residency specialties requiring it, and we're now able to deploy scalable solutions across entire health systems.
Camille Baxter:
So it sounds like there's real momentum right now with med schools, residencies, health systems getting on board. But what's the main barrier stopping point-of-care ultrasound from being ubiquitous?
Dr. Davinder Ramsingh:
Camille, the primary barrier to widespread adoption of point-of-care ultrasound is the innate resistance to change in medicine. We're up against deep rooted traditions and hesitations to move from tried and true methods. This reluctance is heightened when new techniques seem to challenge what's been long established, especially when you're talking about bedside assessment tools like the stethoscope. Over the past 15 years, I've been involved with my own specialty on this topic and have collaborated with clinicians across the health scale landscape. The main challenges often come down to education, competency and confidence. But again, thanks to chip based ultrasound from Butterfly, the technology barriers are dwindling and in many clinical pathways there's a tremendous amount of evidence showing its positive impact. But that goes back to the real challenge today, in how healthcare providers can be trained and learn how to establish it in their workflows.
Camille Baxter:
You noted education, competency and confidence as barriers. Is there one particular use case or application that people could learn quickly that would have a massive impact?
Dr. Davinder Ramsingh:
Camille, when I think about which component of the wide variety of point-of-care ultrasound modalities that is most approachable, I immediately go to lung ultrasound. And that's because it truly stands out as a gateway to point-of-care ultrasound adoption. Here's why. First, ease of learning. The learning curve for the basic lung ultrasound is relatively short. Research suggests that even those new to ultrasound can achieve basic competency in just a few hours of training and education and reach proficiency in terms of their examination with a limited number of hands-on exams. Next, the clinical superiority. This isn't solely about convenience. There's robust peer-reviewed evidence that shows that lung ultrasound can surpass traditional chest x-ray, and stethoscope based examinations for the most common pulmonary disorders like pulmonary congestion, pneumonia, pleural effusion, and pneumothorax. We're discussing sensitivities and specificities over 90% with lung ultrasound performed by handheld ultrasound devices like Butterfly, compared to 50 to 70% range to those traditional modalities of the chest x-ray, and stethoscope.
Let's walk through a health economic value story, specifically on this common care pathway of showing the value of lung ultrasound. Under the topic of shortness of breath, which is a primary reason for ED visits, 2 billion chest x-rays are done globally every year. In fact, chest X-rays account for 40% of the 3.6 billion spent on imaging annually. Yet lung ultrasound with technologies offered by Butterfly that are available in your pocket, provide cost-effective with better sensitivities and specificities that allow you the clinician to have quicker solutions right from their pocket, facilitating swifter and more accurate decision-making for providers and improving the quality of care they can provide their patients.
Camille Baxter:
Wow. Well, it certainly sounds like the evidence is clear that lung ultrasound should be the gold standard. So who should make this change? What specialties?
Dr. Davinder Ramsingh:
Simply put, any provider who listens to a patient's lungs should use this tool. From my perspective as an anesthesiologist, here's a real world example. In the operating room, we often manage patients at risk for both pulmonary congestion from fluid overload as well as airway reactivity from lung issues like COPD. The clinical approach for these two conditions are vastly different, and lung ultrasound has proven to be a superior tool for distinguishing between them. This scenario isn't just found in hospitals, but applies to clinicians everywhere evaluating patients for shortness of breath. Another vital application of lung ultrasound is in managing heart failure, a condition that affects 6.2 million Americans and the WHO has labeled it as a global pandemic. Heart failure stands out at a pressing public health concern accounting for over 1 million hospitalizations every year here in the US. What's really scary about this is the upward trend in its prevalence and the association of increased hospitalizations in recent years.
Furthermore, evidence suggests that nearly 25% of heart failure patients are rehospitalized within a month, underscoring the challenges in patient management post discharge and emphasizing the need for early and accurate detection. Butterfly's FDA cleared AI enabled lung ultrasound tool can help manage these challenges. It allows providers to count B-lines automatically at the bedside in seconds. These B-lines are vertical bright lines seen when patients are in states of pulmonary congestion or volume overload. These are often associated with conditions like congestive heart failure. Being able to see signs of lung congestion at the bedside versus trying to hear it with the stethoscope allows providers to more accurately evaluate for states of fluid overload, facilitating quicker decision-making, and allowing the provider to give more informed process at the bedside. And research has shown that B-lines can help in risk assessment for CHF exacerbation and guide treatment strategies. Again, these are just common applications of the value of lung ultrasound. With Butterfly's pioneering chip based ultrasound technology, healthcare providers can seamlessly integrate the latest evidence-based care armed with an all-encompassing ultrasound system that fits right in their pocket.
Camille Baxter:
Because this is such an important addition to patient care, what is being done to make this change happen? And how can more people get on board?
Dr. Davinder Ramsingh:
Butterfly is at the forefront, championing the adoption of lung ultrasound as a new standard of care. We're facilitating this through AI features such as our Auto B-line Counter, which enhances ease, speed, and consistency during lung ultrasound examinations, and as we discuss education is paramount. Butterfly's heavily invested in training through our solutions such as our academy e-learning curriculum and partnerships for certifications through Butterfly Certified, which is a complete set of virtual and in-person POCUS courses designed to meet local training or privileging requirements delivered in partnership with the Global Ultrasound Institute. Finally, our new standalone education app ScanLab, which is an AI powered education application for ultrasound scanning practice that provides just-in-time walkthrough training with AI enabled anatomical labeling and real-time image quality feedback to enhance the learning process. And all of these are integrated into Butterfly Enterprise, which allows all of this to happen at scale, including training, integration and billing.
Camille Baxter:
That app sounds so helpful. Davinder, Is there anything you'd like to add or leave us with?
Dr. Davinder Ramsingh:
Camille, I'll leave our discussion with restating the value of point-of-care ultrasound as the new bedside assessment modality that will dramatically improve the quality of care we confide patients across multiple healthcare landscapes. We talked deeply about lung ultrasound and its value as a tool that can be learned relatively quickly to providers and offer a high degree of improved sensitivity and specificity for a variety of lung disorders to what's currently being done today as the standard of care. I encourage clinicians through all backgrounds to really learn about the topic of point of care ultrasound and see how it can be incorporated into your practice to improve the quality of care you provide patients, and know that Butterfly is trying to be the best partner we can to incorporate and help facilitate your training, learning, and integration.
Camille Baxter:
Dr. Ramsingh, this was a great conversation. Thank you so much for being here today.
Dr. Davinder Ramsingh:
It's my pleasure, Camille. Thanks so much for the opportunity.
Camille Baxter:
This has been a sponsored episode of Healthcare Insider, created in collaboration with Butterfly Network. For more information, please visit butterflynetwork.com. I'm your host, Camille Baxter. Look for more episodes of Healthcare Insider under the multimedia tab at modernhealthcare.com or subscribe to your preferred pod catcher. Thanks for listening.
