“AI is here to stay, for sure. I embrace it and am excited about it. Our job is to make sure that folks don’t get the wrong impression about AI. It is going to be our friend,” Dr. Victor Rao of the POCUS Certification Academy is optimistic about the merger of AI with POCUS. As a clinician on staff and the Global Clinical Content Manager, Dr. Rao addresses the impacts that artificial intelligence (AI) has made and will continue to make on point-of-care ultrasound (POCUS). He walks us through some of the ways we can expect to see AI positively influence the world of POCUS.
He begins by addressing the areas of experience and training. A reminder that Dr. Rao wastes no time in bringing to the forefront of the conversation is that POCUS is not just for physicians. Most users of POCUS are the non-traditional ultrasound experts. For example, internal medicine doctors are not as well-versed like radiologists or cardiologists in ultrasound. However, POCUS is being utilized by them to diagnosis their patients at the point of care setting. “AI will help them acquire and optimize images or even detect or make a diagnosis,” Dr. Rao shares. Individuals learning how to execute POCUS can take advantage of AI features to help recognize life-threatening conditions, assist with probe alignment, and obtain the next steps in patient management.
With training comes confidence. “Ultrasound is a hands-on modality, which means you have to scan frequently to become more efficient at scanning patients and do so with difficult or challenging patients whose anatomy is not as easy to visualize with ultrasound due to body habitus or some deformity,” Dr. Rao recommends. He agrees that to evolve into a POCUS expert, you must have a practice makes perfect mindset. AI technology will assist early users of POCUS by helping to guide them in acquiring the right kind of images. He believes that the assistance that AI will provide unfamiliar POCUS users with will only increase their eagerness to learn, propelling the POCUS movement forward to new heights.
Dr. Rao provides an example, “You don’t have to have that much experience to be able to tell what the ejection fraction of the patient’s heart is. The AI component is going to compare your patient’s images and video loops with thousands or even hundreds of thousands of other patients’ data to assist you in drawing an opinion.”
Essentially, AI will aid in the thinking process based on significant volumes of patients’ records. Imagine needing to conduct at least 20,000 scans to obtain the same kind of information that AI technology can receive. The technology is going to expedite the process giving POCUS users a high-level of confidence to attain optimal images and reach the correct diagnosis.
Image optimization is another crucial element that Dr. Rao hopes to see as a development of AI synergizing with POCUS. He believes that AI can assist POCUS users in obtaining the best possible images. Optimal images assist with making the correct diagnosis and not missing any crucial information. AI technology can technically ensure the right levels of image brightness or darkness. It can adjust depth control or prompt the user that the depth needs to be corrected. “Your diagnostic ability is hindered if you don’t have the right settings. If an image is too dark or too bright, you can’t see structures. If your depth setting is too deep, the structures of interest appear small on the monitor, which creates the risk of missing a tiny lesion.” Dr. Rao informs.
A noteworthy advantage is that AI can help do what humans can’t or find too tedious to do. Humans can design AI programs to achieve their end objective. Dr. Rao suggests, “Perhaps we can be smart about it and use AI to our advantage. We don’t use it to do the things we can easily perform.” Our highest goal is to provide the most timely and accurate diagnosis. AI can help us achieve this outcome. So instead, we use it to perform the most difficult, time-consuming, and nearly impossible tasks to be conducted by human ability alone.
However, never fear, there’s no replacing humans here. Dr. Rao provides several reasons why he gathers that the marriage of AI and POCUS will not eliminate the need for human intervention but only enhance it.
“Execution of point-of-care ultrasound can happen anywhere. It could be performed at a hospital’s bedside, in a clinic, on the curbside of a road or out in the field on a mission trip in Africa. To have a device sophisticated enough to function with no need for human intervention would cost a million dollars,” Dr. Rao explains. “There’s no way people are going to have a million-dollar device in their pocket.”
He reminds us that when POCUS first arrived on the scene, the initial idea is that it would very quickly replace the stethoscope and become the modality of choice. However, that did not happen because POCUS devices were still costly. We are now seeing the cost decrease enough to have medical professionals flocking to this pocket-sized device. It could very well be a device for most physicians who currently use a stethoscope.
It is essential to have some knowledge of anatomy, pathology and physiology to execute POCUS well. This is another factor Dr. Rao believes signifies that human intervention will always be required when it comes to POCUS. Some conditions are very atypical, and we may not have the data on the condition AI needs to identify it because it’s so rare. Medical professionals still must create data from millions of patients, which will take time. Data is a requisite, and humans are required to generate it.
Let’s not forget the empathy factor that AI also won’t be able to furnish. Human connection is an irreplaceable asset and a vital ingredient to patient care. No matter the case or circumstance, patients still rely on and expect some form of emotional intelligence from any healthcare provider. “So, although AI may reduce the number of physicians needed, it will not eliminate us. This reduction will only make our field more competitive, and that’s fair,” Dr. Rao encourages. Physicians should aim to adopt this technology and aim to provide the best possible care to the patient even if it involves adopting POCUS with AI input built into modern ultrasound devices.
Here’s the key, we must embrace what we fear. We want to look at the advantages and know that the very thing that scares us is here to help us. Dr. Rao leaves us with a word of advice, “AI is not going anywhere, so we might as well accept it. Make AI work for you. Don’t work for it.”
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