POCUS Occupies Denmark’s General Practice, Improving Patient Outcomes
The basis for point-of-care ultrasound (POCUS) usage has been laid by technological advances that have made the production of compact and affordable ultrasound equipment possible. These advancements offer improved resolution that provides high-quality imaging on scales unseen before. Globally, across specialties and disciplines, POCUS continues to serve as an extension of the traditional physical exam. According to the organization, Research and Markets’ December 2021 published article, Global Point-of-Care Ultrasound Device Markets, 2021-2030 – Demand for Therapeutic PoCUS Devices to Rise Faster, the global revenue for the POCUS devices market is estimated to increase to $4,546.5 million by 2030. That’s a $2,359.7 million increase from 2020.
The article highlights that Europe has generated the highest revenue in the POCUS devices market to date. Expanding technical advances, a growing geriatric population, and increasing cases of chronic disease have contributed to the modality’s popularity in the region.
According to the United Nations (UN), with an aging population set to reach 954.6 million by 2050, Asia-Pacific is on track to becoming the fastest-growing POCUS device market. In addition to a large senior community, the contribution to the region’s POCUS demand includes the need for point-of-care treatment and diagnosis and surging chronic disease cases.
Here are some primary factors driving the demand for POCUS globally:
- The UN predicts that worldwide those aged 65 and older will grow from 727 million in 2020 to 1.5 billion by 2050. Sufficiently caring for this population will be heavily dependent on POCUS.
- The World Health Organization notes that the rise of chronic diseases will place a significant demand on POCUS to diagnose, treat, and care for patients.
- The technological advances the device will continue to undergo only will further its attraction and need in medicine.
- Utilizing therapeutic POCUS devices will see an increased application.
Another element impacting the booming use of POCUS is its increased application across medical disciplines. One prominent area of care that is taking claim to POCUS is general practice. Despite a lack of clinical guidelines and training programs, the modality is increasingly entering the office of general practitioners (GPs). Though GPs are using POCUS, there are significant differences in utilization among countries to include the frequency of use and type of examinations performed.
Troels Mengel-Jørgensen, GP, a general practitioner in Vodskov, Denmark, stops by the FOCUS on POCUS™ podcast to share what general practice POCUS usage looks like in his part of the world. Mengel-Jørgensen details how the Danish Society for Ultrasound in General Practice (DAUS), an organization he currently serves as Chairman, works in Denmark to establish education, training, and research to help support POCUS access and usage in family medicine. Recently, the organization conducted a study striving to ascribe the employment of POCUS by Danish GPs. Results were published in the Family Practice Journal on August 25, 2020, documenting substantial outcomes.
There are a couple of elements to note about Danish family medicine. GPs are first-line healthcare providers who govern referrals to other specialists, as well as inpatient and outpatient hospital care. Yet, there is limited knowledge regarding the broad usage of POCUS training programs for general practice and how the modality is applied in this setting. Also, there are no designated measures to better understand POCUS use after participating in training.
In 2013, Mengel-Jørgensen and DAUS were asked to explore the possibility of ultrasound in Danish family medicine. They provided recommendations for the level of machines to use in general practices, and multiple scanning modalities have been suggested as suitable for GPs by other groups. Still, there have been infrequent endeavors to determine the various POCUS examinations GPs find most relevant.
DAUS enrolled 30 GPs in a short ultrasound training program to answer this question and investigate further, teaching them how to perform 22 selected scanning modalities. The program was conducted over three months, in which 1,598 patients were examined. Each GP scanned seven to 112 patients, typically performing obstetrics, abdominal and musculoskeletal scans. After five months, participating GPs were asked to complete questionnaires at an evaluation seminar. Seventy percent indeed returned evaluation questionnaires.
A prominent result included that most ultrasound examinations were deemed conclusive, amplifying diagnostic certainty. Additionally, overall scan times were 10 minutes or less, and over 10% of the scans conducted were outside the training’s curriculum. One of the most significant impacts of the study is that 16 out of 21 participating GPs continue to use POCUS in their daily work. They have purchased or leased the device and have integrated it into their practice. The other five participants have plans to invest in incorporating POCUS in their offices.
To gain more insights into how POCUS is influencing Denmark’s family medicine community, tune into the podcast episode, The Danish Society for Ultrasound in General Practice: A conversation with the Chair. Also, review DAUS’s full study details.