Improving Care While Reducing Costs in Health Care
Would you let your family fly in an airplane at night if the pilot didn’t have radar? I certainly wouldn’t. That pilot would be flying blind. It’s the same for ultrasound. When a physician performs an invasive procedure without ultrasound guidance, it’s akin to flying blind. In one of my recent articles, “Ultrasound Guidance at the Point of Care: This Practice Lets Health Systems and Accountable Care Organizations Improve Patient Safety and Costs,” published in Executive Insight, I argue that health executives should carefully weigh the safety, efficiency, and potential for reducing (or avoiding) costs by implementing the same high standards of care across the organization. Appropriate use of ultrasound guidance at the point of care:1
- Reduces errors
- Increases the efficiency of real-time diagnosis
- Supplements or replaces other imaging modalities in appropriate circumstances
Avoiding complications is not only is good for patient care, it reduces the overall cost of care for hospitals. Data from a recent study conducted by United BioSource Corporation, presented at a recent National Patient Safety Foundation Annual Meeting, demonstrated significant economic savings when ultrasound guidance was used as part of the care pathway. This study found that among 69,859 patients who underwent a paracentesis, suffering a bleeding complication boosted hospital costs to nearly $30,000. That is triple the cost for patients without a complication ($9,476). Length of hospital stay almost doubled, from a mean of 5.2 days for a patient without a bleeding complication to a mean of 9.5 days for a patient with one. (Read more about the UBC study results)
It's not just using ultrasound guidance at the point of care that can reduce cost. Using ultrasound first as a diagnostic modality in appropriate circumstances would add up to significant savings across the healthcare system. In a recent examination of 2009 Medicare Data, KNG Consulting2 found that if ultrasound was used first in diagnosing 30% of rotator cuff injuries instead of MRI or CT, the savings would have exceeded $31 million. Using ultrasound first in 30% of ankle injuries would have saved approximately $8 million. And if ultrasound was used first in 70% of the diagnostic evaluations for both conditions--rotator cuff and ankle injuries--the combined savings to Medicare would have added up to more than $91 million. (If you would like more information about ultrasound's potential cost savings, please click here to read more about the KNG report.)
Given the squeeze on finances coupled with the increased expectation of good clinical outcomes, I believe that health systems can no longer afford to ignore the benefits of ultrasound at the bedside.
1Moore CL, Copel JA. Point-of-care ultrasonography, N Engl J Med. 2011 Feb 24;364(8):749-757
2Koenig L, Ruiz D, Cornejo A. Potential cost savings from the use of diagnostic ultrasound in the Medicare population. KNG Health Consulting LLC, 2011. Prepared for SonoSite, Inc.