por Lauren Dubinsky
, Senior Reporter | July 08, 2019
From the July 2019 issue of HealthCare Business News magazine
Chasen is also a supportive of performing ultrasound scans in the first trimester to identify major abnormalities early in pregnancy. He explained that many structures can be diagnosed before 14 weeks.
He warned against the temptation to solely follow guidelines from professional organizations and payors. If these exams are simply a checklist from the insurer, then abnormalities in the face, heart, extremities and genitalia can be missed.
“Guidelines from professional societies tend to be relatively simple and probably don't set the bar too high in terms of quality,” said Chasen. “They recognize the variation in practice settings and expertise and probably don't want to expose their members to medico-legal liability. The temptation to adhere to the guidelines of payers largely relates to maximizing revenue.”
Ultrasound-guided epidural injections
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Charlottesville-based Rivanna Medical introduced an ultrasound device to the market in 2016 called Accuro, which leverages ultrasound technology to guide epidural injections.
Traditionally, physicians used a technique that involved counting down the number of bones on the patient’s spine to identify the space where the anesthesia should be administered. Once the appropriate level is identified, the physician advances the needle until they reach the correct depth to numb the roots of the nerves for the legs and pelvis.
“Doing the procedure using this technique is a little like throwing a dart across the room with your eyes closed,” said ECRI’s Merton.
Conventional ultrasound systems have been used to guide these injections, but it requires the user to have a lot of skill and experience. The Accuro device provides a 3D display of the location of the bones, the intervertebral space, and indicates the depth that the anesthetic needs to be administered.
“Over the past two decades, the field of anesthesia has migrated toward an image guidance standard of care for needle placement procedures such as vascular access and peripheral nerve blockades,” said Will Mauldin, CEO of Rivanna Medical. “This procedure remains blind despite an abundance of academic literature, including meta-analysis, that demonstrates improved success rates, reduced needle sticks, and improved safety when ultrasound is used to guide the neuraxial placement.”