IN PoCUS project to facilitate closer-to-home ultrasound-based assessment and diagnosis in rural BC

The Rural Coordination Centre of BC (RCCbc) is supporting and facilitating rural physician involvement in the Intelligent Network for Point of Care Ultrasound (IN PoCUS) project, a new initiative that seeks to train rural healthcare providers in PoCUS skills and equip them with a wi-fi enabled handheld ultrasound probe. In addition to building local imaging capacity in rural BC, the project also seeks through its participants to build an anonymized database of ultrasound images for provincial reference. The IN PoCUS group recently issued a call for participants and received an enthusiastic response from interested rural physicians across BC, getting the project off to a promising start. 

This work is being led by Dr. Virginia Robinson, an experienced rural provider who has taught PoCUS to her peers over the past 6 years. “The focus of IN PoCUS is to improve rural physician use of point of care ultrasound as a tool to support in-community diagnosis,” says Dr. Robinson. “Imaging quality for handheld probes has greatly improved, making ultrasound scanning in rural and remote communities both attainable and affordable.” By equipping rural healthcare providers with the knowledge and means to use PoCUS in their local clinics, remote community clinics, and emergency departments, IN PoCUS expands the ability of rural physicians to diagnose select conditions in a timely manner in low resource settings.  

For example, the usefulness of PoCUS is especially evident now during the Covid-19 pandemic. Italian physicians reported that ultrasound can be an effective diagnostic tool for detecting the SARS-CoV2 virus – the presence of B lines in the scan are more sensitive than the first nasopharygeal swab for positive identification, which is only 71 per cent sensitive in the most recent trials. Having local ultrasound capacity during the pandemic will enable BC rural healthcare providers to be more confident in their assessments of potential Covid-19 cases, without relying solely on nucleic acid tests which must be shipped out of the community and processed at a certified laboratory.   

Two types of handheld probes are available to participants in the IN PoCUS project: a cardiothoracic model and a curvilinear model (FAST/OB which can also be used for cardiothoracic applications). Participants will be reimbursed by RCCbc $5,500 towards the purchase price of the probe. Training in the use of the probe for specific types of scans will be offered by the IN PoCUS group; in exchange for receiving a probe and PoCUS training, project participants are asked to submit 25 to 50 of their ultrasound images for use in a provincial database that will be a repository for reference and research purposes. “Our partners, Providence Health, Change Health Care, and UBC, will anonymize and add the images to the database – rural physicians will only be required to select and submit their scans,” notes Dr. Robinson. “Having a repository of images on a secure system that can be shared with any specialist in the province for immediate feedback and consultation will be an invaluable resource in the years to come. Finally, we will have our own PACS system to discuss our images with colleagues.”  

IN PoCUS will also work with project participants in collecting data and feedback to inform the development of a rurally relevant and supportive artificial intelligence (AI) tool that will eventually be integrated into the handheld ultrasound probes. The AI will primarily support a PoCUS user in obtaining the best images required for the task. Building the AI tool in collaboration with front line BC rural physicians will help ensure that supports are useful and effective in BC’s rural and remote context.   

If you would like to learn more about this project, please contact Tracey DeLeeuw at tdeleeuw@rccbc.ca 


BACKGROUND 

The InPoCUS project is one of several initiatives of Canada’s Digital Technology Supercluster, a collaborative group of diverse organizations including some of Canada’s biggest names in healthcare, communications, natural resources, technology, and transportation. INPoCUS specifically aims to: 

  • resolve heterogeneity in a vendor-neutral space and offer standardization of imaging interpretation across any PoCUS transducer platform. 
  • be socially accountable by offering first trimester ultrasounds as close to home as possible, and reducing the significant economic and emotional burdens involved in obtaining a scan.  
  • leverage unique medical expert support – including data libraries – to transparently and independently validate AI algorithms.  
  • be the first to offer an obstetric AI on PoCUS.  

INPoCUS will support rural healthcare in BC by: 

  • healthcare delivery network integration. This project leverages Canada’s unique healthcare environment to create leadership in networking democratized medical imaging. INPoCUS will help leverage the maximal benefits of these networks and technologies for the benefit of all Canadians 
  • healthcare capacity building for remote communities. By directly involving RCCBc and consulting with the First Nations Health Authority, we ensure that the communities with perceived highest benefit will have access to project results.  
  • developing Canadian leadership in telehealth sector.  
  • directly channeling benefits to remote communities through healthcare capacity building and improved patient outcomes, which in turn provides infrastructure for rural-based economic activities.  
  • establishing BC as a leader in imaging AI. 

INPoCUS is a partnership of the following organizations:  

Learn more about INPoCUS on the Canadas Digital Technology Supercluster web site.