Point-of-care ultrasound: levelling the healthcare playing field

Med tech company Butterfly Network is on a mission to democratise health care for the 4.7 billion people around the world who lack access to medical imaging. Its Ultrasound-On-Chip technology is paving the way for earlier detection and remote management of health conditions around the world.

Point-of-care ultrasound (POCUS) is emerging as a valuable tool at the frontline of the COVID-19 pandemic. Using the device, healthcare professionals can instigate mobile lung ultrasound procedures, triage patients according to disease severity and ensure hospital systems and testing facilities aren’t overwhelmed. Disease progression can also be monitored in patients who are receiving treatment or quarantined in homes, temporary hospitals and urgent-care facilities.

Butterfly Network’s low-cost portable whole-body ultrasound technology — Butterfly iQ — is currently used in more than 20 countries by tens of thousands of healthcare practitioners. The enormous cost differential between Butterfly iQ and traditional ultrasound systems (US$2000 vs US$50,000) makes the device a game changer when it comes to remote communities or those with limited resources.

The technology focuses on three key areas:

1. Helping doctors to assess whether patients should be admitted to hospital or rest at home by using POCUS to assess the condition of their lungs. This assessment can be made outside of medical facilities, ensuring only those who need to be in hospital are there.

2. If patients need to be admitted to hospital, POCUS can be used to monitor progression or regression of the virus. This can be done quickly and without having to move patients around wards, therefore helping contain treatment to just one part of the hospital.

3. Ongoing assessment is investigating how the technology can be used for caring for patients at home. POCUS will be crucial in allowing COVID-19 patients to recover at home and ensure the virus is contained.

The Butterfly iQ is proving to be a valuable tool on the COVID-19 frontline.

The Network became aware that physicians across the globe were sharing their COVID-19 lung ultrasound findings on social media in an effort to collaborate and educate. To help consolidate efforts and pool the collective resources, the Butterfly team created a dedicated landing page full of educational, academic and best practice guides for monitoring COVID-19.

“In the midst of the pandemic, point-of-care ultrasound (POCUS) is emerging as a valuable tool for the monitoring and management of COVID-19,” explained Butterfly Network Chief Medical Officer Dr John Martin.

“More specifically, lung ultrasound has been proven effective in detecting pulmonary involvement and avoiding cross-contamination in suspected COVID-19 patients.

“With spread of infection being a critical concern, POCUS devices like the Butterfly iQ can help provide the insights that are needed to be efficient and thorough with care at the bedside. Whole-body portable imaging allows healthcare practitioners to assess multiple organ systems (lungs, heart, abdomen) and to guide the placement of central or IV lines with the same device, limiting the risk for contamination and disease transmission. Thousands of healthcare practitioners are using Butterfly iQ on the front lines and for remote COVID-19 monitoring,” he said.

“Every day, the Butterfly team is working with its broad network of users and healthcare experts to educate the medical community on the power of point-of-care ultrasound, as well as how to use the device in their local market and medical facilities.

“Point-of-care ultrasound is efficient and effective not only in COVID-19 management, but extends into general bedside care. Butterfly iQ is the only single device that can provide image scanning for the entire body,” Dr Martin explained.

How Butterfly iQ is being adopted across the world

Approval in Canada

COVID-19 quickly shifted the healthcare landscape in Canada, leading to priority review of the Butterfly iQ by Health Canada and subsequent medical device licensing.

“As healthcare practitioners work to combat the COVID-19 pandemic that is overwhelming our healthcare systems, it is more important than ever that they have access to tools and resources to help them in this fight. Aligned with our mission of democratising medical imaging, we are proud to offer Canada access to affordable, portable and state-of-the-art technology to better help them monitor and triage affected patients both quickly and effectively,” Butterfly Network CEO Laurent Faracci said.

Butterfly Network is working closely with Health Canada and leading physicians and healthcare systems across the provinces to ensure proper access and use of Butterfly iQ devices, particularly at this critical health moment.

Vancouver BC Emergency physician Dr Adam Thomas is using the Butterfly iQ for rapid pulmonary involvement assessment of COVID-19 patients.

“Given current constraints on health care, from timing to surge capacity, we are not going to be able to use some of the traditional assessments and treatment options. We must turn to solutions that can help us be more efficient and effective, and focus on helping patients. No tool may do that better than Butterfly,” Dr Thomas said.

“The Butterfly iQ has the ability to complete essential functions quickly and safely and in a way that integrates smoothly with hospital workflow. This tool can help us combat the spread of this pandemic.”

Physician self-monitoring

Dr Yale Tung Chen — an emergency room doctor at Hospital Universitario La Paz in Madrid, Spain — self-monitored his own condition using the device while in quarantine after being diagnosed with COVID-19 in March. While in quarantine, Dr Tung Chen monitored the progress, and then regression, of his condition by collecting ultrasound images, which he shared on Twitter to contribute to the evolving understanding of the condition.

Dr Tung Chen became infected with SARS-CoV-2 during the hospital’s preparations for the pandemic, during which time he was treating mostly mildly symptomatic patients. Dr Tung Chen began to feel unwell with chills, dry cough and myalgia, testing positive for COVID-19 after running a CRP test. During his time in quarantine, Dr Tung Chen used the Butterfly iQ to scan his lungs to assess the progression of the disease.

Dr Tung Chen said that sharing information such as scan data was critical to helping the global medical community better understand COVID-19, and lung ultrasound data could be used to guide treatment and manage patients.

University of Melbourne: launch of COVID-19 lung ultrasound free online course

In response to the growing prominence of POCUS in monitoring COVID-19, the University of Melbourne has launched a free online course on COVID-19 lung ultrasound to upskill healthcare professionals across Australia and throughout the world as they combat COVID-19.

To access The Butterfly Network's COVID-19 resources, including a gallery of lung ultrasound images, visit https://www.butterflynetwork.com/covid-19.

Image credit: Butterfly Network