@article{3a812eddde924fbca7d0cb6f06765e9d,
title = "Current Use and Barriers to Point-of-Care Ultrasound in Primary Care: A National Survey of VA Medical Centers",
abstract = "Background: More primary care providers (PCPs) have begun to embrace the use of point-of-care ultrasound (POCUS), but little is known about how PCPs are currently using POCUS and what barriers exist. In this prospective study, the largest systematic survey of POCUS use among PCPs, we assessed the current use, barriers to use, program management, and training needs for POCUS in primary care. Methods: We conducted a prospective observational study of all VA Medical Centers (VAMCs) between June 2019 and March 2020 using a web-based survey sent to all VAMC Chiefs of Staff and Chiefs of primary care clinics (PCCs). Results: Chiefs of PCCs at 105 VAMCs completed the survey (82% response rate). Only 13% of PCCs currently use POCUS, and the most common applications used were bladder and musculoskeletal ultrasound. Desire for POCUS training exceeded current use, but lack of trained providers (78%), ultrasound equipment (66%), and funding for training (41%) were common barriers. Program infrastructure to support POCUS use was uncommon, and only 9% of VAMCs had local policies related to POCUS. Most PCC chiefs (64%) would support POCUS training. Conclusions: Current use of POCUS in primary care is low despite the recent growth of POCUS training in Internal Medicine residency programs. Investment in POCUS training and program infrastructure is needed to expand POCUS use in primary care and ensure adequate supervision of trainees.",
keywords = "Barriers, Point-of-care ultrasound, Primary care, Training",
author = "Robert Nathanson and Williams, {Jason P.} and Neil Gupta and Austin Rezigh and Mader, {Michael J.} and Haro, {Elizabeth K.} and Brandy Drum and Edward O'Brien and Rahul Khosla and Boyd, {Jeremy S.} and Brian Bales and Erin Wetherbee and Harald Sauthoff and Schott, {Christopher K.} and Zahir Basrai and Dana Resop and Lucas, {Brian P.} and Soni, {Nilam J.}",
note = "Funding Information: Funding: NJS receives funding from the US Department of Veterans Affairs, Quality Enhancement Research Initiative (QUERI) Partnered Evaluation Initiative Grant ( HX002263-01A1 ). JSB receives funding from an Agency for Healthcare Research and Quality (AHRQ) Grant ( 1R01HS025979-01A1 ) and a Centers or Disease Control and Prevention (CDC) Grant ( 75D301-20-C-07637 ). BPL receives funding from the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development. This material is the result of work supported with resources and the use of facilities at the South Texas Veterans Health Care System in San Antonio, Texas. Funding Information: Funding: NJS receives funding from the US Department of Veterans Affairs, Quality Enhancement Research Initiative (QUERI) Partnered Evaluation Initiative Grant (HX002263-01A1). JSB receives funding from an Agency for Healthcare Research and Quality (AHRQ) Grant (1R01HS025979-01A1) and a Centers or Disease Control and Prevention (CDC) Grant (75D301-20-C-07637). BPL receives funding from the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development. This material is the result of work supported with resources and the use of facilities at the South Texas Veterans Health Care System in San Antonio, Texas. Authorship: All authors had access to the data and a role in writing this manuscript. RN: Methodology, Formal analysis, Writing – original draft, Visualization; JPW: Methodology, Formal analysis, Writing – original draft, review, & editing; NG: Writing – original draft, review, & editing; AR: Writing – original draft, review, & editing; MJM: Conceptualization, Methodology, Formal analysis, Data curation, Writing – original draft, review, & editing, Visualization; EKH: Conceptualization, Methodology, Writing – review & editing; BD: Conceptualization, Methodology, Investigation, Data curation, Writing – review & editing, Supervision, Project administration; EO: Conceptualization, Methodology, Investigation, Data curation, Writing – review & editing, Supervision, Project administration; RK: Writing – review & editing; JSB: Conceptualization, Writing – review & editing; BB: Writing – review & editing; EW: Writing – review & editing; HS: Writing – review & editing; CKS: Conceptualization, Writing – review & editing; ZB: Writing – review & editing; DR: Writing – review & editing; BPL: Methodology, Formal analysis, Writing – review & editing; NJS: Conceptualization, Methodology, Formal analysis, Investigation, Data curation, Writing – original draft, review, & editing; Supervision, Project administration, Funding acquisition. Publisher Copyright: {\textcopyright} 2023",
year = "2023",
month = jun,
doi = "10.1016/j.amjmed.2023.01.038",
language = "English (US)",
volume = "136",
pages = "592--595.e2",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier Inc.",
number = "6",
}