Diagnostic Uncertainty During COVID-19 Heightens Need for Certified Sonographers Treating Patients

COVID-19 has created uncertainty for medical professionals on the frontline of the pandemic. Disruptions to clinical care abound, from over-filled ICUs to over-stretched healthcare workers, creating an environment ripe for missteps and misdiagnoses.

Yet, despite the chaos and constantly changing variables, the quality of patient care is the one thing that should never suffer. Maintaining high standards through certification of healthcare professionals is the best way to ensure that patients achieve the best outcomes. Fully trained, certified healthcare professionals should be expected for every patient interaction.

Unfortunately, that’s not always the case when it comes to medical imaging. This global health crisis has shown that imaging modalities, such as ultrasound, are particularly effective in the diagnosis of COVID-19. While many hospitals and medical practices require certification, only a handful of U.S. states require medical sonographers to possess specific certifications as a job requirement. Professional training and certification reduce risk, giving healthcare providers the strongest foundation for performing accurate and timely ultrasound examinations.

Why sonography credentialing matters

Maintaining consistency-of-care is critical in normal times and, especially, during a pandemic. Certified healthcare professionals provide greater assurance that medical imaging procedures will be performed to the highest standard of care regardless of the circumstances, location, or patient’s financial situation. The technical and scientific skillsets required to achieve the certification process encourages repeatable, consistent proficiency that non-certified ultrasound users may lack.

Certification also conveys a higher level of competency to the healthcare organization. Independently validated sonography certification serves as a proxy for licensure, as licensure requirements do not exist in most states in the U.S. In states that do require licensure, the universally accepted credentials from the American Registry for Diagnostic Medical Sonography (ARDMS) are accepted as proof of proficiency.

Ultrasound examinations by certified ultrasound professionals can be invaluable in triage management as well, particularly in the identification of patients with SARS-CoV-2 pneumonia needing immediate treatment. In the high-pressure environment of acute medical settings, certified professionals are trained to manage these critically important decisions.

Finally, certified professionals elicit a sense of trust. A certified sonographer has demonstrated the theoretical knowledge and practical application skills required to perform the examination effectively and accurately. This certification provides a heightened level trust from patients, employers, and other healthcare professionals.

What’s at stake?

As health care providers become even more overloaded during a pandemic, they are asked to tend to many needs of the patient that may have been previously addressed by another specialized professional. This is where certification is important. Diagnostic accuracy is expected with highly skilled sonographers. In the absence of certified professionals using these essential diagnostic tools, there is a greater margin of error and potential for misdiagnosis. Inexperience can lead to inadequate or incorrect treatment, increased morbidity, and potential death.

Even prior to the pandemic, research^[1] has realized misdiagnoses have been a primary contributor to patient harm. As much of our understanding of this novel virus is still unknown or unfolding, the complexity of COVID-19 and sheer number of patients being treated during the outbreak are likely to cause an increase in diagnostic errors.

Lung ultrasound is receiving increased attention with the COVID-19 pandemic, and it is important that the exam is performed by trained and certified sonographers. Certified sonographers have the knowledge of proper patient position, transducer selection, and scanning techniques. Sonographers use artifacts produced at the pleural surface to assist in determining lung pathology. Sonographic signs, such as A-lines, B-lines, lung sliding, comet tail artifacts, lung point sign, spine sign, and shred sign, are used by trained sonographers, but are difficult to distinguish to the untrained eye.A substandard ultrasound examination could cause the need for additional diagnostic methods, potentially exposing the patient to unnecessary radiation.

Speed and responsiveness of emergency care are at stake, as well. With many hospital intensive care units under siege during this pandemic, rapid, accurate diagnoses using ultrasound will be critical for managing the large volumes of critically ill COVID-19 patients.

Ultrasound imaging gives practitioners a potentially faster way to triage a patient’s condition than waiting for nasal swab results. Access to certified sonographers enables healthcare providers to put more critical expertise and knowledge on the front lines of care, improving response time and accuracy.

Other ways independently validated certification makes a difference

Certification can be a huge asset for health care practitioners who, due to the pandemic, are seeking to boost their skills and expand their careers into new professional areas. Certification assessment demonstrates that their skills and knowledge have been validated through the certification process, giving them a competitive advantage in their job seeking and advancement.

Beyond the responsiveness to healthcare crises like COVID-19, sonography certification offers significant reputational benefits to healthcare organizations. If the healthcare industry made sonography certification a greater priority, it could help establish a consistent standard of care across the United States and beyond. Standardizing care, in turn, improves patient trust.

Certification serves as proof of knowledge and carries with it a high degree of recognition for the sonographer. This recognition will instill a higher level of confidence for the healthcare provider, assuring they are hiring a highly proficient employee.

Final Thoughts

In these uncertain times, the world needs the skills that certified sonographers provide more than ever. For practitioners seeking these skills, the ARDMS administers examinations and awards certificates in all areas of diagnostic ultrasound. ARDMS certifications have been awarded to more than 100,000 medical professionals worldwide and are recognized as the global standard in sonography credentialing.

------------------------------------------------------------------------------------

[1] 1. Singh H, Graber ML. Improving diagnosis in health care—the next imperative for patient safety. N Engl J Med. 2015;373(26):2493-2495. https://doi.org/10.1056/nejmp1512241.