Standard Enterprise Imaging Process for POCUS Brings in Millions for Hospital

Putting standard processes in place can make it easier to implement point-of-care ultrasound (POCUS) in a facility, potentially opening the door to millions of dollars in new revenue.

Although it is an easy-to-use modality, POCUS utilization can be slow if institutions are unable to bill for it because their providers aren’t credentialed or if their images are not stored in an enterprise archive.

In a poster presented during the Society for Imaging Informatics in Medicine (SIIM) 2021 Virtual Annual Meeting, Laurie Perry, RN, lead systems analyst at Cincinnati Children’s Hospital, detailed how the hospital successfully turned the corner to properly billing for POCUS – a move that brought in $2.25 million in new services from 5,000 studies.

“POCUS was successfully implemented at our hospital,” she said. “This has enabled the reproducible implementation of a new technology demanded by physicians and has generated new revenue for our institution.”

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To reach this goal, the hospital launched an implementation team comprised of imaging informatics professionals and electronic health record (EHR) analysts, as well as a project manager, business director, an educator, and a physician. They focused on five key components to successful implementation: EHR workflow design and creation, procedure codes for billing, provider credentialing, user training, and modality procurement and configuration.

Based on their interactions with leaders from each service, the team pinpointed procedures that could be performed in the division and drafted appropriate billing codes. They also identified providers who should receive customized training and credentialing. In addition, they assessed existing POCUS equipment for Wi-Fi capability and whether it could use a DICOM worklist, as well as create and store DICOM images in an enterprise archive. For divisions without POCUS, the team offered a choice of hospital-approved devices.

Throughout the process, the team overcame two significant challenges. First, they worked with clinical leaders to create a standard POCUS workflow in the EHR that automated as many steps as possible while pulling from both existing workflow and ad-hoc order creation. Second, in order to correctly bill for imaging studies, the team collaborated with the radiology business director to identify and create proper procedure codes.

Based on their success, the hospital has three more go-lives planned for the upcoming year that will focus on each division’s individual needs.

“Creating a standard process has allowed us to implement POCUS in multiple divisions,” Perry said. “Based on our experience, we have made improvements in our process and now provide interested divisions with a list of approved POCUS vendors and involve radiology business directors early in the project.”

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