Rural family physician use of point-of-care ultrasonography: experiences of primary care providers in British Columbia, Canada

BMC Primary Care

Research

Hilary Ho¹  Jude Kornelsen¹  Oron Frenkel²  Virginia Robinson³ 

[1] Centre for Rural Health Research, Department of Family Practice, University of British Columbia, 3rd Floor David Strangway Building, 5950 University Boulevard, V6T 1Z3, Vancouver, BC, Canada;Providence Health Care, St. Paul’s Hospital, 1081 Burrard St, V6Z 1Y6, Vancouver, BC, Canada;Rural Coordination Centre of British Columbia, 1665 West Broadway, V6J 1X1, Vancouver, BC, Canada;

关键词: Point-of-Care Ultrasound;    Rural Medicine;    Telemedicine;    Virtual Medicine;    Rural Health;   

DOI  :  10.1186/s12875-023-02128-z

 received in 2022-03-02, accepted in 2023-08-21,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundIn British Columbia (BC), rural and remote areas lack proximal access to radiographic services. Poor access to radiographic services in rural settings presents a challenge to timely diagnosis and screening across many disease states and healthy pregnancies. As a solution to the lack of access to radiographic services in rural settings, the Rural Coordination Centre of BC (RCCbc) supported rural Family Physicians (FPs) wishing to use PoCUS through the Intelligent Network for PoCUS (IN PoCUS) program. This study evaluates FPs’ experience and use of PoCUS in their clinical practice.MethodsThis qualitative study conducted in-depth virtual interviews with 21 FPs across rural BC. The interview asked participants’ motivation to participate in the RCCbc program, the type of training they received, their current use of PoCUS, their experience with the technology, and their experience interacting with specialists in regional centres. Thematic analysis of findings was undertaken.ResultsThis study used Rogers’ framework on the five elements of diffusion of innovation to understand the factors that impede and enable the adoption of PoCUS in rural practice. Rural FPs in this study differentiated PoCUS from formal imaging done by specialists. The adoption of PoCUS was viewed as an extension of physical exams and was compatible with their values of providing generalist care. This study found that the use of PoCUS provided additional information that led to better clinical decision-making for triage and allowed FPs to determine the urgency for patient referral and transport to tertiary hospitals. FPs also reported an increase in job satisfaction with PoCUS use. Some barriers to using PoCUS included the time needed to be acquainted with the technology and learning how to integrate it into their clinical flow in a seamless manner.ConclusionThis study has demonstrated the importance of PoCUS in improving patient care and facilitating timely diagnosis and treatment. As the use of PoCUS among FPs is relatively new in Canada, larger infrastructure support such as improving billing structures, long-term subsidies, educational opportunities, and a quality improvement framework is needed to support the use of PoCUS among rural FPs.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 2