Health Technology Reviews
Key Messages
What Is the Issue?
- Ultrasound imaging requires highly trained professionals for accurate diagnostic exams and interpretation.
- Ultrasound is more affordable and portable than CT and MRI and does not expose patients to radiation. This makes ultrasound the preferred method for real-time assessment and soft tissue imaging. For more detailed or complex imaging, or when clinically indicated, CT and MRI may be more appropriate.
- In Canada, less than 28% of rural hospitals have in-house access to ultrasound, leading to patient transfers.
- Ultrasound exams are often conducted by sonographers, and there is a notable shortage of sonographers both in Canada and worldwide.
- Limited access to skilled ultrasound professionals has led to the development of teleultrasound (TUS), which supports remote clinical decision-making.
- TUS can be delivered in real time with remote guidance from a sonographic expert.
- TUS can be used by a variety of health care professionals with minimal ultrasound training. However, as the use of real-time TUS continues to expand to different clinical areas, its clinical effectiveness compared with traditional in-person ultrasound remains unclear.
What Did We Do?
- We received a request related to the use of real-time TUS to support policy decision-making.
- A literature search was conducted to identify studies examining the clinical effectiveness of real-time TUS compared with conventional in-person ultrasound and any evidence-based guidelines for TUS use in clinical practice.
- We also report some of the advantages and challenges of TUS as described in the literature.
What Did We Find?
- Real-time TUS was comparable to conventional in-person ultrasound for exam image quality and diagnostic consistency.
- Exams took, on average, more than 25% (or 6 minutes) longer to complete compared with in-person ultrasound.
- Real-time TUS was associated with high clinician satisfaction for comfortability, telecommunication quality, exam duration and quality, and accessibility.
- Several studies reported transient safety-related complications (e.g., increased pressure, pain), patient discomfort or fear, and technical difficulties during 10% of robotic-assisted TUS exams.
- Real-time TUS was studied in a wide range of clinical indications in various settings, highlighting its growing role and potential for expanded application in clinical practice.
- No evidence-based guidelines were identified for the use of TUS in clinical practice.