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Queen’s project brings interactive ultrasound training to remote communities

Queen’s project brings interactive ultrasound training to remote communities

Dr. Johri using a scannerIt’s the stuff of science fiction: a tiny, portable device that can rapidly assess a patient’s physical health at bedside.

Dr. Amer Johri likens point-of-care ultrasound (POCUS) to Star Trek’s famous tricorder; unfortunately, not enough doctors know how to use the cutting-edge medical instrument. Just as the crew of a starship might beam to a distant planet, Queen’s researchers found a way to transmit POCUS expertise to remote and underserviced communities. They developed ARCTICA, a learning management system that offers Tele-POCUS training and support to isolated physicians.

“We remotely teach physicians outside of urban centres so that if a patient comes into a remote clinic they get the same level of care as a patient walking into a clinic in Toronto,” explains Dr. Johri, an Associate Professor in the Department of Medicine and the Founder and Director of the Cardiovascular Imaging Network at Queen's (CINQ).

ARCTICA Program locations
ARCTICA has established five primary location hubs that serve seven northern communities across four provinces.

ARCTICA is a unique collaboration between CINQ, Queen’s, and the Kingston Health Sciences Centre.

Traditional ultrasound machines are large, stationary, and require highly-specialized training. POCUS is cost-effective, streamlined, quick, and can dramatically improve patient outcomes. The diagnostic image it provides assists doctors in cardiopulmonary assessment and physiological monitoring. Dr. Johri calls the dynamic machine “the new stethoscope”; ARCTICA is simply empowering more doctors to use POCUS.

Researchers knew they wanted ARCTICA’s learning management system to be interactive and evaluative: a three-week learning track includes modules, a virtual workshop, testing, and mentorship. Trainees then have ongoing access live-image consultation with experts from primary sites.

“What we're doing is figuring out the best way to teach non-cardiologists how to do heart and lung ultrasound at the bedside,” Dr. Johri says. “With tele-communication and the tele-streaming of ultrasound images, we were able to teach physicians without ever meeting them face-to-face. It's a really tailored teaching strategy for each physician – tailored to the equipment that they have, tailored to how their site is set up, and tailored to their patients.”

Dr. Johri in a remote training sessionThe 2020 pilot project – funded by the Canadian Cardiovascular Congress – saw Kingston provide training and support to three northern Ontario communities in Weeneebayko Area Health Authority (WAHA), which has a long-standing healthcare partnership with Queen’s University.

“The program made me go from someone who had never really touched POCUS to someone a lot more comfortable doing bedside evaluations,” recalls Moose Factory physician Dr. James Walton.

Success in WAHA led to the program’s expansion. At present, ARCTICA has established five primary location hubs that serve seven northern communities across four provinces.

Dr. Johri’s CINQ lab was well-positioned for success with ARCTICA. With over 12 years of POCUS research experience, they are pioneers in the field; it even founded the POCUS Journal in 2016, the first journal dedicated to point-of-care ultrasound. When COVID-19 struck, Dr. Johri saw another opportunity.

“We had this enormous expertise in a tool that's perfect for use during COVID-19,” he says, noting the device’s portability minimizes the risk of patient and staff infection. “It's small, easy to clean, and the doctor that's already taking care of that patient can do it (in the COVID-19 ward).” Dr. Johri authored COVID-19 patient guidelines for the American Society of Echocardiography that recommends POCUS as the first-in-line imaging tool.

Meanwhile, the ARCTICA project has a bright future. A research paper on the pilot project is nearly complete and current training modules have been certified through Queen’s Office of Professional Development and Educational Scholarship.

Up next? Finding a way to train even more physicians. To that end, ARCTICA was recently awarded the Canadian Cardiovascular Ultrasound Research Excellence Award for Technology & Education (CREATE) grant from the Canadian Society of Echocardiography (CSE). The $50,000 award funds collaborative national projects; ARCTICA hopes to greatly expand its number of remote communities and health centres.

It’s not hocus POCUS. ARCTICA could one day impact countless lives from coast-to-coast. With the right support and transformational funding, Dr. Johri envisions “a sort of POCUS dome across Canada … an expanded network of hubs and spokes so that all underserviced regions have access to training and expertise on this important imaging tool.”

Dr. Johri also wants to expand ARCTICA’s educational reach. “The next modules we want to do are going to be disease-specific,” he says. “How does POCUS help things like pulmonary hypertension? How does POCUS help things like heart failure?”

Learn more about Dr. Johri’s CINQ Lab at Queen’s University.

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