Through my years of involvement in improving rural healthcare, I’ve been aware of the value of point-of-care ultrasound (POCUS), but a conversation with a physician assistant in rural Glenwood, Minnesota proved how this single imaging tool can save even more lives when used in new ways.  

When Tom Pahl began working in rural medicine two decades ago, his practice was able to offer traditional ultrasound scans just one day a week and echocardiograms three days a week, during daytime hours.  

Ultrasound uses high-frequency sound waves to produce images of structures inside the body, which helps providers make diagnoses and determine appropriate treatment. Traditionally ultrasound exams were performed in radiology or cardiology departments, but for very ill patients, waiting days and sometimes weeks to receive a diagnosis and begin treatment can mean their condition worsens; patients with some more critical diagnoses may die. 

POCUS is a more focused ultrasound exam performed with a compact portable or handheld ultrasound machine by medical providers at the patient’s bedside. POCUS can immediately be used to identify some life-threatening conditions and enable the immediate initiation of appropriate treatment or to exclude some critical diagnoses. 

Tom told me, “When you’re the sole provider in a rural area responsible for people’s lives, a lot of medicine is detective work.” But some patients present with medical conditions that are time sensitive and require immediate identification and treatment even though providers might not have all the information they need to make a diagnosis.  

For a patient with chest pain or involved in a motor vehicle accident, routine tests and imaging won’t necessarily explain what’s happening in a timely manner. By utilizing POCUS, medical providers can look at the heart, lungs, abdomen, and other organs and see abnormalities immediately. 

This detective work happens a lot faster these days, thanks to Tom’s use and refinement of POCUS, a which is accurate, easy to use, and portable. 

With Helmsley’s support, POCUS has become a crucial part of patient care in the ER at Glacial Ridge Hospital in rural west central Minnesota where Tom works.  Tom sees patients and performs all of the normal aspects of evaluating patients, but with portable ultrasound he can see in a matter of minutes how well a heart is functioning in a patient with chest pain, or if there is blood in the abdomen for a patient involved in motor vehicle accident.  

For a trauma patient, POCUS can identify life threatening bleeding in the abdomen, chest, or other critical conditions, often times before the patient’s vitals and other routine tests reveal the severity of the injuries. This can all be done without the patient leaving the emergency department and delaying immediate treatments.  Identifying critical conditions in minutes at the bedside instead of an hour or longer using conventional tests and imaging can mean the difference between living or dying. 

Healthcare workers like Tom know that POCUS saves time and saves lives, especially in rural communities, which have fewer medical resources and less availability for those resources than do communities in metropolitan areas. POCUS enables doctors to diagnose patients immediately, which means patients can begin treatment quickly.  

Helmsley recently announced grants to fund 97 POCUS devices across Wyoming, which will ensure that people living in remote communities will have access to advanced diagnostic technology at their local health facilities. The funding also supports dozens of general ultrasound systems and cardiovascular ultrasound systems, as well as ultrasound training program for medical professionals. 

We know that ultrasound equipment is expensive for critical access hospitals and healthcare centers to purchase, but it’s part of essential care for patients.  

That is why we are continuing to make grants to expand the use of ultrasound, and POCUS in particular, in the rural Upper Midwest. In 2023 we granted $26.4 million to fund ultrasound imaging devices and sonography training across Minnesota, and in 2022 we provided $4.2 million for a similar initiative in Nevada. 

An individual’s zip code should not determine their access to quality healthcare—and diagnostic imaging is one important part of this care. We will continue to work to ensure people in rural areas can access the same state-of-the-art medical technologies that are in the nation’s urban centers.