Getting a Grip
By Keith Loria
Radiology Today
Vol. 26 No. 2 P. 22

Ergonomic and Workflow Enhancements in Ultrasound

At the RSNA 2024 conference, the spotlight was firmly on enhancing workflow for radiologic technologists, with a particular focus on ultrasound imaging. As the demand for efficient and accurate ultrasound procedures continues to rise, industry leaders are prioritizing solutions to streamline workflows and alleviate the physical strain on technologists. With repetitive movements often leading to fatigue and injuries, vendors are actively developing innovative technologies and ergonomic designs aimed at simplifying procedures and improving the overall efficiency of ultrasound workflows.

“It’s an exciting time for ultrasound, with key innovations largely driven by advancements with AI, ergonomics, portability, and digital clinical tools,” says Philip Rackliffe, president and CEO of advanced visualization solutions for GE HealthCare. “These advances improve efficiency, boost clinicians’ confidence, and optimize workflow.”

Philips recently launched its Elevate platform, featuring EPIQ Elite Elevate and Affiniti Elevate. “The Elevate Release is a new solution that offers stunning image quality, confident exam reproducibility, and intuitive automated workflows to support users on a quicker path to first-time-right diagnosis and planning,” says Jeff Cohen, global business leader of ultrasound at Philips. “The platform enhances workflow efficiency with Quick Launch presets, which improve workflow and reduce ultrasound exam times for higher patient throughput. The improved user interface and user experience save valuable time, enabling clinicians to focus more on patients.”

Additionally, Elevate Release introduces AutoElastQ, which Cohen calls “the next dimension of liver elastography.” AutoElastQ simplifies complex exams, reducing steps for greater ease and efficiency.

Incorporating AI
Not surprisingly, AI is making significant inroads in ultrasound. Courtney Ernst, ultrasound marketing manager for Esaote, says AI is generating significant buzz across various market segments right now, as its applications range from enhancing confidence in detecting abnormalities to facilitating automatic measurements.

“Esaote has introduced new offerings, such as eDetect for breast and thyroid assessments, which provide automatic measurements,” she says. “This innovation not only enhances reproducibility but also improves workflow efficiency.”

The incorporation of AI algorithms helps optimize image quality in real time, adjusting settings automatically to improve the clarity of images without extensive manual intervention. “This reduces the physical demands on sonographers, as they spend less time making adjustments during scans,” Ernst says. “Esaote uses AI to assist with image analysis and interpretation. Automated detection of abnormalities can provide alerts, which aids sonographers in identifying areas of interest more efficiently. This allows them to work more effectively, as they spend less time sifting through images.”

Amanda DePalma, head of corporate marketing and communications for ultrasound at Siemens Healthineers, says the company is leveraging AI to address some of its customers’ biggest pain points: the growing workforce shortage, the prevalence of ultrasound users who are scanning in pain, and the lack of standardization across ultrasound users and exams that have plagued ultrasound since its inception. “At RSNA this year, we introduced AI Abdomen on ACUSON Sequoia, which helps standardize exams across users, with a real-time organ identification feature and freeze-measurement of organs,” she says. “The algorithm provides consistent measurements across users, enhancing diagnostic accuracy and reducing variability associated with manual measurements.”

GE HealthCare has rolled out several recent launches and enhancements across its portfolio, such as the Versana Premier, the latest release within the Versana ultrasound family offering automation and AI-enabled productivity tools designed to improve workflow as well as clinical features designed to enhance clinical efficiency and accuracy. There’s also the Venue Sprint, designed for portability with advanced capabilities for high-quality scanning and support at the point of care; Caption AI, AI-driven software offering real-time guidance and step-by-step instructions for clinicians to conduct scans for cardiac assessments, to capture high-quality images at the point of care on Vscan Air SL; and the LOGIQ ultrasound portfolio—including the new LOGIQ Totus—with new features and AI-based tools to advance imaging capabilities for high quality assessments.

In addition, AI tools can help accelerate training by offering automated measurements and providing postexam quality checks that give immediate feedback on accuracy and technique. Newer ultrasound systems also include educational courses to help ultrasound sonographers build skills through instruction on machine operation and clinical guidance for a variety of exams.

Cohen says Philips’ solutions combining technology and AI will have an increasing impact on users. “The Philips Digital Ecosystem enables efficiency and is embedded on the Elevate release, offering a digital platform foundation ready to help simplify health care,” he says. “Our Next Gen AutoSCAN optimizes images in real time, reducing adjustments and enhancing workflow efficiency. Cardiovascular AI features, including segmental Wall Motion Scoring and SmartView Select, are now available with the Elevate Release. In shared services, AI tools are invaluable, enabling users to deliver precise results even outside their specialty.”

Reducing Repetitive Injuries
Many of the newer innovations in ultrasound equipment are specifically designed to reduce repetitive strain injuries for radiologic technologists, improving overall workflow. For example, DePalma notes AI Abdomen reduces hand motion of the ultrasound user by 89% compared with manual exams and up to 44% compared with protocol exams, which is significant when considering ways to reduce repetitive movements that are causing pain for many ultrasound users.

“At Siemens Healthineers we are focused on what we call practical AI, and what we mean by this is AI that is focused on boosting efficiency, standardizing care, and expanding access, so that users can scan more efficiently, with less pain and strain, and get more patients the answers they need as quickly as possible,” DePalma says.

When it comes to ergonomics, Siemens Healthineers approaches this in two ways—one is looking at ways to improve workflow and perform exams faster. The second is to reduce the number of manual movements— button pushes, knob twists, unnecessary reaching, etc, that contribute to repetitive stress.

“Part of our development process is understanding workflows and protocols so that the AI that we develop is additive and easy to adopt and use because the users will only get the benefits that could reduce repetitive hand motion or speed exam times if they use the tool, so it must be easy and seamlessly integrate into existing workflows,” DePalma says.

Rackliffe says sonographers face a significant physical burden due to their work, and this is exacerbated by several trends they are facing, including increased workload, staffing shortages, more technically challenging exams, and repetitive tasks. “When we design an ultrasound system, we take these challenges into account in multiple ways,” he says. “First, is the physical design of our technology. For example, by incorporating touchscreens, users may customize their probe presets and workflow, which results in fewer manual adjustments, keystrokes, and button presses. Other physical ergonomic considerations include the ability to adjust the height and orientation of the machine, features such as wrist rests to relieve fatigue; adjustable monitors; and touchscreens, keyboards, and probes that are comfortable to hold, including wireless probes that can accommodate a variety of environments and patients.”

Next, is the role of AI. GE believes that adding AI is like having another teammate in the room. “AI is helping sonographers spend more time on high-value tasks and reducing the number of repetitive clicks and manual tasks that can contribute to musculoskeletal stress,” Rackliffe says. “For example, select Voluson women’s health ultrasound systems feature SonoLyst, a suite of tools that leverage AI to identify fetal anatomy seen on standard views, then automatically annotates and measures where applicable, which can reduce the time needed to complete standard International Society of Ultrasound in Obstetrics and Gynecology second trimester exams by up to 40%.”

Easote has put significant thought into its probe designs. For example, the company’s new ultrasound transducers are designed to be lighter and more comfortable to hold, incorporating ergonomic grips that align with the natural posture of the sonographer’s hand.

“Ultrasound machines now often include adjustable stands and mobile carts that allow for better positioning of the equipment, reducing the need for sonographers to bend or reach awkwardly during scans,” Ernst says. “Advanced ultrasound systems come with automated features, such as autofocus and auto-gain, which minimize the amount of manual adjustment needed during imaging. This can significantly reduce the time spent in potentially harmful positions.”

Smart software that assists in image acquisition can also help sonographers obtain high-quality images with fewer attempts, decreasing repetitive motions. “What’s more, new training technologies, like virtual simulations, can help sonographers practice and refine their techniques without the physical strain of handling equipment during training,” Ernst says. “Additionally, the development of wireless ultrasound probes allows for greater flexibility and mobility, enabling sonographers to move around patients more easily and reducing the physical strain from cables and restricted movement.”

Samsung Medison, an affiliate of Samsung Electronics, recently launched the Samsung Z20 in the United States, a premium, AI-powered ultrasound system designed for Advanced OB-GYN applications. “The Z20 introduces innovations aimed at overcoming various diagnostic challenges, such as high-BMI patients, and operator variability, compounded by staffing shortages which impact exam quality and efficiency,” says Kyu Tae Yoo, CEO of Samsung Medison. “In a health care environment increasingly strained by staffing shortages, the Z20’s advanced AI suite streamlines workflows, enabling clinicians of all experience levels to deliver precise, consistent results with ease.”

Ultrasound’s Future
Manufacturers are continuing to look for ways to improve users’ day-to-day workflow, as well as boost efficiency, standardize care, and expand access. “We are staying focused on clinical areas where we have strong offerings, and there is a growing need for ultrasound solutions in cardiology, breast, liver, MSK, vascular, and small parts,” DePalma says.

Rackliffe notes ultrasound technology continues to advance at a rapid pace, and addressing the health and safety of health care professionals is a key focus, as new ultrasound features are introduced. “Ergonomic design is an important part, but it is only one aspect we consider,” he says. “When developing ultrasound technologies, we are taking a holistic view on how we can improve ergonomic design, but also image quality, reporting, workflow, collaboration, feedback, and more.”

AI will increasingly play a key role in these considerations to help provide clinicians with faster, more accurate results, increase their diagnostic confidence, and help drive more efficient workflow. This is good for patients as well as clinicians, allowing them to focus more on patient care and helping alleviate physical stress by reducing the number of repetitive clicks and manual manipulations.

— Keith Loria is a freelance writer based in Oakton, Virginia. He is a frequent contributor to Radiology Today.