All 40 of Minneapolis-based Hennepin Healthcare’s emergency medical service vehicles are equipped with a tool so valued by paramedics, they did not want the devices removed for a necessary system update.
“Our equipment manager tried to pull the ultrasounds off the trucks for 24 hours, which did not fly with our medics,” Aaron Robinson, MD, assistant medical director for Hennepin Healthcare Emergency Medical Services and a Hennepin County Medical Center emergency medicine physician, told Becker’s. “We would not pull the monitor or the EKG machine off for even a second because those are critical pieces of equipment; now the point-of-care ultrasound is viewed as the same.”
Dr. Robinson spearheaded Hennepin EMS’ integration of point-of-care ultrasound technology alongside Nick Simpson, MD, chief medical director for Hennepin EMS and a Hennepin County Medical Center emergency medicine physician.
Both physicians spoke to Becker’s about the effect the technology has had on emergency department operations and patient care.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: What drove Hennepin to invest in point-of-care ultrasound technology?
Dr. Aaron Robinson: Our goal back in 2020 was to expand the role and the ability for EMS to rapidly diagnose and treat critical illness in emergency settings.
We got our first ultrasound systems in 2020, and we started to realize that the ultrasounds were getting utilized a lot more than we expected and in ways that we had really never imagined. We’ve since switched to the Butterfly Network system and storage cloud.
It started with a specialized team of critical care providers that provide advanced care in the pre-hospital setting. Since then we’ve gone from 10 ultrasounds with specific medics to over 50 ultrasounds and 180 trained personnel. They’re on every truck now and even required in certain clinical scenarios to make sure we’re providing the best care.
Dr. Nick Simpson: Hennepin Healthcare overall is very ultrasound forward, especially in our emergency department. Taking that mindset into the streets has really allowed our hospital providers to understand what’s actually happening earlier which does have an impact on the patient’s care downstream. The ultrasounds enable not only better triage, but also better treatment.
Q: How has early diagnostic information from prehospital point-of-care ultrasound affected emergency department admissions and patient throughput?
AR: Every hospital operates differently — in some places, [patients] might go straight from the street to the cath lab or CT scanner. For us, it helps to gather the right tools and activate the right teams. Having point-of-care ultrasound available to our EMS teams allows the hospital to have the right information faster, which means the right teams will meet the patient at the door. EMS can show up and say “Here’s the concern, here’s the pictures,” and the doctor can take it from there.
We have handfuls of anecdotes from individual patients who’ve had their care dramatically changed because of what was seen on the ultrasound. It has sent people on the fast track to the operating room to have their aorta repaired or the fast track upstairs to have a C-section because there’s some fetal distress.
NS: We also have our community paramedics do follow-up care for cardiac patients, which allows those patients to be discharged from the hospital a few days earlier.
Care teams meet patients at their home, provide on-site labs and an assessment with the point-of-care ultrasound, and then send those images back to the cardiologist.
Q: What advice would you offer to other hospital or health system leaders considering EMS point-of-care ultrasound adoption?
AR: It’s an entirely new diagnostic system, so it comes at a cost. But I think everything we’ve been able to build with it, and then the return that we’re getting, is invaluable.
You have to have good medical direction and oversight. You have to have a physician overseeing the integration, developing protocols with leadership and making sure the tools are being used at the clinically appropriate time through education as well.
You also need to have designated ultrasound champions. We’ve got three outstanding paramedics who understand the system just as well as anybody else; they don’t even need me anymore. They perform quality assurance now for our system and are also responsible for teaching the system to new paramedics.
Having operational support and a good relationship with IT is also crucial. We’ve got folks in charge of the equipment, making sure the software and probes are up to date. It takes a big group of people to make this whole thing work.
NS: It’s not easy, but most things that are worth doing are not easy. It has absolutely saved lives.
For a system, it is an investment in time and resources, but it is a patient-centered investment. We’ve made significant changes in clinical care for about 10% of our patients when using the system. That’s a lot of patients that have had their care dramatically altered when you think about the more than 6,000 exams we performed in 2024.
