April 3, 2026. By Emma Comadoll.

The scan took less than five minutes. A pocket-sized ultrasound performed at the bedside during the clinic visit provided immediate information about the patient’s heart function and helped guide clinical management.

Point-of-care ultrasound, or POCUS, is a portable form of imaging that enables clinicians to answer focused clinical questions in real time. Its value in hospital settings is well established, but its role in community-based care is increasingly evident. POCUS offers tangible benefits central to improving patient outcomes and promoting health equity, including improved access, faster diagnostic times, and reduced costs to patients and the health care system.

As a medical student, former cardiology research coordinator, and Schweitzer Fellow, I served many patients who faced barriers that delayed or prevented traditional imaging. Transportation challenges, high costs, long wait times, limited understanding of diagnoses, language, and cultural barriers frequently stood in the way. In my community work, bedside ultrasound has helped overcome many of these obstacles. One patient arrived at our clinic with known heart failure but was in the dark about his current heart function due to a long gap in obtaining formal imaging. By using POCUS, we could gauge his ejection fraction, an important metric of heart function. This assessment allowed for more accurate staging of the disease and directly informed the team’s treatment plan.

POCUS is particularly valuable in bridging gaps in access to imaging and improving diagnostic speeds, especially in rural or remote community clinics. Utilizing POCUS can reduce the need for referrals to formal imaging and allow patients who face multiple barriers to traditional imaging to receive timely evaluation. Because image acquisition is immediate, POCUS also helps mitigate long wait times and the need for travel to imaging centers. For our heart failure patient, this meant that an estimated ejection fraction could be obtained in real time, helping to bridge the gap to formal echocardiography.

Another major strength of POCUS is its cost-effectiveness for both the patient and the health care system. POCUS has the potential to reduce costs by lowering both direct and indirect costs, such as limiting the need for additional diagnostic tests and reducing the cost of late detection. Harvard researchers found that, in a community emergency department, “on average, POCUS use eliminated $1,134.31 of additional testing for privately insured patients, $2,826.31 for out-of-network or uninsured patients, and $181.63 for patients covered by the Centers for Medicare and Medicaid Services”. At the health system level, savings are also promising. A Rutgers quality improvement collaboration with Butterfly Network indicated that integrating POCUS into the daily hospital workflow for the management of congestive heart failure resulted in a substantial reduction in hospital stay duration and costs.

            While POCUS is an excellent screening tool, it is not a substitute for comprehensive imaging, and barriers to implementation remain. Efforts must extend beyond the physical placement of ultrasound devices in rural and community clinics to include developing a well-trained workforce and establishing sustainable reimbursement for these services.

To address these barriers and support equitable implementation of point-of-care ultrasound, coordinated efforts are needed to:

• Expand access to portable ultrasound devices in rural and community-based clinics through institutional and grant-based investment.
• Integrate structured POCUS training into undergraduate medical education, residency, and continuing professional development.
• Develop sustainable reimbursement models that recognize bedside ultrasound as a component of high-quality patient care.
• Support opportunities for students to learn POCUS at bedside, such as student-run clinic initiatives.

Emma Comadoll, MPH

2025-2026 NC Schweitzer Fellow

UNC School of Medicine, Class of 2028

The views expressed are those of the author and do not reflect the official stance of the Fellowship or the University of North Carolina School of Medicine.