Case study

University of Rochester Medical Center Boosts Ultrasound Charge Capture by 116% with System-Wide Deployment of POCUS using Butterfly.

September 16, 2024

Overview

Health System
University of Rochester Medical Center
Headquarters
Rochester, NY
Ultrasound Workflow Solution
Butterfly Compass™
# of Butterfly Devices
862
# of Compass-Integrated Non-Butterfly Devices:
73

Read the peer-reviewed version of this case study.

Published by URMC’s Chief Medical IT Development officer, Dr. David Waldman The Journal of Clinical Imaging Science.

Read Journal Article

The University of Rochester Medical Center (URMC) forms the centerpiece of the University's medical research, health professions education, and patient care missions. It is home to Strong Memorial Hospital, the only Level 1 trauma center and largest safety-net provider in upstate New York's Finger Lakes region, serving a population where approximately 40% of patients are on Medicaid or uninsured.

In early 2021, URMC partnered with Butterfly to deploy a system-wide ultrasound program aimed at improving patients’ access to imaging, streamlining physician workflows, and optimizing revenue capture.

To date, this initiative has involved the deployment of 862 Butterfly iQ™ probes and the integration of Compass™ workflow software across the enterprise. Concurrently, existing ultrasound devices were incorporated into Compass to improve institutional compliance with imaging standards. URMC is on track to continue program expansion and, by 2026, expects to have 2,500 Butterfly probes deployed and integrated with Compass.

Impact

116%

increase in POCUS charges across all of URMC

4.9x

increase in the number of available ultrasound devices across URMC for clinical and educational use

77%

of all clinical exams are fully documented and sent to EHR

64

academic departments and clinical programs credentialed to perform ultrasound

3x

increase in POCUS studies sent to the EHR outside the emergency departments

1.3x

increase in POCUS studies sent to the EHR in the emergency departments

Since 2022, the implementation has resulted in 49,492 Butterfly scanning sessions carried out by 964 distinct users across 64 academic departments and clinical programs. This widespread adoption has led to 1,129 study authors generating 175,197 images, creating 19,399 studies, and finalizing 15,524 reports. Notably, 9,802 studies underwent quality assurance either centrally or within the departments. In 2023, scanning sessions saw a 74% increase compared to the previous year, accompanied by a 147% rise in studies uploaded from Butterfly devices and an impressive 1,782% increase in images uploaded from non-Butterfly devices.

The enterprise-wide deployment of point-of-care ultrasound has led to significant clinical improvements, including early diagnosis of cholecystitis to avoid emergency room visits, distinguishing abscesses from cellulitis, early detection of a bladder mass in patients with poor emptying, identifying foreign bodies, detecting valvular vegetations, screening for abdominal aneurysms, and identifying thyroid nodules. It has also been used to detect bony fractures in pediatric patients, resulting in faster diagnoses and treatments for many patients. Proceduralists benefit from improved compliance with image retention, resulting in significant increases in billing in Emergency Medicine and all other participating departments. In fact, overall POCUS charges have more than doubled across URMC’s clinical enterprise since the pilot began. A full cost-benefit analysis will require additional time and evaluations.

Read the peer-reviewed version of this case study.

Published by URMC’s Chief Medical IT Development officer, Dr. David Waldman The Journal of Clinical Imaging Science.

Read Journal Article

Deployment

The project began in early 2022 with a comprehensive, enterprise-wide needs assessment. This process involved identifying the medical specialty groups that would serve as initial adopters and determining which existing ultrasound systems would be integrated into Compass™. The assessment informed a phased implementation across clinical sites, starting with Primary Care, Home Health, Emergency Medicine, and Intensive Care. The School of Medicine and Dentistry was also an early deployment site, providing each incoming medical student with a personal Butterfly probe. POCUS is now embedded in a revamped four-year curriculum, making ultrasound an integral part of medical education and clinical assessment.

Our strategic deployment of Butterfly technology was designed to maximize clinical efficiency and diagnostic accuracy across departments, while driving value for all stakeholders.

David L Waldman, MD, PhD, FSIR, FACR
Chief Medical IT Development Officer at URMC
January 2022
Project kickoff and partnership announcement.
March 2022
URMC POCUS Governance Committee formed
July 2022
Primary Care is the first sub-specialty to go live with Butterfly probes and Compass across 
7 clinical sites.
August 2022
URMC gifts 220 Butterfly probes to the classes of 2025 and 2026.
July 2023
30 departments and clinical programs are live with Butterfly probes and Compass.
March 2024
Over 64 departments and clinical programs are live with Butterfly probes and Compass.

At the program’s outset, a centralized POCUS governance committee was established. This committee oversaw the enterprise-wide deployment, managed expansion, and established guidelines for credentialing, quality assurance, and documentation. A structured educational program was created with designated leadership responsible for driving adoption, conducting quality reviews, mentoring participants, ensuring guideline compliance, and supporting ongoing training. This program leveraged Butterfly’s educational tools and personnel, including didactic courses and videos from Butterfly Academy, to deliver a comprehensive curriculum.

Our phased deployment of Butterfly devices and Compass software has yielded impressive clinical and administrative results at URMC to date.

Michael F. Rotondo, M.D.
CEO of the University of Rochester Medical Faculty Group, Senior Vice President of URMC

Medical School

The medical school’s curriculum was significantly revamped to integrate POCUS into problem-based learning courses. As of August 2024, the number of scanning sessions for the classes of 2025, 2026, and 2027 totaled 4,808, 2,018, and 2,728 respectively. Each class averages about 103 students.

The provision of Butterfly ultrasound probes coupled with the cloud-based image archiving system has dramatically changed our approach to ultrasound education.

David W. Staudt, M.D.
Assistant Professor, Department of Medicine at URMC, Director of POCUS Training, School of Medicine and Dentistry

Conclusion

The clinical and economic value of POCUS is well-documented, with numerous studies showcasing its impact on improving clinical outcomes, enhancing efficiency, and driving cost savings1-6. The benefit of POCUS to modern medicine is no longer a hypothesis—care improves when POCUS is used.

Across the nation, medical schools and residency programs have acknowledged the importance of POCUS, embedding it as a vital element in their training curricula. This reflects the strong consensus and extensive evidence that POCUS is now a fundamental tool in modern medical practice, making clinician training and adoption essential. However, challenges such as cost, limited device availability, integration infrastructure, and governance continue to impede broader adoption.

URMC’s experience demonstrates that deploying affordable, portable POCUS devices like Butterfly, combined with integrated, device-agnostic software, is both practical and cost-effective. At a time when healthcare margins are thin and efficient care models are essential, URMC has harnessed the power of POCUS to effectively meet these challenges. Their approach serves as a compelling blueprint for other institutions to follow, ushering in a new era where the promise of POCUS is fully realized across all specialties and care settings.

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