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Performance, Training, Quality Assurance, and Reimbursement of Emergency Physician–Performed Ultrasonography at Academic Medical Centers

Section of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut USA (C.L.M.); and Resurrection Medical Center Emergency Medicine Residency, Chicago, Illinois USA (S.G., M.L.).

Address correspondence and reprint requests to Christopher L. Moore, MD, RDMS, Section of Emergency Medicine, Yale University School of Medicine, 464 Congress Ave, Suite 260, PO Box 208062, New Haven, CT 06519 USA. E-mail: chris.moore{at}yale.edu.

Objective. To determine the current state of bedside emergency physician–performed ultrasonography in terms of prevalence, training, quality assurance, and reimbursement at emergency medicine residency programs. Methods. The link to a 10-question Web-based survey was e-mailed to ultrasound/residency directors at 122 emergency medicine residency programs in the United States. Results. The overall response rate was 84%. Ninety-two percent of programs reported 24-hour emergency physician–performed ultrasonography availability. Fifty-one percent of programs reported that a credentialing/privileging plan was in place at their hospital, and 71% of programs had a quality assurance/image review procedure in place. Emergency medicine specialty–specific guidelines of 150 ultrasonographic examinations and 40 hours of didactic instruction were met by 39% and 22% of residencies, respectively, although only 13.7% of programs were completing the 300 examinations recommended by the American Institute of Ultrasound in Medicine. Sixteen programs (16%) reported that they were currently billing for emergency physician–performed ultrasonography; of those not billing, 10 (12%) planned to bill within 1 year, and 32 (37%) planned to bill at some point in the future. Conclusions. Performance and training in emergency physician–performed ultrasonography at academic medical centers continues to increase. The number of emergency medicine residency programs meeting specialty-specific guidelines has more than doubled in the last 4 years, but only a small number are meeting American Institute of Ultrasound in Medicine guidelines. Although only 16% of programs reported that they were currently billing for emergency physician–performed ultrasonography, most had plans to bill in the future.

Key Words: education • emergency • reimbursement • ultrasonography

Abbreviations: ACEP, American College of Emergency Physicians • EM, emergency medicine • EP, emergency physician • EPPUS, emergency physician–performed ultrasonography • FAST, focused assessment with sonography in trauma • QA, quality assurance • SAEM, Society of Academic Emergency Medicine

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