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Tele-Maternal-Fetal Medicine Brings Clarity to Ultrasound Interpretation

Ultrasounds are an essential component of prenatal care. From the first glimpse of the fetal heartbeat and the gender reveal to the peace of mind that comes from seeing that development is progressing appropriately, expectant parents view ultrasounds as a routine part of pregnancy care. On the clinical side, we increasingly rely on technical advances in ultrasound imaging to guide pregnancies to the best possible outcome. For example, identifying a placental tumor known as a chorioangioma is key to monitoring closely for complications such as fetal anemia.

However, as much as ultrasound use in pregnancy is increasing, the training required to interpret the exams has not kept up. Radiology training programs have shifted focus to emerging imaging modalities, and many devote just two months of a four-year program to women’s health ultrasound. Similarly, OBGYN residency programs at best devote a month or two to formal ultrasound training. More than three-quarters of obstetricians report needing additional training to be able to perform or read ultrasound examinations independently, and 43 percent reporting not treating a patient on the basis of their own ultrasound examinations without further confirmation of the results.1

At Access Physicians, we built our maternal-fetal telemedicine program to address these deficits so that patients get the care the convenient, accessible, high-quality care they need. The goal is to support community-based obstetricians, midwives, and other maternity providers with high-value, high-quality ultrasound interpretation.

Our program starts with an initial assessment of a maternity provider’s current practices to see what is working well and what would benefit from our expertise in order to improve. We then introduce standardized, evidence-based protocols, such as those from the Society for Maternal-Fetal Medicine and American Institute of Ultrasound Medicine. We give one-on-one feedback to local sonographers as continuing education and professional development so that over time, they become more skilled. And, we employ advanced practice sonographers who oversee all of our education, communication, quality control, and data collection. Finally, we provide analytics so that practices see the impact.

Our tele-MFM ultrasound program yields results. Our data consistently show that we identify five to 10 percent more abnormalities on exams that were deemed “normal” by the local sonographer—most significantly congenital heart defects. We achieve these results while bolstering the financial health of the local birthing center, OB/GYN practices, and independent imaging centers and supporting the professional advancement of local sonographers. And, most importantly, we keep the patient and her needs and concerns front and center.

1Alrahmani L, Codsi E, Borowski KS. The Current State of Ultrasound Training in Obstetrics and Gynecology Residency Programs. J Ultrasound Med. 2018 Sep;37(9):2201-2207. doi: 10.1002/jum.14570. Epub 2018 Feb 21. PMID: 29464740.