JMIR Publications

ABSTRACT

Background:

Despite its established clinical value, point-of-care ultrasound (POCUS) use remains limited by access to expertise and challenges with workflow integration. Remote interpretation, enabled by cloud-based platforms, has the potential to address these challenges by enhancing accessibility.

Objective:

To conduct a small exploratory pilot study to assess the usability and observed agreement of remote interpretation of lung and inferior vena cava (IVC) POCUS across device types for lung and inferior vena cava (IVC) ultrasound scans leveraging Presuna’s teleultrasound software.

Methods:

Four clinical vignettes with associated lung and IVC ultrasound scans were reviewed by four physicians using Presuna across three device modalities (laptop, tablet, smartphone) over three separate sessions. We calculated inter-rater observed agreement between participants and the reference standard, as well as System Usability Scale (SUS) scores via surveys. Thematic analysis was conducted from observations and participant interviews to gain insight into the overall user experience.

Results:

Observed agreement results revealed that the laptop (lung = 83%, IVC = 75%, clinical impression (CI) =78%) had slightly higher agreement than the tablet (lung = 80%, IVC = 74%, CI=77%) and smartphone (lung = 81%, IVC = 73, CI=78%). Participants found Presuna appealing, particularly for its remote asynchronous capabilities. The laptop version of the platform was favored over tablet and smartphone versions, with SUS scores of 76.5, 55.0, and 59.5 respectively. However, participants emphasized the unique portability advantages of handheld devices, which would be particularly convenient for physicians working remotely and during non-workday hours. Of note, the requirement to record participant sessions caused excessive performance lag for the tablet which led to incomplete responses by one participant and likely impacted the SUS results.

Conclusions:

To support the successful design of more usable remote POCUS interpretation software, it is essential to consider language clarity, interface design, and pre-implementation training.