Point-of-care ultrasound (POCUS) continues to make waves across multiple medical disciplines, yet in internal medicine, the road to widespread adoption remains an uphill climb. While the clinical benefits of POCUS—faster diagnoses, improved procedural guidance, enhanced patient care—are widely recognized, many internists have yet to fully embrace this transformative tool.
A revealing study, “Multi-Level Stakeholder Perspectives on Determinants of Point of Care Ultrasound Implementation in a U.S. Academic Medical Center” by Maw et al., provides much-needed insight into why this gap persists. By gathering perspectives from a broad spectrum of healthcare stakeholders, including hospitalists, subspecialists, and institutional leaders, the study offers a nuanced look at the factors shaping POCUS adoption at both the clinician and health system levels.
POCUS: Recognized Value, Uneven Implementation
The study’s authors set out with a simple yet critical goal: to understand what drives or impedes the integration of POCUS into routine clinical practice within internal medicine. Thirty-one stakeholders from various roles were interviewed, their responses analyzed through the lens of the Practical Robust Implementation and Sustainability Model (PRISM). What emerged were candid reflections that underscored the complex interplay between clinical utility, operational feasibility, and institutional support.
At the heart of the discussion was a shared recognition that POCUS holds significant promise. Stakeholders broadly agreed that ultrasound at the bedside could enhance clinical decision-making, improve patient outcomes, and streamline care delivery. Yet, despite this enthusiasm, implementation remains sporadic. The reasons for this hesitancy are multifaceted.
One major factor is the need for demonstrable clinical impact. While certain specialties, such as emergency medicine and critical care, have well-established POCUS protocols and outcome data, internal medicine lacks consistent, specialty-specific evidence that could solidify POCUS’s role. Some internists remain unsure how best to integrate POCUS into their diagnostic toolbox without disrupting established workflows. The question becomes not whether POCUS is useful—but where, when, and how it can be most effectively deployed.
The Balancing Act: Efficiency and Cost Considerations
Efficiency and cost, two ever-present forces in healthcare, also weigh heavily on POCUS adoption. On one hand, stakeholders acknowledged that ultrasound at the point of care has the potential to expedite diagnoses and reduce reliance on more expensive or time-consuming imaging modalities. On the other hand, the investment required to build a POCUS program—purchasing equipment, training clinicians, and dedicating time for practice—can feel daunting, especially when immediate financial returns aren’t guaranteed.
This tension between long-term clinical benefits and short-term resource allocation creates a persistent challenge. Leaders tasked with managing hospital budgets must balance these competing interests, often requiring clear evidence of cost-effectiveness before greenlighting POCUS programs. For clinicians, time is equally valuable. With already packed schedules, finding space for additional training or integrating new tools into daily practice can be difficult, even when the benefits are clear.
The Role of Policy and Quality Assurance
One of the study’s most compelling findings was the importance of formal infrastructure to support POCUS use. Without standardized credentialing policies and robust quality assurance processes, stakeholders expressed concern about inconsistent practice and variable skill levels among clinicians. This lack of structure can hinder adoption and, in some cases, raise questions about patient safety.
Credentialing policies help ensure that clinicians not only receive adequate training but are also formally recognized as competent to use ultrasound in their practice. Similarly, quality assurance mechanisms—such as image review, ongoing feedback, and performance tracking—are essential for maintaining high standards and preventing skill decay over time. The absence of these elements can leave both providers and institutions wary of expanding POCUS use, even when the interest is there.
These concerns echo broader themes in healthcare innovation: without the systems in place to support sustainable, high-fidelity implementation, promising tools like POCUS risk remaining underutilized.
Moving Forward: Bridging the Gap with Thoughtful Implementation
Maw et al.’s study offers a critical reminder that successful adoption of new medical technologies requires more than enthusiasm—it demands thoughtful implementation that addresses both individual and system-level barriers. For internal medicine, this means crafting strategies that balance the clear clinical promise of POCUS with the practical realities of training, resource allocation, and institutional policy.
It also means recognizing that POCUS cannot exist in isolation. Its adoption must be integrated into the broader clinical ecosystem, with ongoing support, education, and evaluation to ensure that it enhances—not disrupts—patient care. The study’s multi-level approach underscores that real change happens when all stakeholders, from frontline providers to institutional leaders, are aligned in their goals.
How SonoSim Supports POCUS Adoption with Sustainable Solutions
At SonoSim, we understand the challenges highlighted in this study because we’ve designed our solutions to address them. POCUS adoption doesn’t falter for lack of enthusiasm—it falters due to barriers like limited faculty expertise, time constraints, inconsistent credentialing, and the need for ongoing quality assurance. That’s where we come in.
Our comprehensive Ultrasound Training Ecosystem equips institutions with the tools they need to implement POCUS sustainably. With on-demand, expert-led courses, learners can build the skills necessary to meet credentialing requirements without taking time away from clinical duties. The SonoSimulator® provides unlimited hands-on practice with real patient cases, ensuring that clinicians can hone their scanning and interpretation skills regardless of patient availability. And our performance tracking offers robust quality assurance tools, including automated image assessment and progress tracking, to ensure clinicians maintain proficiency over time.
By partnering with institutions to integrate these resources into existing workflows, SonoSim helps bridge the very gaps that Maw et al. identified. Whether it’s creating structured training pathways, offering flexible learning tools, or providing ongoing assessment, we empower both clinicians and leaders to embrace POCUS with confidence.