‘A leap forward’: MUSC begins widespread use of pocket-size, whole body ultrasound system

June 15, 2022
Dr. Rami Zebian holds a smart device while a woman next to him uses a Butterfly ultrasound device on a man's bare back.
Dr. Ramzi Hourany takes a look at a patient's lungs using the new Butterfly handheld ultrasound, with help from nurse practitioner Brooke Chamberlain. Photo by John Russell

The CEO of MUSC Health has seen firsthand how helpful a pocket-size device that’s going systemwide at MUSC can be when it comes to quickly figuring out what’s wrong with a patient.

“Just a couple weeks ago, I had a family member in the hospital at MUSC Health-Charleston. He needed some fluid taken off his lung, and the pulmonologist pulled the Butterfly out of his pocket and began to take care of him right away,” said Patrick J. Cawley, M.D.

Patrick J. Cawley, M.D., MBA 
Dr. Patrick J. Cawley

The Butterfly, an ultrasound device about the size of an electric razor that connects to a smartphone or tablet to give an on-the-spot reading, immediately showed the pulmonologist what Cawley’s family member’s condition was. That meant the doctor was able to start treating the problem with precision – and without delay.

Ultrasounds are considered essential tools for diagnosing and taking care of patients. They use sound waves to create clear images of the inside of the body without the radiation that can come with other types of scans, such as X-rays and CTs.

Cawley called MUSC’s adoption of the Butterfly ultrasound devices and the system that supports them, the Butterfly Blueprint, a leap forward. “For a long time, hand-held ultrasound has been out there. Different companies have offered different technology. But the second we saw the Butterfly technology, we knew it could be transformational in a way that other portable ultrasounds have not been to this point in time.”

The device has 20 presets, meaning it’s capable of doing ultrasounds on 20 different areas of the body, using artificial intelligence. It earned the broadest Food and Drug Administration approval ever for an ultrasound system. Another feature hospital leaders like: The Butterfly is powered by a small chip instead of the piezoelectric crystals traditionally used in ultrasounds, making it more affordable.

Headshot of Dr. Rami Zebian. 
Dr. Rami Zebian

Some doctors had already made the Butterfly leap, buying devices for their own use. But until now, the results didn’t go into patient health records. They were just in-the-moment updates. That changes with the implementation of Butterfly Blueprint, technology that allows for systemwide integration of the information gleaned through Butterfly ultrasounds.

Rami Zebian, M.D., chief medical officer of MUSC Health Florence and Marion medical centers, was an early user of the Butterfly ultrasound. He’s had his own device for a few years and was part of the push for MUSC Health to begin using it on a large scale in its hospitals and clinics.

“The portability of it is the biggest game changer, the price of it also because it’s much cheaper than a regular ultrasound. I think that it does not replace a formal ultrasound, right? This is not to replace radiologist or radiology imaging but serve as an adjunct. And the wow factor is still there. Every time I take it to clinic and I connect it to my phone and show patients what I’m looking at. They love it.”

Florence, Marion and Charleston are the initial focus of the device’s rollout at MUSC Health. Aalap Shah, M.D., co-director of the Emergency Ultrasound Division in MUSC’s College of Medicine and an emergency medicine specialist, said the new technology could be a game changer for clinics and hospitals that aren’t in big cities.

Closeup of a smartphone screen showing an image of an ultrasound gathered by the Butterfly device, which a man is holding next to it. 
The Butterfly can connect to a smartphone or tablet to give on-the-spot images. Photo by Sarah Pack

“A lot of providers have been practicing medicine for most of their lives without having been able to have access to this sort of technology. And so it’s important to find a really robust system to make sure they’re able to train and feel comfortable with the indications that they’re going to be using this for and provide quality care to their patients.”

Dr. Aalap Shah 
Dr. Aalap Shah

Shah, who is also an assistant professor in the College of Medicine, likes the fact that the Butterfly will become part of the training that students receive as well and be available to researchers at MUSC.

Cawley, the CEO of MUSC Health, agreed. “If we start training clinicians and providers on the front end – using a device that’s intuitive and easy to use, it will push us forward in all kinds of ways,” Cawley said.

Zebian said it could save time and energy in the process. “A lot of times, people don't use an ultrasound because we’re running, in a rush. You can schedule an ultrasound for a patient, but that takes a few days. But if you take a quick look with the portable ultrasound, you may still say, ‘Hey, I still want an official read,’ but if you look and you see a blood clot or something like that, then you would say, ‘No, we need to do something today.’”

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