STHS leading the way in ‘game-changing’ diagnostic tool

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Thursday, June 15, 2023

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STHS leading the way in ‘game-changing’ diagnostic tool

Mike Scott, mscott@stph.org

Mike McNeil, St. Tammany Health System’s director of outpatient physical therapy, examines a patient’s wrist using musculoskeletal ultrasound, a diagnostic tool built on the same technology used in pregnancy ultrasounds but to diagnose soft-tissue injuries. St. Tammany Health System began using it as part of its efforts to reduce opioid use. Now, it is leading the way nationally in implementing it. (Photo by Amy Bouton/STHS)

There was something wrong with her knee. Swelling within the joint was creating pain, and her daily activities were grinding to a halt.

But what was causing it? And would it require surgery to repair?

The problem, according to Bert Lindsey, director of inpatient physical therapy at St. Tammany Health System’s flagship St. Tammany Parish Hospital, was that most insurance plans won’t pay for testing such as an MRI or CT scan right away, opting for a wait-and-see approach, sometimes for as long as 30 days.

“Our concern as STHS clinicians was that delays in advanced imaging resulted in prolonged opioid exposure, increased expenses for conservative treatments, as well as quality-of-life disruptions due to the inability of the orthopedic surgeon having access to the imaging valuable to providing the proper diagnosis,” Lindsey said.

The downside of that approach is obvious and outsized. America’s opioid epidemic over the past decade-plus is proof.

There had to be a better way, Lindsey thought.

He was right. And he and his STHS colleague Jay Morange, now director of the health system’s outpatient operations, found it.

As part of an award-winning 2016 initiative at the hospital to explore non-pharmaceutical methods of treating pain, Lindsey and Morange learned about Musculoskeletal Ultrasound, or “MSKUS,” which – in the hands of a trained clinician – can help diagnose soft-tissue injuries quickly, inexpensively and noninvasively.

Although widely used in Europe and Asia, it has only just begun to catch on in the United States. With financial assistance from St. Tammany Hospital Foundation, Lindsey and Morange introduced MSKUS to St. Tammany, including at its Therapy and Wellness Clinic in Covington.

We’re talking real-time imaging for school athletes, weekend warriors and patients experiencing joint pain that will reduce opioid exposure and give patients peace of mind."

- Bert Lindsey, STHS director of inpatient physical therapy

It has been a major success.

For example, that patient with the bum knee? After a quick, painless ultrasound scan, her physician got information to help gain her advanced imaging, if necessary, without the prolonged delay.

“We saved her time, we saved her money and we spared her from opioid exposure. It really is a game-changer – a win-win-win,” Lindsey said.

If there’s a catch to MSKUS it’s that certification involves a rigorous exam. As of this writing, only nine people are certified in Louisiana to perform MSKUS. Five are physicians. The other four are St. Tammany Health System physical therapists, including Lindsey and Morange.

What’s more, STHS has committed to having every physical therapist in the organization certified to perform it. Ten of them, in fact, are set for testing within the next 18 months.

“The support of the administration here is the real secret to this program’s success,” Lindsey said. “Innovation is one of our pillars as an organization, and they walk the walk when it comes to that.”

He continued: “Think of the implications for our community. We’re talking real-time imaging for school athletes, weekend warriors and patients experiencing joint pain that will reduce opioid exposure and give patients peace of mind. Having so many clinicians able to perform this low-cost diagnostic within one community is a first in our nation, and St Tammany Health System is responsible for making it happen.”

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