Transforming Heart Failure Care: Significant Reductions in Length of Stay Across Diverse CHF Acuity Levels and Costs by Up to 50% with POCUS Integration
January 13, 2025
Overview
Background
This report presents the results of a groundbreaking Quality Improvement (QI) initiative conducted by Butterfly Network in collaboration with Rutgers Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital. These findings were initially presented as part of a late-breaking clinical trial at the EuroEcho Conference in December 20241. The study focused on integrating point-of-care ultrasound (POCUS) into routine inpatient care for heart failure (CHF) management, with an aim to evaluate both clinical and health-economic outcomes.
Over 1,000 studies have highlighted the clinical value of POCUS in managing CHF, but few have been specifically designed to evaluate its health-economic impact within the framework of a quality improvement effort aimed at establishing it as a new standard of care. This initiative sought to bridge that gap, using a stepped-wedge cluster randomized trial to reflect real-world conditions. The study included 216 patients, with hospitalists trained through Butterfly Academy and supported by sonographers.
Impact
The study demonstrated the significant impact of daily POCUS on patient outcomes and healthcare costs. Key results included:
- Overall Length of Stay (LOS) Reduction: Over 4 days on average across all patient groups.
- Lower-Acuity Patients (NYHA II & III):
- Median LOS reduced by 1.1 days (from 6.7 to 5.6 days).
- Cost reduction of ~50%
- Higher-Acuity Patients (NYHA III & IV):
- Median LOS reduced by 22.3 days (from 39 to 16.7 days).
- Both cardiac POCUS and lung ultrasound (LUS) were performed and contributed to faster discharges, especially in lower-acuity patients.
The results provide a scalable playbook for healthcare systems to integrate POCUS into routine CHF management, which can lead to improved patient outcomes and reduced costs.
Implementing POCUS as a standard of care for CHF management has proven not only to improve patient outcomes but also to generate significant cost savings for our hospital system.
Henry Rutgers Professor of Cardiology; Chief of Cardiology,
Rutgers Robert Wood Johnson Medical School & Robert Wood Johnson University Hospital University Hospital
Conclusion
This case study demonstrates how integrating point-of-care ultrasound (POCUS) technology into standard hospitalist workflows for heart failure management can lead to significant clinical and economic benefits. With proven reductions in hospital length of stay and cost savings, POCUS hardware and software can provide a scalable, efficient solution for improving inpatient care and outcomes while delivering a clear return on investment for healthcare systems.
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