First Experiences With Tele-Supervision for Bedside Ultrasound in Critical Care Settings

Background Supervising ultrasound (US) examinations in emergency settings means time-sensitive decision-making to ensure accuracy for the critically ill, with the rare ressource of attending physicians often representing a bottleneck. We evaluate the usability of a live tele-supervision workflow for radiology residents performing bedside US in critical care.

Methods We implemented a proprietary system enabling real-time simultaneous US screen capture and webcam streaming of the examined patient region, into our US workflow used for critical care settings (i.e., bedside US at emergency department and intensive care units). The system was adapted allowing seamless live-stream integration into a web meeting call operated by headset. Attendings remotely observed residents' examinations and provided real-time instructions. The system was piloted in 50 cases across the spectrum of our services. Metrics of diagnostic performance, resident confidence, and workflow efficiency were recorded and compared to 50 control cases without tele supervision. Resident and attending satisfaction were assessed via surveys.

Results Preliminary results revealed tele-supervised examinations to significantly improve diagnostic accuracy and work efficiency (p<0.05) by simultaneously increasing teaching quality as observed by residents (p<0.05). Attendings rated remote supervision as comparable to in-person guidance. No adverse events or workflow flaws were reported.

Conclusion Live tele-supervision has the potential to significantly improve the efficiency and accuracy of bedside and distant ultrasound examinations performed by residents, with high levels of satisfaction among both residents and attending radiologists. This approach has the potential to transform ultrasound training and patient care in remote or resource-limited environments, ensuring timely and accurate diagnoses. Future work will focus on scaling this system for broader clinical applications.

Publication History

Article published online:
16 October 2025