A new study published in the BC Medical Journal has found point-of-care ultrasound (POCUS) is improving health care on Haida Gwaii by enabling earlier diagnoses, reducing the need for off-island transfers, and supporting more compassionate, community-based care.
Dr. Tandi Wilkinson, one of the lead authors and a long-time advocate for rural health innovation, told the journal the technology offers more than convenience.
鈥淲hen we can diagnose a life-threatening condition like an ectopic pregnancy or heart failure right at the bedside, we鈥檙e not just saving time鈥攚e鈥檙e saving lives,鈥� she said.
The study focused on how health professionals on the remote island chain are using POCUS to improve outcomes and enhance delivery of care. Interviews with local physicians, hospital administrators and patients formed the basis of the research.
Physicians now use the portable imaging tool in clinics, inpatient wards, emergency departments and outreach clinics.
鈥淚t鈥檚 probably used 10 to 12 times a day, at least, in the clinic,鈥� one doctor said.
With no radiology ultrasound services available on Haida Gwaii, patients needing scans must often travel to Prince Rupert鈥攁n all-day effort that includes a seven-hour ferry crossing, long wait times, and overnight stays. One physician described the trip as particularly difficult for expectant mothers and elderly patients without support.
The growing use of POCUS has allowed more procedures and assessments to be done locally. One patient told the journal the technology helped avoid stress and delays.
鈥淭hat really enhanced my care and enhanced treatment for me, so I think that鈥檚 pretty amazing for a little community,鈥� the patient said.
Doctors also use the scans to support midwives, assist in surgical planning, and help guide decisions around end-of-life care. Images are uploaded to patient records and can be reviewed by specialists or other members of the care team.
鈥淲hen I did have to go for the surgery, the surgeon met me, and he was, like, up to snuff, and he actually had little pictures from the ultrasound,鈥� the same patient said.
Much of the success is credited to local physician 鈥淧OCUS champions鈥濃�攄octors who promote its use, mentor others, and integrate the equipment and records into daily operations.
鈥淰ery frequently, we鈥檙e asked to review a scan or do a scan as a second opinion, probably several times a week 鈥� especially if it鈥檚 going to save a transfer for a procedure,鈥� said a physician.
The study pointed to several enablers of innovation, including peer-based training through the Hands-On Ultrasound Education (HOUSE) program and strong support from administrators and the regional health authority.
鈥淵ou learn in community. It鈥檚 you learning with the people that you鈥檙e going to be continuing to work with,鈥� one doctor said of the program.
Researchers described the initiative as a grassroots model of innovation built through local leadership, collaboration and flexible support systems. The combination of motivated clinicians, responsive education and administrative backing created what the authors called a sustainable and patient-centred system that improves outcomes while reducing costs.
However, the authors noted the study is not a full evaluation of the POCUS program鈥檚 development, but rather an overview of the main elements behind its success. They cautioned that some aspects may not have been captured, and that the specific mix of community, leadership and resources may not be easily replicated in other locations.
The report also underscored the cultural importance of delivering care in community, particularly for Indigenous residents. One physician noted the value of allowing people to be born or die on Haida Gwaii, rather than be transferred away from family and home.
The study鈥檚 authors said the way POCUS evolved on Haida Gwaii reflects a locally rooted approach to health care, more aligned with Indigenous world views than with traditional health system expansion. They referenced the Haida phrase Gina 'waadluxan gud ad kwaagid鈥斺�淓verything depends on everything else鈥濃�攁s a fitting summary.
They concluded that in rural and remote settings, where needs are shaped by geography and resource limitations, solutions should be informed by local knowledge and lived experience.
The full study appears in the July/August issue of the BC Medical Journal.
