This year’s annual conference, hosted by the Society of Diagnostic Medical Sonography (SDMS), was a special one for BB Imaging. We confirmed our suspicion that everyone loves a comfy pair of slippers. We brought a dog to the conference for the first time in SDMS history. AND this conference marked our first big unveiling of TeleScan™ and what the future of sonography is going to look like.

It was a great weekend, and we gained a lot of insights from attendees. We’d like to share our three biggest takeaways with you:

1. Telesonography® is a Hot Topic

The house slipper giveaways drew lots of people to our booth, but the conversations about telesonography® and work-from-home opportunities are what kept them there. We were impressed all over again by how passionate sonographers are about what they do and how much they care about the patients they serve. Our new model of care was met (understandably) with mixed reactions. Since not all of us could attend in person, let’s talk about those reactions and our responses:

  • Excitement

Some sonographers we talked to responded with immediate excitement and enthusiasm. We noticed that many of these sonographers were younger or newer to the field, and they were the most likely to want to hear more about what being a telesonographer® will be like.

Katherine Yancey, a recruiter at BB Imaging, said, “Telescan™ is innovative and groundbreaking for this industry, and people are interested in learning more. Over the weekend we received 400+ applications for more information regarding the telesonographer® position that will be launching in 2023.”

  • Curiosity and Skepticism

Many sonographers just need more information to see all the potential upsides to telesonography®. The greatest concerns we heard were about image quality and its impact on patient care.

We share those concerns, and that’s why our model of care still employs credentialed sonographers to complete diagnostics. This is how it works in a nutshell: local healthcare workers will complete sweeps with the guidance of TeleScan™ software. That data will go to a cloud platform (it’s HIPPA-compliant, super secure, and FDA-cleared), where expert sonographers will capture and annotate the best images and create reports for the physician.

Bedside sonographers might be ideal, but there are so many places in our country where ideal standards are not being met. We have to figure out a way to bring quality care to the underserved, and the partnering of expert sonographers with local practitioners is our answer. Telesonographers® will still need to bring their unique skillset and knowledge base to work every day.

We think Shyanne Foster, a BB Imaging charge sonographer, said it best: “Our biggest win was being able to educate and clearly explain our mission to sonographers who were skeptical and had many great questions about Telescan™. I believe we can all get on board with wanting to decrease the maternal and fetal mortality rate in America.”

  • Dread and Anger

Let’s start by saying that dread is a valid response to something new, and anger is a valid response when we care deeply about what is being changed. We send a sincere “thank you” to everyone questioning our motives, our dedication to quality care, and our compassion for the underserved. Give us a chance to respond to some of the greatest concerns we heard.

“Guiding medical professionals who are not trained in sonography sounds suspicious.” If this is your fear, we hope you’ll take the time to become more acquainted with our model of care, which is designed to make the best use of sonographer expertise and to keep it in the field for a longer amount of time. New technology will always raise eyebrows, but what we find even more “sus” is allowing patients to remain underserved, turning a blind eye to sonographer injuries, and maintaining a system that is not currently designed to care for everyone.

“This sounds like another big corporation just trying to make money.” Goodness, we’ve seen a lot of companies like that, haven’t we? It’s sad how often this occurs—taking advantage of an underserved population to make a quick buck. We want to assure you, though, that we are not that company. One of our cofounders is a sonographer, and the other started her career with a non-profit domestic violence agency. We are built differently, and we are dedicated to solving the maternal mortality crisis. We’ve been around for more than 17 years, and telesonography® is just the next piece we’re building to make positive maternal outcomes a reality for everyone.

“It sounds like you don’t care about best practices.” We can see how easy it would be to think this when you don’t have a full understanding of our model. Beyond encouraging you to review the material we have available online, we want to assure you that we didn’t build TeleScan™ in a vacuum. We had 50 sonographers work with our system, test it, and help us achieve FDA clearance. That means our product doesn’t meet minimum standards—it meets the standards of in-the-field sonographers. Because of their feedback, we are confident that we have a product that empowers sonographers to do their best work.

Overall, this weekend showed us that sonographers are ready and willing to continue this conversation. That has us thinking about more ways to gather that feedback and get sonographers even more engaged with what we’re building. Stay tuned for more opportunities to make your voice heard.

We know we didn’t have the chance to talk with everyone, so if you still have questions about telesonography®, start by checking out the TeleScan website. If you are interested in learning more about a telesonographer® role with BB Imaging, we’d love to receive your application and continue the conversation.

2. We Made More Than 700 New Friends!

More than 700 new folks joined our community over the weekend. Whether we got to talk to you in our booths or shook virtual hands over social media, we say, “Thank You!” and “Welcome!”

If you’re new around here, here’s a quick run-down of what you can expect:

  • Our newsletter, The Wave, hits your inbox once every month. We share in-depth blogs to help you grow your knowledge base and spotlights to help grow your network. It’s also the best way to stay up-to-date on job opportunities and catch the newest webinars.

  • Speaking of which… we publish FREE, CME-earning webinars several times throughout the year. Our webinars are by sonographers, for sonographers, so get ready for deep discussions and lots of real-world images and examples. We’ve recently switched to an on-demand viewing model, so current topics are available for a year after publication. Be sure to check them out before their time expires!

  • We are very active on social media, where we share knowledge material, post event information, and host contests and giveaways. Connect with us on Facebook, Instagram, and LinkedIn, and be sure to say hello!

  • We are always expanding, so keep an eye on our job opportunities. And if you know a physician or clinic who could use a little support, you can refer them here. We’d love to partner with more providers in your region.

3. Dogs Will Always Be a Big Hit

We saw so many people from across the event—other exhibitors and SDMS staff included! They just had to come see the dog, and we get it! In fact, having a dog at the event was such a success that it inspired us to create a mascot for our brand. What do you think about naming her Tellie…?

Javika, the first dog to attend the SDMS Annual Conference, helped tell sonographers about work from home job opportunities

There are many great traditions during the holiday season – house decorating, gift giving, movie watching and so on. But if there is one thing every family in America does around the holidays, its eating, and lots of it. We know this not just because we see our favorite uncle pass out on the couch every year, but because of hospital admission rates.

Compared to the rest of the year, there is a significant spike in hospital admissions related to abdominal pain around the holidays simply because of overeating. However amusing as this may be, persistent bloating and discomfort following a full day of eating can actually be a strong indicator of a more serious problem.

In some cases, your gallbladder could be to blame. Gallbladders aren’t given much attention – but they have the important job of releasing bile into the small intestine to aid in digestion, particularly with fatty foods. And if they’re not in full working order, digesting those ham and potatoes may not go over so well resulting in some strong abdominal pain.

While there are several pathologies that can be associated with the gallbladder – symptoms of a dysfunctional or chronically diseased gallbladder can flare up after overeating during the holidays. In these cases, the gallbladder may have gallstones or mild inflammation, making you regret that second or third helping of food.

The best course of action if you are commonly having these symptoms after your meals is to see a physician for an abdominal ultrasound scan. From there your physician can best assess what kind of care is best for you. So don’t hesitate to head to your doctor or hospital to ensure you’re healthy for the next holiday meal. After all, you may find you are in good company in the waiting room.

When you hear “humility,” you might picture someone who is a pushover. When you picture a confident person, you might think of someone who is bossy and domineering. These stereotypes exist, not because humility and confidence don’t go together, but because people often possess these qualities in proportions that are out of balance. Being overly confident or too humble can end in decreased productivity, more mistakes, and stalled work.

In balance, each quality brings its own benefits. Humility makes you more open to collaboration and critique and fosters creativity, accountability, and workplace satisfaction. Confidence nurtures resilience and courage, increases positivity, and reduces stress.

When confidence and humility are in balance, they make you a better worker, coworker, and human being—someone who can admit they’re not perfect and works to become a better version of themselves.

How Do You Find the Balance?

There are five different skills you can build that will help you find a harmonious balance of humility and confidence. Keep embracing the areas where you are strongest, and use these action items to overcome areas of weakness.

1. Play Well with Others

Being a good collaborator and teammate requires both a humble, other-oriented mindset and the confidence to speak up and help your team accomplish their goals. Too much humility, and your team won’t benefit from your skills and perspectives. Too much confidence, and your teammates won’t have the chance to shine.

Practice Confidence:

  • If you catch yourself overthinking things and stalling a project, practice trusting yourself and your teammates, and move forward with a positive outlook.

  • Allow yourself to make a confident decision, and be willing to learn if it doesn’t work out.

  • Own your skillset and demonstrate your value by speaking up in meetings, volunteering for assignments, and taking on special projects.

  • In-clinic example: Volunteer for an extra shift or help with a cross-departmental project. BB Imaging sonographers help gather content for webinars and test the newest tech from TeleScan!

Practice Humility:

  • Think before you speak or act. Ask yourself how your actions and words will affect those you work with and the patients you serve.

  • Give others time and space to share. When you listen to dissenting opinions, you equip yourself to make the most well-informed decision.

  • If you have a tendency to hog the limelight, take time to purposefully celebrate the ideas, strengths, and abilities of others.

  • In-clinic example: Avoid healthcare terms and jargon that could confuse or scare patients. Instead, use everyday language to keep them comfortable and informed.

2. Train Your Emotional Intelligence

Emotional Intelligence (aka EQ), refers to someone’s ability to perceive, understand, and manage their feelings and emotions. EQ is made up of five components. Practicing these EQ components gives you enough confidence to prevent a downward spiral and enough humility to keep you from getting egotistical.

Practice Confidence:

  • If you struggle with feeling your worth, practice self-awareness. This looks like acknowledging your abilities, believing in your capacity for success, and truthfully evaluating your value. (Hint: You’re crazy valuable!)

  • Practicing intrinsic motivation means pursuing something because it is naturally satisfying to you. When external value isn’t motivating you (think pay and benefits), try to think of internal reasons for completing a task.

  • In-clinic example: If you focus on the fact that being a sonographer means you get to help others, even mundane tasks can take on valuable purpose.

Practice Humility:

  • It can be easy for some people to “lose it” in stressful situations. If you’re one of those people, practicing self-regulation helps you express your emotions appropriately. Work to observe your emotions before you act and react.

  • If you tend to think only about yourself (it happens!), work on looking out for others first. Empathy is that special ability to understand how others are feeling and respond appropriately.

  • In-clinic example: Life isn’t perfect, and sometimes the people around you won’t feel cheerful. Be willing to take a little time to check in with coworkers and patients who seem to be struggling.

Practice Both:

  • Social skills refer to being able to interact and communicate with others. This requires the confidence to speak up and build your reputation as well as the humility to listen and stay out of unnecessary arguments.

  • In-clinic example: Start conversations with coworkers and physicians. Asking questions shows care and interest and builds rapport.

  • In-clinic example: When you’re mentoring a new sonographer or intern, don’t embarrass them when they ask questions.

3. Be Grateful

Studies have shown a gratitude practice helps you overcome negative emotions, boosts your optimism, and improves your overall health. Practicing gratitude for confidence helps you appreciate all of your qualities, attributes, and abilities, which builds your self-esteem. Gratitude can also lead to greater humility when you take time to recognize all the good outside of yourself.

Practice Confidence:

  • If you’re feeling unsure about an assignment, reflect on your past successes and achievements.

  • When stressful situations pop up, or you’re struggling with organizational change, don’t dwell on feeling out of control. Instead, think about all the positive actions or attitudes that are available to you.

  • In-clinic example: When you’re studying for a new certification, remember you’ve crushed it before, and you can do it again!

Practice Humility:

  • When you are successful, don’t keep it to yourself! Acknowledge others’ contributions to your success and remember to say “thank you.”

  • Complaining is hard on workplace culture. Instead, make gratitude a daily habit. Journal, create a list, or just take time to reflect on everything you’re grateful for—big and small things alike!

  • In-clinic example: When you reach a milestone, remember to thank everyone who has helped you achieve it. Show your gratitude in-person, with a quick email, or through a card.

4. Be Honest

Honesty is the best policy, personally and professionally. Being honest and humble gives you the ability to admit your mistakes. Being honest and confident gives you the freedom to not know everything and empowers you to ask questions.

Practice Confidence:

  • Striving for perfection will leave you feeling inadequate. Give up that unattainable standard and set honest, realistic goals.

  • Expect mistakes, and don’t let them define you. Be ready to learn from them and move on.

  • In-clinic example: One day, you’re going to misread a scan. Expecting mistakes can keep you alert and at the top of your game.

Practice Humility:

  • Whether it’s valid or not, blaming others only prevents you from solving the problem. Give others a little grace, acknowledge any role you played, and work together to fix the issue.

  • It might seem counterintuitive, but you shouldn’t hide your failures. Own up to them, embrace what they can teach you, and keep growing. This helps others feel comfortable doing the same and leads to a more open work environment.

  • In-clinic example: Keeping your mistakes secret can make them feel worse and bigger than they really are. Sharing your experiences, even the negative ones, can help you and your team learn and grow.

5. Nurture a Growth Mindset

Psychologist Carol Dweck believes people have either a “fixed” or “growth” mindset. The fixed mindset believes your qualities, intelligence, and talents are unchangeable. The growth mindset, however, believes it can cultivate, and even master, new skills and traits.

Practice Confidence:

  • Don’t indulge self-talk that is hyper-critical or judgmental. Instead, repeat true and positive affirmations that highlight your capacity for growth.

  • When you’re feeling stuck, recall past accomplishments and think about how you overcame obstacles in the past.

  • Celebrate the little wins—when you exceed expectations, complete a project early, or get a meaningful compliment.

  • In-clinic example: Keep a positive affirmation in your pocket or on the ultrasound machine to keep you and your teammates in the right mindset.

Practice Humility:

  • Frame workplace challenges and critical feedback as opportunities for growth—not as threats to your job security or insults to your competence.

  • Show appreciation and respect for the people who provide critique and suggest paths for professional growth.

  • In-clinic example: At some point, you’ll face criticism from a physician or lead/charge sonographer. Stop defensiveness in its tracks and remember to count this as an opportunity to show how you can continually improve.

There you have it! Hopefully this article has demonstrated how humility and confidence go together, and how you can grow these key skills. Do you agree, disagree, or think we missed something? Let us know in the comments. We’d love to hear from you!

Whoever thought being a Rookie was a good thing? Well Liz Wiseman, author of Rookie Smarts did. She turned what was once thought as a disadvantage, and revealed the hidden advantages of being a newcomer of any age and in any field. We thought this idea is too good not too share and is particularly applicable to healthcare, where the learning never stops.

The principal of Rookie Smarts is this—there is an unseen advantage, a hidden skill set, in “rookies.” Traditionally seen an inexperienced and a burden on managers, Rookies often have to work extra hard to prove themselves and to get their bearings in a new work environment. However, these exact qualities give Rookies their competitive advantage. Because they inherit a knowledge gap when they enter a new field, they can’t rely on their previous experiences to guide their steps. They therefore, have to learn at an incredible rate.

By harvesting information from industry experts and other resources, rookies compile a mass of information, parsing through and consolidating them into a perfectly adjusted skill set for the project at hand. Additionally, this knowledge gap results in a larger initial investment for each new project, causing rookies to work with a sense of urgency to close the gap. This reactionary behavior to being behind, conversely propels Rookies ahead of their veteran co-workers. As discovered by Wiseman, coupling a desire to learn with an increased work ethic produces a worker that regularly outpaces an employee with years of experience. Additionally, being a rookie opens you up to other people’s perspective, granting the rookie a unique ability to listen to other people’s ideas and applying them in a synergistic way to solve problems and create value.

At first, this idea of Rookie Smarts may seem to cast doubt on the skill sets of experienced workers and give praise the vitality of youth. This is not the case. Wiseman makes clear that these ideas categorize behavior and not people. By making a conscious effort to suppress that “know-it-all” tendency that comes with years of experience, we operate with a willingness to learn, allowing us to better develop our own skill sets. A CEO of 20 years can tap into their rookie smarts by adjusting their perspective towards their staff and processes. This often results in better, more well-balanced solutions and engages team members on a level previously unseen.

This way of thinking can be toggled on and off depending on the situation as well. Mastery of Rookie Smarts means you know when to apply it. Protocols and tried-and-true methodology have an important place in a company structure and can allow for efficient work flow while minimizing risks. Rookie Smarts is about tapping into a skill set that is more suitable for the problem at hand.

For healthcare workers this is critical. In a field where research is constantly being conducted and new information on patient care is continually being disseminated, operating with a willingness to learn is in direct relation to the longevity and vitality of one’s career. Additionally, this allows for better working relationships with co-workers and ultimately delivering the best care possible for the patient.

If you find this idea compelling and want to learn more about the hidden talents of Rookies, be sure to check out Liz Wiseman’s book, Rookie Smarts.

While visions of sugar plums may not dance in your head anymore, we’re betting visions of a fulfilling sonography career do. Let’s put those visions on paper and see how BB Imaging might check off your dream job wish list:

The opportunity to do my best work

We get it. You didn’t go to sonography school so that you could spend half your time filling out paperwork. Wouldn’t it be nice if you could hand those tasks off to another competent professional? You can. Say hello to the Technical Assistants (TA), BB Imaging’s very own administrative support superheroes! TAs handle administrative tasks, cleanup, room prep, and much more so that you can focus on patient care, scanning, and diagnostics. Our TAs empower you to focus on what you are most passionate about: high-quality ultrasound exams.

Wellness benefits that keep me healthy and happy

We know that to be your best in-clinic, you’ve got to care for yourself outside of clinic. Your physical and mental health are important, and cost shouldn’t get in the way of seeking the care you need. That’s why we offer monthly wellness stipends you can put toward whatever keeps you feeling good. Massages to destress? You know it. Gym memberships to build strength and stamina? Of course. Yoga class to stay zen? Absolutely. Let us help you take care of YOU.

A schedule that works for ME

Our sonographers typically work clinical hours and have nights, weekends, and holidays off. So, if you’re the type who needs a regular schedule that you can depend on, we’ve got it.

What if you’re looking for something a little more dynamic and flexible? As our company grows, opportunities to cover shifts outside of clinical hours are increasing, and we even have travel positions from time to time!

Parental leave so I can put my family first

It should come as no surprise that we’re big proponents of caring for parents and newborns well into the fourth trimester. That care extends to our team members via generous parental leave—even if you both work with us!

Reimbursement for travel costs

Many of our sonographers will work at 2-3 clinics within a regional area. We know driving gets expensive, so we offer mileage reimbursements that get lumped in with your paycheck. We even bump up your hourly wage if you travel 60+ miles outside your normal zone. All you have to do is provide your receipts. And if you’re traveling even further for work (think extended stays and travel gigs), we’ll pick up your expenses there too.

Professional development opportunities that help me reach my goals

From training programs for our sonographers to a regular cadence of reviews and check-ins, we provide lots of opportunities for managers and team members stay aligned on goals and next steps. We also offer financial help for professional development including tuition reimbursement, conference stipends, and AIUM membership fees.

A positive and affirming company culture

We all feel taken for granted sometimes, and that just shouldn’t be the case. An email that says “thanks” is nice and all, but doesn’t cut it when it comes to celebrating you and your accomplishments. That’s why we incorporate celebratory opportunities everywhere we can. We’re talking about weekly kudos that get shared during team calls, our end-of-year STAR Awards, a special celebration or gift for Medical Ultrasound Awareness Month, and lots of internal contests and giveaways throughout the year.

The chance to work with all my besties

If leaving your work bestie behind is stopping you from applying, fear no more! BB Imaging’s sonographer referral program means you can bring your friends and get paid for it too.

So… how’d we do? Did we check off your sonography career Christmas list?

Recently, we’ve been talking a lot about telesonography and how we know it’s the next big thing in ultrasound. But claims like that deserve an explanation, and today we’ve got some explaining to do. Let’s talk about what telesonography is, how it’s performed, and the healthcare pain points telesonography can solve.

We’ll start with…

A Basic Definition

When you combine sonography and telemedicine, you get telesonography. Telesonography is the provision of ultrasound services via a telecommunications link (phone call, video conference, chat message, etc.). It connects a local provider with a remote sonography expert who can perform diagnostics and provide a preliminary report. It may also be referred to as remotely-supported ultrasound or teleultrasound, but we like the term telesonography.

Two Types of Telesonography

Telesonography can be conducted synchronously or asynchronously. While both methods increase access to sonography specialists and eliminate the requirement to travel for a face-to-face consultation, we think one method is just a little bit better than the other.

Asynchronous transmission involves acquiring ultrasound images, storing them locally, and then transmitting them for expert analysis at a later time. The primary benefit of this method is that patient care is not dependent upon sonographer availability—the patient can get examined at a time that is most convenient for them, and the sonographer can review the images when their schedule allows. Asynchronous transmission is currently the most common method of telesonography, and it’s been especially beneficial for rural populations where maternal-fetal care specialists are not readily accessible. It’s also beneficial to sonography trainees, who can perform scans, save the images, and review them when a physician or mentor is available.

Conversely, synchronous transmission occurs in near real-time. While a local healthcare worker obtains the cine loops, the expert sonographer is available to review the cines and provide feedback as needed. This method is beneficial because it increases diagnostic quality and pathology detection. This is particularly beneficial if the sonographer identifies a concern that requires immediate intervention, as they can begin escalating the level of care while the patient is still present. Historically, synchronous transmission has been hampered by poor Internet connections, but as access to quality broadband increases, we believe the synchronous mode will become more commonplace. In fact, our own telesonography solution, TeleScan®, utilizes synchronous data transmission via a secure, HIPAA-compliant cloud platform.

Solving Problems: The Why of Telesonography

Okay, now that we know what telesonography is and how it works, let’s get down to the why. Why do we think telesonography is the future of ultrasound, and more specifically, what problems will it solve?

Problem 1: Limited Healthcare Resources

We all know there is a shortage of healthcare providers and specialists, and that this problem is exponentially worse in rural areas. Some rural patients have to travel more than 200 miles to the nearest OB/GYN. A scarcity of local resources leads to limited patient access, inappropriate triage, delayed diagnoses, and slow intervention—all of which result in poorer health outcomes for patients.

Solution: Telesonography Uses Local Healthcare Workers

Our version of telesonography leans heavily on the idea that augmented care is better than no care. That’s why TeleScan utilizes local healthcare workers to obtain cine loops and remote expert sonographers to review and perform diagnostics. While we have heard some skepticism regarding this model, we’re not the only ones who think this is an effective method.

Consider one study that examined the feasibility of tele-mentored sonography for identifying the appendix. Results showed “no significant difference between time taken and success rate of image acquisition between onsite and remote mentoring.” Pediatricians who examined tele-radiology found that it produced “reliable and timely diagnoses.” Another study that tested diagnosing pediatric acute appendicitis found that it was highly effective, stating, “The diagnostic performance of tele-mentored ultrasonography was as high as that of onsite expert ultrasonography.”

These, along with other studies, have verified the feasibility of using non-sonographers with medical backgrounds to obtain cine loops. Additional studies have shown users’ perceptions of telesonography are also positive. Telesonography was considered beneficial in several studies, with one study finding 93% of respondents were either satisfied or very satisfied with their telesonography interaction.

Problem 2: Image and Diagnostic Quality are Operator-Dependent

So, utilizing non-sonographers to capture cines is feasible—but does the telesonography model result in quality care? Present-day ultrasound requires a high level of expertise, and image acquisition and interpretation are major challenges. Gaps in image quality between a trained sonographer and a non-sonographer can easily occur due to a deficit in training, a misunderstanding of operational protocols, or confusion regarding the use of ultrasound equipment.

Solution: Telesonography Augments Care

TeleScan, like other telesonography solutions, is not interested in removing expert sonographers from the care equation. However, when sonographers cannot be physically present, telesonography has been shown to successfully augment care to provide reliable, high-quality diagnostics.

Consider Queensland, Australia, a state where 55% of the 3.3 million residents live in rural areas. The entire state is served by only two urban maternal-fetal echocardiography centers. After implementing telesonography and measuring its success, they found it demonstrated diagnostic accuracy and identified 100% of fetal abnormalities in the cases examined. This saved one-third of patients from a trip of up to 932 miles to the nearest specialist.

Or think of South Dakota, where 63.6% of counties are maternity care deserts. A telesonography program designed for neonates with suspected congenital heart disease accurately distinguished between those who needed immediate care and those with a less critical disease. Accurate diagnoses resulted in appropriate levels of care and saved patients with less critical cardiac disease from the unnecessary impacts of emergency transportation.

The successful augmentation of care reported in these studies is only possible because telesonography tools, even in the hands of non-sonographer healthcare workers, provide diagnostically reliable images. In a systematic review of articles, 12 articles describing telesonography image quality were assessed, and only four studies determined that image quality was less than 75% of the quality of the reference standard. Conversely, five studies found image quality was very good (between 75% and 87% of the reference standard), and three studies listed image quality as excellent (above 90% of the reference standard).

Additionally, in our own testing of TeleScan, we’ve found that as non-sonographers gain experience using a transducer, their image recognition and technical skills improve, and they quickly require little to no intervention from the reviewing sonographer. This finding is mirrored in a telesonography study by Johnson et al., who found only 13% of cases required real-time video conferencing for diagnosis.

Problem 3: Costs Incurred

Imaging systems are not cheap, and the costs incurred are still one of the largest barriers to care for rural communities. Even when considering some of the telemedicine options available, a dedicated system could cost up to $50,000-$100,000 per bed.

Solution: Telesonography Decreases Healthcare Costs Without Large Investments

Many modern telesonography platforms solve the cost issue by opting to utilize off-the-shelf components (like laptops and smartphones) or existing ultrasound machines. TeleScan, for instance, is compatible with laptops and 2D ultrasound machines and transfers cine clips to our secure, cloud-based software via an internet connection. And it’s delivered as a tiered monthly software subscription fee.

Additionally, quality telesonography can reduce healthcare costs by reducing liability and minimizing unnecessary surgical procedures and hospital stays. Ultrasound is also a more affordable imaging modality in general and requires very few consumables (gel, probe covers, etc.).

Problem 4: Security of Health Data and PII

When you talk about any form of telemedicine, you have to address the security and confidentiality of the data you’ll be transmitting. Patients, providers, and vendors all share the aim of keeping personally identifiable information (PII) and health data secure, and the solution has to be a group effort.

Solution: TeleScan is Built Right

Security has been a top consideration as we have developed TeleScan. What we bring to the table is a super-secure cloud platform that is both HIPAA-compliant and FDA-cleared. From there, we collaborate with local security and IT specialists to ensure that we meet each clinic and hospital’s individual requirements as well.

There you have it! Now that you know the what, how, and why of telesonography, do you agree that it could be the future of ultrasound?

Dear Sonographers,

We know your job is challenging. We know it’s easy to feel taken for granted at work. We know it can feel like no one sees everything you do. But we want you to know that we see you, we hear you, and we are so grateful for all you do. Below, in no particular order, are some of our favorite things about you and the incredible work you do. This is an open love letter to you…

You are brilliant. Day after day, with poise and professionalism, you make sense of complex images created of 256 shades of gray. You rely not only on keen eyesight, but also on a hard-earned understanding of advanced imaging technology, physics, anatomy, and abnormalities. And maybe most incredible of all, you leverage these superpowers toward a single, selfless mission: providing accurate diagnostics so that patients receive the right kinds of care.

You are inquisitive and insightful. While others might think you’ve gained enough knowledge to last a lifetime, you continue to learn and to engage with cutting-edge developments in the industry. CMEs, certifications, HIPAA compliance, health and safety protocols—your knowledge bank continuously grows! And we would be remiss if we failed to mention that your patients aren’t the only ones who benefit from your expertise. You are forever making suggestions, improvements, and contributions to your places of work, elevating both us and the industry.

You are strong. We know it takes some serious muscular endurance to lift and move patients and equipment all day. Not to mention being on your feet between exams, and all that arm and wrist exertion! But you’re also mentally strong—keeping it together when you can see results will be disheartening and offering encouragement and support to your teammates when they need it most.

You are compassionate. Not everyone is cut out for providing one-on-one patient care. Yet you tackle this task with empathy and kindness every single day. Whether patients need to better understand the exam, require comfort as they process deep emotions, or simply need someone to put them at ease, you are there. We are forever amazed by your drive and desire to help others.

You are devoted. Sometimes there are emergencies. Sometimes there are schedule mix-ups. Sometimes your teammate needs someone to fill in for them. Without a sonographer, questions will remain unanswered. Treatments will be delayed. Patients won’t get the care they need. Who steps up to fill these gaps? You do—because you are devoted to patient care and determined to meet the need.

That makes you vital. If you don’t show up to document it, no one will see it. You are the doctor’s eyes and an integral part of the care team. Not only that, we believe you are vital to achieving health and wellness goals at both the local and national levels. The truth is, our clinics and hospitals need you because our communities need their healthcare heroes.

And after everything we’ve mentioned so far, it should come as no surprise that we end on this note: you are inspiring. You bring so much good to your workplaces when you clock in for the day. Your brilliance, inquisitiveness, insight, strength, compassion, devotion, and vitality challenge us to bring more good into the world too.

Sonographers, we love you. Thank you for all you do.

The BB Imaging Team

P.S. If you’d like to sign your name to this virtual love letter or give a shout-out to your favorite sonographer(s), please do so in the comments!

We’ve been talking a lot about how telesonography works and why it will benefit patients and practices. But one exciting question we haven’t answered yet is: What benefits will telesonography provide for sonographers?

What Does a Telesonographer® Do?

Before we talk about benefits, let’s review how the telesonographer role works at BB Imaging. Put simply, a telesonographer provides remote diagnostic services to our provider partners via telemedicine. This role is intended to fill care gaps and identify high-risk pregnancies in underserved and rural areas. A telesonographer completes this vital work through a cloud-based software solution called TeleScan®.

Here’s how it works, in a nutshell:

  1. The telesonographer logs into TeleScan and selects the exam order.

  2. They begin by reviewing provided patient charts, reports, lab results, and medical history.

  3. The exam begins, and they evaluate cine loops as they are captured and communicate requests for additional cines as needed.

  4. The telesonographer then puts their diagnostic expertise to work, evaluating the cine loops to identify fetal anatomy, take measurements, and rule-out patient/fetus anomalies. They can also tag a few images from the cine loops to share with the patient.

  5. To finish up, they prep a preliminary diagnostic report, including any notes or impressions, and send it to the provider for final review.

That’s it! The BB Imaging telesonographer role is currently a hybrid position with opportunities to work in-clinic routinely. Additionally, a telesonographer will need to maintain their credentials by earning CMEs. Now, let’s dive into those benefits!

How Does Telesonography Benefit Sonographers?

1. Career Longevity

Sonographers know better than anyone how quickly and easily pain from scanning can set in. The Society of Diagnostic Medical Sonography found 90% of sonographers are scanning in pain thanks to work-related musculoskeletal disorders. Additionally, the average sonographer will scan for only five years before sustaining an injury. These injuries often result in abbreviated careers, taking sonographers’ specialized knowledge and skillset out of the industry and creating a shortage of highly experienced leaders.

Telesonography provides a way to keep that sonography expertise in the field by reducing physically demanding time with a transducer. Telesonography provides rest for sore muscles and a chance to recover from injury while still seeing patients and meeting a need for underserved demographics. “This is a great way to be able to still do what you love, but not have the strain on your body,” said Alex Knott, RDMS (AB, OB/GYN), RDCS (FE), RVT.

We have received some skeptical feedback suggesting that the telesonographer role minimizes a sonographer’s unique skillset, but we disagree. Amber Blair, RDMS, RDCS, says it best:

“Nothing can compare to the quality of highly-skilled, traditional MFM sonographers, but that level of specialized care comes at a cost to many of our arms, shoulders, and wrists. Telesonography gives our upper bodies a breather so that we can continue to provide that irreplaceable hands-on MFM care without all of the pain.”

2. Work-Life Balance

Again, sonographers know better than anyone how long some commutes can be. Some of our own team members travel to outreach clinics scattered throughout the large state of Texas, and providing a break for them was one of our goals with telesonography.

Since a telesonographer works from home on some days, they’ll be saved from those long commutes, giving them more time to spend with family, friends, and pets—or on themselves! Like other work-from-home positions, we’re hoping this provides the opportunity for sonographers to take more time for healthy habits like homemade meals, working out, breathing in some fresh air during a walk, or taking time to stretch or meditate.

And while we can’t make any promises, we’re keeping an open mind toward other work styles too. Maybe in the future, we can join the gig economy or provide ways for sonographers to earn supplemental income via an “Uber model.”

3. Ideal Workspace

Historically, sonographers haven’t had much of a say in how their work environment is designed, but a telesonographer gets to create their ideal workspace. From space heaters to ergonomic chairs to height-adjustable desks, all the swoon-worthy remote work accessories can be theirs. Plus, they can ditch the scrub bottoms and sneakers and break out their best (or worst, we’ll never know!) sweatpants and slippers.

The other plus here is location independence—the ability to work from anywhere. Just ask Melissa Mercado, RDMS (OB/GYN, FE), who performs telesonography from sunny Puerto Rico:

“I’m able to spend more time at home since there’s no commute. And I love working from my back patio in the sun versus being in a dark room all day.”

4. Healthier Environment

We all know by now that a key benefit of working from home is limiting the spread of disease. And even when a pandemic isn’t the primary threat, a telesonographer can still avoid the colds and flus clinical settings often expose them to.

Conversely, a telesonography position presents the opportunity to continue earning income, even if the sonographer is feeling under the weather or recovering from injury. Although we’ll be honest, we have great benefits and prefer sonographers to take time off when they need it!

5. Expanded Reach 

A telesonographer has the unique benefit of reaching underserved areas with their specialized expertise. Sometimes these clinics are in dense urban areas, struggling to meet patient volume demands, and sometimes they’re in rural areas where prenatal care isn’t available or accessible. Either way, a telesonographer is empowered to provide care to patients who wouldn’t receive it otherwise.

“I have had the privilege to work with TeleScan and love it,” said Sonia Graham, RDMS (OBGYN, FE). “Sure, nothing takes the place of scanning a patient in person, but this new technology helps our expertly trained eyes help more people in rural areas. In some areas, ultrasounds done by untrained medical professionals are the only accessible prenatal care mothers have. Most of these medical professionals don’t have the time or skills to pick up subtle abnormalities like we do. TeleScan helps us use our experience and knowledge as MFM sonographers to help more patients.”

Patients aren’t the only ones benefiting from the reach of telesonography, though. Onsite sonographers love having TeleScan services in their clinics because it reduces their patient volume and gives their arms more of a break too!

6. Support Leading-Edge HealthTech

Telesonography is a new, innovative technology, and it’s just getting started. Our software engineers are working hard to continuously update and improve the software, and most of these improvements come directly from clinical feedback. For a telesonographer, that means having the opportunity to assist in the creation of a great product through ideas, creativity, and constructive criticism. This role isn’t just on the frontlines of healthcare. It’s on the frontlines of the future of ultrasound.

“One of the core responsibilities of a sonographer is being the ‘eyes’ for the reading physician,” said Kate O’Brien, RDMS (AB, OB), RDCS (FE). “In a similar way, working on the clinical side of a new healthcare technology allows me to be the ‘eyes’ for the developers. I’m able to give suggestions and feedback about what works and what improvements can be made that only a medical professional or sonographer could give. Being able to use my experience in ultrasound to contribute to a product that will directly improve access to care and likely reduce maternal mortality gives an even greater sense of purpose to my career. No two days are ever the same in ultrasound and working with TeleScan is no different.”

How Can a Sonographer Get Involved with Telesonography?

These are compelling benefits, and we’ve seen a lot of excitement from the sonography community about this role. For sonographers who are interested in this opportunity, here’s what we’re currently looking for:

  • Graduate of a CAAHEP-accredited Diagnostic Medical Sonography program

  • Registered Diagnostic Medical Sonographer (RDMS)

  • Currently certified with ARDMS

  • OB/GYN and Fetal Echo specialties

  • Credentialed in Nuchal Translucency and Nasal Bone and Cervical Length Education and Review (CLEAR)

  • 2+ years of MFM, high-risk OB sonography experience

We encourage those who are interested or want to learn more to fill out an application for the OB Telesonographer position. We’ll begin hiring this year; we’re building out a bench and beginning to interview for future roles. Our goal is to create a pipeline of sonographers who are ready to take on this new opportunity so that when a facility signs on the dotted line, we’re ready to service it.

Did We Miss Anything?

Let us know in the comments what other benefits you think telesonography will bring to sonographers!

Last year, we published an article entitled Telemedicine, Rural Pregnancy, and Decreasing the Maternal Mortality Rate. That article cites data from five years ago, which said that for every 100,000 U.S. births, 17 women die from pregnancy complications. Since then, data from 2020 has been published, which shows the ratio has increased by 40%, from 17 to 23.8, a rate three times higher than other high-income countries.

The national average is bad, but when we look closer, we see the maternal mortality risk is not equal across populations. In our previous article, we focused on the rural demographic. Here, we will compare the level of risk between races and ethnicities.

Recent data from the United States Government Accountability Office shows minority women have higher rates of pregnancy-related death than White women (Figure 1) and carry the highest risk for severe maternal morbidity (maternal morbidity refers to conditions that reflect unexpected outcomes of labor and delivery and result in short- or long-term health consequences).

We cannot view these statistics without concluding that inequalities exist in maternal healthcare. But before we discuss solutions, let’s gain a better understanding of the key issues surrounding this problem.

Key Issues

We are not going to deal directly with systemic racism, implicit bias, and social determinants of health (SDOH) in this article, but it is vital to understand these issues and their ties to the challenges that we will discuss. If you are not familiar with these topics, we encourage you to visit the following resources:

1. Timely Care

The first problem we’ll tackle in detail is timely care. Adequate prenatal care begins in the first four months of pregnancy and includes the appropriate number of visits for the baby’s gestational age. Timely care is important because research indicates a link between fewer prenatal visits and maternal mortality and morbidity, as well as low birthweights, preterm births, and infant mortalities.

Recent data from the U.S. Department of Health and Human Services clearly illustrates racial disparities in access to timely care (Figure 2). We also know results are worse for women who go without prenatal care completely: they are 3-4 times more likely to die from pregnancy-related complications than their peers who do receive care.

2. Quality Care

Even when non-white patients do access timely care, the second problem we need to consider is the quality of care they receive.

We support and appreciate all our nation’s healthcare workers (including our own incredible team), but we must admit that not all hospitals are equal. Research shows women of color suffer more often from a lack of high-quality care. Hospitals with higher percentages of non-white patients tend to have higher mortality rates and lower rates of effective, evidence-based care. They also perform poorly on delivery-related indicators when compared to other facilities.

3. Risk Factors and Likelihood of Complication

Lastly, let’s consider risk factors and the likelihood of complications during pregnancy. A recent study indicates the leading causes of maternal death are obstetric embolism and eclampsia and preeclampsia. (For the clinical folks in our audience, the authors note amniotic fluid embolism, pulmonary embolism, and any other type of embolism occurring during pregnancy or the postpartum period were included in the obstetric embolism category.)

Women with pre-existing conditions like asthma, diabetes, and high blood pressure are at a much higher risk for pregnancy complications, and according to Blue Cross Blue Shield, and are more likely to identify as a minority. One study showed Native American, Native Alaskan, and Black people are 1.5-2 times more likely to have diabetes. The American Heart Association found Black women are twice as likely to have high blood pressure. Additionally, a Black or Hispanic woman who develops pregnancy-induced high blood pressure is six times more likely to die than a White woman.

Review of Telemedicine

Now, let’s turn to the technology we believe can reduce racial disparities and maternal mortalities: telemedicine. Defined simply, telemedicine uses telecommunication technologies to deliver medical, diagnostic, and treatment-related services. Examples include remote monitoring devices, virtual appointments, and remote diagnostics. With its many benefits, and the potential to increase access to care, telemedicine is poised to impact every area of healthcare, including maternal-fetal care.

So, how can telemedicine positively impact the key issues we’ve outlined?

Overcoming Key Issues with Telemedicine

1. Telemedicine and Providing Timely Care

One type of telemedicine, dubbed the hub-and-spokes model, uses technology to connect centrally located experts with remote and underserved areas. This model provides patients with both a local touchpoint and an expert provider. For example, one fetal telecardiology program connected underserved patients with a cardiologist who practiced 243 miles away. When surveyed about their experience, all patients preferred the telecardiology appointments due to saved time and costs.

In a 2012 analysis, which was completed years before telemedicine use skyrocketed, researchers asked low-income, urban-located Black and Hispanic people about their feelings toward telemedicine. Both groups indicated telemedicine provided increased access and reduced wait times compared to non-telemedicine options.

We also have evidence that telemedicine can result in increased efficiency, which increases a clinic’s ability to provide timely care. One clinical location implemented our telesonography® solution, TeleScan®, and was able to provide 20% more patients with an ultrasound appointment. That resulted in a 50% reduction in the time until the next available appointment.

2. Telemedicine and Increasing Quality of Care 

By connecting underserved patients with expert care, telemedicine can also improve the quality of care they receive. Increased access to maternal-fetal medicine specialists is associated with improved health outcomes among pregnant patients with chronic illness and complications. In a 2022 study of high-risk obstetric patients (of which 72% were Native American/Alaskan and 23% were Hispanic) 94.7% were satisfied with the quality of service being provided via telemedicine and 71.5% would consider receiving telemedicine care again.

Better outcomes from telemedicine persist outside of obstetrics as well. One systematic review assessed the effectiveness of telehealth and patient satisfaction and found improved outcomes made up 20% of success factors. And 75% of clinicians believe telehealth enables them to provide quality care.

3. Telemedicine and Caring for Risk Factors

Finally, what about the risk factors that minority patients are more likely to experience—conditions like diabetes and high blood pressure?

Diabetes, especially gestational diabetes, has been widely studied. Telemedicine patients reach optimum glycemic control sooner and with fewer insulin doses than those without telemedicine—and experience up to a 66% decrease in both planned and unplanned appointments. A study from the University of Arkansas for Medical Sciences found telemedicine also improved the utilization of prenatal care among pregnant women with pre-existing diabetes, more than one-third of whom were Hispanic. Patients experienced fewer inpatient admissions, lower insulin use rates, and lower costs.

Regarding high blood pressure, one study found both clinic-based care and telemedicine care were successful in lowering blood pressure. However, after six months, patients supported by telemedicine were more satisfied with their treatment than clinic-based patients, more likely to rate their care as high quality and convenient, and more likely to take their blood pressure at home.

It’s time for Telemedicine

The data is clear: maternal mortality is a huge problem for our nation, and it disproportionately impacts minority demographics. The good news is, we have the technology to take a big step forward in providing equitable care. The pandemic accelerated our adoption of telemedicine, and legislative efforts are under way to keep it accessible and affordable. That means the time for telemedicine is now.

Are you looking for all the sonography career advice you could ever want? You found it!

We’ve curated our best content and resources into one easy-to-use reference article. Just find the statement that best describes you, click the link, and discover helpful information specifically for your stage of the sonographer journey.

1. I’m Considering It

Sonography is an attractive career path for many reasons. It usually requires only two years at an accredited school, offers a comparatively high salary, and keeps you engaged through unique challenges and variety in your day-to-day work. As you consider this field, see if these resources come in handy.

  • I need more information. We highly recommend you start with How to Become a Sonographer from the American Registry for Diagnostic Medical Sonography (ARDMS). It answers the why and how of becoming a sonographer and introduces the specialties you can pursue.

  • I want to apply to a school. We have lots of tips for getting accepted to a diagnostic imaging program. These programs are highly competitive, and we don’t want you to miss the chance to gain an edge. If you haven’t chosen a program yet, we have some advice for that too!

2. I’m Just Getting Started

We’re so excited for you! Sonography is a highly rewarding career, and many of our team members find their purpose and fulfillment in this profession. We can’t wait to watch you learn, grow, and excel in this incredible field.

  • I’m a new grad—or about to be. Congratulations! You’ve taken a huge step by getting through classes and clinical hours, and the best is yet to come. We’ve gathered the best advice for graduating sonographers from our clinical team to help you start strong.

  • My next step is board exams. Passing boards can feel like a monumental task, but we’re here to help you break it down into manageable steps. From studying to practicing to testing with confidence, we’ve got all the tips and tricks you need.

  • I’m looking for a job. You’ve got the skills, you’ve got the knowledge, and now it’s time to get paid. We can help you prepare for an interview and ace a speed interview. Plus… we are almost always hiring sonographers. If you haven’t checked our job board yet, please do! We’d love to see your application.

3. I’m Working My Way Up

A sonography career presents so many exciting opportunities that it can be difficult to decide which ones are most worth pursuing. We encourage you to embrace different seasons as you experience them and remember you always have the power to stop what isn’t serving you, start something new, or pause to rest and reevaluate.

  • I just want to maintain my current skillset. This is a great place to be. What you already know is highly valuable and deserves to be maintained at the highest level. If you need any help with that, check out these CME and learning resources.

  • I don’t know what to pursue next. If you’re starting to feel like it’s time for something new, try using these six steps to help you set a professional goal.

  • I’m overwhelmed and burned out. Unfortunately, this does happen. While working hard and pursuing goals is important, finding ways to rest is vital for a long, successful career. If that feels easier said than done, we recommend reading How to Take a Break Without Taking PTO. Take your favorite idea or two and staring building some rest into your week.

4. I’m a Seasoned Professional

It’s such an honor to sit at the pinnacle of your profession—but don’t let it get lonely at the top! Knowledge is meant to be shared, and there are so many who can benefit from your hard-earned wisdom.

  • I want to set an example. Young professionals look up to you, and not just for scanning guidance. Help them become well-rounded leaders by demonstrating how to balance confidence and humility in the workplace.

  • I want to provide advice. You might be surprised by how many people want career advice, but don’t know how to ask for it. Start with this article to see our tips for participating in mutually fulfilling sonography mentorships.

  • I want something more. If you’re looking for a way to take your advanced skillset in a different direction, have you considered remote work? Telesonography is touted as a great solution for providers and patients, but it also benefits sonographers.

5. Bonus Goodies for Everyone

No matter what stage of the sonographer journey you find yourself in, you’ll benefit from brushing up on these timeless topics.

We hope you find this article useful as you progress in your sonography career, and we’d love to hear from you. What advice can you add? Drop it in the comments below!