| Alibaba sells fully featured non-fda approved (usually) veteranary ultrasound machines for as little as $800 USD - this includes a monitor and control panel etc. That is probably pretty close to commodity pricing for a specialised device. There are also wireless ultrasound probes for around $800 USD - these could potentially come down in price too. The reason commercial ultrasound sound machines cost 50-500k is that hospital are paying for: - a brand name with reliability behind it - the ultrasound rep to come and demo the machine a few times before and after it is purchased, as well as bring in some platters of food. Also the ultrasound machine reps also bring additional machines along for courses in use of the ultrasound for intern teaching etc. - a support contract The cheap, ubiquitous ultrasound machine seems like a great idea, and is useful in some settings (like ER especially), however there are some significant issues - probably best understood with the example of echocardiography. Performing an echocardiogram (ultrasound of the heart) is a highly specialised field with neverending levels of complexity. Firstly, you are often dealing with inadequate images due to the patient's obesity or other anatomical factors, therefore less experienced operators get worse images which can make interpretation impossible. Even when you do get good pictures, it is a very subjective area and 2 operators will commonly have divergent results for the same scan. Thirdly the there are dozens and dozens of parameters which can be measured or calculated which are used as surrogates for functional measurement of the heart - these are being proven or disproven/or becoming fashionable or falling out of fashion over time. Practicioners need to perform a certain number of echos per year to maintain base competency, and those with low numbers generally perform much worse than those who do echos every day. A quick, goal directed, focused echo can yield useful results, and does work a lot better than a stethoscope, but then many would argue that allowing allcomers (physicians/ED docs/anaesthesiologists/ICU docs) to perform poor quality scans is a step back from having more specialised doctors performing fewer, high quality scans. So overall, the issue is probably not that the machines are too expensive, it is that we have not worked out exactly who should be doing these scans. The truth lies somewhere between a very few people (ultrasound trained cardiologists/radiologists) and everyone, but we are not sure exactly where. Overall I think that the technical advances here will not come from building cheap open source ultrasound machines (although it does sound fun!), but from improving ultrasound machines in their ability to acquire and interpret pictures themselves. This may be by having a remote telesonographer that guides and interprets a scan performed by a layman (eg a nurse) which would allow rapid, remote results without the telesonographer present (and could also allow utilisation of excess sonographers in some locations to places where they are scarce, or allow daytime sonographers on one side of the world to help scan patients at 3am on the other side, or allow utilisation of outsourced remote indian/filipino sonographers for cost savings. Alternatively, new tech would perform scans automatically (eg. robotic arms, or human operator guided with instructions or haptic feedback) and then do tech guided interpretation - eg. generate all the important data from the information given and present it at a level appropriate to the person requesting the scan. |