April 2002

An evolutionary change in medical technology is occurring with the introduction of the HCU imager. The ultimate configuration is a use-specific small ultrasound machine capable of being used during any medical encounter.This technology can extend the concept of the “complete physical examination,” allowing more rapid assessment of cardiovascular anatomy, function, and physiology. Because diagnostic ultrasonography is extremely safe, the information obtained is unique,and the cost is relatively low, wide dissemination of the HCU device is expected. Specific groups of health care workers or individual medical practices are expected to embrace this technologic advancement rapidly. A family of user-specified HCU devices may evolve that will complement and extend the classic physical examination and advance noninvasive medical diagnosis. As with any test or examination, society should be most concerned about the inappropriate use or inaccurate data acquisition, interpretation, and response to the result. For this reason, the ASE recommends a minimum of Level 1 training for independent performance or interpretation of HCU and Level 2 for independent performance or interpretation of comprehensive echocardiography. User-specific training and assumption of responsibility will be essential to ensure the most appropriate use of the obtained information. Reimbursement for specified testing will obligate appropriate training, and a method of permanent record keeping suitable for auditing.