We report our experience working with cardiac sonographers (SONO) in outpatient settings between April 2019 and December 2022.

Our observation focused on 7 outpatient cardiac centers in the Auvergne Rhône Alpes region, 35,743 patients had at least one consultation between April 2019 and December 2022. In total, 23,657 patients an echocardiogram (ECHO) performed (66%). Seven SONOs were involved, supervised by 15 cardiologists. All ECHOs were technically performed based on a standard acquisition protocol. Data was saved on a dedicated cloud-based Picture Archiving and Communication System (PACS) allowing the cardiologist to check the image quality, results and complete the report, automatically included in the electronic health record.

Out of a total of 25,686 ECHO (i.e., an average of 1.1 ECHO/patient), ∼19,800 (77%) were performed by SONOs (range from 72% to 92% depending on the medical center). In total, ∼2000 ECHO (∼10%) required technical expertise and additional acquisition of images by the referring cardiologist (range from 5% to 25% depending on the experience level of the SONO). Based on a study sample, the average ECHO acquisition time was 12±7minutes. Thus, over the entire period of 33-month period, the total medical time saved was estimated up to 4,700hours.

Teamwork is mandatory to improve access to outpatient care in cardiology. Working with cardiac sonographers is efficient and saves cardiologists up to 700hours/SONO/year of medical time. This organizational workflow should be paired with dedicated imaging data management systems and HER (Fig. 1).