Lowering DVT-Related ED Visits via a Primary Care POCUS Pathway

Lower extremity deep vein thrombosis (DVT) requires prompt diagnosis to prevent pulmonary embolism (PE). DVT point of care ultrasound (POCUS) is shown to be effective in emergency department (ED) settings, though few studies have demonstrated impact in primary care settings. This quality improvement (QI) project aimed to establish a primary care DVT POCUS pathway to reduce ED visits.

From June 2024 to August 2025, a POCUS fellowship-trained physician at an academic family medicine clinic received referrals from other primary care clinicians for suspected DVTs and performed POCUS evaluations and DVT management. Patient outcomes and clinician feedback were collected via chart review and surveys to assess the project's feasibility and acceptability.

Eighty patients were evaluated, with a positive DVT rate of 5% (4/80). The pathway potentially avoided ED visits for 46% of patients (37/80), translating to an estimated cost savings of $85,100. With a 98% (43/44) response rate, most referring clinicians strongly agreed that the DVT pathway improved patient safety and access, reduced their cognitive burden, and reduced ED referrals.

The DVT POCUS pathway effectively managed patients with suspected DVT in the primary care setting, demonstrating feasibility and acceptability with clinicians, as well as potential cost savings. This model warrants further research as a framework for integrating DVT POCUS into primary care, enhancing diagnostic capabilities and patient care, while alleviating pressures on EDs.