By: Rishika Chugh, MD

Assistant Professor of Medicine, Director, Intestinal Ultrasound Program

University of California San Francisco

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Why Intestinal Ultrasound?

Launching an intestinal ultrasound (IUS) program isn’t just about adopting a new imaging tool—it's about transforming how we care for patients with inflammatory bowel disease (IBD). IUS provides rapid, real-time insights into disease activity without radiation or sedation, offering a game-changing alternative to more invasive testing.

But to bring it to life takes more than a probe and enthusiasm. This article outlines an all-in-one strategy—from business planning to credentialing to clinic integration—for clinicians ready to build or scale their own IUS program.

Step 1: Craft a Strong Business Plan

Starting with a clear, revenue-aware proposal is essential to gaining institutional support.

Essentials to include

• Estimated equipment costs (e.g., Samsung RS85 Prestige, lower-end machines)
• Training costs (travel, registration, living expenses for training)
• Billing codes (e.g., CPT 76705 for limited abdominal ultrasound for Medicare)
• Revenue projections based on anticipated patient volume over time

This plan can help secure buy-in from both your division and the radiology department—and opened doors for philanthropy and local grants.

Step 2: Create a Credentialing Pathway

Standardization is key. Develop formal credentialing criteria to ensure our IUS practitioners are well-trained and aligned with international standards.

Example Credentialing Criteria

• Initial: Completion of a training pathway, such as the IBUS training pathway (Modules 1–3 + final exam), or equivalent IUS certification program.
• Observed scans: At least 40 observed IUS exams, documented and reviewed.
• Maintenance: 25 IUS exams/year + at least one IUS-related CME annually (i.e. IUS Monthly Webinar)

This process can legitimize your program within your institution and lay the groundwork for broader acceptance.

Step 3: Build Infrastructure for Daily Use

Once the machine is in place, think through every operational detail.

Example Set Up

• Dedicated ultrasound machine in the GI/IBD clinic
• PACS & IT support for image storage and proper billing practices
• Billing workflow with appropriate CPT codes
• Clinic schedule that supports real-time image acquisition and reporting
• Standard reporting templates with fields for indication, BWT, color Doppler signal, and other imaging/endoscopy/pathology notes

Step 4: Build Your Network and Ask for Help

The IUS community is generous and global. Throughout the process, reach out to other iUSCAN experts via social media, message experienced colleagues, and lean on mentorship. If you need a place to get started, please email team@iuscan.org with details about your interest and we will help you from there.

You don’t have to do this alone—and you shouldn’t. Sharing your vision not only builds momentum but may inspire others to join your mission.

Step 5: Train and Teach—Become a Center of Excellence

After scanning over 500 patients, I felt confident stepping into a new role: training others. Your confidence level may require more or less exams, but please consider teaching this important skill to others once you are ready, particularly trainees at your own institution.

We became a training site for others, which required:

• Adequate patient volume (15–27 exams/week)
• Saved and annotated cases for discussion with a variety of pathology (i.e. fistula, stricture, abscess)
• Protected time for learners and strategic discussions
• Administrative support for onboarding and communication

Becoming a teaching center isn’t just about expertise—it’s about structure and intention.

Bonus: Launch Loud

To celebrate the opening of our IUS clinic, we held a formal launch event with live demonstrations and invited colleagues from radiology, colorectal surgery, and GI. Public events like this help spread awareness and showcase the impact of IUS in real time. Think about how you may promote the implementation of this new tool to educate both patients and providers alike regarding proper use and its accessibility.

Final Thoughts: Start Small, Think Big

Building an IUS program takes vision, persistence, and collaboration—but it’s absolutely possible and incredibly rewarding. For me, it’s been life-changing, both professionally and personally.

You don’t have to be an expert to start—just passionate enough to plan, resourceful enough to reach out, and committed enough to keep going.

Let this blueprint guide your own journey from inspiration to implementation. For the business plan of your blueprint, we have created a downloadable and editable profitability and projection sheet so you can better plan with your administration to incorporate IUS into your clinic.

Want to start your own IUS program or become a training site?

Reach out to us at team@iuscan.org and we will help guide you along the journey

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