Table 5.

Lancet commission recommendations (1–5), including relevance to India and proposals stemming from this roadmap

Lancet commission recommendations	Relevance to India	Proposal
National diagnostics strategy to include an evidence-based EDL, with a prioritised subset for universal health coverage	Current EDL[49] lists USI only under “Radiology”; and only at community health centre, sub-district hospitals and district hospitals levels	EM PoCUS has applicability across a range of healthcare setting levels. Therefore we advocate an amendment of the EDL to list PoCUS (including for EM purposes) across a range of healthcare setting levels
Primary health centre diagnostic availability and accessibility (specifically advocates PoCUS at “Primary health centre” and “First level hospital” settings)	Potential for EM PoCUS to have transformative impact on primary health centre care, particularly in low resourced or remote regions	We advocate embracing of Lancet commission recommendation 2 to make EM PoCUS available in such locations
Health workforce expansion and upskilling for contemporary diagnostic skills Includes “develop high-quality task-shifting programmes, and exploit the full capability and skills of all staff”	Existing barriers to EM PoCUS in India means that this potential is not being realised	We advocate embracing the opportunity to upskill the EM workforce to use PoCUS in highly specific applications
Governance and regulatory frameworks to support and oversee diagnostic quality and safety Includes “national professional bodies concerned with diagnostics should have a framework of standards for their members”	Acceptability of the expansion of USI (from solely the domain of radiology) will require governance frameworks. The PCPNDT act draws this into sharp focus	We advocate mechanisms such as the establishing of a national body to accredit EM PoCUS courses – which in turn will support the ScoP of the subsequent imaging practice of EMs
National financing strategy to provide sufficient, long-term financing to plan, and implement diagnostics, including infrastructure	Wide range of health-care delivery settings means an emphasis on financial sustainability is essential	When identifying EM PoCUS ScoP, undertake modelling of onward patient care cost savings (e.g., reduced risk of iatrogenic harm, fewer complications, etc.) to provide financial rationale

EDL: Essential diagnostics list, PoCUS: Point-of-care ultrasound, EM: Emergency medicine, PCPNDT: Preconception and prenatal diagnostic techniques, USI: Ultrasound imaging, ScoP: Scope of practice