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Surfing the NASH Tsunami begins its year-end series to reflect on a momentous 2022 for NAFLD and Season 3 of the podcast. In this conversation, Surfers Jörn Schattenberg, Louise Campbell and Roger Green continue to share their respective highlights.

Louise and Jörn begin by discussing some of the benefits of FibroScan in terms of how practitioners have come to use data more appropriately with the newer iterations of the product. As Louise points out, older machines tracked kilopascals only. This could help identify disease but not support liver health as effectively. Newer machines measure liver stiffness, providing more nuanced insights into overall health. Jörn raises a question: why test when virtually everyone with liver disease has NAFLD? He suggests a test offers inexpensive therapy in the form of enhanced patient education and self-care. Louise mentions from her experiences in Australia that people even forget the role the liver plays in metabolism. She emphasizes this is in a country where the Aboriginal populations have such exceptional documentation about liver disease and education tools, both of which Louise describes in some detail. Jörn speculates that FibroScan use in the German system will continue to be limited due to low levels of reimbursement, unless there is a patient co-pay. Louise speculates that costs will come down, using her experience in the UK to support her suggestion.

The remainder of the conversation stems from Roger’s question about how digital tools will integrate with FibroScan over time. Louise believes they can work together in driving patient motivation. From a different view, Jörn suggests that in the German system, where data transfer is highly inefficient, practitioners will be challenged to integrate the data from these tools into patients records. As a result, it will remain difficult to integrate the tools themselves into patient care. Lastly, Roger notes that electronic health record systems can essentially eliminate this issue, however someone needs to pay for developing them.