As point-of-care ultrasound (POCUS) has become standard in emergency medicine, critical care, and hospitalist workflows, healthcare organizations are now facing the next challenge: integration. POCUS devices in isolation are not sufficient in systems where clinical data must be accessible, reportable, and auditable.
To maximize efficiency in your point-of-care ultrasound workflow, seamless integrations with your PACS (Picture Archiving and Communication System) and EMR (Electronic Medical Record) system are essential. This article outlines best practices and technical considerations for integrating point-of-care ultrasound into healthcare IT ecosystems, without compromising speed, accuracy, or compliance.
Understand the POCUS Workflow First
Before attempting integration, map your existing point-of-care ultrasound workflow from image acquisition to interpretation to storage. Common questions to ask include:
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- How are studies currently stored—locally, or in the cloud?
- Are images linked to patient records in the EMR?
- Is there a QA process in place (or attending over-read) for credentialing?
Understanding the current state ensures your integration strategy is aligned with your real-world clinical needs.
Step 1: Select POCUS Devices That Are DICOM-Compliant
The foundation of interoperability is DICOM.
Modern point-of-care ultrasound devices should support:
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- DICOM image and metadata export
- Worklist queries (for patient demographics)
- Secure, automated image routing to PACS
Once you have ensured your devices meet this criteria, you should aim to choose a vendor-neutral (and regularly updated) PACS to optimize compatibility with your POCUS devices. Selecting a vendor-neutral PACS ensures that it is compatible with both the devices you’re using now, and those you might use in the future.
Step 2: Configuring a PACS to Accept and Archive POCUS Studies
A robust PACS solution for point-of-care ultrasound should be able to responsively display studies across multiple viewing platforms, including mobile devices, for remote consultation. Someone will need to configure your PACS to ingest and route point-of-care ultrasound exams. You can work with your PACS vendor to configure a workflow that meets the needs of your department, such as enabling automated routing to reading physicians and/or quality assurance queues.
Step 3: Integrate with EMR for Full Clinical Context
Routing POCUS exam data to the EMR closes the loop in the patient care cycle. This allows real-time access to ultrasound findings alongside other clinical notes, progress reports, and discharge summaries.
Outcomes include:
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- A bidirectional HL7 integration for automatic procedure registration and status updates
- Automatic study routing to the EMR upon final approval in your PACS
- Attaching study reports (as PDFs) to the patient record for future reference
This step is important for your overall imaging workflow, especially when point-of-care ultrasound is used in critical care for high-stakes decision-making.
Step 4: Implement QA and Credentialing Workflows
PACS integrations can also enable automated workflows for quality assurance, review, and training.
Features to look for:
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- Routing exams from resident to attending for over-read
- Randomized peer review of archived exams
- Dashboards for tracking usage, outcomes, and status
This supports credentialing requirements and aligns with emerging point-of-care ultrasound guidelines on image retention and documentation. Additionally, if you are looking to earn or maintain accreditation, it is crucial to ensure that any QA functionality built into your PACS complies with ACEP guidelines.
Point of Care Ultrasound and the Benefits of Integration
By integrating POCUS devices with your PACS and EMR, you can unlock:
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- Faster access to studies across care teams
- Improved documentation and billing accuracy
- Reduced image loss or duplication
- Higher quality and consistency in clinical practice
- Compliance with accreditation and regulatory bodies
Integrating point-of-care ultrasound with your PACS and EMR isn’t just an IT problem—it’s about ensuring clinical agility, diagnostic accuracy, and enterprise-wide alignment. As POCUS devices continue to evolve, building a scalable, standards-based infrastructure ensures you’re prepared for the future of emergency medicine.