Impact of an epic-integrated point-of-care ultrasound workflow on ultrasound performance, compliance, and potential revenue

A primer for clinical POCUS leadership in your emergency department

“…While archiving practices in Canada are heterogenous, it is ideal that both the POCUS images and interpretations are readily available to all physicians caring for the patient [3][4][5]7]. CAEP recommends image storage in a picture archiving and communication system (PACS), dedicated POCUS image archiving software called middleware, or as a last resort, printed in a paper chart [3,7,8]. CAEP also has recommendations for the minimum image archiving requirements for common emergency POCUS applications [4].…”

Perioperative applications of focused cardiac ultrasound

“…Documentation can be eased with the creation of templates to decrease the amount of time required to document the study within the electronic medical record. Although workflow efficiency varies between hospital systems, the transition from a cumbersome workflow to a more efficient one has been shown to increase POCUS utilization 68. Increasing efficiency by reducing the number of administrative steps required of a provider has been shown to improve patient care when compared with more cumbersome workflows, and streamlined workflows allow scans to be appropriately documented at higher rates 68.…”

“…68 Increasing efficiency by reducing the number of administrative steps required of a provider has been shown to improve patient care when compared with more cumbersome workflows, and streamlined workflows allow scans to be appropriately documented at higher rates. 68 Since FOCUS can be considered an adjunct to physical examination, at this time it is reasonable for the findings to be documented in the physical examination section of a patient's chart, however, ideally images would be stored in a retrievable location. Importantly, FOCUS does not meet the criteria for limited echocardiography and as such the authors suggest that it should not be billed as such by anesthesiologists at this time.…”

“…66 Workflow varies between institutions and can be extremely efficient with a single order populating the patient's information in the ultrasound machine, flagging the record for QI, and automatic image uploading following acquisition. 67,68 Image storage as well as reporting are critical to ensure subsequent clinical decision making and that QI processes can occur. Documentation can be eased with the creation of templates to decrease the amount of time required to document the study within the electronic medical record.…”

“…Although workflow efficiency varies between hospital systems, the transition from a cumbersome workflow to a more efficient one has been shown to increase POCUS utilization. 68 Increasing efficiency by reducing the number of administrative steps required of a provider has been shown to improve patient care when compared with more cumbersome workflows, and streamlined workflows allow scans to be appropriately documented at higher rates. 68 Since FOCUS can be considered an adjunct to physical examination, at this time it is reasonable for the findings to be documented in the physical examination section of a patient's chart, however, ideally images would be stored in a retrievable location.…”