POCUS Workflow

Learn more about POCUS workflow

The Basics: Learn terms, definitions and more

The Types: Learn more about the two different types of workflow

The Data: See the results of the 2021 survey of emergency ultrasound leaders

The Basics

Let's face it, IT speak isn't something we learned in medical school. There are a lot of terms that are unfamiliar to physicians when talking about imaging workflows. Moreover, many terms are acronyms that are thrown around like candy at Halloween. The first step to understand an imaging workflow is to understand these terms. Below are two resources that are excellent starting points to understand these basic terms and their definitions. 

"Understanding IT Speak 101" by Rob Ferre and Dave Hennon

"IT Basics and Definition of Terms" by Rob Ferre and Christian Dameff

The Types

There are two types of imaging workflows. The traditional imaging workflow is called an "Order Based Workflow." This workflow begins when an order is placed to begin the workflow process, hence the name. This workflow has been around for decades and is how radiologic studies go from an order to an imaging study that has an interpretation and a link that allows the image to be viewed within the electronic medical record (EMR). 

The second type of imaging workflow is called an "Encounter Based Workflow." This workflow begins when an image is obtained as part of a visit within a healthcare facility. Images are obtained by physicians as part of a procedure (e.g. colonoscopy) and archiving those images with an attached report is needed. In order to get these images into a long term storage solution (e.g. PACS) with an attached report within the EMR, certain requirements are needed. These are accomlished using an encounter based workflow.

To learn more about the differences between an order and an encounter based workflow, including a flow diagram, click here

The Data

In September 2021, a survey was conducted about workflow preferences for emergency ultrasound workflows. There was strong consensus surrounding four items by emergency ultrasond experts who completed the survey. These included the following:

To access a presentation on the data, click here or you can access this from "The Data" tab on the top of this page. 


In 2020, a workflow process map was created through the ACEP Emergency Ultrasound Section's Industry Roundtable that mapped out the process of an encounter based workflow from the perspective of an Emergency Ultrasound Director. The map provides detailed insights into the POCUS workflow process and potential areas for design improvement. This map is available here.

Creating Workflow Standards- The POCUS Workflow Work Group

In 2022, a collaborative group of emergency physicians, informaticists, and representatives from both the ultrasound and electronic health record industry formed a work group to examine and create best practice standards around POCUS workflows. The purpose of this work group was to examine current workflow processes and published IHE profiles with respect to POCUS workflows and to optimize or propose new industry standards. 

Background Documents: The following have been published regarding POCUS workflows:

Work Group Documents: The following documents have been presented as part of the workflow work group meetings

Workflow Presentations:

SCUF Tech Summit 

SCUF Tech Summit and Workflow Workshop 2023

2023 SCUF Workflow Presentation: This presentation covers the basics of workflow and the development of standards, including the ACEP EBIW IHE Workflow update.

Clinical Use Case: Clinical Use Case

Educational Use Case: Educational Use Case

Split and Merge Exception Case: Split and Merge Use Case 

Procedural Use Case: Procedural Use Case


SCUF Tech Summit and Workflow update 2024

We have made a lot of progress in defining POCUS workflows! Check out the 2024 SCUF presentation on workflow. The ACEP IHE Workflow Workgroup has submitted a proposal to IHE for the creation of a new IHE POCUS EBIW Profile. At the time of SCUF 2024 Conference, the most current updated version of the proposed POCUS EBIW Profile can be found here

Reports and the creation of dashboards for tracking completion of workflow is a much needed part of any POCUS workflow. Dr. Matt Flannigan presents work done by members from the ACEP EUS IRT. Check out his presentation delivered at the SCUF Tech Summit

ACEP Emergency Ultrasound Section's Industry Round Table Presentations

You can see recent presentations from ACEP's Emergency Ultrasound Section's Industry Round Table from 2021-2024 by clicking on the "Resources" tab above or clicking here. These presentations from thought leaders in emergency ultrasound address the relevant and critical challenges the POCUS community faces today.

Need Resources?? Check out our Resources Page. You will find many a variety of aids including:

About pocusworkflow.com

Dr. Rob Ferre created and maintains pocusworkflow.com in an effort to collaborate with POCUS leaders and our industry partners. The purpose of the website is to provide a simplified overview of POCUS workflows, with particular attention to encounter based imaging workflows.  The work of physician thought leaders in POCUS is reported on the website.  

For more information, please reach out to Dr. Rob Ferre, rferre@iu.edu 

For more information about Dr. Rob Ferre, please check out his Linkedin profile or his IU School of Medicine bio