Reporting & Documentation

We expect images from all scans should be stored, and a formal structured report created for all POCUS non-training scans.

This is the standard expected by GPICS guidelines, and allows easy review of images and reports for clinical management, as well as quality control as part of governance processes.

All reports should include:

• Operator and accreditation
• Machine images are stored on
• Study findings and interpretation
• Title highlighting report

We have created an acronym expander for common POCUS reports, based upon the FUSIC templates. These can be used to populate a custom-named clinical note as described below.

	1. On EPR, Navigate to the “Preferences” menu and then to “Acronym Expansion”
	2. From the window of your own acronym expansion, click the button “import from other users”. From the new window select “Cranfield, Dr Alistair”.
	3. Now you can see all Aistair’s acronym expansions. Tick the box next to required structured reports and press OK. Available reports are: #POCUSheart #POCUSlung #POCUSabdo #POCUSdvt
	4. In the patient’s page in EPR add a new “clinical note v2”. Click on the bubble at the top to name the note with the appropriate titel (e.g. POCUS Heart).
	5. In the note type the acronym expander (e.g. #POCUSheart) and press enter. The report should appear, ready to be populated.