Enterprise Imaging Vendor Neutral Archive Workflow Imaging Informatics

Where Do Your POCUS Images Actually Live?

Mike Moore November 12, 2026

Where Do Your POCUS Images Actually Live?

Point-of-care ultrasound is spreading across specialties, and the clinicians and informaticists who study it expect that growth to continue. The catch: the images it produces can end up somewhere no one can find them again.

The growth is easy to see. What it hides is the operational reality behind it: a stream of bedside studies that order-based imaging systems were not designed around.

POCUS breaks the assumption PACS is built on

Traditional imaging assumes a study is ordered, tied to the patient by an accession number, acquired by a technologist, and read from a worklist. Point-of-care ultrasound satisfies almost none of that. At the bedside, a single clinician often orders, acquires, interprets, and documents the exam, frequently with no order placed beforehand and no accession number. A 2025 HIMSS-SIIM whitepaper written with AIUM notes that POCUS exams are often unsolicited, and that in some workflows completing the exam is what generates the imaging order, after the fact.

Without an order, someone usually types the patient's name and medical record number at the device. An earlier HIMSS-SIIM white paper on encounter-based imaging warns that a typo at that step can leave images lost or filed in the wrong patient's record.

Take those anchors away and a study has nowhere reliable to file itself. At worst it becomes what a POCUS consensus paper calls a phantom scan: on audit, it is in neither the medical record nor the archive.

What a phantom scan costs you

A lost study is not just missing data. It may have to be redone, which is avoidable cost; the HIMSS-SIIM whitepaper counts minimizing unnecessary repeat imaging among the reasons to archive POCUS images where clinicians can find them. It can fall short of the documentation and image retention that billing depends on in some jurisdictions. And it quietly breaks quality assurance, because you cannot run QA on images you never kept. The exact dollar figure varies by program, but every one of those costs traces back to the same root cause: the image never reached a durable, accessible home.

Phantom scans are a governance problem, not just an IT one

Undocumented, unsaved scans undercut care, compliance, and quality at once. The HIMSS-SIIM Enterprise Imaging Community, working with AIUM, frames the answer as governance across five areas (program, clinical, technology, information, and financial) backed by an enterprise imaging strategy, so that POCUS images can be appropriately captured, indexed, stored, and viewed.

That is why the organizations getting POCUS right treat it as a data-governance decision, not just a device purchase. They charter a governance committee, define credentialing and quality assurance, set documentation standards, and, crucially, give the images a durable place to live. Most of that work is theirs to own. The last part, where the images live, is where the archive and viewer decide whether the rest holds.

The archive and viewer are where governance becomes real

A governance policy only holds if the underlying systems can deliver on it. Enterprise imaging, the strategy for capturing, indexing, storing, distributing, and viewing images across the organization, explicitly includes POCUS. The HIMSS-SIIM whitepaper names a PACS or a vendor-neutral archive as the place POCUS images and video clips are archived. In practice that means an archive that can take encounter-based images regardless of the acquiring device, keep them for as long as your retention policy requires, and make them accessible from a single viewer alongside the rest of the patient's imaging record.

This is the layer Mach7 Technologies works in, and it is worth being precise about the boundary. Mach7 does not acquire POCUS, credential the people who perform it, or run your governance committee. Its enterprise imaging offering gives POCUS a home: the Vendor Neutral Archive stores encounter-based studies on open standards regardless of device, the Communication Workflow Engine matches studies to the right patient with an HL7 engine and patient-identity matching, and the Enterprise Viewer (eUnity™) puts POCUS in front of clinicians alongside everything else in the imaging record. AI enablement completes the family, with Flamingo™ as the next Mach7 offering. The common thread is data independence: open standards and no lock-in, so an early POCUS choice never boxes in the enterprise.

In the United States, eUnity is an FDA-cleared Class II medical device (510(k) K172490) that enables healthcare professionals to view, manipulate, and analyze medical images to aid in diagnosis. Professional and prescription use only.

Three questions to ask about your POCUS program

  • Where do our POCUS images go today, device by device, and can we retrieve them a year from now?
  • Is every saved study bound to the right patient and encounter, or are we creating phantom scans?
  • Does our archive store POCUS on open standards we control, or are we locked to one vendor or one department?

If any answer is uncomfortable, the fix is rarely a different scanner. It is a governance model, and an archive and viewer built to sustain it.

For the full checklist, including who owns what and the archive and viewer requirements, download our guide, Governing Point-of-Care Ultrasound: An Enterprise Imaging Best-Practices Guide.

Governing POCUS at scale starts with where the images live. If you want to compare notes on where yours go today, talk to our team. And for conversations with the people who run imaging programs every day, listen to Flight Path, the Mach7 podcast.

Sources

  • Nomura JT, et al. "Consensus Terminology for Point of Care Ultrasound Studies with Incomplete Documentation and Workflow Elements." POCUS Journal 7(1), April 21, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9979923/
  • Ma IWY, Francavilla ML, et al. "Governance Considerations for Point-of-Care Ultrasound: a HIMSS-SIIM Enterprise Imaging Community Whitepaper in Collaboration with AIUM." Journal of Imaging Informatics in Medicine 38(5):2585-2599, published online January 3, 2025. https://doi.org/10.1007/s10278-024-01365-7
  • Cram D, Roth CJ, Towbin AJ. "Orders- Versus Encounters-Based Image Capture: Implications Pre- and Post-Procedure Workflow, Technical and Build Capabilities, Resulting, Analytics and Revenue Capture: HIMSS-SIIM Collaborative White Paper." Journal of Digital Imaging 29(5):559-566, published online July 14, 2016. https://doi.org/10.1007/s10278-016-9888-7

Regional availability and content notice. eUnity is a medical device for professional and prescription use by qualified healthcare professionals. Regulatory status, available modules and approved indications vary by market. For the approved indications in your market, contact your Mach7 representative or Mach7 Regulatory Affairs.