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HL7: Encounter Based Worklist for Patient Association

This is a guide to configuring an encounter based worklist (EBW) from a facility’s EMR or interface agent(s) to work with Butterfly Cloud. The following instructions will take you through setting up a connection to ingest HL7 ADT messages to generate an EBW in addition to establishing a Butterfly Link to receive C-FINDs from modalities.


This capability is available for Enterprise customers. Please consult System Integration: Butterfly Link Installation if you do not have an installed Butterfly Link and please consult HL7: EHR Integrations if you have not set up a connection to your EHR. 


The following actions are available to users with Read & Write permissions for Connectivity Management in their Butterfly Access Roles.


Note that initial configuration of an EBW is typically conducted with the help of Butterfly Professional Services, a team that will work to understand the dynamics of your institution's HL7 messages, patient flow at your institution and help curate your EBW.


Setting Up a New EBW Endpoint

  • Navigate to the Integrations menu from Enterprise settings. Select the “Connectivity” section and scroll down to the “Integrations” section.
  • Click the ‘+ Add’ option next to Integrations and select EBW to create a new HL7 endpoint.
  • An EBW configuration screen will display after you have selected the ‘Connection Type’.
  • Proceed to add a friendly display name for the EBW connection and specify the following parameters:

  • Procedure ID - Specifies the value that will appear in the the DICOM tag for RequestedProcedureID. Also populates OBR.4.1 in HL7 for ORUs.
  • Procedure Description - Specifies the value that will appear in the the DICOM tag for RequestedProcedureDescription. Also populates OBR.4.2 in HL7 for ORUs.
  • PACS Push Delay - Specifies the delay between an ORU sent to the EHR and DICOM data being pushed to PACs. Note: In order for this to work, the EBW/EHR and PACs must all be linked to the same Link server.
  • Timezone - Specifies the timezone of the modality to provide correct datetimes for C-FINDs.

The next section specifies which EHR connection and ADT feed that will generate the EBW.

  • EHR - Specifies the associated EHR.
  • HL7 Butterfly Link Port - Specifies the Port where Butterfly Link will listen for traffic from the EHR.

The next section enables configurable accession number generation and is available only by request from Butterfly. By default Butterfly regenerates new accession numbers every 5 minutes. In some care settings faster generation may be preferred for successive point of care ultrasound exams.

  • Accession Number Prefix - Specifies the alphabetic prefix to the accession number and must be between 2-4 letters in length.
  • Number of Digits - Specifies the length of the numeric component of the accession number. The minimum length is 12 and the prefix plus digis may not exceed 16.
  • Accession Number Generation - Specifies the period of time that elapses to get a new accession number for a given encounter. By default set to 5 minutes but may go as low as 1 minute. Faster regeneration recommended only in scenarios where point of care exams necessitate more frequent turnover.

Note: Once accession numbers settings change, the updates take effect immediately. Customer is responsible for testing any impacts to PACS, connected modalities and EHR before turning these settings on more broadly. These settings take effect in a proactive manner and will not retroactively apply to exams that already have a patient association.


The next section configures the EBW for C-Finds from modalities:

  • SCP AET - Specifies Butterfly’s AE title as an SCP.
  • DICOM Butterfly Link Port - Specifies the port where Butterfly Link will listen for incoming C-FINDs.

8. Click Save. You can now see the contents of your EBW by clicking on the options menu and ‘Viewing Worklist’.

Setting an EBW for an Organization

After configuring an EBW you can associate it with an organization so that the EBW becomes the default way to add patients to studies in Butterfly Cloud and mobile.

  • Navigate to ‘Enterprise Settings’ and the ‘Organizations’ section. Select the ‘Settings’ option of the organization where you’d like to set up a patient association method.
  • Select ‘Connectivity’ and from the Primary Worklist dropdown select the appropriate EBW.
  • Save and the patient association method will take effect immediately.
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