In most fertility clinics, ultrasound scans are among the most clinically significant events in a patient's care. Antral follicle counts, follicle growth across a stimulated cycle, endometrial thickness, and any structural findings all come from imaging. And yet, in the majority of clinics we have spoken with, imaging data is the last type to be integrated with the rest of a patient's clinical picture.
The pattern we see consistently is this: cycle data sits in one system or spreadsheet, hormone lab results arrive as a separate printout or lab portal export, and scan notes live in a PACS folder or the sonographer's local document store. All three exist; none of them talk to each other.
Why imaging gets left out
Part of the explanation is technical. Imaging systems in clinical settings tend to be closed environments. PACS (Picture Archiving and Communication Systems) are designed to store and display image files, not to export structured clinical observations. The useful clinical information from a scan is most often in the sonographer's or clinician's written notes, not in the image file itself, and those notes exist in a format that is difficult to pull into a structured data workflow without some effort.
The other part is historical. Fertility EMRs and cycle management tools were built around the primary workflow of the clinic: appointment scheduling, cycle start and end dates, medication protocol records, and lab result entry. Imaging was treated as a supplementary record type that clinicians could review separately when needed. That design assumption made sense when the primary use of clinical software was billing and scheduling; it creates friction when the primary use is preparing for a consultation.
A consultant reviewing a patient before an IVF monitoring appointment needs to know not only where the patient is in the cycle, but how follicle development has progressed over the preceding scans and how that progression compares to the patient's previous cycles. That question requires imaging data to be present alongside the cycle record, with the scan dates correctly positioned on the same timeline. When it is not, the consultant either reconstructs the picture manually or proceeds with an incomplete view.
What structured imaging integration looks like
At the practical level, integrating imaging observations into a patient timeline does not require access to the PACS image files themselves. What matters for the timeline view is the clinical summary of each scan: the date, the scan type, the key numeric findings (antral follicle count, follicle sizes, endometrial measurement), and any qualitative notes the clinician or sonographer recorded.
These observations are typically available as text in the scan report, which may be a PDF, a structured note in the EMR, or a typed entry in a spreadsheet. Parsing that text and placing it correctly on the patient timeline is a structuring task, not an imaging analysis task. Amilis does not read image files and does not interpret scan findings. It reads the recorded observations and places them in their correct position relative to the patient's cycle and lab data.
The result for the consulting clinician is a timeline where an appointment on day 9 of a stimulated cycle shows not only that a scan was performed, but that antral follicle count was noted, and how that sits alongside the oestradiol level from the same day's blood draw. The two pieces of information are already in the clinic's records; they have simply never been visible on the same screen.
The practical gap this addresses
Consider a patient attending a monitoring scan at a mid-sized UK fertility clinic, mid-way through her third stimulated cycle. The clinical team has records from the previous two cycles, including scan reports and lab results. Before the appointment, the reviewing clinician needs to contextualise this cycle's response against the patient's history.
In the current system, that means pulling two previous cycle folders, locating the scan reports within them, finding the relevant monitoring appointments, and cross-referencing the lab results from around the same cycle days. This is not a technically difficult task; it is a time-consuming one, and in a busy morning session with back-to-back appointments, the time available for it is limited.
When all of that is assembled on a single timeline, the review drops from a multi-step retrieval exercise to a single reading task. The clinical decision remains entirely with the clinician; what changes is the time and effort required to have the information available before that decision is made.
What we cannot do yet
There is a boundary worth stating clearly. Amilis can structure and display the clinical text recorded about a scan. It cannot process raw DICOM image files, cannot extract measurements from scan images, and does not integrate with PACS at the image level. For clinics where the primary record of a scan is the image itself rather than a clinical note, the pathway to integration requires the sonographer or clinician to record the key observations as text at the time of the scan.
This is a workflow requirement as much as a technical one. If scan observations are not recorded in a format that can be parsed and structured, the data is not available to include on the timeline regardless of how the clinic's imaging system stores the original images. The starting point for imaging integration is typically ensuring that scan reports exist as readable text records somewhere in the clinic's workflow.
We also do not summarise or interpret imaging findings. If a scan note records an observation, that observation appears on the timeline as recorded. The clinician reading it applies their own judgement; Amilis does not add layers of clinical interpretation between the original record and the reading screen.
A practical first step
For clinics considering how to bring imaging data into a more integrated workflow, the least disruptive starting point is a consistent note format for scan observations. A structured template that captures date, scan type, key measurements, and clinical notes in a fixed order is importable into any structured data system, including Amilis. Clinics that have adopted a basic scan note template consistently report that it reduces the time needed to integrate historical imaging data, because the structure is already present rather than needing to be reconstructed from free-text variation.
The imaging gap is rarely the first thing a fertility clinic identifies as a data problem. It tends to surface when the cycle and lab data are already well-organised and the remaining friction in consultation preparation is traced back to having the scan history in a separate location. Addressing it does not require a PACS overhaul; it requires treating imaging observations as structured data from the moment they are recorded.