The user again takes measurements on the Ultrasound System which are recorded in the Simplified Adult Echo SR object and if multiple instances of a measurement are included, one of them may be flagged by the Ultrasound System by setting the Selection Status for that instance to the reason it was selected as the preferred value.

The Ultrasound System stores the SR object to the PACS.

The receiving database or processing system retrieves the SR object and parses the contents. The contents of TID 5301 “Pre-coordinated Echo Measurement” have known semantics and are processed accordingly.

On first encounter, measurements in TID 5302 “Post-coordinated Echo Measurement” will likely have unfamiliar pre-coordinated codes (since the pre-coordinated code in Row 1 of TID 5302 is not taken from CID 12300 “Core Echo Measurement”, but rather was likely produced by the vendor of the Ultrasound System). Depending on the sophistication of the receiver, parsing the modifiers may provide sufficient information for the receiver to automatically handle the new measurement. If not, the measurement can be put in an exception queue for a human operator to review the values of the modifiers and decide how the measurement should be handled. In between those two possibilities, the receiver may be able to compare the modifier values of known measurements and provide the operator with a partially categorized measurement.

In any case, once the semantics of the measurement are understood by the receiver, the corresponding pre-coordinated code can be logged so that future encounters with that measurement can be handled in an automated fashion.

The receiver may also make use of the Selection Status values or may database all the provided measurement values or allow the human to select from the provided set.

Note that in this use case the receiver handles the measurements based on the semantics associated with the measurement.