The primary function of a clinical information system is to allow health care practitioners to report and retrieve clinical findings about their patients.  In most systems, these findings are stored in the patient record database as free text.   The problem with free text is that it lacks structure:  information is trapped in the language of the report, making it difficult to compare reports or find a specific detail without reading through the text.  For example, following the progress of a particular lesion across a series of reports requires the radiologist to scan through many lines of text.  By contrast, a structured reporting system would allow the information to be standardized and presented in a clear, organized format, tracking the attributes of each finding (size, location, etc), and prompting the radiologist for changes or impressions.  In addition to improving report readability, structured reporting can be more time-efficient than dictation, facilitate automated billing and order entry, and support analysis for research and decision-support.

Structured Reporting has been a research topic for many years, but only recently is it beginning to make its way into the marketplace as a viable technology.  This site is dedicated to providing an overview of structured reporting resources available over the net.  Please submit contributions to: info@structuredreporting.com.  

• The Future of Radiology Reporting (pdf, 2MB)  - by B.Reiner, E. Siegel, K. Shashtri, from Electronic Reporting in the Digital Medical Enterprise, SCAR U. 
• DICOM SR book  - comprehensive (394 pages) book about the structured reporting extension to the DICOM standard. 
• Langlotz Bibliography - organized by topic. 
• SPIDER Bibliography - 1998 list of annotated references covering the evolution of 30 years of structured reporting research.
• Introduction to SR.ppt - slides by Dr. Dean Bidgood (247 KB).

• The Next Digital Frontier. Decisions in Imaging Economics, 6/2003.
• eDictation aims to make dictation faster, cheaper. Auntminnie.com, 1/2002.
• New radiology technology streamlines patient care.  Triad Business News, 6/2002.
• New reporting methods may provide competitive edge.  RSNA News, 3/2002.
• 4-year case study of 160,000 structured reports (pdf).  StructuRad LLC, RSNA presentation, 11/2001. 
• Structured reporting in radiology, SHSRR, 12/2000.

• eDictation - eDictation uses a combination of structured reporting, electronic signature and speech recognition to create and distribute radiology reports. The application automatically remembers unique terms and phrases to produce one-click reports for many common combinations of findings.  See the site for an animated demo.
• REX by PointDx - PointDx's flagship product, REX, integrates image analysis and structured reporting in a unique workflow process, creating a new paradigm for radiology reporting. The inefficient and costly steps associated with analysis, dictation, transcription, approval and distribution are reduced to a single step, permitting instantaneous distribution of web-based reports.
• StructuRad  - The StructuRad application features an extensive set of knowledge base modules for generating report phrases, based on decision trees developed over 5 years by practicing radiologists.  presentation.pdf (794KB)
• PenRad - Structured reporting for mammographers.
• Cyberpulse - Clinical reporting for cardiologists.

• DICOM - The ubiquitous standard for medical image distribution is being augmented with an information model for describing the findings contained in those images.  Presentations from the DICOM SR Workshops in  March 2002  and June 2001.   Technical specification: supplement23-1999.pdf.  
• IHE - Integrating the Healthcare Enterprise is an initiative to promote cross-vendor interoperability;  includes a "Report Integration Profile" that specifies a template for diagnostic reporting.  Slides.ppt.
• HL7 - Health Level 7 is the leading standard for transmission of medical records; defines the Reference Information Model for specifying attributes, roles, and transactions.
• SNOMED - Systemized Nomenclature of Medicine is the largest controlled vocabulary, codifying hundreds of thousands of concepts across different categories.
• UMLS - Unified Medical Language System is an expansive collection of semantic networks and hierarchical lexicons for representing knowledge across a wide range of clinical domains.
• Foundational Model of Anatomy - Part of the UMLS semantic network, this resource is particular useful for structured reporting, which requires deep anatomical knowledge to support context-sensitive menus and prompts.

• RadLex - Feasibility study to develop a unified lexicon for indexing medical imaging resources.

• RSNA MIRC - Medical Imaging Resource Center was originally conceived as a proposal to develop a central repository of medical images and text for supporting research and education. The emphasis of the project has shifted towards the development of resources for linking distributed medical image repositories.  A demo is available.