Radiology reports, as a form of clinical narrative, are more than a repository of patient information but are active in patient care. They are not unique and individual to each patient but have structured content suitable for supporting the activities of care. We consider these activities of care and how they manifest in the report. This recognition of the infusion of clinical organisation in clinical narrative leads to the recognition of seven properties of radiology reports: labels, concepts, genre, structure, author, subject, reader. These properties exist across two relationships: the intertextual relationship between radiology reports and the interpersonal relationship between a radiology report and people.

Clinical Narrative and Clinical Organisation: Properties of Radiology Reports

The etiology for many of the mucosal lesions we encounter in clinical practice is frequently uncertain or unknown and there is reason to believe that multicausality plays an important role. To detect multicausal relationships, the analysis must include multiple variables and large amounts of data. A traditional retrospective analysis is often based on a limited number of variables and frequently entails methodological errors where vital information may be missing. Prospective studies may be hampered by the fact that the prevalences of many conditions are relatively low. The search for new knowledge in oral medicine should therefore be facilitated by prospective use of formalized information gathered in multicenter studies. MedView is a computer program that is based on formalized input and registration of all clinical information. The output applications are focused on visualization and statistical analysis. MedView is aimed at clinical research and is well suited for multicenter studies. It also contains applications for education and distant consultations.

MedView: an instrument for clinical research and education in oral medicine.

In order to achieve real benefit from the potential offered by a Computer-Based Patient Record, the capabilities of the technology must be applied along with true re-engineering of healthcare delivery processes. University Hospital recognizes this and is using systems implementation projects, such as the catalyst, for transforming the way we care for our patients. Integration is fundamental to the success of these initiatives and this must be explicitly planned against an organized systems architecture whose standards are market-driven. University Hospital also recognizes that Community Health Information Networks will offer improved quality of patient care at a reduced overall cost to the system. All of these implementation factors are considered up front as the hospital makes its initial decisions on to how to computerize its patient records. This improves our chances for success and will provide a consistent vision to guide the hospital's development of new and better patient care.

Beyond the computer-based patient record: re-engineering with a vision.

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Beyond the computer-based patient record: re-engineering with a vision.