The Next Step

In traditional radiology practice, reports are typically dictated and then transcribed.? While the free-text reports represent the semantic knowledge interpreted and conveyed by a physician, the information can be hard to access. The advantages of representing medical data in a structured format using standard terminology are clearly recognized. These include the ability to implement a standardized electronic medical record, automatically invoke medical guidelines when appropriate, and conduct outcomes research. Standard structured reports facilitate intelligent indexing, searching, and retrieval of documents from clinical databases. Recent attempts have been made in the industry to enable structured data entry using preformatted templates, but these have yet to gain widespread acceptance.1,2 These preformatted templates do not necessarily use standard nomenclature and tend to disturb a clinician’s normal workflow. This paper presents a prototype system that incorporates the benefits of both dictated free-text reports and standard, structured reports

Teleradiology as a Foundation for an Enterprise-wide Health Care Delivery System

An effective, integrated telemedicine system has been developed that allows (a) teleconsultation between local primary health care providers (primary care physicians and general radiologists) and remote imaging subspecialists and (b) active patient participation related to his or her medical condition and patient education. The initial stage of system development was a traditional teleradiology consultation service between general radiologists and specialists; this established system was expanded to include primary care physicians and patients. The system was developed by using a well-defined process model, resulting in three integrated modules: a patient module, a primary health care provider module, and a specialist module. A middle agent layer enables tailoring and customization of the modules for each specific user type. Implementation by using Java and the Common Object Request Broker Architecture standard facilitates platform independence and interoperability. The system supports (a) teleconsultation between a local primary health care provider and an imaging subspecialist regardless of geographic location and (b) patient education and online scheduling. The developed system can potentially form a foundation for an enterprise-wide health care delivery system. In such a system, the role of radiologist specialists is enhanced from that of a diagnostician to the management of a patient’s process of care

A Field Theoretical Approach to Medical Natural Language Processing

Abstract—A parser for medical free text reports has been developed that is based on a chemistry/physics inspired “field theory ” for word–word sentence-level dependencies. The transition from the linguistic world to the world of interacting particles with potential energies is guided by a psycholinguistics thought experiment related to the amount of “work ” required to bring a reference word into an anchored configuration of words. Calibration experiments involving four and five grams were conducted. Data from these experiments were used as a knowledge source for estimating field conditions for words in sentences sampled from a corpus of medical reports. The result of the parser is a dependency tree that represents the global minimum energy state of the system of words for a given sentence. The system was trained and tested on a corpus of radiology reports. Preliminary performance, as quantified by link recall and precision statistics, is 84.9 % and 89.9%, respectively. Index Terms—Knowledge representation, natural language processing (NLP), structured medical reporting. I