title: Implementing DICOM structured reporting in a large-scale telemedicine network.
abstract: BACKGROUND
  Large-scale asynchronous telemedicine networks can offer a unique opportunity for the acquisition of detailed epidemiological information if the data are acquired and handled in an appropriate way. In this work, an approach is presented for the integration of medical reports in the Digital Imaging and Communications in Medicine (DICOM) Structured Reporting standard in telemedicine networks using structured vocabularies.
  
  
  METHODS
  The use of these structured vocabularies is extended beyond radiology, and a case study in telecardiology is presented. The approach was applied in the context of a real-world statewide public telemedicine network; nowadays on average 470 written electrocardiographic structured reports daily are being performed. Cardiologists provided more than 220,000 written structured reports, and these reports are stored into a central database.
  
  
  RESULTS
  This study was performed during a 12-month period, and it was possible to examine possible associations between a list of co-morbidities and cardiac risk factors with a diagnosis that indicates the presence of cardiac ischemia, cardiac injury, or possible necrosis by using DICOM Structured Reporting. Our application is responsible for coordinating the process of issuance of reports through various technologies and devices. The system works as a library in an HTTP server, which accesses information from studies in DICOM format from the database and from structured vocabularies.
  
  
  CONCLUSIONS
  Results indicate that traceability of morbidity, diagnoses, and patient clinical information can be achieved, resulting in an efficient data mining-friendly framework. A multidevice application for Web-based and smartphone-based platforms showed that it is a viable solution for applying the DICOM Structured Reporting standard in telemedicine networks.
authors.affiliation: Post-Graduate Program in Computer Science, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil. awangenh@inf.ufsc.br
authors.forename: Aldo
authors.initials: A
authors.lastname: von Wangenheim
authors.forename: Cloves Langendorf
authors.initials: CL
authors.lastname: Barcellos
authors.forename: Rafael
authors.initials: R
authors.lastname: Andrade
authors.forename: Isabela
authors.initials: I
authors.lastname: de Carlos Back Giuliano
authors.forename: Adriano Ferreti
authors.initials: AF
authors.lastname: Borgatto
authors.forename: Dalton Francisco
authors.initials: DF
authors.lastname: de Andrade
mesh_terms: D001938:Brazil; D002309:Cardiology / Q000592:standards; D003195:Computer Communication Networks; D004562:Electrocardiography / Q000592:standards*; D008499:Medical Records / Q000592:standards*; D016730:Program Development; D011634:Public Health; D011873:Radiology Information Systems; D018511:Systems Integration; D013685:Telecommunications; D017216:Telemedicine / Q000458:organization & administration*; D009626:Terminology as Topic; D018875:Vocabulary, Controlled