A UNIFIED APPROACH TO THE DESIGN OF CLINICAL REPORTING SYSTEMS

Computer-based Clinical Reporting Systems (CRS) for diagnostic departm ents that use structured data entry have a number of functional and st ructural affinities suggesting that a common software architecture for CRS may be defined. Such an architecture should allow easy expandabil ity and reusability of a CRS. We report the development methodology an d the architecture of SISCOPE, a CRS originally designed for gastroint estinal endoscopy that is expandable and reusable. Its main components are a patient database, a knowledge base, a reports base, and screen and reporting engines. The knowledge base contains the description of the controlled vocabulary and all the information necessary to control the menu system, and is easily accessed and modified with a conventio nal text editor. The structure of the controlled vocabulary is formall y presented as an entity-relationship diagram. The screen engine drive s a dynamic user interface and the reporting engine automatically crea tes a medical report; both engines operate by following a set of rules and the information contained in the knowledge base. Clinical experie nce has shown this architecture to be highly flexible and to allow fre quent modifications of both the vocabulary and the menu system. This s tructure provided increased collaboration among development teams, ins ulating the domain expert from the details of the database, and enabli ng him to modify the system as necessary and to test the changes immed iately. The system has also been reused in several different domains.