Reporting

February 2026 · 7 min

Overview

The Reporting Workstation is where radiologists create, review, and finalize imaging reports. Reports are linked to the study, automatically available in the patient's EMR, and delivered to the ordering doctor in real-time.

Bio-Ecko supports structured reporting, free-text dictation, template-based reporting, and voice-to-text integration -- giving radiologists flexibility to use their preferred workflow while maintaining data consistency for analytics.

Report Creation Workflow

1. Open a completed study from the worklist (status: Completed / Images Available).
2. View Images -- The integrated Study Viewer (DICOM web viewer) opens alongside the report editor. Windowing, zoom, pan, measurements, and annotations are available.
3. Select Template -- Choose from pre-built templates or start with a blank report. Templates pre-fill the report structure with headings and normal-finding defaults.
4. Document Findings -- Enter observations using structured fields (checkboxes, dropdowns, measurements) or free text. Structured fields enable downstream analytics (e.g., 'How many lung nodules were reported this quarter?').
5. Impressions & Recommendations -- Summarize the key findings and suggest next steps (follow-up imaging, biopsy, clinical correlation).
6. Attach Key Images -- Select representative images from the study and annotate them (arrows, circles, measurements). Key images appear in the final report.
7. Submit -- The report enters the validation queue as 'Preliminary'.

Validation & Sign-Off

Reports follow a two-tier review process:

Preliminary Report -- Created by the reporting radiologist (or radiology resident). Available to the ordering doctor immediately but clearly marked as 'Preliminary'.

Final Report -- The supervising/attending radiologist reviews, edits if necessary, and signs off. The report status changes to 'Final'. Any changes between preliminary and final are tracked as an addendum.

Addendum -- After a report is finalized, additional findings can be added as a timestamped addendum (never by editing the original). Both the original and addendum are visible.

Peer Review -- Configurable random or targeted peer review where a second radiologist reviews completed reports for quality. Discrepancies are graded (minor/significant/major) and tracked for quality metrics.

Critical Results & Alerts

When a radiologist identifies a critical finding (e.g., tension pneumothorax, acute stroke, pulmonary embolism):

1. Click Flag Critical on the report.
2. Select the critical finding category from a standardized list.
3. The system sends an immediate push notification and SMS to the ordering doctor.
4. A communication log records the notification time.
5. The ordering doctor must acknowledge receipt within a configurable window (e.g., 30 minutes).
6. If not acknowledged, the alert escalates to the department head and then to the medical superintendent.

Critical result communication compliance is tracked as a quality metric. Regulatory and accreditation bodies (NABH, JCI) require near-100% documented communication of critical results.

Report Templates

Pre-built templates for common studies ensure consistent, complete reporting:

• Chest X-ray (PA/AP) -- Heart size, mediastinum, lung fields, pleural spaces, bony thorax.
• CT Abdomen/Pelvis -- Organ-by-organ structured review (liver, gallbladder, pancreas, kidneys, bowel, etc.).
• MRI Brain -- Ventricles, white matter, cortex, posterior fossa, sella, orbits.
• Ultrasound Abdomen -- Liver (size, echo, portal vein), gallbladder, CBD, kidneys, spleen, pancreas, bladder.
• Mammography (BI-RADS) -- Structured BI-RADS assessment with category selection and management recommendation.
• Echocardiography -- Chamber dimensions, wall motion, valve assessment, ejection fraction.
• Obstetric Ultrasound -- Gestational age, fetal biometry, anatomy survey, amniotic fluid, placenta.

Templates can be customized per radiologist preference. New templates can be created by the department admin and shared across the team.

Reports & Quality Metrics

• Reporting TAT -- Time from study completion to final report. Track by radiologist, modality, and priority. Target: <2 hours for routine, <30 minutes for STAT.
• Preliminary-to-Final Discrepancy Rate -- Changes between preliminary and final reports, indicating training needs.
• Critical Result Communication -- Percentage of critical findings communicated within the target window.
• Peer Review Scores -- Discrepancy rates from peer review, categorized by severity.
• Report Completeness -- Percentage of reports using structured templates vs. free text. Higher structured reporting = better analytics.
• Addendum Rate -- Frequency of addenda, potentially indicating rushed initial reporting.

Notes

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