Structuring data in pathology reports: overcoming challenges with new tools

Traditional pathology reports have been textual with a high degree of variability. Checklist based structured pathology reports contribute significantly towards standardization and error reduction. As implemented, most of these are text templates making data retrieval dependent on natural language search. We describe a toolset that has been used to construct Laboratory Information System (LIS)-integrated checklists with forward chaining inference capabilities and contextual decision support. Data is saved directly into the LIS database facilitating queries and reporting.