Images and Text Operation Records: Xi'an Agreement

Abstract

Operation notes are a very important part of a patient's medical record. They not only record the operation process during the surgery, but also objectively describe the organs lesions. They play a useful role in the referral disease communication, pathological diagnosis, medical practice education, and cases review. However, the current operation notes are hand-written texts therefore many deficiencies as follows: 1. It is difficult to describe the difficult and complicated operation process accurately with the hand-writte notes; 2. It is hard to objectively describe the degree of pathological changes of complex lesions and the relationship with the surrounding organs, which may reduce the basic value of the operation notes. It difficult for pathology doctors to comprehensively understand the disease and make an accurate diagnosis; 3. Due to the differences among doctors and departments in personnel medical professional knowledge and cognition. Text is difficult to realize the condition of accurate communication；4. For the innovation surgery and new implant materials, the text lacks of intuitive feelings.