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Supported: CSV, TXT, XML

How Conversion Works

The Challenge

Each radiology dictation system uses a different proprietary format for report templates. Converting directly between every format combination would require building many separate converters.

Our Solution: IHE MRRT

TemplatExchange uses IHE MRRT (Management of Radiology Report Templates) as an intermediate format. MRRT is an industry standard developed by the IHE Radiology workgroup and endorsed by RSNA.

PowerScribe XML

→

MRRT

→

Any Format

Fluency CSV

→

MRRT

→

Any Format

Fluency TXT

→

MRRT

→

Any Format

Why MRRT?

Benefit	Description
Industry Standard	Developed by IHE, adopted by RSNA RadReport.org
Future-Proof	Growing adoption across radiology systems
Semantic Structure	Supports sections, fields, and coded terminology (RadLex)
HL7 Compatible	Based on Clinical Document Architecture (CDA)

What Gets Converted

Element	Preserved?	Notes
Template name	Yes	Fully preserved
Section headers	Yes	FINDINGS, IMPRESSION, etc.
Free text fields	Yes	Default values preserved
Pick-list options	Partial	Default value preserved; options may be lost
System tokens	Yes	Mapped to equivalent tokens
Voice triggers	Partial	Converted where formats support them

References

Nuance PowerScribe 4 Format (XML)

File: AutoTextExport.xml

Overview

PowerScribe exports templates as XML containing both RTF-formatted content and embedded XML metadata for interactive fields. Each template includes a plain text version and a rich text version with field definitions.

Structure

<PortalAutoTextExport>
  <AutoText>
    <Name>Template Name</Name>
    <ContentRTF>...RTF with embedded XML...</ContentRTF>
    <ContentText>...plain text version...</ContentText>
    <GUID>unique-id</GUID>
    ...
  </AutoText>
</PortalAutoTextExport>

Field Types

Type	Description	Example in Plain Text
Type 1	Free text field - user enters any text	`History`
Type 3	Pick-list - dropdown with predefined options	`liver:unremarkable/mild fatty/severe fatty`
Type 4	Merge field - system-populated from RIS/PACS	`CONTRAST`

Common Merge Fields

CONTRAST - Contrast agent details
Referring Name - Referring physician
Report Create Date - Report timestamp

Fluency for Imaging Importable Format (CSV)

File: TemplateManagerExport_YYYY-MM-DDTHH_MM_SS.csv

Overview

The importable CSV format contains template metadata in columns with HL7 CDA-based XML in the InfoSet column. This format can be imported back into Fluency for Imaging.

CSV Columns

Column	Description
`ID`	Internal database ID
`Guid`	Unique template identifier
`Name`	Template display name
`InfoSet`	XML containing template structure and content
`WorkType`	Work type category
`Modalities`	Applicable imaging modalities
`ExamCodes`	Associated exam codes

InfoSet XML Structure

Uses HL7 CDA (Clinical Document Architecture) with mModal extensions:

<documentModelObject xmlns:mm="http://mmodal.com/cdaExtensions">
  <worktype>...</worktype>
  <allowableSections>...</allowableSections>
  <template>
    <structuredBody xmlns="urn:hl7-org:v3">
      <component>
        <section>
          <code code="10004" codeSystemName="MM-LOINC"/>
          <title>FINDINGS:</title>
          <text>...content...</text>
        </section>
      </component>
    </structuredBody>
  </template>
</documentModelObject>

Section Codes (MM-LOINC)

Code	Section
5013	PROCEDURE:
10000	HISTORY:
10001	COMPARISON:
10002	TECHNIQUE:
10004	FINDINGS:
10005	IMPRESSION:

Field Types

Voice-Activated Fields (styleCode="voiceActivatedField"): Editable fields with voice command support. Shown as [default text]
Token Fields (styleCode="fluencyToken"): System-populated fields. Shown as [<Reason For Exam>]

Fluency for Imaging Read-Only Format (TXT)

File: *.txt or TemplateManagerExport_*.txt

Overview

Human-readable plain text format for viewing and documentation. Templates in this format appear as read-only in Fluency for Imaging and cannot be imported.

Structure

-------------------------------------------------------
TEMPLATE NAME: CT ABDOMEN AND PELVIS WITH

TEMPLATE CONTENT:
EXAMINATION:
[<Procedure Description>]

HISTORY:
[<Reason For Exam>] []

COMPARISON:
[None]

TECHNIQUE:
[Axial postcontrast images...]

FINDINGS:
Liver: [There are no lesions or masses.]
Spleen: [Normal in size and appearance.]
...

IMPRESSION:
[Normal examination.]

-------------------------------------------------------
TEMPLATE NAME: Next Template...

Elements

Element	Description
`-------` (55 dashes)	Template delimiter
`TEMPLATE NAME:`	Template identifier
`TEMPLATE CONTENT:`	Start of template body
`[text]`	Editable field with default value
`[]`	Empty editable field
`[<Token>]`	System-populated token field

Common Tokens

<Procedure Description> - Procedure name from imaging order
<Reason For Exam> - Clinical indication from order

Limitations

This format lacks metadata (GUIDs, exam codes, voice cues) required for full import capability. Use the CSV format for templates that need to be imported into Fluency.

Known Limitations

Template conversion preserves the structure and content of your templates, but some features may not transfer perfectly between systems due to fundamental differences in how each platform handles templates.

Data That May Be Lost

Feature	Status	Details
Pick-list options	Partial	The default/selected value is preserved, but the list of available options may not transfer. Fields become free-text in the target system.
Voice triggers	Partial	Verbal activation phrases are converted where supported, but may need manual verification in the target system.
Formatting (bold, italic)	No	Rich text formatting from PowerScribe RTF is not preserved. Plain text content only.
Custom field properties	No	Platform-specific field attributes (field length limits, validation rules) are not transferred.
Exam code associations	Partial	Exam codes may need to be remapped to the target system's code set.

Merge Field / Token Mapping

System-populated fields (merge fields in PowerScribe, tokens in Fluency) are mapped to their closest equivalent. However, each system has different available tokens:

PowerScribe	Fluency	Notes
`CONTRAST`	`<Contrast>`	Direct mapping
`Referring Name`	`<Referring Physician>`	Direct mapping
`Report Create Date`	`<Current Date>`	Approximate mapping
Custom merge fields	—	May not have equivalents; become regular text fields

File Size Limits

Limit	Value	Reason
Maximum file size	9 MB	API Gateway payload limit (10 MB with overhead)
Typical capacity	~500-700 templates	Varies by template complexity

For larger template collections, export your templates in smaller batches and convert them separately.

Recommendations

Test first: Convert a small batch of templates and verify they work correctly in the target system before converting your entire library.
Review pick-lists: After import, check templates that had pick-list fields and recreate the options if needed.
Verify tokens: Ensure system tokens (patient name, date, etc.) populate correctly in test reports.
Keep originals: Always maintain backups of your original template exports.

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Conversion Complete

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Upload Template File

Drag & drop your template file

Confirm Source Format

Select Output Format

Conversion Complete

Converting...

Template Format Guide

How Conversion Works

The Challenge

Our Solution: IHE MRRT

Why MRRT?

What Gets Converted

References

Nuance PowerScribe 4 Format (XML)

Overview

Structure

Field Types

Common Merge Fields

Fluency for Imaging Importable Format (CSV)

Overview

CSV Columns

InfoSet XML Structure

Section Codes (MM-LOINC)

Field Types

Fluency for Imaging Read-Only Format (TXT)

Overview

Structure

Elements

Common Tokens

Limitations

Known Limitations

Data That May Be Lost

Merge Field / Token Mapping

File Size Limits

Recommendations

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