ISO/TR 24936:2026

Technical
Report
ISO/TR 24936
First edition
Health informatics — Endoscopic
2026-05
video and related clinical
information
Informatique de santé — Vidéo endoscopique et informations
cliniques associées
Reference number
© ISO 2026
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Published in Switzerland
ii
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Abbreviated terms . 2
5 Laparoscopic video and endoscopic video . 2
5.1 General .2
5.2 Case report form (CRF) .2
5.3 Use cases of video data from endoscopies .3
5.3.1 Record keeping and evidence retention .3
5.3.2 Clinical training and education .3
5.3.3 Medical device research and development .3
5.3.4 Challenges of the current data structure for these emerging use cases .3
6 Data structure for video from endoscopy . 4
6.1 General .4
6.2 Data structure .4
6.2.1 Video data .4
6.2.2 Data from a typical CRF .6
Bibliography . 8

iii
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
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This document was prepared by Technical Committee ISO/TC 215, Health informatics.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.

iv
Introduction
Endoscopies are devices widely used in diagnosis, treatment and surgeries in modern healthcare. While there
are different types of endoscopies for various purposes and subjects, one common and core functionality
within these devices is the assistance by optical elements which allow the operator to see the environment
of the subjects administered. Modern endoscopies can be attached to recording devices that enable them to
store video data obtained from the optical elements of these devices.
The video data are the track records of the internal conditions of the subjects administered, and of how
devices and the operator are performing during treatment and diagnosis. The video file consists of series
of sequential moving pictures. These can contain a lot of information that can be relevant for medical
education and even for the improvement of the endoscopic device functionality. In fact, using video data
is highly common in the research and development of fields such as robot-assisted medical devices and
machine learning modules. Laparoscopy, which is one of the types of endoscopies that are mainly used for
surgeries, is an area where such technologies are actively been researched. The general flow of the video
data file is outlined in the Figure 1.
There is increasing awareness of the importance of video data from endoscopy, and such data is more
available and accessible. Aside from the video data that are typically produced by these medical devices,
other metadata are attached to them and provide additional context to the image data.
Furthermore, for the development of more complex and technological medical device, there can be a wish
to obtain contextual information about the healthcare treatment that goes beyond what the device would
normally produce. Such data points can include more information about the clinician, surgeon, patient, pre-
or intra- or post-operative complications, bleeding volume, size of affected area, etc.
Due to the nature of such use cases, the video file is typically used outside the facilities where the treatment
or recording has taken place originally. Since the data is delivered to third parties, it requires several data
processing steps before it reaches data users from the data providers or the source facilities. This is mainly
due to privacy protection purposes for any individual or privacy information that are recorded in the video
file, which may include the patient, doctors, nurses and other healthcare professionals. The general flow of
such activities is outlined in Figure 1.
This document reports on the various data points that are typically utilized in the recent research and
development of medical devices mainly related to laparoscopy, endoscopy and surgery robots. The report
also covers the source of the information, the format of the information, how the information is stored and
in what types of devices.
The report also refers to relevant healthcare standards, such as DICOM, to discuss how essential data points
for these use cases can be processed.

v
Figure 1 — General flow of endoscopic video data processing and delivery from the data provider to
the data users
vi
Technical Report ISO/TR 24936:2026(en)
Health informatics — Endoscopic video and related clinical
information
1 Scope
This document reports on data structure for the video data, image recording device and related clinical
information. This document includes data from endoscopic video and clinical information, but not static
single images or audio data that can also be recorded through these types of devices.
This document does not cover the remaining data processing for data delivery to users. Figure 2 illustrates
the scope of the document.
Figure 2 — Scope of data points within the entire data processing and value chain flow covered in
this document
2 Normative references
There are no normative references in this document.
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.
ISO and IEC maintain terminology databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/

3.1
digital imaging and communications in medicine
DICOM
standard for the communication and management of medical imaging information and related data
Note 1 to entry: The DICOM standard facilitates interoperability of medical imaging equipment.
Note 2 to entry: For further detail on DICOM, see ISO 12052.
3.2
clinical information
information about a person, relevant to his or her health or health care
4 Abbreviated terms
CRF case report form
EHR electronic health record
FHIR fast healthcare interoperability resources
HEVC high efficiency video coding
ICG indocyanine green
SR DICOM structured report
5 Laparoscopic video and endoscopic video
5.1 General
There is a growing awareness of the need for objective schemes that will enable a more digitized and
streamlined clinical information management process, as well as for data storage and analysis perspectives.
Furthermore, with the increasing necessity of the video data for the improvement of the device functionality
itself, the significance of objective data management across different devices is also increasing. Examples
of such development efforts are observed in associations such as the Medical Imaging and Data Resource
Center (MIDRC), the National Cancer Institute (NCI) and Cancer Imaging Programs (CIP).
Video data recorded by endoscopy during clinical treatments include several parameters that define image
quality. Also, different recording formats, encoding formats and video formats are used depending on the
specific use cases and purposes of the data. The length of the video data can range from 2 hours to sometimes
15 hours, depending on the complexity of the treatment and patient’s conditions. With the increasing
diversity of use cases of the video data from endoscopies, such as for the purpose of more sophisticated
clinical training and medical devices research and development, more compatible data structure with
higher data quality, such as interoperable format, sufficient image quality, minimal consistent metadata set,
is demanded.
5.2 Case report form (CRF)
CRF is a report that describes the clinical context of medical treatment including laparoscopic surgery and
endoscopic examination. The report consists of detailed information about the patient’s profile, the patient’s
clinical background, the medical institution that the treatment has taken place, the surgeon’s profile. If the
treatment was a surgery, the information includes subject, procedure, duration, size of tumour, bleeding
volume, intraoperative or postoperative complications and so on. It also includes information about
recording devices, surgical devices used during the treatment and diagnosis and the details of endoscopies.
CRF items can be represented in DICOM SR or exported from EHR (e.g. FHIR resources) and linked to video.

5.3 Use cases of video data from endoscopies
5.3.1 Record keeping and evidence retention
Traditionally, video data has been a trustful source of truth of the event that is recorded. This also applies
to me
...