Back to Blog

Tracking Medical Exams Evolution Over Time with File Links

By Sergio Vieira Greve
Tracking Medical Exams Evolution Over Time with File Links

Medical professionals often need to quickly compare a patient's current exam results with previous ones. But when reports — laudos — are stored inside date-stamped folders alongside dozens of DICOM images, finding them means clicking through folder after folder, hunting for that one PDF.

The request was simple: "Can I just see all the reports for each exam type in one place?"

The Problem

In a health records project, exams are organized by type, then by date:

Ecocardiograma bidimensional com Doppler/
  2019-10-30/
    000_laudo.pdf    ← the report
    001_image_s0001_i0001.jpg
    002_image_s0001_i0002.jpg
    ... (16 images)
  2021-05-31/
    000_laudo.pdf
    ... (14 images)
  2023-10-25/
    000_laudo.pdf
    ... (67 images)
  2024-12-13/
    000_laudo.pdf
    ... (many images)
  2026-02-06/
    000_laudo.pdf
    ... (75 images)

This structure makes sense for archival — each exam session is self-contained with its report and all associated images. But for a doctor doing a quick temporal comparison, it's painful. Opening five folders to see five reports is not efficient.

The Solution: Sutram's File Links

Sutram offers a feature called File Links — a content type that creates a read-only symbolic reference to an existing file. No storage duplication, no versioning complexity, just a pointer to the original.

Instead of duplicating files or restructuring the archive, File Links were used to create a new Laudos folder under each exam type:

Ecocardiograma bidimensional com Doppler/
  2019-10-30/
  2021-05-31/
  2023-10-25/
  2024-12-13/
  2026-02-06/
  Laudos/                    ← NEW
    2019-10-30.pdf  →  links to 2019-10-30/000_laudo.pdf
    2021-05-31.pdf  →  links to 2021-05-31/000_laudo.pdf
    2023-10-25.pdf  →  links to 2023-10-25/000_laudo.pdf
    2024-12-13.pdf  →  links to 2024-12-13/000_laudo.pdf
    2026-02-06.pdf  →  links to 2026-02-06/000_laudo.pdf

Now the Laudos folder shows every report sorted chronologically by filename. The evolution from 2019 to 2026 is visible at a glance.

Even better, Sutram's universal viewer makes navigating between reports seamless. Once a report is open, switching to the next or previous one is just a button click — no need to go back to the folder, find the next file, and open it again. This turns what used to be a multi-step folder dive into a smooth, sequential review of how results have changed over the years.

By the Numbers

Across all exam types, 10 Laudos folders were created containing 42 file links total:

Exam Type Reports
Ecocardiograma com Doppler 5
Doppler de vasos cervicais 5
Ultrassonografia de abdome total 5
Ultrassonografia de próstata 5
Ultrassonografia de tireoide com Doppler 5
Exames Laboratoriais 8
Teste ergométrico 2
Cintilografia (estresse) 1
Cintilografia (repouso) 1
MAPA 1

The naming convention uses the exam date as the filename (2024-12-13.pdf), making it immediately clear which report is which — no need to open the file to check.

Why File Links?

Other approaches were considered:

  • Moving files would break the self-contained exam folder structure

  • Copying files would waste storage and create sync headaches

  • Shortcuts/aliases are OS-specific and don't work in a web-based system

File Links offer the best of both worlds: the original structure stays intact for archival purposes, while doctors get the centralized view they need for clinical work. And because they're just references, adding a new exam report takes seconds — just one more file link.