In order to improve medical processes in nephrology, we present an application that allows doctors to create biopsy protocols by using a digital pen on a tablet. The biopsy protocol app is seamlessly integrated into existing infrastructure at the hospital (see figure 1). Compared to other reporting tools, we provide (1) real-time hand-writing/gesture recognition and real-time feedback on the recognition results on the screen; (2) a real-time digitisation into structured data and PDF documents; and (3) the mapping of the transcribed contents into concepts of the Banff classification. Our approach combines the benefits of paper with the automatic digitisation and digitalisation of hand-written user input. A fully digital and mobile approach should empower nephrologists to produce high quality data more effectively and in real-time so that it can be directly used in hospital processes.