hi Tim,
you can create a custom xslt if you're using crystal reports 2008 or higher. please go here first for samples, paying attention to the health care sample report.
then go to your online help > search > xslt. there's not much as far as documentation for this feature though.
otherwise, you can go to the online help and look for xml and you'll see options for customizing xml including "Why create your own XML format"
-jamie