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FORUM

Instructions for Use

FORUM® ArchiveFORUM® Viewer

Software version 4.0

About these Instructions These Instructions for Use form part of the delivery package.

• Read carefully before using.

• Keep them at the same location as the software.

• Retain them throughout the service life of the software.

• Please pass them on to any subsequent owner or user of the software.

The example patient data shown are fictitious. Any similarity to living persons is therefore purely coincidental.

Scope These Instructions for Use apply to the 4.0 version of FORUM.

Information about themanufacturer

Subject to changes in design and the scope of delivery, as well as further technical developments. Printed in Germany.

© Carl Zeiss Meditec AG 2015

Carl Zeiss Meditec AGGöschwitzer Str. 51-5207745 JenaGermany

Email: [email protected]: www.meditec.zeiss.com

FORUM

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Chapter overview

Introduction 5

Hazard symbols in these Instructions for Use 5

Symbols 5

Definition of terms 6

Trademark information 7

CE conformity 7

Software description 8

User profiles 13

Safety measures 17

Security measures for IT systems and networks 17

Data protection and information security 18

Information on use 19

Calibrated recording devices and monitors 20

Limitations of the archiving system 20

Intended use / Indications for Use 21

Contraindication 21

Use in accordance with the designated purpose 21

General operating instructions 23

Start/stop FORUM Viewer 23

Individual settings 25

Higher-level functions 27

Help 32

FORUM

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Management 33

Patient Directory 33

Creating a new patient data record 37

Worklist 39

Patient Administration 47

Remote data (MultiSiteQuery) 59

Importing data 66

Depositing procedure codes 70

Clinical View 73

Overview 73

Work area (Document Display) 83

Toolbar 90

Actions 95

Additional functions 101

Clinical Displays 116

Troubleshooting 127

Malfunctions 127

Error messages 128

Index of technical terms 131

Index 137

FORUM Introduction: Hazard symbols in these Instructions for Use

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Introduction

Hazard symbols in these Instructions for Use

The following safety information is incorporated into the Instructions for Use. Please observe this safety information and take particular care in these situations.

Symbols

The following information symbols are used in these Instructions for Use:

– Listings

Prerequisite for an action

• Prompt for an action

Result of an action

The term following this symbol is explained in the list of technical terms (Page 131)

Additional information and tips.

CAUTION Indicates a hazard which may result in minor and moderate injuries if not avoided.

NOTE Indicates a hazard which may result in material damage if not avoided.

Introduction: Definition of terms FORUM

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Functions that require an additional license are marked as follows:

If a described function relates to an additional license, the "Option" field is also highlighted.

The following symbols are used on the DVD label:

Definition of terms

The following term is used in these Instructions for Use with the meaning given here:

– Plugin:A plugin is an optional software module for FORUM.

Option

Please follow the Instructions for Use.

Manufacturing date

Manufacturer

FORUM Introduction: Trademark information

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Trademark information

The following brand name is used in these Instructions for Use:

"Windows"® is a registered trademark or a brand name of the Microsoft Corporation in the USA and/or other countries.

Mac and iPad are registered trademarks of Apple Inc. in the USA and other countries.

CE conformity

The product meets the basic requirements stipulated in Annex I of the 93/42/EEC Directive governing medical devices. The product is marked with:

0297

Introduction: Software description FORUM

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Software description

General

FORUM is software for managing, archiving, and viewing e.g. patient data, images, videos, and reports provided by computer-controlled diagnostic devices or other documentation systems.

FORUM features an extensive document viewer that enables the comprehen-sive viewing of stored documents. FORUM offers a clinically relevant display of the data. Different documents and also several Modality(ies) can be flex-ibly arranged side by side and so easily compared with each other.

FORUM enables users connected to the FORUM server via a local network to access and view stored data from any computer via a FORUM client application.

Patient master data can be synchronized between FORUM and connected examination devices or applications to achieve a unified database.

Furthermore, FORUM supports the workflow in practices and clinics. FORUM enables you to centrally schedule patient examinations and forward these to connected devices as orders. The examination data together with the patient master data can be opened on the respective devices, so no patient master data needs to be entered and all the required information on the examination to be performed is available. Once the examination results are transmitted they are automatically imported and assigned to the patient by FORUM. This provides immediate access to all diagnostic data for all users.

FORUM manages DICOM files. The DICOM file contains both image data from the patient master data and, e.g., name, date of birth, etc. FORUM reads the patient master data in from the DICOM files and stores them together with a reference to the image data ("documents") in the FORUM database. The complete DICOM files are saved to the active storage location in the file system.

FORUM can work with all devices and software products that support the DICOM standard and which are compatible with FORUM in accordance with our DICOM Conformance Statement.

FORUM can be used as the primary image and report management system, but can also be integrated into an existing system via interfaces. Patient master data are then managed by the primary system.

FORUM Introduction: Software description

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ZEISS offers the product version FORUM GO as a preconfigured package solution adapted to the needs of small and medium-sized doctor’s offices. You can find more details on the Internet at: www.zeiss.de/meditec/de_de/produkte-loesungen/ophthalmologie/forum.html#produkt

Overview of functions

FORUM offers the following functions (depending on product variant or installed additional licenses):

– User Administration:an unlimited number of users can be configured.The number of users that can access the FORUM database at the same time depends on the product variant and number of installed additional licenses.

– Option of connecting to other systems (ZEISS devices and non-ZEISS devices) that support the DICOM standard.The number of configurable systems and their type is set by the product variant, and additional licenses installed.AutoConnect™ configuration: Devices supporting this function are automatically connected to FORUM.

– "MultiSiteQuery":Option to access other FORUM systems on the local network. With this function, data and thumbnails can be loaded or imported from other FORUM systems.

– Patient administration:Processing of patient master data and organization of stored documents.

– Patient Directory:Patient list for the selection of a patient and for opening the associated data in the clinical view.

– Clinical View:Special document view with comprehensive functions such as display and comparison of examination results. The Document Display, Clinical Displays and any installed FORUM Workplace Plugins with their specific analysis and processing functions are available in this view.

– Clinical DisplaysThe Clinical Displays offer preselections for opening documents for various syndromes in the Document Display.


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– Order management:Option for creating examination orders, sending these to configured systems and re-importing the results (DICOM Modality Worklist).Devices can be defined as "Modality Worklist Users" for accepting standard orders.

– Automatic forwarding of documents:Option for the automatic forwarding of DICOM files received by FORUM to connected devices or software products (immediate forwarding). For-warding can also be time-controlled.

– Saving image, report, and video data.

– Import:Various options for importing data and assigning them to a patient.

– Combined reports:Option to create combined reports from individual reports stored in FORUM.

– Accession No.:Option to change the accession number.

– Marking of favorites:Option of marking documents as "Favorite". "Favorite" status makes it possible to find documents quickly.

– Measurements:Option of performing length measurements1 in fundus images.

– Comments:Option of providing comments on documents and displaying the com-ment history of a document.

1) The measurements made in FORUM are based on the scaling information provided by the DICOM header of the corresponding fundus image.

FORUM Introduction: Software description

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Interfaces

With FORUM you can exchange patient data, medical image data, raw data, videos, and reports between devices that support the "DICOM PS 3-2011" standard.

FORUM conforms to DICOM in accordance with our DICOM Conformance Statements. The DICOM Conformance Statement is available on ZEISS’s Internet site.

The following interfaces are available:

– DICOM interface with connected devices and software products

– DICOM import

– Document import (see page 66)

– HL7 interface for HL7 patients and order management

– HIS interface for the use of FORUM connected to a patient management system

– EMR interface for using FORUM in connection with an EMR systemIf a license is installed for this interface, the maximum storage space for DICOM files may be limited to 100 MB. Data are then stored in accor-dance with FIFO principle.

– Opening the FORUM client application from an EMR system

– Opening Review Software from the FORUM Viewer

With the help of an Ethernet interface, a PC on which the FORUM software is installed can be integrated into the hospital or practice network and therefore be networked with other DICOM-compliant devices as well as HIS and EMR systems.


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Supplementary products

The following products are optionally available for FORUM:

– FORUM ASSIST match:for software-based reconciliation of the data sets for large FORUM databases.

– FORUM Workplace Plugins:The FORUM Workplace Plugins provide specific analysis and processing functions for examination data of particular devices.

– FORUM Glaucoma Workplace:for the software-based analysis and display of glaucoma data based on the data available in FORUM visual field measurement.

– FORUM Retina Workplace:for processing and displaying optical coherence tomography data and for generating reports containing the results of optical coherence tomography and fundus photography.

– FORUM Viewer App:for mobile access to FORUM (via iPad). Documents stored in FORUM can be opened on the iPad for viewing.

– FORUM LINK Toolsfor connecting non-DICOM-enabled devices to FORUM.

The optional FORUM products are offered separately and each has its own Instructions for Use.

FORUM Introduction: User profiles

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User profiles

These Instructions for Use provide information necessary for safe operation of the FORUM software as a medical product.

The installation and initial configuration are performed by a specially trained ZEISS Service technician. Therefore, no information on installing the software is found in this handbook.If necessary, later configurations can be performed by a designated local sys-tem administrator after corresponding training. Information on configuration options is provided in a separate IT handbook. The local system administrator is granted access via an admin account for performing configurations.

Operation is performed by the following user groups: Qualified medical employees, nursing staff, opticians, and ophthalmologists. Only members of the stated expert groups may use FORUM. The operator of the FORUM software is responsible for ensuring that the users identified in his or her own clinic/office are correctly assigned to the corresponding user profiles in the software (editor/reader).

Use of FORUM requires different user qualifications. In these Instructions for Use, the activities/functions of FORUM are subdivided according to the neces-sary skills into:

– Managing data

– Evaluating data

There follows a description of which individuals take on which tasks/functions and which minimum qualification is assumed for this. The operator of FORUM is responsible for ensuring that all necessary activities connected with FORUM are performed by persons with the respective minimum qualifications.

Introduction: User profiles FORUM

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Installing software/configuring FORUM

ZEISS application specialist – CAS

Person who has been intensively trained by ZEISS in the installation, configuration, and use of FORUM.

Duties:

– Installation of FORUM (with the support of the local system administrator)

– Basic FORUM configuration

– Instructing the user on the functions of FORUM

ZEISS Service technician – ZEISS Service

Individual who has been intensively trained by ZEISS in the installation of FORUM and is employed by ZEISS in the role of a service technician.

Duties:

– Installation of FORUM on site in the office/clinic

– Answering service queries/eliminating faults

Local system administrator

Individual with in-depth knowledge of the administration of hardware, operating systems, and computer networks.

Duties:

– Selecting and setting up the hardware environment to be used

– Installing the FORUM Viewer on the workstations

– Configuration and management of the user accounts

– System configuration

– Data backup

FORUM Introduction: User profiles

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Managing data

Qualified medical employees/MTA

Individuals who have completed training as a qualified medical employee and/or doctor’s assistant.

Duties:

– Entering and maintaining patients’ demographic data

– Importing patient data from patient management systems and/or EMR systems

– Managing patient visits

– Planning examinations

Nursing staff

Individuals with special nursing training who are familiar with the use of EMR systems and trained to operate medical systems and prepare patients for treatment.

Duties:

– Managing and monitoring patient data

– Importing patient data from patient management systems and/or EMR systems for examination preparation and follow-up

Introduction: User profiles FORUM

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Evaluating data

Optician, MD, OD, photographer

Individual who has completed qualified training as an optician or a similar qualification.

The training and associated skills of an optician may differ from country to country.

Duties:

– Examining eyes

– Analysis and diagnosis

– Treatment suggestions

Ophthalmologists

Individuals who have completed studies in medicine and training as a special-ist in ophthalmology.

Duties:

– Examining eyes

– Analysis and diagnosis

– Treatment

FORUM Safety measures: Security measures

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Safety measures

Security measures for IT systems and networks

RA301RA408

The FORUM software may only be operated in virus-protected networks. The FORUM software may only be operated in virus-protected networks. The ope-rator operating the software is responsible for the security of the network.

The operator operating the software is responsible for the security of the network.

The consequences of attacks cannot be foreseen.

The user is responsible for ensuring that the external storage media (e.g., USB sticks) used for data exchange are free of viruses.

If devices are connected that do not meet the requirements of the DICOM Conformance Statement, there is the possibility of data being falsified or lost.

Please note that subsequent changes to data that have already been transmit-ted in connected systems are not automatically applied by the "FORUM" software.

An analysis, evaluation, and any measures required for controlling the risks by the user are recommended. These must be updated any time the network or data connections are changed.

Safety measures: Data protection and information security FORUM

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Data protection and information security

– The user and/or person responsible for IT must ensure compliance with national laws and regulations on data protection.

– Operators of IT systems and IT networks are responsible for determining the necessary security standards, i.e. for creating the necessary technical and organizational framework conditions.

– Misuse has occurred if protected personal data are collected, processed or used without proper authorization.

RA408 – Suitable measures must be taken to ensure that only authorized users can access computers on which FORUM is installed (e.g. by locking the computer).The FORUM software may only be operated in virus-protected networks. The operator operating the software is responsible for the security of the network.

Note the following definitions:

– Personal data: All information regarding personal or physical circum-stances of a particular or identifiable person. All data (e.g. name, age, gender, etc.) that can be directly assigned to a person (patient, employee, customer, supplier) must be protected.

– Data processing: The storage, transfer (transmission to third parties outside of the organization), modification (including anonymization and pseudonymization), deletion, and blocking (marking to limit further pro-cessing or use) of data.

– Use: The use of data (e.g. transfer within the company).

– Recipients: Persons or entities that receive data.

– Third parties: Persons or entities that are not part of the entity responsi-ble (legal entity). The transmission of data to third parties is considered data transfer.

FORUM Safety measures: Information on use

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Information on use

• Make sure you are thoroughly familiar with the contents of the Instruc-tions for Use before starting up the software. You should also read the Instructions for Use of any devices and systems to be connected.

• Rx OnlyCaution: Federal (USA) Law restricts this device to sale by or on order of a physician.

• Keep the Instructions for Use at hand at all times for users.

• FORUM may only be used by appropriately trained and instructed person-nel. It is the operator’s responsibility to train and instruct the users.

• FORUM may only be used by medical experts.

• Please familiarize yourself with the user settings in the software.

• Use the software only for the intended purpose as described.

• The warranty and liability depend on the contractually stipulated conditions.

• The manufacturer does not accept any liability for damage caused by unauthorized tampering with the product. Furthermore, this will forfeit any rights to claims under the warranty.

• Modifications to this product are not permitted. Making modifications to the device that are not described in these Instructions for Use makes you a manufacturer of a medical device as defined by the applicable national law (legal manufacturer).

• After the system time or date is changed on the server, the computer must be restarted before FORUM can be used.

• Please refer to the latest Release Notes for the installed software version. These form part of the delivery package when the software is supplied. If the software is updated, you will always receive the latest version.

• Please observe the legal regulations on accident prevention and occupa-tional safety applicable in the particular country.

Safe functioning

The FORUM product is a support system and does not assume any diagnostic functions that are critical to safety. Treatments can be performed without the aid of FORUM at any time.

If a fault arises that you cannot correct based on the chapter "Troubleshoot-ing", mark the product as non-functional and inform ZEISS Service.

Safety measures: Calibrated recording devices and monitors FORUM

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Calibrated recording devices and monitors

The stored images, videos and reports may only be used for medical purposes if the recording device and monitor are calibrated. If the recording device and monitor are not calibrated, the reproduced images may contain deviations with respect to the scale, form, and color.

This applies especially when the images, videos, and reports are viewed on different types of monitors.

RA502 If FORUM is used for subsequent medical assessment or review of diagnostic data, it is the duty of the operator to ensure that suitable monitors are used.

Limitations of the archiving system

The software is intended for data archiving.

RA402 The operator of the software is responsible for regular data backup to protect the data.

FORUM provides a utility program for performing file backups.

ZEISS accepts no liability for any loss of patient, image, report, video, or raw data, as well as system or user-specific configuration data. Ensure that patient, image, report, video, and raw data are regularly backed up by your IT officer using a data backup program. If data backups are performed regularly in this way, the data can be restored in the event of a fault.

ZEISS Service is not responsible for restoring patient, image, report, video, raw, or configuration data.

FORUM Safety measures: Intended use / Indications for Use

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Intended use / Indications for Use

FORUM is a software solution intended for use in storage, management, processing, and display of patient, diagnostic, video and image data and measurement from computerized diagnostic instruments or documentation systems through networks. It is intended to work with other FORUM applications.

FORUM is intended for use in review of patient, diagnostic and image data and measurement by trained healthcare professionals.

Contraindication

FORUM is not intended to be used for radiology image (X-ray) diagnostic support.

Use in accordance with the designated purpose

The "FORUM" software system application is available in the "FORUM Archive" and "FORUM Viewer" versions. Optional additional FORUM applications are offered separately and have their own user manuals.

FORUM Archive is intended to archive and administer patient and examina-tion data (images, reports, videos, and raw data). FORUM Viewer additionally makes it possible to plan examinations on connected systems and display stored data in detail. Depending on the data available, scaling information can also be shown.

Furthermore, FORUM offers the option of exchanging data between con-nected systems.

Safety measures: Use in accordance with the designated purpose FORUM

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FORUM General operating instructions: Start / stop FORUM

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General operating instructions

Start/stop FORUM Viewer

Start

Prerequisite The computer to be used is connected to the same network as the FORUM server.

FORUM Viewer is installed on the computer to be used.

The FORUM server has been started and is accessible in the network.

Actions • Open the FORUM Viewer either by clicking on the icon on the desktop or via the start menu: <Start><FORUM Viewer>

• Enter your user name and password.

Always work with your own FORUM user account, since certain settings are stored for the user account that is currently logged on. You might otherwise change another user's individual settings.

Result FORUM checks the available licenses and those opened by the user.

Functions that are activated through floating licenses (e.g. the functions of the optional FORUM Workplace Plugins) are only available to the user if the maximum number of users for this function has not been reached. The maximum number of simultaneously logged in accounts is 50.

CAUTION Wrong runtime environmentRA302 The software functionality can be impaired if an incompatible operating

system is used.

General operating instructions: Start / stop FORUM FORUM

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Logout

You can log yourself out from FORUM as a user, e.g. to interrupt your work or release the computer for another user’s work.

To release user licenses and floating licenses for use by other users, it is advis-able to always log yourself out of the FORUM server if you are not working directly with FORUM.

Actions • Click on <Logout> at the upper right of the window.

If automatic logout is activated in FORUM, an inactive user is automatically logged out after the expiry of a defined period of time. A corresponding mes-sage window appears in this case. Your local system administrator configures the system-wide automatic logout.

Result The window for entering the login details of a user is displayed.

All licenses that were previously being used by the logged-out user are released.

Closing the FORUM Viewer

If you want to stop working with FORUM, you can close the program completely:

Actions • Click the X in the upper righthand corner of the main window of the FORUM Viewer.

If you have already logged out as a user:

• Click on <Close FORUM> in the login window.

Result The program is completely terminated. If it is necessary to continue working with FORUM, the software must be restarted.

FORUM General operating instructions: Individual settings

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Individual settings

Changing the language of the user interface

The language of the user interface is user-specific and can be changed at any time in the User Administration.

To access User Administration, select the <System><User Administration> menu item.

General operating instructions: Displaying icons (e.g. OCT scans) FORUM

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Prerequisite The corresponding language package is installed for the desired language.

If necessary, contact your local system administrator if the language you want is not available.

Actions • Select the desired language from the "Language" drop-down menu.

• Click on <Save>.

Result The user interface language is changed.

The language setting is stored for the user account. Every time you log in, the FORUM client application starts with the language that is currently selected.

Displaying icons for the special data types (e.g. OCT scans)

Data sent to FORUM from examination devices as raw data do not always contain image information that can be displayed by FORUM. Files that cannot be displayed are therefore not displayed in the thumbnail gallery. However, FORUM offers the option of including certain non-displayable raw data in the thumbnail gallery using placeholder images. If corresponding review software or an appropriate FORUM Workplace plugin is installed, these files can be opened directly with this software or in the plugin's work area.

To activate or deactivate the display of placeholder images, select <System><Show icons (e.g. OCT scans)>. If the display is activated, the checkbox preceding the menu item is checked.

The particular setting of this function is workstation-specific, not user-specific. I.e., if the same user logs on to another workstation, he or she may need to reconfigure the display of the placeholder images.

FORUM General operating instructions: Buttons

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Higher-level functions

Buttons

Some functions in FORUM can be invoked in multiple windows. The buttons associated with these functions are described in the following table:

Changing list displays

The way the lists contained in the various FORUM windows are displayed can be changed:

Changing the sorting

The criterion for sorting list entries can be specified by clicking on a title list field. The sorting direction changes every time a title list field is clicked.

Up to three sorting criteria can be combined by clicking on the corresponding title list fields while holding down the "Shift" key. The priority of the criteria is determined by the order in which the title list fields are clicked. All list fields which are currently relevant to the sorting process are indicated with an arrow in the title list field.

Refresh

Refreshes the screen contents.

When a window opens, the current data are retrieved from the server and displayed. The contents in the window are not refreshed until the window is reopened. To see changes made during the session by another user, or to retrieve newly received data, it is possible to perform an update manually with this button without having to leave the window.

Reset

Deactivates all active filters.

Extended Search

Opens the extended search function (see section "Extended search function" on page 30).

General operating instructions: Multiple selection FORUM

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Changing the column width and order

The width of the list fields can be changed by moving the column edges.

By clicking on a title list field and holding down the mouse button, the column can be moved to a different position.

Multiple selection

To select multiple elements (visits, thumbnails, etc.), the standard key combinations of the operating system are available:

Selecting individual elements• Click on all the desired elements one after another while holding down the

<Ctrl> key (Mac: <cmd>);

• If necessary, click on a selected element again while holding down the <Ctrl> key (Mac: <cmd>) to deselect it.

Selecting a series of entries• Click on the first entry in the desired series.

• Click on the last entry in the desired series while holding down the <Shift> key.

Under Windows, both methods can also be combined: the series of entries must be selected first, and further elements can then be added to it.

Selecting all elements• Press the keys <Ctrl> + A at the same time.

In the preview area, elements are selected with this key combination across visits, i.e. all documents contained in all open thumbnail galleries are selected.

Clicking the mouse without an additional key deselects all previously selected elements.

FORUM General operating instructions: Patient search

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Patient search

Standard search

It is possible to search for patients in the Patient Directory, the Worklist, or the Patient Administration with the following methods:

If necessary, deactivate all active filters by clicking on the button.

All data corresponding to the search criteria for the patient selected are displayed. In the case of more than one visit, the last visit is automatically selected. The related data are sorted by type groups.Documents of one type group are of the same type, the same laterality, the same modality, and from the same device.

Patient Name/IDLast Name/IDa)

a) The "Patient Name/ID" or "Last Name/ID" filters and the date filters can be combined ("AND" function)

Search for patients whose names or patient IDs contain the string entered in this field. Depending on the setting in the user administration ("Toolbar search field"), the string entered must occur either at the beginning or in any position.

The search will begin automatically shortly after you stop typing. By hitting the enter key you can start the search manually.

Visit DateDateStudy Date

Today

2 days

Week

Search for patients for whom data exist with a date corresponding to the filter.

To enter the date, either type it into the input field or click on the arrow to the right of the input field and select the date from the calendar.

The filters are activated by clicking and deactivated by clicking again.

Only Favorites

Search for patients who have documents marked as "Favorite". The "Favorite" filter can be activated in addi-tion to the other filters.

See section "Marking favorites" on page 112.

General operating instructions: Patient search FORUM

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Extended search function

This search function makes it possible to enter any parameters, including mul-tiple parameters, as the basis for searching for patients with certain master data or documents. The function is available in the Patient Directory, the Worklist, and the Patient Administration.

Details in the various input fields in this window can be combined as desired. The search is subject to an "AND"-operation, i.e. the patient data are listed that correspond to all of the parameters entered.

The window that is displayed when the extended search is opened from the Patient Directory is shown below.

For a search stating one or more components of the name, the data in all three components of the name are taken into account (alphabetical, ideo-graphic, or phonetic; see section "Creating a new patient data record" on page 37).

If the "Only Favorites" checkbox is activated, only patients are displayed who have documents marked as "Favorite".

Patients who are not visible because they only have documents that cannot be displayed in FORUM (e.g., OCT scans or OPV data) can be found through the "Extended Search" by activating the "Include Hidden Documents" checkbox.

FORUM General operating instructions: Patient search

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Search with placeholders

a* Search for patients whose entry begins with the string entered.

*a* Search for patients whose entry contains the string entered.

*a Search for patients whose entry ends with the string entered.

Ma?er Search for patients for whom the spelling of the entry is unclear. Unclear characters are replaced with a "?".

General operating instructions: Help FORUM

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Help

The following functions are available to the user in the <Help> menu item in the FORUM Viewer.

Contact your local system administrator for functions which are not described.

About ...

The information window gives you information on the current version of FORUM and installed licenses. This information can be copied and, if neces-sary, provided to ZEISS Service.

User manual

Direct link to the user manual (PDF file with bookmarks for navigation).

Online help

Direct link to the ZEISS website with detailed product information on FORUM.

FORUM Management: Patient Directory

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Management

Patient Directory

The Patient Directory provides an overview of the patients and their docu-ments stored in FORUM.

The patient is selected in the Patient Directory whose data are to be displayed in the Document Display of the Clinical View. In addition, several other func-tions can be invoked for the selected patients using the context menu (right-click on an object) (e.g. create an order or import data).

To access the Patient Directory, go to <Patient><Patient Directory>.

Management: Patient Directory FORUM

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After logging on to FORUM, the "Today" filter is activated by default (the only patients in the database who are listed are those who have data which have been created on that day).

In the left-hand section of the screen, all patients are listed who in FORUM correspond to the currently activated filters. Enabled filters are displayed above this screen section. The icon to the left of a patient name indicates that there is a conflict (see section "Resolving conflicts" on page 52).

The middle section of the screen shows all visits for the selected patient.

The right-hand section of the screen lists the type groups available in FORUM for the visit selected. At least one document exists for each type group.

All documents available for a patient and corresponding to the entered filter criteria are first grouped according to the date of the visit and then subdivided into different type groups. Documents of one type group are of the same type, the same laterality, the same modality, and from the same device.

The visit and document lists are merely an overview. A selection cannot be made in these lists.

Right click mouse functions

CAUTION Incorrect treatment of a patientRA514 For systems with a predominantly HL7 or EMR system:

If you notice inconsistencies in patient data, please take into account that a data merge might have been triggered by a leading system. In this case please contact the administrator of your local leading system because FORUM does not provide a function to revert a data merge.

Right-click on a title list field

Show or hide the respective column.

The currently displayed columns are checked.

This function allows the list view to be customized.

The settings are saved for the individual user.

FORUM Management: Patient Directory

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Right-click on a patient

Create Automatic Order Create an order with procedure requests for all devices for which the functions "Modality Worklist User" and "Automatic Orders" are active in "AET Administration".

See section "Creating an automatic order" on page 43.

Create Automatic Order for...

Creates an order with requested proce-dures for a specific device.

All devices for which the functions "Modality Worklist User" and "Automatic Orders" are enabled in "AET Administration" can be selected.


Remote Dataa)

Load preview

Search through connected FORUM systems for addition-ally available data. Any data found are temporarily loaded as reference entries (see sec-tion "Load preview" on page 60).

Import data Search through connected FORUM systems for addition-ally available data. Any data found are permanently imported (see section "Importing data" on page 62).

a) This function is only available if an appropriate license ("MultiSiteQuery") is installed.

Management: Patient Directory FORUM

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Import Opens the import function for docu-ments to be saved for the selected patient.

See section "Importing documents" on page 66.

Show Patient in Patient Administration

Opens Patient Administration. The selected patient is displayed in the left section of the window with all related studies, procedures, and documents.

Show Patient in Worklist Opens the Worklist. The selected patient is displayed with all created orders.

Create Patient ID Only enabled if no Patient ID is assigned to the selected patient and if Patient ID creation is "fully automatic" or "semi-automatic".

With this function, a Patient ID automat-ically created by FORUM and the default issuer are assigned to the selected patient.

FORUM Glaucoma Workplacea)

a) This function is only available and selectable if the optional software application "FORUM Glaucoma Workplace" as well as a corresponding license are installed on the FORUM server.

Open FORUM Glaucoma Workplace for an analysis of visual field examinations.

Create HFA-Cirrus Combined reporta) Open the assistant to create a combined

report.

FORUM Management: Creating a patient

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Creating a new patient data record

In FORUM, patients can either be created manually or imported via one of the following interfaces:

– by importing findings from medical procedures from systems connected to FORUM (in this case the patient master data are transferred as so-called "meta files" together with the documents and imported by FORUM).

– by DICOM importing.

– by automatically importing all patient master data from a patient admin-istration system (or any other "leading system") via the HIS interface.1

– by importing via the EMR interface.2

– by an HL7 message from a leading system.3

The data of patients whose patient name, patient ID, issuer of the patient ID, birth date, and gender are identical to data already contained in FORUM is assigned to the corresponding patient data record in FORUM. If the patient data differs only in that the data record contains no information about the issuer of the patient ID and/or the title, suffix, middle name, and gender, then the patient data is combined under one patient. In this case, the empty attri-butes are completed using the information available from the other patient. The DICOM data are correspondingly modified. In all other cases, the imported patient appears as a new entry.

In the following, the manual creation of a new patient in FORUM is described.

Prerequisite The logged in user has administrative or editor rights.

1) Requires a license for "HIS interface" option.2) Requires a license for "EMR interface" option.3) Requires a license for "HL7 Patient Administration" option.

CAUTION Incorrect treatment of a patientRA514 Prevent duplicate patient entries by checking the data when creating a new

patient.

Management: Creating a patient FORUM

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Actions • Switch via the <Patient><Patient Administration> menu to Patient Admin-istration.

• Click on <New Patient>.

• Enter all relevant patient data into the "New Patient" dialog window. As a minimum, the following details must be entered:

– Last name and first name of at least one of the name components "alphabetic", "ideographic", or "phonetic" (Multi-component name)

– Date of birth

– Gender

In the standard configuration of FORUM, the "Patient ID" and "Issuer of Patient ID" are generated semi-automatically. This means the software pro-poses both the number and issuer, but these parameters can be edited.The generation of this data can also be fully automatic or manual. To do this the basic settings have to be changed by your local system administrator.

• Confirm the entries with <Save>.

Result The new patient is created and appears in the patient list.

For more information about patient administration (editing or deleting patients), please refer to section "Patient Administration" on page 47.

FORUM Management: Worklist

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Worklist

General description

FORUM allows the scheduling of certain procedures with connected devices for every patient contained in the database. This is performed with the Worklist.

To schedule procedures for a patient on the connected devices, "Orders" are created in FORUM. The orders can be opened and imported from the con-nected devices. All data required for the procedure (patient master data and information on the procedure to be performed) is then directly available on the device.

Once the procedure results are available in the devices, they can be trans-ferred from the devices to FORUM. FORUM then automatically reads in this information and allocates it to the relevant patient.

This centralized order scheduling ensures error-free transmission of the patient master data from FORUM to the connected devices and vice versa. FORUM can also provide an overview at any time of all scheduled procedures, so that on the connected devices the user has a view of all of the procedures scheduled for these devices. Filters allow information to be displayed for specific patients or scheduled procedures for particular days.

To access the Worklist, go to <Patient><Worklist>.

Management: Worklist FORUM

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When opening the Worklist the default filter "Today" is enabled, i.e. the only patients who are displayed are those who are scheduled for procedures on the current date.

The window is divided into three sections: The left section is for the patient list, the middle section is for scheduled orders, and the right section is for the corresponding scheduled procedures.

Orders can be created manually or automatically. As a rule, the automatic creation function is used.


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Specific buttonsNew Patient Opens the input window for the data of

a new patient that is to be created.Only possible if the user has editor or admin-istrator rights.

Edit Patient Opens the editing window for the patient master data.

See section "Editing patient master data" on page 51.

New Order Opens the input screen for the data for a new order.

See section "Creating a new order manually" on page 44.

Edit Order Opens the editing window for the data in the selected order.

The data contained in the input fields can be changed, supplemented or deleted and then re-saved.

Delete Order Deletes the selected order.


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Right click mouse functionsRight-click on a patient

Create Patient ID Only enabled if no Patient ID is assigned to the selected patient and if Patient ID creation is "fully automatic" or "semi-automatic".

With this function, a Patient ID is automat-ically created by FORUM and the default issuer is assigned to the selected patient.

New Order Opens the input screen for the data for a new order

See section "Creating a new order manu-ally" on page 44.

Create Automatic Order

Create an order with procedure requests for all devices for which the functions "Modality Worklist User" and "Automatic Orders" are active in "AET Administration".


Create Automatic Order for...

Creates an order with requested proce-dures for a specific device.

All devices for which the functions "Modality Worklist User" and "Automatic Orders" are enabled in "AET Administration" can be selected.



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Creating an automatic order

The "Create Automatic Order" function allows you to request standard procedures for a patient without any further intermediate steps.

This function is available for all devices which have been defined as a "Modality Worklist User" with the "Automatic Orders" option.

Prerequisite The patient to be examined is already contained in the database (add initially as a new patient if necessary; see page 37).

At least one examining device is connected to FORUM and has been con-figured as a "Modality Worklist User" with the "Automatic Orders" option.

The patient data record for which an automatic order is to be created is free from any conflicts.

Actions • Select the patient for whom you wish to create an order from the Worklist or Patient Directory.

• Right-click on the patient.

To create an order for all devices:

• Select "Create Automatic Order" from the context menu that appears.

To create an order for a specific device:

• Select "Create Automatic Order for ..." from the context menu that appears.

• Select the desired device from the list that appears.

Result An order with procedure requests is added to the Worklist for the selected patient. The respective devices will immediately be able to call up the requested procedures.

The order can if necessary be modified in the Worklist (see section "Worklist" on page 39).


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Creating a new order manually

Prerequisite The patient to be examined is already contained in the database (add initially as a new patient if necessary, see page 37).

The desired procedure device is connected to FORUM and configured as a "Modality Worklist User".

Actions • Select the desired patient from the list.Search options: see section "Patient search" on page 29.

The left column shows all patients who correspond to the currently enabled search criteria. The middle column displays the metadata of all orders created for the selected patient. The right column lists all requested procedures for the selected order.

• Click on <New Order>.

• Enter all relevant order data for the order in the "New Order" dialog window.

• Adapt Accession No. if necessary.

In its default configuration, FORUM generates the accession number semi-automatically. This means the number is proposed by the software but can be edited if required.The accession number can also be generated fully automatically. To do this the basic settings have to be changed by your local system administrator.


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• Click on <Add> to add a "Requested Procedure" to the order.

• Fill in all mandatory fields at least:

– Modality (Device group) or name (device name)All devices are selectable that have been defined as a "Modality Worklist User" in "AET Administration".

– Procedure Code/Code Meaning or Procedure DescriptionProcedure Codes and Code Meanings are only available if they have been predefined (see section "Depositing procedure codes" on page 70).

Many of the input fields (see section 46) are designed as drop-down lists. If you click on the appropriate field, an arrow appears. Clicking on the arrow folds open the list. An entry can be selected from this list.

The <Add> button is enabled again as soon as all mandatory fields are completed.

• Add an additional procedure request if necessary by clicking on <Add>.

• Once all of the required procedures have been created, confirm the order with <Save>.

Result The order will be allocated to the respective patient and appear in the Worklist. All procedures requested in the order can now be retrieved by the respective devices.

The orders remain stored in the "Worklist". As soon as the procedures have been performed by the devices and transferred to FORUM, it imports the results again and saves them as documents to the individual proce-dures. Orders for which no procedure data is available can be deleted again by clicking on <Delete>.


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Input fields

Modality Select the device group of the device to be used to perform the procedure.

All device groups can be selected for which at least one device has been defined as a "Modality Worklist User" in "AET Administration".

Name Selection of the device to be used to perform the procedure.

All devices belonging to the selected device group ("Modality") are available for selection.

Procedure code Selection of a procedure code.

All procedure codes defined for the selected device in the "Name" field are available for selection.

Code Meaning Procedure Description

All procedure code descriptions defined for the selected device in the "Name" field are available for selection.

This field is automatically completed when a procedure code is selected.

Procedure Description

This field serves as an alternative or additional field to the procedure code or code meaning field and can be used to enter a procedure description (max. 16 characters).

Perf. Phys. Last name

Name of the attending physician.

Date Scheduled procedure time.

The current date and time (to the nearest 15 minutes) are automatically entered. Both entries can be customized.

Time

Status Current procedure status.

scheduled Scheduled procedure. No procedure data is yet available.

started Performed procedures. Procedure data is available.

Comment Comment on the requested procedure.

FORUM Management: Patient Administration

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Patient Administration

General description

In the Patient Administration, new patients can be created, master data of existing patients can be edited, and stored patients or related files can be deleted from the database. In addition, files can be moved, i.e. assigned to other procedures, studies, or patients ("reassign").

Furthermore, Patient Administration can be used to display and resolve any conflicts in the database. Patients unintentionally created twice or with differ-ent names can be merged into one data record. Incorrectly assigned docu-ments can be moved to another patient or to another Study or procedure (Series) ("reassign").

To access Patient Administration, select the <Patient><Patient Administration> menu item.

Prerequisite The logged in user has administrative or editor rights.

CAUTION Incorrect treatment of a patientRA514 When merging/editing/adding/reassigning patient data, there is the danger of

mixing up data. Please check that the data is correct when you select it.

Management: Patient Administration FORUM

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In the "Patient Administration" window, all conducted studies and associated procedures and documents are listed below the patient list for the selected patient. A selected filter is shown above the patient list. A thumbnail1 is dis-played for each selected document.

The special feature of Patient Administration is that the patient data is dis-played in both the left and right halves of the window. This double display is required for moving documents or merging patients: select the document to be moved or the patient to be merged in one half of the window (source) and define the target in the other half.

1) Data that cannot be displayed in FORUM are displayed with a blue placeholder image (see section "Hidden documents" on page 81).


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Specific buttons

Show patients with conflicts

Opens all data records with conflicts in the left half of the window.

Once a patient has been selected in the left half of the win-dow, the data records that conflict with the selected data record are displayed in the right half of the window.

See section "Resolving conflicts" on page 52.

The filter is only disabled by clicking on the button again.

New Patient Opens the input window for the data for a new patient.

See section "Creating a new patient data record" on page 37.

Edit Patient Opens the editing window for the patient master data.

See section "Editing patient master data" on page 51.

Delete Patient Deletes the selected patient.

See section "Deleting a patient data record" on page 54.

Delete Document Deletes selected documents of a patient.

See section "Delete document" on page 57.

Save as Saves the selected document to any desired storage loca-tion. Images are saved as *.jpg format, reports as *.pdf for-mat, and videos as *.mpeg format in their original quality.

The active document can also be saved as a DICOM file. To do so, the "DICOM" (*.dcm) format must be selected in the "Files of type" field. In this case, the complete DICOM files are saved.

Raw data from procedure devices (indicated by the place-holder symbol instead of a thumbnail) can only be saved as DICOM files.


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Right click mouse functionsRight-click on a patient

Create Patient ID

Only enabled if no Patient ID is assigned to the selected patient and if Patient ID creation is "fully automatic" or "semi-automatic".

With this function, a Patient ID automatically created by FORUM and the default issuer is assigned to the selected patient.

Remote Dataa)

a) This function is only available if an appropriate license ("MultiSiteQuery") is installed.

Load preview

Search through connected FORUM systems for additionally available data. Any data found is temporarily loaded as reference entries.

See section "Load preview" on page 60.

Import data Search through connected FORUM systems for additionally available data. Any data found is permanently imported.

See section "Importing data" on page 62.

Right-click on a document row

Show DICOM Header

Displays all information contained in the DICOM Header as well as the storage location of the DICOM file.

This function is not available for reference entries.

Show Reference Information

Displays the "Reference Information" window. This window displays all documents that are linked with the selected document.

The connected systems transfer the link information to FORUM along with the documents.


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Icons to identify specific data

Icons in the thumbnails in the Patient Administration refer to specific file properties:

Editing patient master data

The patient master data can be edited at any time:

Actions • Select the patient to be edited.

• Click on <Edit Patient>.

• Change/supplement the desired data.

• Confirm the changes by clicking on <Save>.

– Multi-page PDF document

– DICOM OPT document with several B-scans

Video

Reference entry on a document from a different FORUM system (see section"Load preview" on page 60).

Temporary copy (see section"Importing temporary copies" on page 62).


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Result The altered patient master data is saved. The data will be transferred to connected systems via any activated interfaces or as part of procedure requests. The patient information provided in the DICOM Header of the documents assigned to the patient is adapted in line with the changes before the system is exited.

Resolving conflicts

In the FORUM database, the combination of Patient ID and Issuer must be unique. If this is not the case, a conflict exists which is indicated by a conflict icon to the left of the patient name. Conflicts can arise if e.g. patient master data is imported which is already present in FORUM but which is slightly different (e.g. due to spelling mistakes).

Conflicts are displayed in the following cases:

– If a data record has no Patient ID.

– If several data records have the same combination of Patient ID and Issuer but differ in terms of the patient name, date of birth, or gender.

The data records with identified conflicts can be searched for in the list and edited to resolve the conflicts.

Actions • Click on .

The left-hand half of the window displays all patients with a conflict, and the right-hand half the patients associated with this conflict.

• Select a patient.

Result In the right half of the window, all patients are displayed that conflict with the one selected on the left.

Depending on the type of conflict, you can resolve it in the following ways:

– by adding a Patient ID via "Edit Patient" or right-clicking with the mouse

– by merging two patient data records

– by editing the Patient ID and/or the Issuer of the Patient ID


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Merging patient data records

Actions • If necessary, turn off any enabled filters in both window sections by clicking on .

• If necessary, turn off the conflict filter by clicking on .

• In the left-hand patient list, select the first of the two patients to be merged.

• In the right-hand patient list, select the second of the two patients to be merged.

• Click on either ("Merge patient data with right patient") or ("Merge patient data with left patient").

The display shows all master data of both patients; differing data is highlighted.

• Check the data and merge the two data records by clicking on <Yes>.

Result The studies and all of the associated procedures and documents of both patients are assigned to the selected target patient. The other patient data record is automatically deleted. The patient information in the DICOM Header of the documents newly assigned to the patient is modified accordingly.

Any reference entries and temporary copies loaded for the patient prior to merging are deleted.

CAUTION User ErrorRA516RA517

When merging patient data, there is a danger of mixing up data. Please check that the data is correct when you select it.If a patient has been merged accidentally into a wrong patient, please contact the ZEISS Service.


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Deleting a patient data record

Prerequisite No scheduled orders exist for the patient to be deleted.

No further studies are assigned to the patient to be deleted. If necessary, all assigned documents must first be deleted (see section "Delete docu-ment" on page 57).

Actions • Select the patient to be deleted in the left-hand or right-hand window section.

• Click on <Delete Patient>.

• Confirm the prompt.

Result The patient data record is removed from the database, together with all assigned files.

Deleted patient records cannot be restored!

CAUTION Data lossRA404 When deleting patient data, there is the danger of mixing up data. Please

check that the data is correct when you select it.


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Moving ("reassigning") documents

Documents can be moved from one patient to another, but also within the same patient. A document can be added to a patient as a new study or to an already existing study as a new procedure. Both the procedure date and time remain unchanged. The moved document is deleted from the original proce-dure. If as a result the procedure then no longer contains any documents, the procedure is also deleted. The same applies to the study.

Prerequisite The document to be moved is not a reference entry or temporary copy.

Actions • If necessary, turn off any active filters in both window sections by clicking on .

• If necessary, turn off the conflict filter by clicking on .

• Select the document you wish to move in the left-hand patient list (source):

• Select the patient required.

• Select the study to which the document you wish to move is assigned.

• Select the procedure to which the document you wish to move is assigned.

• Select the desired documents.

• In the right-hand patient list, select the patient to whom you wish to move the document (target).

If you wish to assign a document to another study or procedure of the same patient, select the same patient as in the left-hand patient list.

The most recent study of the selected patient along with the most recent procedure and related documents is automatically selected.

• Select at which hierarchical level you wish to add the document:

• Disable the currently selected procedure in order to add the document as a new procedure to the selected patient.

• Disable the currently selected study in order to add the document as a new study to the selected patient.

CAUTION Incorrect treatment of a patientRA514 When reassigning patient data, there is the danger of mixing up data. Please

check that the data is correct when you select it.


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• Click on ("Reassign documents from left to right").

If you reassign the document within the same patient record:

• Confirm the prompt.

If you assign the document to another patient:

In the "Reassign Documents" window, all of the documents may be listed with which the document to be moved is linked. Click on the respective entry to display detailed information about the individual documents.

Linked documents cannot be separated from one another. If linked documents are present, all of them are moved together (exception: the linked document was not available in FORUM before the docu-ment was moved).


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Result The selected document is assigned to the patient in the right-hand patient list. It is deleted from the left-hand screen section and displayed in the right-hand screen section.The patient information contained in the DICOM Header of the docu-ments is modified accordingly.

This procedure can also be performed in reverse, i.e. from right to left. In this case, use ("Reassign document from right to left").

Delete document

Actions • If necessary, turn off any active filters by clicking on . If it is enabled, also turn off the conflict filter by clicking on .

• Select the document you wish to delete in a patient list (source):

• Select the desired patient.

• Select the study to which the document you wish to delete is assigned.

• Select the procedure to which the document you wish to delete is assigned.

• Select the document to be deleted, if applicable.

• Click <Delete Document>.

The "Delete Documents" window displays detailed information about the document selected. In addition, it displays all documents, if any, which are linked to the document to be deleted.


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• If necessary, deselect the linked documents which are not to be deleted as well.

• Click on <Delete> to confirm your selection and complete the deletion process.

Result The selected document and any selected linked documents were removed from the database.

If not all linked documents were deleted, the link information for the deleted documents is retained in the remaining documents.

Deleted documents cannot be restored!

Deleting the last document in a procedure will automatically also delete the procedure from the study. If this is the only procedure of the study, the com-plete study will be removed.

FORUM Management: Remote data (MultiSiteQuery)

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Remote data (MultiSiteQuery)

FORUM offers the optional function "Remote Data"1 to enable the network-ing of several locations of a practice or clinic. For this a FORUM system is installed at each site. A connection between the FORUM systems can be created via "AET Administration", thereby enabling communication between the systems.

This function enables all connected FORUM systems to be searched for entries assigned to the selected patient that are not contained in the local FORUM database. This data can be temporarily loaded or permanently imported into the current FORUM system.

This function is useful if a patient is managed in multiple FORUM systems within a local network (e.g. because the patient has been examined at multi-ple practice sites) and different DICOM data for this patient is stored in the systems.

Select the "Remote Data" function by right-clicking on a patient in the Patient Directory or in Patient Administration.

No database synchronization occurs when data from another FORUM system is loaded or imported. The data is not automatically aligned between the FORUM systems. Where necessary and desired, the user must manually ensure that changes are made in both the source and target systems.

Option

1) An additional license is required for connecting to further FORUM systems ("MultiSiteQuery").

Management: Remote data (MultiSiteQuery) FORUM

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Prerequisite An appropriate license has been installed ("MultiSiteQuery").

At least one other FORUM system has been configured as a connected system in the AET Administration.

The patient data record for which data in another FORUM system is to be searched for is free from any conflict.

The connected FORUM system contains a patient data record which matches the patient data record selected in the current FORUM system in at least the following points:

– Patient name (first name and last name)

– Date of birth

– Patient ID

– Issuer of patient ID

If any of these items differs, data is not imported.

Load preview

All connected FORUM systems are searched for documents which are assigned to the selected patient and are not contained in the current FORUM database. The database entries pertaining to all of the documents found are temporarily loaded as "reference entries" and displayed in the Patient Administration as well as in the Clinical View as thumbnails. All of the DICOM files of these documents are loaded only if the thumbnails are opened for dis-play in the Clinical View. They are then saved in the FORUM database as "tem-porary copies".

All reference entries and temporary copies are deleted overnight and/or when the FORUM server is restarted.

Actions • Right-click on the desired patient in the Patient Directory or Patient Administration.

• Select "Remote Data" and then "Load Preview".

The context menu is displayed.


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Result FORUM attempts to contact all connected FORUM systems and to search these systems for additional database entries pertaining to the patient selected.

A two-part icon ( ) appears to the left of the patient name. All config-ured FORUM systems are searched for database entries. If FORUM suc-ceeded in contacting all FORUM systems, the icon turns green/gray ( ).

If the icon turns red, the searching and loading operation was aborted due to an error (see section "Icons" on page 64).

The green icon indicates that the loading operation was performed with-out any error. The green icon is also displayed if at the time of loading the connected FORUM system contains no data on the selected patient or no entries which were to be additionally loaded.

Additional database entries are included in the FORUM database as reference entries for the patient. Each document found is displayed in the Patient Administration and Clinical View as a preview. Reference entries are highlighted in the Clinical View in the status bar with the following icon: ).

During loading, the structures present in the connected FORUM system (affiliated to Study and procedure (Series)) are also loaded.

Generating temporary copies

If a thumbnail of a reference entry is opened in the Clinical View or saved as a file from the Patient Administration, the associated DICOM files are loaded as a temporary copy. A temporary copy is identified in the Clinical View in the status bar with the following icon:

Temporary copies are removed from FORUM overnight. If in the meantime the source document is changed, the temporary copy is not automatically updated. To ensure you are working with current data, you should always reload temporary copies before opening them in the Clinical View.


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Importing temporary copies

The following actions cause a temporary copy to be imported into the current FORUM system:

– The document is marked as a favorite (see section "Marking favorites" on page 112).

– A measurement is taken in the document (see section "Measurement function" on page 109).

– A comment is added to the document (see section"Comment function" on page 107).

– The document is transferred to a review software or a device.

The data already available in FORUM is reloaded and then completely imported. The result of the import is described in section "Importing data" on page 62.

Importing data

All connected FORUM systems are searched for documents which are assigned to the selected patient and are not held in the current FORUM database. The documents found are completely loaded for the patient and saved in the FORUM database.

Actions • Right-click on the desired patient in the Patient Directory or Patient Administration.


• Select "Remote Data" and then "Import data".

FORUM attempts to contact all connected FORUM systems and to search these systems for additional database entries pertaining to the patient selected.

Additional database entries are initially included in the FORUM database as reference entries for the patient. After successful completion of the loading operation, the related DICOM files are imported.


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Result

If the icon is completely or partially red, either the search and loading operation or the import was aborted because of an error (see section "Icons" on page 64).

During importation, the structures present in the connected FORUM system (associated withStudy and procedure (Series)) are also imported together with any included measurements or comments.

The green icon indicates that the loading and import operation was performed without any error. The green icon is also displayed if at the time of importation the connected FORUM system holds no data on the selected patient or no additional data was present.

If a report is imported and a license has been installed for the automatic generation of combined reports, or the optional FORUM Glaucoma Workplace plugin is installed, a combined Glaucoma report is generated, provided that the corresponding prerequisites are met (also see the sepa-rate Instructions for Use for FORUM Glaucoma Workplace).

The imported data has no link to its source, so that after editing it is not synchronized with the source system.

An icon ( ) appears to the left of the patient’s name.


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Icons

Patients for whom data has been loaded or imported from a connected FORUM system are marked with a special two-part icon1. This icon indicates the following statuses:

1) The icon is temporary and is removed overnight (or when the FORUM server is restarted).

Remote Data

Load preview Import data

The system attempts to contact connected FORUM systems. If successful, matching database entries are searched and if necessary loaded.

The system attempts to contact connected FORUM systems. If successful, matching database entries are searched and if necessary loaded.

Contact with a connected FORUM system has been successfully established and the searching and loading operation has been com-pleted. If matching database entries have been found, they have also been loaded.

Contact with a connected FORUM system has been successfully established and the searching and loading operation has been com-pleted. If matching database entries have been found, they have also been loaded. Found DICOM files are imported.

The searching and loading operation was aborted due to an error (e.g. no response from server). Any database entries found could not be loaded or could only be partially loaded.a)

Import completed. Found DICOM files were successfully imported.

The searching and loading operation was aborted due to an error. Any database entries found could not be loaded or could only partially be loaded and so were not imported.a)


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Contact with a connected FORUM system has been successfully established and the searching and loading operation has been com-pleted. However, the importa-tion process was not correct. Any database entries found could not be imported or could only be imported partially.a)

a) The tooltip displays the connected FORUM system from which data could not be loaded or imported.

Remote Data

Load preview Import data

Management: Import data FORUM

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Importing data

Importing documents

Documents associated with a patient, e.g. images or pdf files, can be imported into FORUM and assigned to the patient master data. Files with the following formats can be imported: *jpg1, *.bmp2, *.tif3, and *.pdf.

Multi-page image files are automatically excluded from the import. In this case, after completing the import the user is notified of the files that were not imported.

Prerequisite The patient data record for which documents are to be imported is free from any conflict.

Actions • Right-click on the desired patient in the Patient Directory.


• Select "Import".

• Click on the <Browse> button and select the folder containing the files to be imported.

1) When importing multiframe images, the individual frames have to be the same size.2) Only 8-bit and 24-bit files.3) Only 24-bit files.

FORUM Management: Import data

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The importable files available in this folder are displayed as thumbnails. The path to the files is stated in the "Source Directory" field.

• Select the files to be imported.

• Select one of the listed Modality(ies).

• Enter all requested information.

• Click on <Import> if you wish to import further files associated with this patient subsequently, or on <Import+Close> if you wish to return to the Patient Directory after having imported the file(s).

Result Each imported file is saved together with the data entered in DICOM format in FORUM. For each importation process, a new Study with a procedure (Series) is created for the selected patient. If several files are imported simul-taneously, they are combined into one procedure.

In the default setting, the imported files are deleted from the source directory. If this is not desirable, the "Delete files in file system" checkbox must be deactivated.

ButtonsBrowse Opens the folder containing the files to be imported.

Select all Selects all displayed files for import.

Deselect All Deselects all files already selected for import.

Invert Inverts the selection of the files to be imported.

Import Imports all files selected in FORUM for the selected patient.

Following completion of the importation process, the "Import" window remains open to allow the importing of further files for the patient.

Import+Close Imports all files selected in FORUM for the selected patient.

Following the completion of the importation process, the "Import" window is closed and the "Patient Directory"is displayed.

Management: Import data FORUM

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Input fieldsSource directory Path to the folder containing the files to be imported.

The selected folder remains preset for the current user.

Delete files in file system

If this checkbox is activated, all imported files will be deleted from the source directory after the import has been completed.

Modality Selects a device group to which the file to be imported relates in terms of subject.

PDF Document Title Option of entering detailed information about the file to be imported.

All information entered in these fields is saved to the DICOM Header of the generated file and can be opened via the DICOM Header (right-click on the particular doc-ument in the Patient Administration).

If you have selected several files for import, the information entered is saved for all files.

Laterality

Accession No.

Content Date

Content Time

Acquisition Date

Acquisition Time

Referring Phys.

Image Type

Horizontal Field of View

Image Comment

Burned in Annotation Activate this checkbox if the file to be imported contains text notes.

FORUM Management: Import data

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Importing DICOM files

DICOM files from unconnected devices or other archiving systems can be manually imported into FORUM.

Prerequisite The files to be imported have the DICOM format (*.dcm).

Actions • Select the <Patient><DICOM-Import> menu item.

The import window is opened.

• Select the files to be imported.

• Click on <Import>.

Result If the patient information contained in the imported DICOM files already matches the patients already contained in FORUM, the new documents are added to these.

If the imported DICOM files contain new patient information, new patient records are created in FORUM.

Management: Procedure codes FORUM

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Depositing procedure codes

For recurring procedures, procedure codes can be created that describe a particular procedure with predefined devices. Each procedure code defines a description of the procedure to be performed and a preselection of the devices to be used for this procedure.

The procedure codes are used in order creation. On entering the code, all pro-cedure data defined by the code is opened and integrated into the order. This allows recurring procedures to be quickly compiled in an order.

To access the procedure codes, select the <System><Procedure Codes> menu item.

Prerequisite All devices for which a procedure code is to be created are connected to FORUM via the "AET Administration".

The "Modality Worklist User" option is enabled for the respective device.

If necessary, please contact your local system administrator.

FORUM Management: Procedure codes

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Input fieldsProcedure code Abbreviation for a predefined procedure.

The abbreviation can be taken from an existing catalog or freely selected.

The procedure code must be unique.

Code Meaning Description of the procedure to be performed.

The code meaning must be unique.

Procedure Catalog Procedure codes can be taken from existing catalogs or freely defined. The source of a procedure code can be stored in this field. By default, FORUM proposes "CZM-FORUM" as the entry, i.e. this is a procedure code specifically defined for FORUM.

AE Title Name Selection of the device to be used to perform the procedure.

Only devices that are connected to FORUM and defined as a "Modality Worklist User" can be selected.

By holding down the <Ctrl> key (Mac: <cmd>), multiple devices can also be selected.

Management: Procedure codes FORUM

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FORUM Clinical View: Overview

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Clinical View

Overview

The Clinical View contains the following sections:

Patient identification (see page 74)

Document Display (see page 75)

Clinical Displays (see page 116)

FORUM Workplace Plugins (see page 75)

Document selection (see page 76)

Toolbar (see page 90)

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Clinical View: Patient identification FORUM

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Patient identification

In this section, the most important patient data is displayed:

A double-click on the "Patient identification" section leads back to the Patient Directory.

Patient’s name (last name, first name; alphabetical)a)

a) FORUM manages the alphabetic, ideographic, and phonetic representation of names (Multi-component name). The order of the display of this name information can be changed centrally. If necessary, please contact your local system administrator.

Gender: female

Gender: male

Patient IDb)

b) The display of the patient ID in NHS format (required in the United Kingdom) is possible. The adjustment is carried out in the Service Tool. Please contact your system administrator if necessary.

Date of birth (age)

Patient’s name

If the patient has additional name information (ideographic or phonetic representation), the area for the patient identifica-tion is enlarged and the second completed name group below the patient ID displayed. Any existing third item of name information is displayed in the tool tip.

CAUTION Delayed treatmentRA520 If patient data is displayed without the patient's name, this data is not to be

used for subsequent medical assessment or review of diagnostic data.

FORUM Clinical View: Document Display

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Document Display

The Document Display is used to display and edit documents stored in FORUM (no raw data). The documents to be shown in the working area of the Document Display can be opened manually by the document selection or automatically by preselecting from Clinical Displays (see also section "Clinical Displays" on page 116).

When changing from the Patient Directory to the Clinical View, the Document Display is automatically enabled. As soon as documents are opened, the working area of the Document Display becomes visible and the tools that are available are enabled.

See also section "Work area (Document Display)" on page 83 and section "Toolbar" on page 90.

Clinical Displays

The Clinical Displays offer preselections for opening documents for various syndromes in the Document Display.

See also section "Clinical Displays" on page 116.

FORUM Workplace Plugins

Optional FORUM Workplace Plugins are displayed below the Clinical Displays. They provide preselections which ideally preselect and represent the data in conjunction with the Workplace Plugins.

Each of the FORUM Workplace Plugins has its own workspace with specific tools and functions.

Preselections, tools, and functions are described in the respective Instructions for Use of the FORUM Workplace Plugins.

Clinical View: Document selection FORUM

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Document selection

Using the document selection it is possible to manually select the documents to be displayed in the workspace.

The document selection has three different appearances:

– expanded (maximum size):the visit selection is shown, the preview section is maximized, and the workspace is hidden

– expanded (minimum size):the visit selection is shown, the preview section is minimized, and the workspace is partially visible

– collapsed (gray bar on the right-hand edge of the screen):the visit selection and the preview section are hidden, and the workspace is completely visible

The document selection contains the following elements at maximum and minimum size:

Visit selection with filter option (see page 77)

Preview section (see page 78)

Thumbnail gallery (see page 80)

Thumbnail (see page 80)

Buttons for controlling document selection

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FORUM Clinical View: Document selection

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Control of document selection

Collapse document selectionThe document selection is collapsed as follows:

– With a click in the gray area at the right-hand edge.

– By opening a document in the full-screen view.

– By opening documents in the workspace (see page "Opening documents" on page 97).

– Click .

– If the preview section is displayed with its minimum size:Click .

– By clicking on a document in the workspace.

– By clicking on a tool.

Expanding a document selectionThe document selection can be expanded as follows:

– By opening the Document Display (maximum size)

– By clicking in the gray area on the right-hand edge (minimum size)

– By clicking on (minimum size)

– By clicking on (maximum size)

– By clicking on <Close all> in the toolbar (minimum size)

Visit selection with filter option

This section displays all of the appointments (visits) for which data is stored in FORUM for the patient who is currently selected. The visits are arranged and displayed in descending order of date.

By default, the most recent visit is selected when changing from the Patient Directory to the Clinical View. The associated thumbnail gallery is displayed with all of the documents contained in the Document Display that can be displayed1 in the preview section.

The visit selection can be changed as desired, with the selection of more than one visit being possible. A configurable filter makes it possible to reduce the visits displayed.

1) Documents which cannot be displayed in FORUM can be displayed using a placeholder image. For this purpose, the "Show icons (e.g. OCT scans)" function must be enabled (see page 26).


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The visit selection has the following buttons:

Preview section

In the preview section, a thumbnail gallery with thumbnails is displayed for each date selected in the visit selection.

If it is not possible to display all thumbnail galleries at the same time, a scroll bar appears in the preview section at the right-hand edge. Thumbnail galleries are arranged and displayed in descending order according to the date of the visit.

The preview section can be displayed in two sizes:

– MaximumThe workspace is hidden; the space up to the toolbar is used for the preview section.In order to maximize the preview section, click on .

– MinimumThe preview section is just large enough that one line of a thumbnail gallery with thumbnails can be displayed.To minimize the preview section, click on .

Filter settings

Filtering the visits and documents.If a filter is enabled, the button turns blue and is provided with a tab close button to delete the filter.

See also section "Filtering visits and documents" on page 96.

Refreshes the screen contents.

Upon switching to the Clinical View, all of the data available for the selected patient is retrieved. This data is not automat-ically updated.

To see changes made during the session by another user, or to retrieve newly received data, it is possible to perform a dis-play update manually with this button without having to leave the Clinical View.

Newly received data is displayed at the bottom left-hand edge of the screen by a corresponding remark.


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The preview section contains the following elements:

Add Opens selected documents in addition to the documents already displayed in the currently enabled workspace (of the Document Display or a FORUM Workplace Plugin).

Document Display

Opens selected documents in the workspace of the Document Display.

Any documents already open are closed, i.e. the displayed documents are completely exchanged.

... In the case of additionally installed FORUM Workplace Plugins there are further menu entries available by means of which the selected documents can be opened directly in the workspace of a particular plugin. The preconditions for this are described in the Instructions for Use of the particular FORUM Workplace Plugin.

Start Review Softwarea)

a) This function is only available if review software appropriate to the selected document is installed on the computer. Review software can be installed separately for examina-tion devices (e.g. for CIRRUS HD-OCT, Stratus OCT, GDxPRO). Please contact your ZEISS sales partner or ZEISS Service if necessary.

Launch the review software appropriate to the selected document.

The review software can be used to view and evaluate the original files generated by the examination device.

DeviceLaterality

Selector switch for the primary sorting criterion of the thumb-nails in the thumbnail galleries, as well as the documents in the workspace. By default, the laterality is preselected as the primary sorting criterion (blue selector switch).

See also section "Sorting" on page 84.

Selected X Number of the documents currently selected in the preview section.


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Thumbnail gallery

For each selected visit, a separate thumbnail gallery is displayed in the preview section. Each thumbnail gallery contains thumbnails of documents which are available (displayable) for this visit.

If there is no (displayable) data available for a visit, the visit is not displayed.

Each thumbnail gallery begins with a date range in which the associated visit date is displayed.

Thumbnail galleries which are not required can be closed again:

– by means of the tab close button.

– by deselecting the corresponding visit.

A thumbnail gallery can also be closed if the documents it contains are open in the workspace. The open documents continue to be displayed.

Thumbnail

Each displayable document that is available for the selected visit in the FORUM is displayed with a thumbnail in the thumbnail gallery.

StructureA thumbnail contains the following elements:

– Header with the following information:

– Time of compilation

– Document type

– Laterality

– Status bar with icons (see section "Status line" on page 88)

– Image area (representation of the document with a low resolution)

The structure of a thumbnail is identical to the structure of a display window in which the open document is displayed in the workspace (see section "Display windows" on page 85).


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StatusThe thumbnails can have the following status:

Hidden documents

The following data is not displayed in FORUM:

– Data sent from examination devices in the form of raw data to FORUM.

– OPV (Ophthalmic Visual Field) data

– If a license is installed for the optional "FORUM Glaucoma Workplace" plugin, the following reports are also not displayed in the thumbnail gallery:

– GPA1 and overview reports created from FORUM Glaucoma Workplace where a newer report exists that contains the same information

– Individual HFA reports from examinations for which additionally a report exists that has been created via FORUM Glaucoma Workplace

– Older reports created via FORUM Glaucoma Workplace that have been replaced by a new one

The older (hidden) reports can be found and displayed via the "filter" function (see section "Filtering visits and documents" on page 96).

Reports labeled as a "Favorite" are never hidden.

Normal

The cursor is located above the thumbnail.

The status line is displayed.

For a short time, additional document information is displayed.

The thumbnail is selected.

1) GPA = Guided Progression Analysis.


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If a visit only contains data which is not displayable, the visit is not listed in the visit selection. If this data is to be shown, the "Show icons (e.g. OCT scans)" has to be enabled (see page 26). Then visits with data which is not displayable also appear in the visit selection, and in the thumbnail gallery the documents are displayed using placeholder images.

Fig. Placeholder image: Example "OCT scan"

FORUM Clinical View: Work area

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Work area (Document Display)

The Document Display and all FORUM Workplace Plugins have a workspace1 in which the open documents and/or data can be processed and compared. The workspace is located behind the document selection and becomes com-pletely visible as soon as documents are opened or the document selection is collapsed.

In the workspace of the Document Display it is possible to open up to 24 doc-uments simultaneously. The documents are arranged in a matrix according to the type of sorting selected in the preview section.See also section "Interaction between the preview section and workspace" on page 83.

Interaction between the preview section and workspace

Synchronization

There is no synchronization between the preview section and the workspace. This has the following effects:

– Documents which are closed or hidden in the workspace remain selected in the preview section until the selection is cancelled by selecting one or more other thumbnails.

– If a visit is deselected for which documents are open in the workspace, the thumbnail gallery is no longer displayed, but the documents are not closed.

– Whether a document can be displayed is only determined when it is opened. This means that although it is possible to select all of the docu-ments available in the thumbnail galleries for a display, these are only opened if the data is displayable. In the case of non-displayable data, only the thumbnail is shown in an enlarged form.

1) The working areas of the document display and the FORUM Workplace Plugins have differ-ent specific functions. The working areas of the plugins are described in the Instructions for Use of the FORUM Workplace Plugins concerned.

NOTE Please note that data transfer is delayed or interrupted if the available network bandwidth is insufficient.RA503

Clinical View: Work area FORUM

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Matrix

The matrix determines the maximum number of documents which are display-able in the workspace, as well as their arrangement. A maximum of 24 docu-ments can be displayed at the same time. If an attempt is made to open more than 24 documents, an error message appears.

When documents are opened, FORUM automatically selects the appropriate matrix for the display.

If documents are closed in the workspace, the matrix is not automatically adjusted. In place of the closed documents, empty display fields remain in which drag-and-drop can be used to open other documents from the thumb-nail gallery.If you would like to reduce the size of the matrix and therefore rearrange the documents, this can be performed by selecting a corresponding matrix in the toolbar (see page 90). Documents which no longer fit in the matrix are closed.

By clicking on <Add> it is possible to open additional documents in the active workspace. Any empty fields are initially removed from the matrix, and then the newly retrieved (as yet unopened) documents inserted at the end. If necessary, the matrix is automatically enlarged.If the adding process causes the maximum number of displayable documents to be exceeded, an error message appears and the action is not performed.

The matrix can be changed at any time manually via the toolbar. If a matrix is selected which contains fewer fields than currently displayed documents, all of the documents which no longer fit into the matrix are closed.

Sorting

The method of sorting the thumbnails in the preview section also determines the order of the documents shown in the workspace (from top left to bottom right). By default, the primary sorting criterion is the "laterality" (blue selector switch). The thumbnails are then displayed within a thumbnail gallery in the following order:

– Laterality (OD, OS, OU, without laterality assignment)

– Device type

– Document type

– Time of compilation (descending, i.e. the most recent document first)

Exception: Documents of an angiography series are arranged in ascending order according to their offset.


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As an alternative, the user can use the selector switch to select the device type ("Device") as the primary sorting criterion.

If documents are added to the workspace or the arrangement of the docu-ments in the workspace is changed manually, the automatic sorting of the documents is cancelled.

Display windows

Each document is opened in a display window. The window of the enabled (selected) document in each case is indicated with a blue frame and a blue header.

Structure

A display window contains the following elements:

Header

Status line

Image section

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Header:The following information is displayed in the header of a display window:

– Visit date

– Time of compilation

– Document type

– Laterality

Status line:See section "Status line" on page 88.

Image section:In the image section of a display window, the contents of the document are displayed (image, report, ...).

Depending on the user-specific defaults, the document is displayed in its orig-inal quality or compressed. Compression is identified in the context-sensitive toolbar by the following icon:

If FORUM cannot display the contents, e.g. because the original document is no longer available, the following icon is displayed:


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Additional functions

Brightness/contrast adjustment with the mouse

• Hold the shift key down and click on the document to be edited.

The cursor is displayed with the following icon:

• Move the cursor horizontally to change the brightness or

• Move the cursor vertically to change the contrast.

• Click on the document again to switch off this function.

In the case of OPT images, the changes relate in each case to the currently displayed slice. Each slice can be changed separately.

The changes are stored in FORUM and in any installed FORUM Workplace Plugins. The original data on the server remains unchanged and can be restored at any time

See also section "Brightness/Contrast" on page 93.

Panning As soon as the display size of the document exceeds the field size and the mouse is above the document, the cursor is dis-played with the following icon: . Now the image section within the display window can be moved.

Change size with mouse wheel

• Position the cursor above the desired document.

• Turn the mouse wheel upwards to zoom in and down-wards to zoom out.

Full-screen view • Double-click on a displayed document.

The document opens and fills the screen in the full-screen view.

• Double-click again on the document displayed in order to close the full-screen view again.This is also possible with the <Esc> key or the <Close> button.


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Status line

Each thumbnail and each document displayed has a status line. In the status line, icons are displayed which provide information about certain document properties or enable the rapid retrieval of special functions.

The status line is located directly below the header. This is shown if the cursor is located above the image section and displayed permanently if at least one icon is enabled or the document is opened in the full-screen view.

Icons are arranged on the left of the status line which refer to specific docu-ment properties. Interactive icons are arranged on the right, e.g. the icons for "Comment" and "Favorite". With the interactive icons, the corresponding function can be performed by clicking on an icon (e.g. opening the comment window or changing the favorite status).

If the status line is not permanently visible, the status line is displayed with the following icons as soon as the cursor is located above a thumbnail or document:

If at least one of the following icons is enabled, the status line is displayed permanently:

Clicking on this icon marks the corresponding document as a "Favorite".


The comment window is opened by clicking on this icon.

See section "Comment function" on page 107.

The document is one of the following document types:

– Multi-page PDF document

– DICOM OPT document with several B-scans

The document is a video file.

See also "Play movie" on page 94.

Reference entry for a document from a different FORUM system.

See section "Load preview" on page 60.

Temporary copy

See section "Generating temporary copies" on page 61.


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The document has been edited (a measurement added, the bright-ness of the contrast changed).

A document marked as a "Favorite".

By clicking on this icon, the favorite status of the document is deleted.

See section"Marking favorites" on page 112.

The document contains a comment.

By clicking on this icon the comment window opens.

See section "Comment function" on page 107.

Clinical View: Toolbar FORUM

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Toolbar

In this area there are various tools available for displaying and editing the documents displayed in the workspace and full-screen view.The tools are only enabled if documents are open in the workspace or full-screen view.

The toolbar has general and context-sensitive tools. The general tools are available for all document types. The context-sensitive tools depend on the document type and are only shown if a corresponding document type is selected in the workspace or opened in the full-screen view.

Furthermore, there are plugin-specific tools which are only shown if the work-space of a FORUM Workplace Plugin is opened. The plugin-specific tools are described in the Instructions for Use of the particular FORUM Workplace Plugin.

General tools

Tools only available in the work area

Compare OD/OS Opens a specific arrangement of documents in the work-space for a direct comparison of documents of the right and left eye. Documents without defined laterality are hidden.

See also section "Compare OD/OS" on page 105.

Close all Closes all open documents in the work area.

Selection of a matrix for the arrangement of the documents displayed in the workspace. The first figure stands for the number of columns displayed, the second for the number of rows. The documents can be displayed in a maximum of 6 columns and 4 rows (6 × 4). This means that there is a maximum number of 24 displayable documents.

FORUM Clinical View: Toolbar

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Tools available in the workspace and in the full-screen view

Save as

Saves the active document to any desired storage location. Images are saved in *.jpg format, reports in *.pdf format, and videos in *.mpeg format.

The active document can also be saved as a DICOM file. To do so, the "DICOM" (*.dcm) format must be selected in the "Files of type" field. In this case, the original data is saved in its entirety.

Print

Prints the active document.

Print all

Print all documents opened in the workspace.

Zoom out

Decreases the display size of the active document. The display is reduced in size with each click of this button.

Selection or input of a specific scaling factor. The active document is displayed in the size entered in this field. Values between 1% and 200% can be entered (only whole numbers).

The desired value can be entered directly in the field or set via the pop-up menu with the help of the slider bar. A manual input has to be confirmed with the <Enter> key.

Invalid values are displayed in red and have no effect on the display.

Zoom in

Increases the display size of the active document. The display is increased in size with each click of this button (max.: 200%).

As soon as the display size exceeds the field size, scrollbars appear on the right side and at the bottom of the display win-dow which make it possible to move the display section.

Fit to window

Fits the active document to the size of the display window. The entire document is displayed.


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Original size

Displays the active document in its original size (scaling factor = 100%). It is possible that only an image section is displayed in the display window. In this case scrollbars appear at the right-hand side and bottom of the display window which allow the image section to be moved.

Comments

Opens the comment function.

See section"Comment function" on page 107.

Marking of favorites. By clicking on this icon, the favorite status of the document is set or deleted.


Hide Overlays Not active in FORUM. This function is only available in the FORUM Workplace Plugins.

FORUM Clinical View: Toolbar

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Context-sensitive tools

Note on the display of compressed data.

The data is not displayed in the original quality in order to achieve a faster transfer rate. In order to change this user-specific setting, please contact your local system administrator.

Measurements

Length measurement in calibrated fundus images

Opens the measurement function.

See section "Measurement function" on page 109.

Brightness/Contrast

Image files

Opens the brightness and contrast settings for the active doc-ument, or for the slice displayed in the case of OPT images.

In the window the current settings in relation to the original document are displayed.If changes are made to the document, these are visible imme-diately. If the changes are saved, the icon is displayed in the status line.

Changes are saved and also displayed in any installed FORUM Workplace Plugins.The original data on the server remains unchanged and can be restored at any time.

The original settings are stored by clicking on <Undo> (in the case of OPT data only for the displayed slice).


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Play movie

Video files

Opens the "Video player control" window.

The selected video plays automatically.

Start

Plays video from the beginning.

If the <Pause> button was clicked while play-ing the video, the video continues from this point.

Pause

Pauses video.

Clicking on the <Start> button continues the video.

Stop

Stops and closes the video. The "Video Player Control" window remains open so that video playback can be restarted at any time.

Positionen Displays the currently shown time in the video.

Trims In this progress bar it is possible to move the two squares at the beginning and end of the bar to select a video sequence to be stored.

Save

Storing the complete video or the defined sequence as a video at any location (as a DICOM file or in *.mpeg or *.mpg format).

Close

Stops playback of the video and closes the "Video Player Control" window.

Previous

OPT data/PDF documents/image series (multipage)

Displays the previous or following page of PDF documents, the previous or following image in image series, and the pre-vious or following slice in OPT data.

Following

X / Y X: Number of the currently displayed page or slice or the dis-played image with the option of directly entering the number to be displayed.

Y: Total number of pages, slices, or images available

FORUM Clinical View: Actions

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Actions

A patient is selected in the Patient Directory, and the documents to be displayed are selected in the Clinical View.

Selecting a patient

Actions • Open the Patient Directory (see section "Patient Directory" on page 33).

• Select the desired patient (see section "Patient search" on page 29).

Opening the Clinical View

Actions • Double-click in the Patient Directory on the desired patient.

Result The Clinical View is opened, the document selection expanded, and the preview section displayed in its maximum size.

In the area for patient identification, all patient data is displayed, which enables a quick check of the identity of the patient.

In the visit selection, all of the visits stored for the patient in FORUM are listed. The most recent visit is selected.

The thumbnail gallery for the latest visit is displayed with all displayable documents.If there are no (displayable) documents available for the latest visit, the thumbnail gallery is displayed, but does not contain any thumbnails.

Clinical View: Actions FORUM

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Filtering visits and documents

In order to reduce the visits and thumbnails displayed in the document selec-tion, a filter can be enabled in the visit selection. After the desired filter criteria have been entered, only the visits are displayed which contain the documents corresponding to the filter criteria. The thumbnails displayed in the thumbnail galleries are also filtered.

By clicking on above the visit list, the "Filter" window appears for defining the filter criteria:

Filtering can be performed in the following categories:

– LateralityThe documents must display the selected or at least one of the selected lateralities.

– Device type ("Document types per device")Only the device and document types which are present are displayed. The figure in parentheses after the document types indicates the respective number of documents available (if appropriate, depending on the selected laterality).The documents must correspond to at least one of the selected device or document types.

– Specific editing properties ("Only ...")The documents must have all of the selected properties.

The three categories in turn are subject to an "AND" link, i.e. the documents searched for must have both the selected laterality and correspond to one of the selected device types and all of the checked "Only" properties if applicable.


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If the "Include Hidden Documents" checkbox is enabled, visits and documents are also displayed to which the filter criteria apply in documents which cannot be displayed in FORUM (see also section "Hidden documents" on page 81)1.

If a filter is enabled, the button is highlighted in blue:

With the tab close button it is possible to reset the filter so that all of the visits and documents available for the patient are displayed again. By clicking on the button again, the "Filter" window is opened and the filter criteria can be changed.

Opening documents

Documents can be opened automatically by preselections or manually via the document selection. In the manual selection, the documents can be selected from different thumbnail galleries (visits).

For the selection of visits and documents, please also refer to section "Multiple selection" on page 28.For the interaction between the preview section and the workspace (arrange-ment and sorting of the documents etc.) please note the corresponding section on page 83.

There are three ways of opening documents manually:

<Add> button:

Of the documents selected, all of those which have not yet been opened in the currently enabled workspace are opened and added to the end of the matrix. Any documents already opened remain open.

<Document Display> button:

The workspace is completely emptied first of all (all open documents are closed), then the selected documents are opened in the workspace of the Document Display or – if a submenu item is selected – in the selected workspace.

1) The "Show icons (e.g. OCT scans)" function must be enabled (see page 26).


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Drag&Drop:

The selected documents are opened in the desired position in the matrix. It is possible to drag a single or several documents into the workspace at the same time.Documents can be positioned as follows using drag-and-drop:

– Dragging to a free display fieldIf more than one document is selected, any subsequently opened docu-ments are replaced.

– Dragging to an opened document (the document is replaced)If more than one document is selected, any subsequently opened documents are also replaced.

– Dragging between a document, in front of the first one, or to the end (the target position is displayed by a white bar).If several documents are selected, any subsequently opened documents are moved to the end of the matrix and the size of the matrix adjusted if necessary.

If several thumbnails are dragged into the workspace using drag-and-drop, the documents are opened in their target position in the same order as in the thumbnail gallery, with the first document being arranged in the target posi-tion and all subsequent documents directly after it.

For the behavior of the matrix, see also section "Matrix" on page 84.

Changing the position of the documents

The open documents can be moved to another position in the workspace using drag-and-drop:

– Dragging the header of a document to another free display field

– Dragging the header of a document to another document in order to exchange positions with this document

– Dragging the header of a document to the start (top left), between two documents, or to the end (bottom right)

If the automatic arrangement of the documents is changed in this way, the automatic sorting of the documents is also disabled (see section "Sorting" on page 84).


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Closing documents

In order to close an open document, click on the tab close button in the top right hand corner of the display window.

In order to close all open documents, click in the toolbar on the <Close all> button.

Opening a document in full-screen view

For a detailed view of individual documents, these can be opened in the full-screen view.

Opening the full-screen view

– Double-click on a document in the work area

– Double-click on a thumbnail

Closing the full-screen view

– Click on <Close>

– <ESC> key

– Double-click on the displayed document


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Editing a document

Documents displayed in the workspace or full-screen view can be edited as follows:

– Saving as a file

– Printing

– Adding a comment

– Adding measurements (in the case of calibrated fundus images)

– Marking as a "Favorite"

– Changing the brightness/contrast

– Storing a video (sequence)

See also section "Toolbar" on page 90ff.

FORUM Clinical View: Additional functions

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Additional functions

Context menu

Some functions are also available via the context menu so that they can be accessed quickly. The context menu is reached with a right click of the mouse on an individual thumbnail or a selection of thumbnails or on a document opened in the workspace or in the full-screen view.

The context menu is context-sensitive, i.e. for the functions that are available all of the selected documents must fulfill the respective conditions. Functions which cannot be invoked are not visible.

The following applies in the preview section:

– With a right click of the mouse on a selected document, all functions are available via the context menu which are valid for all currently selected documents.

– With a right click of the mouse on a thumbnail that has not been selected, all functions are available which are valid for this document even if other thumbnails are selected. The respective functions are then also listed exclusively for this document.

The following functions can be invoked for open documents via the context menu:

Display DICOM Header

Displays all information contained in the DICOM Header, as well as the storage location of the DICOM file.

Start Review Softwarea)

a) This function is only available if review software appropriate to the selected document is installed on the computer. Review software can be installed separately for examina-tion devices (e.g. for CIRRUS HD-OCT, Stratus OCT, GDxPRO). Please contact your ZEISS sales partner or ZEISS Service if necessary.

Launches the review software appropriate to the selected document.

The review software can be used to view and evaluate the original files generated by the examination device.

Clinical View: Additional functions FORUM

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Layer images (OCT B-scans, OPT data)

Slice images generated by OCT devices which are transmitted as DICOM files of the "OPT" type to FORUM can be viewed slice by slice. If the data contains a link to a fundus image or LSO image, this is displayed above the OPT image. Depending on the imaging mode with which the OPT image was generated, a different number of slice images are available. A blue line displayed in the fundus/LSO image is used for orientation purposes when viewing the various slices.

Create Combined Reporta)

a) This function is only available if a corresponding license is installed.

Generates a combined report from the selected single docu-ments.

See section "Generating a combined report" on page 114.

Workplace ... The additionally installed FORUM Workplace Plugins provide specific functions in this context menu (e.g. the option of opening the selected documents directly in the workspace of the plugin concerned). The functions and the prerequisites for this are described in the Instructions for Use of the associated FORUM Workplace Plugin.

CAUTION Incorrect treatment of a patientRA510 When viewing image results of an ophthalmic tomography exam, the

T/N-indication is not displayed if the visible OPT-image is less than 88 pixels on your monitor in height. The missing T/N-indication may lead to not knowing the scan-direction of the displayed image; correlation between the colored line in the OP image and the OPT image below it may not be obvious.

Decrease the number of rows in the screen arrangement to trigger the visualization of the T/N-indicator.


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Fig. left image = CIRRUS imaging mode "CIRRUS HD 5 Line Raster"right image = CIRRUS imaging mode "CIRRUS Macular Cube"

Depending on the information contained in the dataset, the thumbnail of the OPT image shows either a slice marked as the fovea level or the central slice of the image. Upon opening the OPT image in the workspace, this slice is also displayed first.

If the fundus/LSO image does not contain all of the relevant information, it is displayed in the Document Display together with the OPT image, but without the orientation line for the slice currently being viewed.


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Viewing different slices:

It is also possible to view slice by slice OPT images without linked fundus/LSO images and OPT images for which the linked fundus/LSO image is not avail-able in FORUM. In the former case the OPT image is represented without a fundus/LSO image, while in the latter case the following icon is depicted above the OPT image instead of the fundus/LSO image:

Scrolling with the mouse wheel

If the cursor is above the fundus image, it is possible to scroll through the individual slices quickly with the scroll wheel.

Click in the fundus/LSO image

Display of a specific slice.

The slice is displayed which is closest to the position of the click.

Previous

Display of the slice above the currently selected one.

Following

Display of the slice below the currently selected one.

X / Y X: Number of the slice currently displayed with the option of directly entering the number of the slice to be displayed.

Y: Number of the total slices available


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Compare OD/OS

The OD/OS comparison enables a direct comparison to be made between documents of the right and left eye in the workspace. By enabling this func-tion, the workspace is divided vertically and the documents which are already open arranged in the two halves according to their laterality (left "OD", right "OS"). Documents which apply to both eyes ("OU") are shown in both sec-tions, whereas documents without any laterality assignment are hidden.

The behavior of the matrix and the sorting of the documents is analogous to the normal view (see section "Interaction between the preview section and workspace" on page 83). The maximum number of displayable documents applies to both sections of the display together, i.e. in each section it is possi-ble to show a maximum of 12 documents.


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Actions • Enable the function <Compare OD/OS> in the tool bar.

Documents which are already open are arranged according to their laterality in the corresponding sections, whereas documents without any laterality assignment are closed.

• Open the documents to be compared (see section "Opening documents" on page 97).

In the OD/OS comparison it is only possible to open documents via the <Add> button or by drag-and-drop. By clicking on <Document Display> the OD/OS comparison is closed.

Result A matrix is automatically selected which matches the number of open documents. The matrix is always the same for both sections, i.e. the selected matrix is determined by the section with the most documents.

The documents are arranged in the matrix (from top left to bottom right) in each section in accordance with the sorting selected in the preview section. See also section "Sorting" on page 84.

Documents with the laterality "OU" are displayed in both sections ("OS" and "OD").

If documents are opened using drag-and-drop, it must be ensured that all of the documents have the laterality of the target section. Documents with an inappropriate laterality are rejected and a corresponding message is dis-played.


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Comment function

FORUM offers the option of adding comments to documents. Any number of comments can be added to each document. The comments entered are listed in descending chronological order by their creation date and author.

Adding a comment

Actions • Click in the status line on the icon or in the toolbar on the correspond-ing button.

• Enter the desired comment in the text field.

The entry is limited to a maximum number of 10,240 characters. It is possible to enter line breaks or to copy text into the input field.

• Save your entry by clicking on <Add>.

• Enter a further comment if applicable.

By clicking on <Close> the dialog window is closed. Entries not saved using <Add> are deleted.


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Result The comments are saved to the selected document.

The status line is permanently displayed from now on.

The comment icon changes as follows:

Comments are also available to other connected FORUM systems via the function "Remote Data" (see section "Remote data (MultiSiteQuery)" on page 59).

A temporary copy with an added comment is automatically imported fully into FORUM (see section "Importing temporary copies" on page 62).

The automatic transmission of documents does not include the comments.

Displaying comments

Actions • Click in the status line on the icon or in the toolbar on the correspond-ing button.

Result The "Comments" window opens and displays all entered comments for the document.

Once comments have been stored, they cannot be changed or deleted. Fur-ther comments can be added at any time to those which are already present.


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Measurement function

FORUM offers the option of performing measurements in fundus images 1 and storing the measurement result for the image.

Performing measurements

Prerequisite The document on which the measurement is to be carried out is a calibrated fundus image.

The area to be measured is displayed completely in the workspace or in the full-screen view.

Actions • In the workspace, select the document on which you would like to carry out the measurement or open it in the full-screen view.

• Position the image section in such a way that the area to be measured is as central as possible.

• Click on the tool .

• Click with the left mouse button on the starting point of the measurement and hold down the mouse button.

• Drag the mouse to the target point and release the mouse button.

A line marks the distance between the start point and the respective current mouse position.

The measurement is stopped if the mouse button is released outside of the displayed document.

1) The measurements performed in FORUM are based on the scaling information made available from the DICOM Header of the corresponding fundus image.


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Result

The measurement result is displayed in "mm" to two decimal places in a frame next to the start point on the measurement line that has been drawn.

The measurement is saved to the document and is also available in other connected FORUM systems via the function "Remote Data" (see section "Remote data (MultiSiteQuery)" on page 59).

A temporary copy in which a measurement is taken is completely imported into FORUM (see section "Importing temporary copies" on page 62).

Where documents are transmitted automatically, the measurements do not accompany them.

Measurements are retained until they are deleted by the user. Existing mea-surements are shown in the workspace and in the full-screen view, provided that they are positioned within the visible area.

A line extending from the starting point to the target point is displayed.


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Changing/deleting measurements

Actions • Open the document concerned in the workspace or in the full-screen view.

• Click on the tool .

• Activate the measurement to be amended or deleted by clicking on the associated line.

• To change the line, click with the mouse on one of the endpoints and move it to the desired position while holding down the mouse button.

• In order to delete the measurement, press the "Del" key.

The endpoints of the line are displayed as green squares.

The line is shown in Violet.

CAUTION Incorrect treatment of a patientRA525 If the frame surrounding the measurement value is not completely displayed,

parts of the measurement value might be outside the visible area. In this case please move the framed measurement value completely to the visible area.


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Marking favorites

Documents can be marked as a "Favorite" as follows:

– In the thumbnail, workspace or full-screen view by clicking on the favorite icon in the status line.

– In the workspace or full-screen view, also via the corresponding button in the toolbar.

If a document is marked as a favorite, this is shown by the following icon in the status line and in the toolbar:

The favorite status has the following effects:

– The status line is displayed permanently.

– In the search for patients or visits, it is possible with the help of the favorite filter to reduce the data quantity displayed (see section "Filtering visits and documents" on page 96).

– A temporary copy is completely imported into FORUM (see section "Importing temporary copies" on page 62).

– Documents marked as a "Favorite" are preferentially used in the selection criteria of the "preselections" (see section "Clinical Displays" on page 116).

– Reports marked as a "Favorite" are not hidden even if there are more recent reports.

The favorite status is deleted again by clicking once more on the icon or the button in the toolbar.

The favorite status is also available in FORUM Workplace Plugins and can also be changed in these.


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Scrolling through PDF documents / image series

If multipage PDF documents or image series are displayed in the workspace or in the full-screen view, it is possible to scroll between the individual pages/images or change directly to a specific page number or image number. In addition to the tools for scrolling (see page 94), there is a menu available for scrolling and entering a page number which is superimposed in the lower section of the image as soon as the cursor is located in this area.

Prerequisite A multipage PDF-document or an image series is open in the workspace or full-screen view.

Actions • Move the cursor to the middle of the lower edge of the image.

• Click on the superimposed keys or in order to scroll between the pages / images.

or

• Enter the desired page or image number in the text field.

Result The desired page or the desired image is displayed.

The pop-up menu is displayed.


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Generating a combined report

If FORUM Glaucoma Workplace or an optional additional license is installed for compiling combined reports, new combined reports can be generated from individual reports available in FORUM. The result is PDF documents in which structural and functional examination data from the source documents (including graphical elements) are combined.

A combined report is automatically generated as soon as a report on a patient is read in which can be combined with a document that is already available1. However, manual generation in the case of documents which are already stored is also possible as described below.

Combined reports can be compiled for the following combinations:

Prerequisite A corresponding license is installed.

The selected source documents have one of the following formats:

– CIRRUS RNFL Thickness Report or CIRRUS ONH and RNFL Thickness Report (from CIRRUS 5.0 or higher)

– HFA SFA (from HFA-2i version 4.2.2 or higher)

It is possible to combine one to two visual field documents with a CIRRUS document.

Option

1) Here, temporary copies from other connected FORUM systems are also taken into account.

HFA report CIRRUS report

Left eye Right eye Left eye Right eye Both eyes

× × ×

× × ×

× × ×

× ×

× ×

× ×

× ×


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Actions • In the thumbnail gallery or workspace, select one or two HFA documents and a CIRRUS document.

• Right click with the mouse on one of the selected documents.


• Select the function "Generate combined report".

Result A combined report is generated. All of the texts available in the source documents are taken over in the original language (source language). The language of all newly generated text elements corresponds to the source language, in the case of different source languages of the texts from the visual field examination (provided that this language is supported by FORUM). If the source language is not supported by FORUM, the new text elements are created in English.

The combined report is stored as a document for the selected patient. The visit date corresponds to the compilation date of the combined report.

Clinical View: Clinical Displays FORUM

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Clinical Displays

The "Clinical Displays" offer predefined preselections for the following groups of clinical pictures:

– Cataract

– Glaucoma

– Retina

A specific combination of filter criteria is assigned to each preselection. By clicking on a preselection, all of the documents available for the patient are searched according to the corresponding filter criteria and the matching documents displayed in the workspace. A predefined matrix for the display is automatically selected.

The "Clinical Displays" offer a fast option for selecting and opening documents. The work with these documents is identical to the work with documents opened manually via the document selection.

Basic rules

The following basic rules apply when opening a preselection:

– At least one document contained in FORUM for the selected patient corresponds to the respective selection criteria.

– The documents to be considered were generated within a defined time span. The time span is the period that has elapsed between the most recent document found and the other documents to be considered.

– If there is more than one valid document of a type available, the document which is marked as a favorite is used (see section "Marking favorites" on page 112);If no document or more than one document is marked as a favorite, the newest document is used.

– The documents have an assignment to the selected laterality.

In the document selection, any existing reference entries are also taken into account. Matching documents are then loaded as temporary copies into FORUM and opened in the workspace (see also section "Remote data (MultiSiteQuery)" on page 59ff).

FORUM Clinical View: Clinical Displays

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Document types

Documents are assigned to different document types on the basis of pre-defined parameters so that they can be displayed in a preselection. For the assignment, certain values from the DICOM files are evaluated. These values include the SOP class, file type, device name, modality, and document name.


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Selection rules

Cataract

Cataract Displays documents which are often used as part of a cataract examination.

Laterality: OD, OS

Documents which are assigned to "OU" (both eyes) are also taken into account in each selection, while documents with-out an assignment are ignored.

Matrix: 1×3

If matching documents are not found for all display fields, the corresponding field remains empty.

Topography report (report on a cornea topography examination in PDF format, e.g. generated by ZEISS Atlas™).

CIRRUS-OCT report on macular thickness (report on a "Macular Thickness" analysis in PDF format, e.g. generated by ZEISS CIRRUS™ HD-OCT).

Biometric IOL Master Report (report on an optical biometric examination in PDF format, e.g. generated by an IOL-Master™).

Time span: All three documents must have been cre-ated on the same examination day and must not be more than 180 days old. The decisive aspect here is the examina-tion day of the newest of the three doc-uments. Documents marked as a favorite are preferred, even if they are older than the other documents.

Device name: contains "IOLMaster" or begins with "ATLAS"

Document title:

contains "Macular Thickness"


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Glaucoma

Glaucoma (OCT-VF-FI) Displays an OCT report, a visual field document, and a fundus image for the laterality selected.

Laterality: OD, OS

Documents which have an assign-ment "OU" (both eyes) are also taken into account in each selec-tion.

Matrix: 1×3

If matching documents are not found for all display fields, the cor-responding field remains empty.

OCT report (ONH or RNFL-analysis)

HFA_SFA report

Color-, red-free, or green fundus image

Time span: All three documents must have been created on the same exam-ination day and must not be more than 180 days old. The decisive aspect here is the examination day of the newest of the three docu-ments. Documents marked as a favorite are preferred, even if they are older than the other docu-ments.

Image type: contains "COLOR", "REDFREE", or "GREEN"

Document title:

contains "ONH" and "RNFL OU Analysis"

or "RNFL Thickness OU"

or "RNFL OU Thickness"

or "SFA"


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Glaucoma OU (OCT-VF-FI) Display of a combined report and fundus image for each laterality.

Laterality: OU

All documents are taken into account which have an assign-ment of "R", "L", or "B".

Matrix: 1×3


Colored fundus image of the right eye

A combined report generated by FORUM from an HFA and an RNFL.

Color fundus image of the left eye

Time span: All three documents must have been created on the same exam-ination day and must not be more than 180 days old. The decisive aspect here is the examination day of the newest of the three docu-ments. Documents marked as a favorite are preferred, even if they are older than the other documents.

Image type: contains "COLOR"

Document title:

contains "HFA Visual Field and CIRRUS RNFL Combined Report"


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Glaucoma Progression (FI) Display of fundus images of a specific time span for the selected laterality.

Laterality: OD, OS

Matrix: 2×2

If there are fewer than four docu-ments, the display fields move up in chronological order.

Oldest colored fundus image (earliest visit)

Second oldest colored fundus image (second earliest visit)

Second latest colored fundus image (penultimate visit)

Latest colored fundus image (last visit)

Time span: In each case the newest docu-ments of the first and second visit are taken into account, as well as those of the last (current) and pen-ultimate visit for which documents of the corresponding type were generated.

Image type: contains "COLOR"


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Glaucoma Progression (OCT-VF) Display of documents for the guided progression analysis.

Laterality: OU

All documents are taken into account which have an assign-ment of "R", "L", or "B".

Matrix: 1×4


Report on an "OPTIC DISC GPA" (CIRRUS), right eye

Report on a guided progression analysis, e.g. HFA GPA, right eye

Report on an "OPTIC DISC GPA" (CIRRUS), left eye

Report on a guided progression analysis, e.g. HFA GPA, left eye

Time span: All three documents must have been created on the same exam-ination day and must not be more than 180 days old. The decisive aspect here is the examination day of the newest of the three docu-ments. Documents marked as a favorite are preferred, even if they are older than the other docu-ments.

Document title:

contains "Guided Progression Analysis"

or "GPA"


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Retina

Retina Overview Display of fundus images, including individual phases of an angiography series for the selected eye.

Laterality: OD, OS

Matrix: 2×3

If matching documents are not found for all display fields, the corresponding field remains empty.

Colored fundus image Prerequisite:FA (=fluores-cence angi-ography) times in the datasets

red-free fundus image

Fundus angiography image, generated within 25 seconds of contrast medium adminis-tration

Fundus angiography image, generated between 26 and 60 seconds after contrast medium administration


Fundus angiography image, generated at least 121 seconds after contrast medium administration

Time span: All documents must have been created on the same examination day. In each case the newest fundus images are taken into account, as well as the four oldest images from the different phases of an angiography series.

Image type: contains "COLOR", "REDFREE", "GREEN", "FA", "FAG", or "ICG"


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Angiography (2 visits) Comparison display of corresponding phases of two angiography series.

Laterality: OD, OS

Matrix: 2×4

Top line: last visit

Bottom line: penultimate visit


Fundus angiography image, generated within 25 seconds of contrast medium administration



Fundus angiography image, gen-erated at the earliest 121 seconds after contrast medium administra-tion

Time span: In each case the oldest images from different phases of angiogra-phy series of the last (current) and penultimate visit are taken into account.

Image type: contains "FA" or "FAG" or "ICG"


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Choroidal Procedure Display of documents and reports with retinal, choroidal findings.

Laterality: OD, OS

Documents which are assigned a "B" (both eyes) are taken into account in each selection.

Matrix: 1×3


Fundus angiography image after contrast medium administration

OCT report (extended display)

OCT report (HD_images)

Time span: All three documents must have been created on the same visit day. The decisive aspect here is the examination day of the newest of the three documents.

Image type: contains "FA" or "FAG" or "ICG"

Document title:

contains "Advanced Visualization"

or "High Definition Images"

or "FA" or "FAG" or "ICG"


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AMD Progression (OCT) Display of OCT documents (Reports on "Macular Thickness" Analyses) for a progression analysis for the selected laterality.

Laterality: OD, OS

Matrix: 1×4

If suitable documents are available for fewer than four visits, a corre-sponding number of display fields remains empty from right to left.

Most recent report of the oldest visit

Most recent report of the second oldest visit

Most recent report of the penulti-mate visit

Most recent report of the last visit

Time span: In each case the newest docu-ments of the first and second visit are taken into account, as well as those of the last (current) and pen-ultimate visit for which documents of the corresponding type were generated.

Document title:

contains "Macular Thickness"

FORUM Troubleshooting

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Troubleshooting

Malfunctions

Malfunction Cause/procedure

A combined report is generated The requirements for the maximum name links in the CIRRUS report have not been fulfilled:

– The patient's last name consists of more than 20 characters

– The middle name consists of more than 20 characters

– The first name and the middle name of the patient consist together of more than 20 characters

– The patient's first and last name together consist of more than 20 characters

The CIRRUS report was generated by a CIRRUS version <5.0.

The HFA report was generated by a version <4.2.2.

When videos edited in FORUM are displayed, the time display is wrong.

When videos are displayed which have been stored as an excerpt from another video in FORUM, an incorrect time may be displayed. This might also result in incorrect video sections being stored when such videos are edited again.

You should therefore not rely on the time displayed in edited videos.

A new license has been success-fully installed using the function <Help><Upload License file>. Nevertheless, the corresponding function is not available.

Log out as a user in the FORUM client application and then log in again. New functions are only available after a renewed login.

Troubleshooting FORUM

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Error messages

As a rule, error messages contain meaningful information with solutions for the user. If an error occurs which you cannot correct using the following information, mark the product as out of order and contact the ZEISS Service Department.

The following table contains all of the error messages which are not self-explanatory.

Area of the software

Error message Cause Procedure

Overall No connection to server <Hostname or IP address>

The server processes are stopped or the settings for the firewall on the server are not correct.

Check whether the server pro-cesses have started correctly, and check the set-tings for the fire-wall on the server.Then start the FORUM client application again.

No network con-nection, server: <Hostname or IP address>

The network connec-tion has been inter-rupted, or the settings for the firewall on the server are not correct.

Check the net-work connection and the network settings, as well as the settings for the firewall on the server.Then start the FORUM client application again.

FORUM Troubleshooting

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Login Login failed The username does not exist or the password that has been entered is wrong.

Please check the capitalization.

When logging onto the FORUM client applica-tion on the computer on which the FORUM server is also installed:

The name of the user logged on to the Windows® operating system of the FORUM server does not satisfy the name requirements. If neces-sary, please contact your local system administrator.

Check the name of the user logged onto the Windows® oper-ating system on the FORUM server and log on if necessary with a different user.

Area of the software

Error message Cause Procedure

Troubleshooting FORUM

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FORUM Index of technical terms

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Index of technical terms

Accession No. A unique order number. Each order scheduled in FORUM is provided with a unique number, the so-called "accession number". All of the examination requests contained in an order are assigned the same accession number. With this number they are transferred to the examining devices. All examination data are saved to this number. When the data are read into FORUM, they are identified on the basis of the accession number and assigned to the corre-sponding order.

AE Title (AET) Application Entitiy Title

Every device and every DICOM application in a DICOM network is provided with a unique name (AE Title).

Together with the IP address or the computer name, the AE Title allows the clear addressing and therefore the specification of unmistakable communica-tion partners. The computer or the device is clearly identified by the IP address or the computer name. The service that belongs to the AE Title is connected to a specific port on which it listens for incoming connections. The AE Title also enables the differentiation of the software that is installed on it.

Clinical Displays Clinical Displays make it possible to open documents for certain clinical pictures in accordance with predefined filter rules.

DICOM Digital Imaging and Communications in Medicine

DICOM is an open standard for exchanging medical images and image-related information. DICOM stipulates in which format data are stored and with which communication protocol they are exchanged. The DICOM standard is mainly used in image-processing systems.

The DICOM standard describes:

– Data format for medical images and image-related data

– Network-oriented services, e.g. image transmission, querying an image archive (PACS), printing (hardcopy) and integration of RIS-PACS modality

– Formats for storage media exchange

– Requirements for devices and software

In the data format, entries are defined which contain information about the examinations performed on a patient. The examination results are stored in the form of image data, reports, or signals. Examples of the image-related information that is stored are the device parameters, time of the examination, etc.

Index of technical terms FORUM

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A DICOM dataset contains all of a patient’s master data (so-called "meta data") such as the patient's name, date of birth, patient ID, etc.

DICOM enables data to be stored and transmitted in compressed or uncom-pressed form. The compression can be lossy or non-lossy.

For the transmission of data without complications via a network, the DICOM standard stipulates how devices and applications must behave in order to be able to establish a connection with one another.

For the user, the DICOM standard has the advantage that if there is confor-mity, the interoperability between various medical applications ("application entity") and devices from different manufacturers is guaranteed.

DICOM defines the data structures by mapping the real world into the units of "patient", "study", "series", and "objects". In FORUM a "series" is desig-nated an "examination" and an "object" a "document". Several studies (e.g. several hospital stays) can be assigned to a patient, several examinations (e.g. results of various examination devices) to each study, and in turn several documents (individual images of an examination) to each examination.

Document A document corresponds to an "object" in the DICOM data structure. In this structure, an object is hierarchically the lowest information unit.

Each document is part of an examination, a study, and a patient.

EMR Electronic Medical Record

The electronic medical record represents the central electronic collection and management of all of the data relating to the course of the disease and treat-ment of a patient (findings, diagnoses, course of the treatment, result of the treatment, associated correspondence). The information on all of the medical fields involved, with their suitable formats and media (text, chart, image, film, sound), is collated for the documentation and made available.

FIFO principle First-in-first-out

This principle can be selected to ensure that no unnecessary disk space is used up if FORUM is only used to forward data from an EMR system. As soon as the maximum storage capacity of 100 MB is reached, the oldest data are over-written with the new data in each case.

HIS Hospital Information System

"HIS" always refers to a software application of another manufacturer. A hospital information system is the totality of all information-processing units for the processing of medical and administrative data in the hospital. This includes computer programs, people, and non-IT-based information systems.


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HL7 = Health Level 7. This is a group of international standards for the exchange of data between healthcare organizations working in healthcare and their computer systems.

"HL7" is used as the designation for the organization which develops and sup-ports standards in healthcare, as well as for versions 2.x and version 3 of the standards and other standards which are developed by the local HL7 organi-zations in 30 countries.

The number 7 in the name "HL7" refers to layer 7 of the ISO/OSI reference model for communication (ISO7498-1) and therefore expresses the fact that here the communication is described at the application level.

Source: wikipedia.de

Index No. In FORUM the datasets of a patient have a hierarchical relationship with one another. Each dataset is assigned an index number for this purpose in the database. The index numbers are combined according to the following system:

#Patient.#Study.#Examination.#Document

This system allows the hierarchical association of documents, studies, and examinations to be quickly identified.

LSO Laser Scanning Ophthalmoscope

Modality "Modality" is a collective term for various groups of imaging devices which is derived from the DICOM standard. The modalities are clearly assigned in DICOM systems. FORUM supports the following groups of devices:

– AR (Autorefraction)

– DOC (Document)

– GM (General microscopy)

– KER (Keratotomy)

– LEN (Lensometry)

– OAM (Ophthalmic axial length measurement)

– OP (Ophthalmic photography)

– OPM (Ophthalmic mapping)

– OPT (Ophthalmic tomography)

– OPV (Ophthalmic visual field)

– OT (Other)

– SRF (Subjective refraction)


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– US (Ultrasound)

– VA (Visual acuity)

– XC (External camera photography)

Multi-component name In various countries, personal names can be represented in more than one way. In addition to transliteration to the Latin alphabet (alphabetical represen-tation), a name can be represented by an ideographic depiction or an addi-tional spelling that shows the pronunciation of the name (phonetic transliter-ation).

OCT = Optical coherence tomography, OCT, is an examination procedure in which light with a short coherence length is used for the distance measurement of scattering materials with the help of an interferometer. The object under examination is scanned point by point. Its main field of application is medicine.

Source: wikipedia.de

OPV = Ophthalmic Visual Field"OPV" is the abbreviation specified by the DICOM standard for instruments used in ophthalmology which measure the visual field of a patient. Devices of this type are supposed to write data in the DICOM format "Ophthalmic Visual Field Static Perimetry Measurements IOD". As a result of the manufacturer-independent format it is possible that software products of other manufactur-ers can read these data.

Series DICOM subdivides all data into the levels of "Patient", "Study", "Series", and "Object". Several studies (e.g. several hospital stays) can be assigned to a patient, several series (e.g. results of different examining devices) to a study, and in turn several objects (individual images of an examination) to each series.Each series is therefore part of a study and patient and contains at least one object (document). In FORUM, a "series" corresponds to an "examination".

SOP class Service-Object Pair

An SOP class is a specific combination of an information object and transfer service. Each DICOM device supports various SOP classes. For the communi-cation between two DICOM devices, a common SOP class has to be defined and supported by the partners involved in the corresponding roles. One side acts as the Service Class User, the user of the service. The other side acts as the Service Class Provider, the provider of the service.

In addition to the SOP class, the transfer syntax used for the exchange of data must also match. If the two partners do not agree on a common pairing from the SOP class and transfer syntax, no data are exchanged.


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Study DICOM subdivides all data into the levels of "Patient", "Study", "Series", and "Objects". Several studies (e.g. several hospital stays) can be assigned to a patient, several series (e.g. results of different examining devices) to a study, and in turn several objects (individual images of an examination) to each series.Each study is therefore part of a patient and contains at least one series with the associated objects (documents).


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FORUM Index

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Index

A

Accession No. ........................................................................................ 131Accessories ............................................................................................... 12Additional functions ............................................................................... 101Address of the manufacturer ...................................................................... 2AE Title .................................................................................................. 131AET ........................................................................................................ 131Archiving system, limitations .................................................................... 20Automatic Orders ..................................................................................... 43

B

Buttons .................................................................................................... 27

C

CE conformity ............................................................................................ 7Changing the list display ........................................................................... 27Changing the list sorting .......................................................................... 27Clinical Displays ........................................................................................ 75

Basic rules ................................................................................... 116Document types .......................................................................... 117Filter descriptions ........................................................................ 118Preselections ............................................................................... 116

Code Meaning ......................................................................................... 71Combine reports .................................................................................... 114Combined reports .................................................................................. 114Comments ............................................................................................. 107Compare OD/OS ..................................................................................... 105Configuring FORUM, user profile .............................................................. 14Conformity (CE) .......................................................................................... 7Context menu ........................................................................................ 101Contraindication ....................................................................................... 21Create

New order (automatic) .................................................................. 43New order (manual) ...................................................................... 44New patients ................................................................................ 37

Create Patient ID ................................................................................ 36, 42Create, Patient ID ............................................................................... 36, 42Creating a patient data record .................................................................. 37

Index FORUM

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D

Data protection ........................................................................................ 18Definition of terms ..................................................................................... 6Delete

Document .................................................................................... 57Patient data record ....................................................................... 54

Depositing procedure codes ..................................................................... 70DICOM ................................................................................................... 131DICOM Header ................................................................................. 50, 101Display windows ...................................................................................... 85Displaying icons ....................................................................................... 26Displaying raw data ................................................................................. 26Document .............................................................................................. 132Document Display .................................................................................... 75Document View, see Document Display ................................................... 75Documents

Delete ........................................................................................... 57Import .................................................................................... 36, 66Move ............................................................................................ 55Reassign ....................................................................................... 55Sorting ......................................................................................... 84

E

Editing master data .................................................................................. 51EMR ....................................................................................................... 132Error messages ....................................................................................... 128Evaluating data, user profile ..................................................................... 16Extended search function ................................................................... 27, 30

F

FIFO ....................................................................................................... 132Filter ........................................................................................................ 96Filter descriptions (Clinical Displays) ........................................................ 118Filtering visits ........................................................................................... 96FORUM Viewer ........................................................................................ 23

Close ............................................................................................ 24Logout .......................................................................................... 24Start ............................................................................................. 23

G

General settingsDisplaying icons ............................................................................ 26Language ..................................................................................... 25

Glossary ................................................................................................. 131

FORUM Index

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H

Hazard symbols .......................................................................................... 5Header, DICOM ................................................................................ 50, 101Hidden documents ................................................................................... 81HIS ......................................................................................................... 132HL7 ........................................................................................................ 133

I

IconsPatient Administration .................................................................. 51Remote Data ................................................................................. 64Status line ..................................................................................... 88

ImportData from remote FORUM systems ............................................... 62DICOM Files .................................................................................. 69Documents ............................................................................. 36, 66

Import from FORUM systems ................................................................... 62Importing DICOM files .............................................................................. 69Index No. ............................................................................................... 133Index of technical terms ......................................................................... 131Indications for Use ................................................................................... 21Information on trademark law .................................................................... 7Information security ................................................................................. 18Information symbols ................................................................................... 7Intended use ............................................................................................ 21Interfaces ................................................................................................. 11

L

Layer images (OPT data) ......................................................................... 102Load preview ........................................................................................... 60

M

Malfunctions .......................................................................................... 127Managing data, user profile ..................................................................... 15Manufacturer's address .............................................................................. 2Marking favorites ................................................................................... 112Matrix ................................................................................................ 84, 90Measurements (fundus images) .............................................................. 109Modality ................................................................................................. 133Monitors .................................................................................................. 20Move (documents) ................................................................................... 55Multiple selection ..................................................................................... 28MultiSiteQuery ......................................................................................... 59

Index FORUM

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O

OCT ....................................................................................................... 134OCT scans ................................................................................................ 26OPT data ................................................................................................ 102Order

Automatic creation ....................................................................... 43Automatic generation ................................................................... 43Create manually ............................................................................ 44

Overview of functions ................................................................................ 9

P

PatientCreate .......................................................................................... 37Delete ........................................................................................... 54Editing master data ...................................................................... 51Merge .......................................................................................... 53Search .......................................................................................... 29Selecting ....................................................................................... 29

Patient Administration ............................................................................. 47Icons ............................................................................................ 51

Patient Directory ...................................................................................... 33Patient directory, see Patient DirectoryPlaceholder search ................................................................................... 31Play video ................................................................................................ 94Plugin (definition) ....................................................................................... 6Preselections .......................................................................................... 116

R

Reassign (documents) .............................................................................. 55Recording devices .................................................................................... 20Reference entry (icon) .............................................................................. 51Reference files, temporary ........................................................................ 60Refreshes the screen contents .................................................................. 27Remote Data ............................................................................................ 59

Icons ............................................................................................ 64Import .......................................................................................... 62Load preview ................................................................................ 60

Reset filter ................................................................................................ 27Resolving conflicts .................................................................................... 52

FORUM Index

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S

SaveDICOM files .................................................................................. 91Documents ................................................................................... 91

Save DICOM files ...................................................................................... 91Search function, extended ........................................................................ 30Search with placeholders .......................................................................... 31Security measures for IT systems and networks ........................................ 17Series ..................................................................................................... 134Setting the language ................................................................................ 25Software applications (optional accessories) ............................................. 12Software description .................................................................................. 8

Accessories ................................................................................... 12Interfaces ...................................................................................... 11Overview of functions ..................................................................... 9

SOP class ................................................................................................ 134Sorting

Documents ................................................................................... 84Lists .............................................................................................. 27Thumbnails ................................................................................... 84

Special functions .................................................................................... 101Comments .................................................................................. 107Compare OD/OS ......................................................................... 105Context menu ............................................................................. 101Generate combined reports ........................................................ 114Layer images (OPT data) .............................................................. 102Marking favorites ........................................................................ 112Measurements (fundus images) ................................................... 109

Start the review software ....................................................................... 101Status line ................................................................................................ 88Study ..................................................................................................... 135Symbols ..................................................................................................... 5

Hazard symbols ............................................................................... 5

T

Temporary copy (icon) .............................................................................. 51Temporary reference files ......................................................................... 60Thumbnails

Filtering ........................................................................................ 96Sorting .......................................................................................... 84

Trademark information ............................................................................... 7

Index FORUM

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U

Use in accordance with the designated purpose ....................................... 21User profiles ............................................................................................. 13

CAS .............................................................................................. 14Configuring FORUM ..................................................................... 14Evaluating data ............................................................................. 16Installing software ........................................................................ 14Local system administrator ........................................................... 14Managing data ............................................................................. 15Nursing staff ................................................................................. 15Ophthalmologists ......................................................................... 16Optician ........................................................................................ 16Qualified medical employees ........................................................ 15ZEISS Service ................................................................................. 14

V

Video (icon) .............................................................................................. 51

W

Worklist ................................................................................................... 39

FORUM

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Carl Zeiss Meditec AG

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