archive viewer - zeiss.com · page 8 000000-2240-366-ga-gb-171117 forum manages dicom files. a...

FORUM

Instructions for Use

FORUM® ArchiveFORUM® Viewer

Software version 4.2

Released/Main version: V4

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

Scope These Instructions for Use apply to the 4.2 version of FORUM.

Information about themanufacturer

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

© Carl Zeiss Meditec AG 2017

Document number and language version 000000-2240-366-GA-GB

Version 4.2

Date 171117

Carl Zeiss Meditec AGGoeschwitzer Str. 51-5207745 JenaGermany

E-mail: [email protected]: www.zeiss.com/med

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 6

CE conformity 7

Software description 7

User profiles 12

Safety measures 16

Overview of risks 16

Security measures for IT systems and networks 19

Data protection and information security 20

Information on use 21

Calibrated monitors 22

Limitations of the archiving system 22

Intended use / Indications for Use 23

Contraindication 23

Use in accordance with the designated purpose 23

General operating instructions 24

Start/stop FORUM Viewer 24

FORUM Viewer in EMR-controlled environments 26

Individual settings 27

User rights 29

Higher-level functions 30

Help 35

FORUM

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Management 36

Patient Directory 36

Creating a new patient data record 40

Worklist 42

Patient Administration 50

Remote Data (MultiSiteQuery) 62

Import data 69

Depositing procedure codes 72

Clinical View 74

Overview 74

Work area (Document Display) 85

Full-screen view (Document Navigator) 91

Toolbar 92

Actions 98

Additional functions 105

Clinical Displays 120

Troubleshooting 131

Malfunctions 131

Error messages 132

Index of technical terms 134

Index 139

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 exercise particular caution in these situations.

Symbols

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

– Listing

Prerequisite for an action

• Prompt for an action

Result of an action

The term following this symbol is explained in the Index of technical terms (Page 134)

Additional information and tips.

Functions that require an additional license are marked as follows:

If a described function requires additional license, the "Option" field is also highlighted.

NOTE Hazard which may result in minor injuries or impairments if not avoided.

Option

Introduction: Definition of terms FORUM

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The following symbols are used:

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.

Trademark information

The following trademarks are used in these Instructions for Use:

"Windows®" and "Active Directory®" are registered trademarks or brand names 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.

Note of electronic Instructions for Use (eIFU)

Please follow the Instructions for Use

Manufacturing date

Manufacturer

FORUM Introduction: CE conformity

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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:

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 the FORUM Viewer.

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 called up 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.

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Introduction: Software description FORUM

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FORUM manages DICOM files. A DICOM file contains both image data from the patient master data and, e.g., name, date of birth, etc. FORUM reads in the patient master data 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 leading system.

ZEISS offers the product version FORUM Office as a preconfigured package solution adapted to the needs of small and medium-sized medical practices. You can find more details on the Internet at: https://www.zeiss.com/meditec/us/products/ophthalmology-optometry/forum-guiding-your-decisions.html

Overview of functions

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

– User administration:In FORUM, an unlimited number of users can be configured, however, FORUM can also be connected to an existing user directory service (e.g. Microsoft® Active Directory® or LDAP1).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 for 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.

1) LDAP = Lightweight Directory Access Protocol.

FORUM Introduction: Software description

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– "MultiSiteQuery":Option to access other FORUM systems on the local network. Using 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 clinical pictures in the Document Display.

– 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 User" 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.

– Printing the work area or individual documents.

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

– Export:All documents or individual documents belonging to a patient can be exported as DICOM files for use in other DICOM systems.

– Accession No.:Option for changing the accession number.

– Marking favorites:Option for marking documents as "Favorite". "Favorite" status facilitates the finding of documents quickly.

– Measurements:Option of performing length measurements1 in images.

Introduction: Software description FORUM

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

– FORUM hospital IT connection (external archive):FORUM can be integrated into a DICOM storage hierarchy.

– SSL encrypted communication between FORUM and all connected components.

Interfaces

With FORUM, you can exchange patient data, medical image data, raw data, videos, and reports between devices that support the DICOM standard1.

FORUM conforms to DICOM in accordance with our DICOM Conformance Statements. The DICOM Conformance Statement is available on the ZEISS website.

The following interfaces are available:

– DICOM interface with connected devices and software products

– DICOM Import

– Document import (see page 69)

– 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 accord-ance with FIFO principle.

– Opening the FORUM Viewer from an EMR system

– Opening review software or software for the playback and processing of videos from the FORUM Viewer

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

1) NEMA PS3 / ISO 12052, Digital Imaging and Communications in Medicine (DICOM) Standard, National Electrical Manufacturers Association, Rosslyn, VA, USA (can be obtained free of charge from: http://medical.nema.org/).

FORUM Introduction: Software description

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With the aid 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.

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 the examination data of particular devices.

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

– 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 Tools:for connecting non-DICOM-enabled devices to FORUM.

– FORUM Hospital IT Integration Module – Vendor Neutral Archive (VNA) support:Integrates FORUM into other DICOM storage devices in terms of a mem-ory hierarchy. This module stores DICOM files in a DICOM storage system (VNA) and retrieves them on the occurrence of certain triggers. FORUM is thus connected, organization-wide, to the PACS-independent archive.

– FORUM Hospital IT Integration Module – LDAP/SSO support:Integrates FORUM into the organization-wide IT user administration so that no parallel administration is required and a uniform security standard is applied automatically.

– FORUM Enterprise Backup:An additional license to facilitate faster backup of the data.

The optional FORUM products are offered separately, some having dedicated Instructions for Use.

Introduction: User profiles FORUM

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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 manual.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 manual. 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 soft-ware is responsible for ensuring that the users identified in their clinic/office are correctly assigned to the corresponding user profiles in the software (Editor/Reader).

The use of FORUM requires differing user qualifications. In these Instructions for Use, the activities/functions of FORUM are subdivided according to the necessary 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.

FORUM Introduction: User profiles

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Installing software / configuring FORUM

ZEISS application specialist – CAS (Clinical Application Specialist)

A person who has been 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

An individual who has been 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 practice / clinic

– Answering service queries / eliminating faults

Local system administrator

Individuals 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

Introduction: User profiles FORUM

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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 training in nursing who are familiar with the use of EMR sys-tems and are trained to operate medical systems and prepare them for the treatment of patients.

Duties:

– Managing and monitoring patient data

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

FORUM Introduction: User profiles

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Evaluating data

Opticians, M.D., O.D.1, photographers

Individuals who have 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

1) M.D. = Doctor of Medicine, O.D. = Doctor of Optometry.These titles refer to professional degree doctorates as are common in the USA for many medical professions and other professions (Law, Pharmacy).

Safety measures: Overview of risks FORUM

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Safety measures

Overview of risks

A risk assessment was performed to identify potential risks of FORUM. The risks were evaluated and minimized as far as possible to ensure the security and effectiveness of FORUM. The following list of risks will serve as an over-view for the user:

– After updating to a new software version, it is possible that FORUM can-not be started, the system is in an error state, or data have been lost when the database was overwritten. As a result, the user is automatically prompted to perform a data backup prior to updating.

– If malware is present on the FORUM installation medium, it is possible that it will also be installed on the client’s system. Therefore, the installation medium is checked for the presence of malware before use.

– To prevent the loss of original data after image processing, the original documents contained in the archive always remain unchanged.

– To prevent unauthorized persons from obtaining access to FORUM and viewing or changing patient data, access is protected by means of user authentication. In addition, there are various user roles with different rights and an automatic logout function.

– For the Windows standard user, the access permissions to the database used in FORUM have been limited to prevent erroneous modification or deletion of data in the database. The Instructions for Use note that it is prohibited to make changes that are not described in the Instructions for Use.

– To ensure that the image data loaded into FORUM by a user are displayed correctly, only defined image formats are supported.

FORUM Safety measures: Overview of risks

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– Data may be lost when saving if the storage medium is faulty or full, if the saving procedure is defective, or if the network connection was inter-rupted during the procedure. FORUM uses the DICOM standard for stor-age and thus receives a reply to every storage request when it has been performed successfully.

– If backup is not performed successfully, the user is informed of this immediately. This prevents them from failing to notice this fact until the recovery stage.

– When data are sent to FORUM, one patient’s data may be assigned to another patient on the basis of automatic assignment rules if the patients’ attributes differ only slightly. In this case, the data association can be reconstructed with the help of the assignment information found in the log file.

– To ensure that all HL7 messages are correctly assigned for patients who were added via an HL7 interface, it is not possible to edit these patient records in the FORUM user interface.

– If patient data that do not belong together are incorrectly merged in the course of consolidation of patient data by an HL7 message of a leading system, and this escapes notice, the relevant information on the consoli-dated patients and studies involved is recorded in log files (event logging).

– To prevent incorrectly referenced documents from being deleted when a document is deleted, a list containing all of the documents referenced is displayed. The user can deselect documents that should not be deleted and must confirm deletion for the documents displayed. The deleted doc-uments are saved in a separate directory.

– If more documents for one patient are opened in the Document Display than are visible at once, a scroll bar will indicate the presence of further documents.

– If elements of the graphical user interface are too small to completely dis-play the information they contain, it can be made visible using a tool tip.

– To ensure that information located behind measurements can be made visible when they are displayed, these overlays can be moved to other positions on the screen. The information can also be made visible by reducing the document. The original documents contained in the archive remain unchanged by image processing.

– To minimize the risk of mixing up patients, only one patient can ever be selected at once. A comparison of patients is not possible. In the Document Display, the patient name and the date, time, and laterality of documents of the selected patient are displayed.

– If data are displayed in OD/OS comparison mode, the laterality is also dis-played for every document to ensure that the laterality is identified.

Safety measures: Overview of risks FORUM

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– To prevent documents in the Document Display from being placed on the wrong side of the display during OD/OS comparison, each side only per-mits appropriate documents to be opened.

– To prevent the unit of a measurement from being changed in such a way that it does not match the scale of the measurement, units cannot be changed by the user.

– To prevent misinterpretation of measurements, they are always displayed with the associated unit.

– To prevent measurements from obscuring important image information, measurements can be hidden to make the information obscured by them visible again.

– To prevent incorrect measurement data from being displayed, no meas-urement data are loaded if erroneous data transfer between FORUM systems occurs. In this case, the data on the remote FORUM system are not available.

– Distance measurements are only possible on image data meeting the DICOM standard. The length of the reference distance is not calculated but is rather read from the metadata of the image.

– To prevent the user from misinterpreting the scan direction of an OCT scan and thus assuming that a pathological condition is present at the wrong place, the scan direction of OCT scans is displayed.

– To prevent the user from overlooking relevant details due to changes in the brightness and contrast settings of an image, these images are marked. The settings can also be reverted. The original documents con-tained in the archive remain unchanged by image processing.

– In FORUM, the visible patient data, documents, and information can be fil-tered and thus reduced. The filter settings can be reverted. A display also indicates when a reduced quantity of information is displayed due to the use of filters.

– If image data is modified for display due to a preset lossy compression, the lossy compression is indicated in the Document Display. The user may switch to a lossless display in the user administration.

FORUM Safety measures: Security measures

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Security measures for IT systems and networks

RA301 The FORUM software may only be operated in virus-protected networks. Suitable protection mechanisms must be installed on computer systems (e.g. anti-virus software) and the hardware may only be used in accordance with IT directives within the environment specified by the operator.

The operator 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 flash drives) 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.

Before starting up FORUM, and whenever changes are made to the network or data sharing, it is recommended that users carry out an analysis, evaluation and if necessary, implementation of any measures required for the control of risks.

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 com-puter).Hence, FORUM software may only be operated in protected networks. The operator 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, gen-der, 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 out-side 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.

• Make sure that users have access to Instructions for Use at all times.If you received the Instructions for Use in electronic form, save it at a storage location accessible to all 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.

• 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.

Safety measures: Calibrated monitors FORUM

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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 "Troubleshooting", mark the product as non-functional and inform ZEISS Service.

Calibrated monitors

A color-calibrated monitor should be used for the medicinal evaluation of the images, videos and reports saved. If the monitors used are not color-calibrated, the images, videos and reports reproduced may contain errors of scale, form, and color.

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

Limitations of the archiving system

The software is intended for data archiving.

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

Essentially, FORUM consists of the two base components "FORUM Archive" and "FORUM Viewer". Additional FORUM applications are available as an option. Each additional application has a dedicated Instructions for Use manual.

FORUM is intended to archive and administer patient and examination data (images, reports, videos, and raw data). FORUM Viewer facilitates the sched-uling of examinations on connected systems and displays 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.

General operating instructions: Start/stop FORUM FORUM

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General operating instructions

Start/stop FORUM Viewer

Start

In order to log in to FORUM, a user account is required which can be used to control the individual roles and rights in FORUM (see section "User rights" on page 29). FORUM has its own user administration system, but it can also be integrated into an existing user directory service (e.g. Windows® Active Directory® or LDAP).

If the user administration in FORUM is used, you will receive your user name and password for logging in to FORUM from your system administrator.Always work with your own user account, since certain settings are stored for the user account that is currently logged on. You might otherwise change another user’s settings.

If FORUM is integrated into an existing user directory service, use your familiar user data in FORUM (user name and password).In some environments, the login procedure in FORUM is performed automat-ically using the user data already entered on the computer.

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 can be accessed over the network.

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

FORUM General operating instructions: Start/stop FORUM

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The user data is requested:

• Enter your user name and password.

• Activate "Save Login Data" if, from this point on, the user name and the password are to be automatically entered when opening the FORUM Viewer on this computer.1

• Click on <Log in>.

Result FORUM checks the available licenses and those called up by the user.

Functions that are activated using so-called floating licenses (e.g. the func-tions 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 during the login process.

Logout

You can log yourself out of FORUM as a user, e.g. to interrupt your work or free up 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 the <Logout> button in the top right corner of the window.

If automatic logout is activated in FORUM, an inactive user is automatically logged out after a defined period of time has expired. 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.

1) Only possible if this function is always enabled. Please contact your local system adminis-trator, if necessary.

General operating instructions: FORUM Viewer in EMR-controlled environments FORUM

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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 the <Close FORUM> button 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 Viewer in EMR-controlled environments

If FORUM is connected to an EMR system, the diagnostic workflow can be controlled completely from the EMR system. In this case, a patient or a par-ticular document is selected in the EMR system and transferred to FORUM in conjunction with the attending physician’s user data. The patient’s data are displayed directly in the clinical view. If a unique document was transferred, it will automatically open in the full-screen clinical view.If the FORUM Viewer is closed, it will be started automatically.

If patient data is to be opened exclusively via the EMR system, the users can be assigned the user group "EMR Reader". Users in this group can exclusively view or add to the data of patients called up from the EMR system in FORUM; a change of patients in FORUM is not possible. This close pairing avoids the risk of having different patients for viewing in FORUM and the EMR system.

FORUM General operating instructions: Individual settings

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Individual settings

User settings

Some settings are user-specific and can be altered by the user in the user administration:

– First name and last name1

– Password1

– Search options

– Language of the user interface

– Image transfer quality settings

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

If anything is unclear regarding the settings or if the desired language for the user interface is not available, contact your local system administrator.1) Here, the user can only change the name or password if FORUM is not integrated into a

user directory service.

General operating instructions: Individual settings FORUM

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Displaying icons for 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 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. This means that if the same user logs on to another workstation, they may need to reconfigure the display of the placeholder images.

FORUM General operating instructions: User rights

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User rights

Each user in FORUM is assigned to a particular user group. Each user group in turn is assigned different rights, i.e., all functions described in these Instruc-tions for Use are not available to every user. In the following table all menu entries in FORUM and their availability for the individual user groups are listed:

= available = available on a limited basis = not available

Menu item Adminis-trator

Editor Reader EMR Reader

Patient Patient Directory

Document Display

Worklist a)

a) Not possible: create / delete new patient, edit patient data

Patient Administration

DICOM Import

System Messages

Forward Documents

Storage Locations

AET Administration

User Administration b)

b) Only viewing and editing user’s own data. No change for access to the optional"Glaucoma Workplace" software module.

b) b)

Procedure Codes

Configuration Administration

Show icons (e.g. OCT scans)

Workplace Administrationc)

c) Only available if an optional FORUM Workplace Plugin is installed.

General operating instructions: Higher-level functions FORUM

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Higher-level functions

Buttons

Some functions in FORUM can be called 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

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.

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

Reset

Deactivates all active filters.

Extended Search

Opens the extended search function (see section "Extended search function" on page 33).

FORUM General operating instructions: Multiple selection

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which are currently relevant to the sorting process are indicated with an arrow in the title list field.

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 combi-nations 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 section, 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.

General operating instructions: Patient search FORUM

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Search patient data

Patient data can be searched in the Patient Directory for viewing in the clinical view, in the worklist for creating examination orders and in the patient admin-istration for editing patient information. The different search methods are described below.

Furthermore, patients can also be searched for in the clinical view and their data can be called up (see "Patient selection" on page 76).

Standard search

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

Patient Name/IDLast Name/IDa)

a) "Patient Name/ID" filters or "Last Name/ID" 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 be located either at the beginning or in any position.

The search will begin automatically shortly after you stop typing. Pressing the <Enter> key starts 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 "Favorites" filter can be activated in addition to the other filters.

See section "Marking favorites" on page 117.

FORUM General operating instructions: Patient search

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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.

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, Worklist, and 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 40).

General operating instructions: Patient search FORUM

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

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.

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 where the spelling of the entry is unclear. Unclear characters are replaced with a "?".

FORUM General operating instructions: Help

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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.

Legal Notices

This button is only active if the national laws demand that the user is provided with specific legal information about the software. The respective notes are then provided in a PDF and can be opened by clicking the button.

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, made available to ZEISS Service.This window will also display the UDI (Unique Device Identification).

User Manual

Direct link to the user manual (PDF file with bookmarks for navigation). These Instructions for Use can be stored at any location.

Online Help

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

Management: Patient Directory FORUM

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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 functions 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 menu item <Patient><Patient Directory>.

FORUM Management: Patient Directory

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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 an existing conflict (see section "Resolving conflicts" on page 55).

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

NOTE 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.

Management: Patient Directory FORUM

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Right-click on a patient

Create Automatic Order Creating 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 46.

Create Automatic Order for ...

Creates an order with requested procedures 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 is temporarily loaded as reference entries (see section "Load preview" on page 63).

Import data Search through connected FORUM systems for addition-ally available data. Any data found is permanently imported (see section "Import data" on page 65).

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

FORUM Management: Patient Directory

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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 69.

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 is auto-matically created by FORUM and the default issuer are assigned to the selected patient.

Glaucoma Workplacea)

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

Open Glaucoma Workplace for an analysis of visual field examinations.

Management: Creating a patient FORUM

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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 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 attributes 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.

FORUM Management: Creating a patient

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

• Click on the <New Patient> button.

• 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 "Alphabetical", "Ideographical", or "Phonetical" (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 soft-ware proposes 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 using the <Save> button.

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 50.

Management: Worklist FORUM

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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, select the <Patient><Worklist> menu item.

FORUM Management: Worklist

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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 cre-ation 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 54.

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

See section "Creating a new order manually" on page 47.

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 are assigned to the selected patient.

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

See section "Creating a new order manually" on page 47.

Create Automatic Order

Creating 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 requesting standard proce-dures 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 ini-tially as a new patient if necessary; see page 40).

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 the entry "Create Automatic Order" from the context menu that appears.

To create an order for a specific device:

• Select the entry "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 42).


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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 40).

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 "Search patient data" on page 32.

The left column shows all patients who correspond to the currently ena-bled search criteria. The middle column displays the metadata of all orders created for the selected patient. The right column lists all requested pro-cedures for the selected order.

• Click on the <New Order> button.

• 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 the <Add> button to add a requested procedure to the order.

• Fill in all mandatory fields at least:

– Modality (device group) or Name (device name)All devices that have been defined as a "Modality Worklist User" in "AET Administration" can be selected.

– 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 72).

Many of the input fields (see section 49) 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 the <Add> button.

• 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 the <Delete> button.


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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. 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.

Management: Patient Administration FORUM

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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.

NOTE 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.

FORUM Management: Patient Administration

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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 83).


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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 55.

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 40.

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

See section "Editing patient master data" on page 54.

Delete Patient Deletes the selected patient.

See section "Deleting a patient data record" on page 57.

Delete Document Deletes selected documents of a patient.

See section "Delete document" on page 60.

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 is automatically created by FORUM and the default issuer are 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 63.

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

See section "Import data" on page 65.

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 "Show 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 the <Edit Patient> button.

• Change/supplement the desired data.

• Confirm the changes by clicking on the <Save> button.

– 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 63).

Temporary copy (see section"Importing temporary copies" on page 65).


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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 dif-ferent (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 button.

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 Patient ID


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Merging patient data records

Actions • If necessary, turn off any enabled filters in both window sections by click-ing on the button.

• 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 one of the two buttons ("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 the <Yes> button.

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.

NOTE User ErrorRA514RA517

When merging patient data, there is a risk of mixing up the source and target patient. Verify whether the patient selection is correct, and reassign the data in the desired direction.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

RA404 Deleted patient data records cannot be restored!

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 document" on page 60).

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

• Click on the <Delete Patient> button.

• Confirm the prompt.

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


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Moving documents ("reassigning")

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 the button.

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

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

• Select the desired patient.

• 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.

NOTE Incorrect treatment of a patientRA514 When reassigning patient data, there is a risk of mixing up the source and tar-

get patient. Verify whether the patient selection is correct, and reassign the data in the desired direction.


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• Click on the button ("Reassign document 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 which are linked with the document to be moved may be listed. 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 the button ("Reassign document from right to left").

Delete document

When deleting patient data, there is a risk of mixing up data. Please ensure selection of the correct document before you delete it.Deleted documents cannot be restored!

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

• 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 on the <Delete Document> button.

The "Delete Document" 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.

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

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


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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.

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.

Management: Remote data (MultiSiteQuery) FORUM

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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. A FORUM system is installed at each site for this purpose. 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.

If FORUM is integrated in a DICOM storage hierarchy via the (optional) FORUM hospital IT connection, all data that is available for a patient is pro-vided automatically. In this case the function "Remote Data" is not required and is not available, even with existing licenses.

Option

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

FORUM Management: Remote data (MultiSiteQuery)

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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 display in the Clinical View. They are then saved in the FORUM database as "temporary 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 67).

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 refer-ence entries for the patient. Each document found is displayed in the Patient Administration and Clinical View as a thumbnail. Reference entries are highlighted in the Clinical View in the status line 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 line 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 117).

– A measurement is taken in the document (see section "Measurement function" on page 114).

– A comment is added to the document (see section"Comment function" on page 112).

– 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 "Import data" on page 65.

Import data

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 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 67).

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

The green icon indicates that the loading and import operation was per-formed 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 for the optional Glaucoma Workplace plugin is installed, a combined Glaucoma report is generated, provided that the corresponding prerequisites are met (also see the separate Instructions for Use for 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 con-tact connected FORUM sys-tems. If successful, matching database entries are searched and if necessary loaded.

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

Contact with a connected FORUM system has been suc-cessfully established and the searching and loading opera-tion has been completed. If matching database entries have been found, they have also been loaded.

Contact with a connected FORUM system has been suc-cessfully established and the searching and loading opera-tion has been completed. 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)

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

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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Remote Data

Load preview Import data

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 tool tip displays the connected FORUM system from which data could not be loaded or imported.

FORUM Management: Import data

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Import 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.

Management: Import data FORUM

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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 subsequently import further files associ-ated with this patient, or click on <Import+Close> if you wish to return to the Patient Directory after importing.

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 in file system" checkbox must be deactivated.

Buttons

Input fields

Browse 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.

Source Directory Path to the folder containing the files to be imported.

The selected folder remains preset for the current user.

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

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.

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 Visual Field

Image Comment

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

Management: Procedure codes FORUM

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Depositing procedure codes

For recurring procedures, procedure codes can be created that describe a par-ticular 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 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.

Clinical View: Overview FORUM

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Clinical View

Overview

The Clinical View contains the following sections:

Patient identification (see page 75)

Presets (see page 77); collapsed

Document selection (see page 78); collapsed

Work area (see page 85)

Toolbar (see page 92)

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FORUM Clinical View: Patient identification

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Patient identification

In this section, the most important patient data is displayed1:

RA520

Double-clicking on the field "Patient identification" returns you to the Patient Directory2. A single click on this field displays the patient search, another click hides it again (see section "Patient selection" on page 76).

1) If patient data is displayed without the patient’s name, this data must not be used for med-ical assessment or review of diagnostic data.

Patient 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. Please contact your local system administrator, if necessary.

Gender: female

Gender: male

Patient IDb)

b) The display of the patient ID in NHS format (required in the United Kingdom) is possi-ble. The adjustment is carried out centrally. Please contact your system administrator if necessary.

Date of birth (age)

Patient 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.

Export all the patient’s DICOM files to a selected target directory.

See "Exporting documents" on page 119.

2) May not be possible in EMR-controlled environments, see section "FORUM Viewer in EMR-controlled environments" on page 26. In that case, the patient change takes place via the EMR system.

Clinical View: Patient identification FORUM

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Patient selection

Clicking on the field "Patient identification" displays the field "Patient selection" below patient information; it enables a faster patient change.

"Patient selection" allows user to search for a patient and to select the same from the displayed patient list for a display of data.

A red bar to the left of the patient name in the patient list indicates an existing conflict between different patient data records. Conflicts can be solved in the patient administration. For details regarding causes of conflicts as well as their solutions see section "Resolving conflicts" on page 55.

Patient Name / ID / Date of Birth Search for patients whose name, patient ID or date of birth contain the string entered in this field. Depending on the setting in the user admin-istration ("Toolbar Search Field"), the string entered must be located either at the beginning or in any position.

The search will begin automatically shortly after you stop typing. Pressing the <Enter> key starts the search manually.

Today Patient list filtering: only patients whose data are available for the current date are listed.

The filter is activated by default.

All Patients Deactivating the "Today" filter. All patients con-tained in the FORUM database are listed, a search is done within the entire data pool.

FORUM Clinical View: Presets

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Presets

Presets allow different functions to be opened for the display of documents in the work area. Presets can be collapsed for a larger work area so that they are only visible as a gray bar at the left edge of the screen. Clicking on the bar expands them again.

The following Presets are available:

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 work area of the Document Display can be opened manually by the document selection or automatically by preselection from Clinical Displays (see also section "Clinical Displays" on page 120).

After calling up a patient in the Patient Directory or via an EMR system, the clinical view is opened and the Document Display is activated. As soon as doc-uments are opened, the work area of the Document Display becomes visible and the tools that are available are enabled.

See also section "Work area (Document Display)" on page 85 and section "Toolbar" on page 92.

Clinical Displays

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

See also section "Clinical Displays" on page 120.

FORUM Workplace Plugins

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

Each of the FORUM Workplace Plugins has its own work area 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 work area.

The document selection has three different appearances:

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

– expanded (minimum size):the visit selection is shown, the preview section is minimized, the work area 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 work area is completely visible

The expanded document selection contains the following elements:

Visit selection with filter option (see page 79)

Preview section (see page 80)

Thumbnail gallery (see page 82)

Thumbnail (see page 82)

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:

– By expanding Presets (see "Presets" on page 77).

– 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 work area (see section "Opening documents in the work area" on page 101).

– By clicking on the button.

– If the preview section is displayed in its minimum size:By clicking on the button.

– By clicking on a document in the work area.

– 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 the button (minimum size)

– By clicking on the button (maximum size)

– By clicking on the <Close All> button 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. For every appointment, colored quad-rants are also recognizable that identify which document types are in the selected visit.

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.

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 28).


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The visit selection can be changed as desired. Using different filters, it is possible to show a selection of several visits as well as reduce the number of documents shown in the preview section. The following filters are available (see also section "Filtering visits and documents" on page 99):

Preview section

In the preview section, a thumbnail gallery with thumbnail 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 visit date.

The preview section can be displayed in two sizes:

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

– 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 the button.

Filter Settings

Filtering the visits and documents.If a filter is enabled, the button turns blue and next to the filter symbol there is a tab close button to delete the filter.

OCT OCT images By clicking the name of a type class, the documents are filtered accordingly, i.e. in the preview section only the documents are shown that correspond to the selected type class.The selection of several type classes using the Ctrl key is also possible.

FI Fundus image

VF Visual field documents

BIO Biometry documents

... All document types that do not belong to the other four classes.a)

a) The rule set for the classification of documents can be adjusted. Contact your local system administrator to this end, if required.


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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 work area (of the Document Display or a FORUM Workplace Plugin).

Document Display

Opens selected documents in the work area 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 work area of a particular plugin. The pre-conditions for this are described in the Instruc-tions for Use of the particular FORUM Workplace Plugin.

Start Review Softwarea)

a) This function is only available if review software appropriate for 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.

Launching the review software appropriate for 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 work area. By default, the laterality is preselected as the primary sorting criterion (blue selector switch).

See also section "Sorting" on page 86.

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:

– using 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 work area. The open documents continue to be displayed.

Thumbnail

Each displayable document that is available for the selected visit in 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 line with icons (see section "Status line" on page 89)

– 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 work area (see section "Display windows" on page 87).


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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 Glaucoma Workplace plugin, the following reports are also not displayed in the thumbnail gallery:

– GPA1 and overview reports created from 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 Glaucoma Workplace

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

Older (hidden) reports can be found and displayed via the "Filter" function (see section "Filtering visits and documents" on page 99).

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.

Clinical View: Work area FORUM

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Reports labeled as a "Favorite" are never hidden.

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 visible, the "Show icons (e.g. OCT scans)" has to be enabled (see Page 28). 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"

Work area

The Document Display and all FORUM Workplace Plugins have a work area in which the open documents and / or data can be processed and compared.1

In the work area of the Document Display it is possible to open up to 24 documents simultaneously. The documents are arranged in a (selectable) matrix according to the type of sorting selected in the preview section.See also section "Interaction between the preview section and work area" on page 85.

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.

FORUM Clinical View: Work area

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Work area (Document Display)

Interaction between the preview section and work area

Synchronization

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

– Documents which are closed or hidden in the work area 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 work area, 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.

Matrix

The matrix determines the maximum number of documents which are display-able in the work area, 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 work area, 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 92). Documents which no longer fit in the matrix are closed.

By clicking on the <Add> button it is possible to open additional documents in the active work area. 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.


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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 work area (from top left to bottom right). By default, the primary sorting criterion "Laterality" is preselected (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 latest document first)

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

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 work area or the arrangement of the docu-ments in the workspace is changed manually, the automatic sorting of the documents is cancelled.


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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

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

– Visit date

– Time of compilation

– Document type

– Laterality

2

3

1

1

2

3


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Status line:See section "Status line" on page 89.

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:

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 96.

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


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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:

Change size with mouse wheel

• Position the cursor above the desired document.

• Turn the mouse wheel upwards to zoom in and downwards 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 display document in order to close the full-screen view again.This is also possible with the <Esc> key or the <Close> button.

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 112.


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

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 95.

Reference entry for a document from a different FORUM system.

See section "Load preview" on page 63.

Temporary copy

See section "Importing temporary copies" on page 65.

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

A document marked as a "Favorite".

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


The document contains a comment.

By clicking on this icon the comment window opens.


The document is not located at the local storage location, but in an external archive. When it is opened, the document is first loaded to the local storage location before it is displayed in the FORUM Viewer. Depending on the local infrastructure, loading time may increase when opening documents.

FORUM Clinical View: Full-screen view

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Full-screen view (Document Navigator)

Every document can be viewed and edited in a full-screen view. The full-screen view can be opened by:

– Double-click on a thumbnail

– Double-click on an open document in the work area

– Context menu entry "Document Navigator"

The current Document Navigator is integrated in the "normal" full-screen view from FORUM Version 4.2. The full-screen view can thus provide an option for gaining an overview of the patient’s documents. It allows the user to successively "move through"1 the documents along the thumbnails.

The user can "move through" all documents of the individually selected visits or a certain selection thereof:

– To "move through" all of the selected visits, double-click on a thumbnail.

– To "move through" a specific number of documents, select the corre-sponding thumbnails and select the entry "Document Navigator" in the context menu.

If an angiography series is part of the opened documents, the entire series is opened. When "moving through", the first image of the respective series is displayed. It is possible to scroll between the individual images of the series using the scrolling tools (see section "Scrolling through PDF documents / OPT data / image series" on page 118).

In addition, in the full-screen view there is the option – if necessary, depend-ing on the file type – to save, print or measure the respective document shown (see section "Toolbar" on page 92). The related DICOM file can also be exported to a selected target directory.

See also "Full-screen view (Document Navigator)" on page 91.

1) FORUM Workplace Plugins data that is computationally intensive (raw data) is passed over in this function.

Clinical View: Toolbar FORUM

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Toolbar

In this area, various tools are available for displaying and editing open documents.

The toolbar has general and context-sensitive tools. General tools are always available. Context-sensitive tools are only shown under specific conditions (e.g. if a corresponding document type is selected in the work area or opened in the full-screen view).

Furthermore, there are plugin-specific tools which are only shown if the work area 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 area 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 109.

Close All Closes all open documents in the work area.

Selection of a matrix for the arrangement of the documents displayed in the work area. 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 max-imum number of 24 displayable documents.

Print All

Print the entire work area. The work area is scaled in propor-tion to the page size for printing.

FORUM Clinical View: Toolbar

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Tools available in the work area and in the full-screen view (Document Navigator)

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.

There are special export functions available to save documents in DICOM format (see "Exporting docu-ments" on page 119).

Print

Prints the selected document.

See section "Print" on page 111.

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. 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 side of the display window 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.

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.


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Tools available in the full-screen view (Document Navigator) only

Comments

Opens the comment function.


Favorite

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


Close Closes the document in the full-screen view.

DICOM Export

Exports the DICOM file of the displayed document to a selected target directory.

See "Exporting documents" on page 119.

First Document

If several documents were opened in the full-screen view, you can scroll between these documents.

See section "Full-screen view (Document Navigator)" on page 91.

To scroll within a document, see section "Scrolling through PDF documents / OPT data / image series" on page 118.Previous

Document

Next Document

Last Document


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Context-sensitive tools

General

Video files

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-spe-cific setting, please contact your local system administrator.

Play Movie

Opens the "Video Player Control" window.

The selected video plays automatically.

Start

Plays video from the beginning.

If the <Pause> button was clicked to interrupt playing the video, the video continues to play from this point on.

Pause

Pauses video.

Clicking on the <Start> button continues play-ing 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.

Positions Displaying 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

Saves the complete video or the defined sequence as a video in a location of your choice (as a DICOM file or in *.mpeg or *.mpg format).

Close

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


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Calibrated fundus images / OCT images1 / image files2

1) OCT images from CALLISTO eye from version 3.6.2) The measurements performed in FORUM on fundus images are based on the scaling infor-

mation made available by the DICOM Header of the corresponding image.Measurements on other image files are possible if, in the corresponding DICOM file, the size of the image pixels (pixel spacing) is defined in accordance with the DICOM standard.

Measurements

Opens the length measurement function (only possible in Document Display).

See section "Measurement function" on page 114.

Brightness/ Contrast

Calls the brightness and contrast settings for the active docu-ment, 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.

Original settings are restored by clicking on the <Undo> but-ton (in the case of OPT data only for the respective displayed slice).


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OPT data / PDF documents / Image and angiography series

Back

Scrolls through the pages of multi-page PDF documents, through the layers of OPT data, through Image and angiography seriesa).

a) Scrolling between the individual documents of an angiographic series is only possible in the (Document Navigator) full-screen view (see page 91).

Continue

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

Clinical View: Actions FORUM

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Actions

Generally, a patient is selected in the Patient Directory, and the documents to be displayed are selected in the clinical view.

Opening the clinical view

In EMR-controlled environments patient data may possibly be accessed exclusively using the EMR system. In this case the clinical view is called up automatically. See section "FORUM Viewer in EMR-controlled environments" on page 26.

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

Result The Clinical View is opened; Presets and document selection are expanded, and the preview section is displayed at 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.

FORUM Clinical View: Actions

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Filtering visits and documents

There are two functions for filtering the visits and the documents shown in the thumbnail gallery that can also be combined:

– Individually configurable filters

– Filtering according to document type

Individually configurable filters

In order to reduce the visits and thumbnails displayed in the document selec-tion, a filter can be configured and 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 dis-played in the thumbnail galleries are also filtered.

By clicking on the button 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 behind 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.


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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.

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 83)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.

Filtering according to document type

FORUM classifies all in documents contained in the database according to specific types2. By clicking the name of a type class in the visit selection, the documents are filtered accordingly, i.e. in the preview section only the docu-ments are shown that correspond to the selected type class.

It is not possible to combine the document type filter with the selection of a specific visit.

See also section "Visit selection with filter option" on page 79.

1) The "Show icons (e.g. OCT scans)" function must be enabled (see Page 28).2) The rule set for the classification of documents can be adjusted. Contact your local system

administrator to this end, if required.


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Opening documents in the work area

Documents can be opened automatically in the work area via preselections ("Clinical Displays"), 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 31.For the interaction between the preview section and the work area (arrange-ment and sorting of the documents etc.) please note the corresponding section on page 85.

There are three ways of opening documents manually in the work area:

Button <Add>

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

Button <Document Display>

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 work area.

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 work area 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 docu-ments 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.


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If several thumbnails are dragged into the work area 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 85.

Changing document position in the work area

The open documents can be moved to another position in the work area 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 the position 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 deactivated (see section "Sorting" on page 86).

Closing documents in the work area

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.


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Opening a document in full-screen view

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

Context menu entry "Document Navigator"

All documents selected in the preview section are opened as a series in the full-screen view. You can scroll through the opened documents. See also section "Scrolling through PDF documents / OPT data / image series" on page 118.

Double-click on a thumbnail

Double-clicking on a thumbnail opens the document and all subsequent doc-uments during the respective visit in full-screen view. You can scroll through the opened documents using the appropriate tools. See also section "Scrolling through PDF documents / OPT data / image series" on page 118.

Double-clicking on an individual document in the work area

The document opens in the full-screen view.

Closing the full-screen view

Exit full-screen view by

– clicking on the <Close> button,

– <ESC> key.


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Editing a document

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

– Saving as a fileSee section "Save as" on page 93

– PrintSee section "Print" on page 111

– Adding commentsSee section "Comment function" on page 112

– Add measurements (in the case of images)See section "Measurement function" on page 114

– Marking as a "Favorite"See section "Marking favorites" on page 117

– Changing Brightness / ContrastSee sections "Brightness/ Contrast" on page 96 and "Additional functions" on page 88

– Saving a video (sequence)See section "Save" on page 95

See also section "Toolbar" on page 92ff.

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 or a selection of thumbnails or on a document opened in the work area 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 called up are not visible.

Preview section

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.

– By right-clicking on a non-selected thumbnail, all functions that are valid for this document become available, even if other thumbnails are selected. In this case, the respective functions are also listed for this document only.

Document Display

Opens the selected documents in the work area.

Document Navigator

Opens all selected documents, or all documents relating to the visit, in full-screen view.

See also section "Scrolling through PDF documents / OPT data / image series" on page 118.

DICOM Export Exports the DICOM files associated with the selected thumb-nails to a selectable target directory.

See also section "Exporting documents" on page 119

Clinical View: Additional functions FORUM

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Work area and full-screen view

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

Show 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 for 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.

Launching the review software appropriate for the selected document.

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

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 work area of the plugin concerned). The functions and the prerequisites for this are described in the Instructions for Use of the associated FORUM Workplace Plugin.


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Layer images (OCT B-scans, OPT data)

Layer images generated by OCT devices which are transmitted as "OPT" type DICOM files to FORUM and 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 recorded, a different number of slice images are available. A blue line dis-played in the fundus/LSO image is used for orientation purposes when view-ing the various slices.

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

Depending on the information contained in the record, 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 work area, 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 availa-ble 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 Document

Display of the slice above the currently selected one.

Next Document

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 work area. By enabling this func-tion, the work area is divided vertically, and the documents which are already open are arranged in the two halves according to their laterality (left "OD", right "OS"). Documents which apply to both eyes ("OU") are shown in both sections, 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 work area" on page 85). The maximum number of displayable documents applies to both sections of the display together, i.e., each section can display a maximum of 12 documents.


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Actions • Activate the function <Compare OD/OS> in the toolbar.

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 in the work area" on page 101).

In the OD/OS comparison, documents can only be opened via the <Add> button or by using drag-and-drop. By clicking on the <Document Display> button, the OD/OS comparison will be 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 sec-tion. See also section "Sorting" on page 86.

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 displayed.


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Print

The "Print" tool behaves differently in the work area and in the full-screen view:

In the work area

Each of the selected documents is printed. It is scaled up to the page size regardless of the section of the screen currently being displayed.

In full-screen view

The current section of the screen is printed. If there is information on the insti-tute (name, address, telephone number, logo) stored in the Service Tool, this is also printed out with the document1. The ZEISS logo at the top right is replaced by the stored logo.

For multi-page PDF files, either the complete document is printed or a selec-tion of pages is determined using the print dialog.

1) Not for reports and PDF documents.


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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 the <Add> button.

• Enter a further comment if applicable.

Clicking on the <Close> button closes the dialog window. Entries not saved using the <Add> button 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 62).

A temporary copy with an added comment is automatically imported fully into FORUM (see section "Importing temporary copies" on page 65).

The automatic forwarding 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, OCT images from CALLISTO eye version 3.6 and later, and on other image files, and of storing the measurement result for the image.1

Performing measurements

Prerequisite The full area to be measured is displayed in the work area or in the full-screen view.

Actions • Select the document which you would like to carry out the measurement on in the work area.

• 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 on images in FORUM are based on the scaling information made available by the DICOM Header of the corresponding image.Measurements on image files are possible if, in the corresponding DICOM file, the size of the image pixels (pixel spacing) is defined in accordance with the DICOM standard.


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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 62).

A temporary copy in which a measurement is taken is completely imported into FORUM (see section "Importing temporary copies" on page 65).

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

Measurements are retained until they are deleted by the user. Existing meas-urements are shown in the work area and in the full-screen view, provided that they are positioned within the visible area. Measurements are not dis-played in the full-screen view.

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


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Changing / deleting measurements

Actions • Open the required document in the work area.

• Click on the tool .

• Activate the measurement to be changed 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.

• To delete the measurement, press the <Del> key.

The endpoints of the line are displayed as green squares.

The line is shown in Violet.

NOTE 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, work area or full-screen view by clicking on the favorite icon in the status line.

– In the work area 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 99).

– A temporary copy is completely imported into FORUM (see section "Importing temporary copies" on page 65).

– Documents marked as a "Favorite" are used preferentially in the selection criteria of the "preselections" (see section "Clinical Displays" on page 120).

– 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 / OPT data / image series

If multi-page PDF documents, OPT data or image series are displayed in the work area or in Document Navigator, it is possible to scroll between the indi-vidual pages, layers or images or to change directly to a specific page number, layer or image number.

In addition to the tools for scrolling (see page 97), a menu is available for scrolling and entering a number; the menu is displayed in the lower half of the image as soon as the cursor is located in this area:


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Exporting documents

To use documents outside FORUM (e.g. to make documents available to another doctor), FORUM provides various options for exporting the DICOM files associated with them:

– Exporting all the documents available for a patient (including raw data and hidden documents)See "Patient identification" on page 75.

– Exporting a selection of documents for a patientSee "Preview section" on page 105.

– Exporting a document currently open in the full-screen view (Document Navigator)See section "Full-screen view (Document Navigator)" on page 91.

In each case, the complete DICOM files are exported. These can be input into any other DICOM-capable system.

After accessing the export function, the target folder for the files to be exported can be selected:

The export is started by clicking on <OK>. The progress of the export is dis-played by means of a progress bar in the bottom left of the screen:

When the export is completed, a note appears in the bottom right of the screen:

Clinical View: Clinical Displays FORUM

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The file names of the exported files consist of the following data:

– Patient name

– Date of birth

– Procedure date

– Description of the document

Clinical Displays

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

– Cataract

– Glaucoma

– Retina

A specific combination of filter criteria (selection rules) is assigned to each preselection. Clicking on a preselection launches a search for all the docu-ments available for the patient according to the corresponding filter criteria, and the matching documents are displayed in the work area. A predefined matrix for the display is selected automatically.

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

FORUM Clinical View: Clinical Displays

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Basic rules

For documents to be displayed by accessing a preselection ("Clinical Dis-plays"), documents that satisfy the relevant criteria must be accessible to the selected patient in FORUM. Documents not assigned to a laterality are not taken into account. In addition to this, the following rules apply:

– The documents to be considered were generated within a defined time span. Here the time span indicates the period that has elapsed between the most recent document found and the other documents to be consid-ered. Unless otherwise specified, this time span equals half a year.

– If there is more than one valid document of a particular type available, the document marked as a favorite is used (see section "Marking favorites" on page 117);If no document or more than one document is marked as a favorite, the more recent document is used.

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 work area (see also section "Remote Data (MultiSiteQuery)" on page 62ff.).

Document types

Documents are assigned to different document types on the basis of prede-fined parameters in order that they can be displayed in a preselection. For 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

Glaucoma

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

Laterality: OD or OS (selectable)

Documents which are assigned an "OU" (both eyes) are taken into account in every selection.

Matrix: 1×3

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

Most recent OCT report (ONH or RNFL analysis)

Most recent SFA report (HFA or Glaucoma Workplace)

Most recent color or red-free fundus image

Time span: See "Basic rules" on page 121.

The procedures associated with the documents must be carried out at maximum intervals of a half year (180 days).

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) Displays a fundus image for each laterality and a combined report.

Laterality: OD, OU, OS

Matrix: 1×3


Most recent colored fundus image of the right eye

Latest combined report generated by Glaucoma Workplace from an HFA and an RNFL, ONH, or OCT report.

Most recent colored fundus image of the left eye


The procedures associated with the documents must be carried out at maximum intervals of a half year (180 days).

Image type: Contains "COLOR"

Document title:

Contains "HFA Visual Field and CIRRUS RNFL Combined Report" or "HFA Visual Field and Cirrus ONH Combined Report" or "COM-BINED_REPORT" (from Glaucoma Workplace)


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Glaucoma Progression (FI) Comparative display of the oldest and most recent fundus images for the selected laterality.


Matrix: 2×2

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

Most recent colored fundus image of the oldest visit

Most recent colored fundus image of the second-oldest visit

Most recent colored fundus image of the penultimate visit

Most recent colored fundus image of the last visit


All visits for which documents of the corresponding type were gen-erated are taken into account. The length of time between the last and penultimate visit can be freely chosen.

Image type: Contains "COLOR"


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

Laterality: OD, OD, OS, OS

Matrix: 1×4


Most recent report on an "OPTIC DISC GPA" (CIRRUS), right eye

Most recent report on a guided progression analysis, e.g. HFA GPA or Glaucoma Workplace GPA, right eye

Most recent report on an "OPTIC DISC GPA" (CIRRUS), left eye

Most recent report on a guided progression analysis, e.g. HFA GPA or Glaucoma Workplace GPA, left eye


The procedures associated with the reports must be carried out at intervals of a half year (180 days) at the maximum.

Document title:

Contains "Guided Progression Analysis"

or "GPA"


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Retina

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


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 penultimate visit

Most recent report of the last visit


All visits for which documents of the corresponding type were gen-erated are taken into account.

Document title:

Contains "Macular Thickness"


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


Matrix: 2×4

Top line: last visitBottom line: penultimate visit


First fundus angiography image, generated within 25 seconds of contrast medium administration

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


Fundus angiography image, gen-erated 121 seconds or more after contrast medium administration


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


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


Documents which are assigned an "OU" (both eyes) are taken into account in every selection.

Matrix: 1×3


Last fundus angiography image after contrast medium administration

Most recent OCT report (extended display)

Most recent OCT report (HD images)


All three documents must have been created on the same visit day.

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

Document title:

Contains "Advanced Visualization"

or "High Definition Images"


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


Matrix: 2×3


Most recent colored fundus image

Prerequisite:FA (=fluores-cence angi-ography) times in the records

Most recent red-free fundus image

First fundus angiography image, generated within 25 seconds of contrast medium administration

First fundus angiography image, generated between 26 and 60 seconds after con-trast medium administration


First fundus angiography image, generated 121 seconds or more after contrast medium administration


All documents must have been created on the same examination day.

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


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Cataract

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


Documents which are assigned an "OU" (both eyes) are also taken into account during each selection, while documents without an assignment are disregarded.

Matrix: 1×3


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

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

Most recent biometric IOLMaster report (report on an optical biometric examina-tion in PDF format, e.g. generated by an IOLMaster™).


The procedures associated with the reports must be carried out at intervals of a half year (180 days) at the maximum.

Device Name: Contains "IOLMaster" or starts with "ATLAS"

Document title:

Contains "Macular Thickness"

FORUM Troubleshooting

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Troubleshooting

Malfunctions

Malfunction Cause / procedure

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 installed successfully using the function <Help><Upload License File>. Nevertheless, the corresponding function is not available.

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

If you are missing new functions from the area of a FORUM Workplace Plugin, have your local system administrator check if this function was enabled for your user account.

In the patient selection, patients with an NHS format patient ID are not found.

This behavior is particularly prevalent when the patient ID entered or copied into the field is separated by blank spaces.

Enter the patient ID without blank spaces or activate the "Search in all Name Fields and Patient ID" search option in your user settings.

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 infor-mation, 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.

Software area

Error message Cause Procedure

Overall No connection to server <Host-name or IP address>

The server processes are stopped or the set-tings for the firewall on the server are not correct.

Check whether the server processes have started correctly, and check the set-tings for the fire-wall on the server.Then restart the FORUM Viewer.

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 restart the FORUM Viewer.

FORUM Troubleshooting

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Login Login failed! The user name does not exist or the pass-word that has been entered is wrong.

Please check the capitalization.

Please contact your local system administrator, if necessary.

The user was automatically logged off since no matching patient was found.

The user was part of the user group "EMR Reader". However, FORUM is not con-nected with an EMR system.

Contact your local system administrator.

A user of the user group "EMR Reader" has tried to log in to the FORUM Viewer, how-ever, no patient data are currently trans-ferred from there to FORUM.

Call up a patient for FORUM in the EMR system and try to log in again.

Software area

Error message Cause Procedure

Index of technical terms FORUM

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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 No.". 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 Entity 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.

FORUM Index of technical terms

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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.

A DICOM record contains all of a patient’s master data (so-called "metadata") 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 complication-free transfer of data 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.

The DICOM standard has the advantage for the user that, provided there is conformity, interoperability between various medical applications ("applica-tion 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 designated 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.


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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 overwritten 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.

HL7 = Health Level 7. This is a group of international standards for the exchange of data between healthcare organizations and their respective 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]

Via the HL7 standard, news is exchanged within a hospital information system that controls administrative functions for patient and task administration:

– Patient Administration: Admitting patients, discharging patients, moving patients;

– Task administration: Creating, changing and deleting worklists.

FORUM responds to these functions.

FORUM Index of technical terms

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Index No. In FORUM the records of a patient have a hierarchical relationship with one another. Each record is assigned an index number for this purpose in the data-base. 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 measurement)

– OP (Ophthalmic photography)

– OPM (Ophthalmic mapping)

– OPT (Ophthalmic tomography)

– OPV (Ophthalmic visual field)

– OT (Other)

– SRF (Subjective refraction)

– 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 rep-resentation), a name can be represented by an ideographic depiction or an additional spelling that shows the pronunciation of the name (phonetic transliteration).


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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, as the user of the service. The other side as the Service Class Provider, as 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.

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).

FORUM

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Index

A

Accession number .................................................................................. 134Accessories ............................................................................................... 11Additional functions ............................................................................... 105Address of the manufacturer ...................................................................... 2AE Title .................................................................................................. 134AET ........................................................................................................ 134Angiography series ................................................................................... 91Automatic Orders ..................................................................................... 46

B

Buttons .................................................................................................... 30

C

CE conformity ............................................................................................ 7Changing the list display ........................................................................... 30Changing the list sorting .......................................................................... 30Changing the password ............................................................................ 27Clinical Displays ........................................................................................ 77

Basic rules ................................................................................... 121Document types .......................................................................... 121Filter descriptions ........................................................................ 122Preselection ................................................................................ 120

Clinical ViewDocument Display ......................................................................... 77Document selection ...................................................................... 78FORUM Workplace Plugins ........................................................... 77Overview ...................................................................................... 74Presets .......................................................................................... 77

Clinical ViewsClinical Displays ............................................................................ 77

Code Meaning ......................................................................................... 73Comments ............................................................................................. 112Configuring FORUM, user profile .............................................................. 13Conformity (CE) .......................................................................................... 7Context menu ........................................................................................ 105Contraindication ....................................................................................... 23Create Patient ID ................................................................................ 39, 45

FORUM

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Create, Patient ID ............................................................................... 39, 45Creating

New order (automatic) .................................................................. 46New order (manual) ...................................................................... 47New patients ................................................................................ 40

Creating a patient data record ................................................................. 40

D

Data protection ........................................................................................ 20Definition of terms ..................................................................................... 6Delete

Document .................................................................................... 60Patient data record ....................................................................... 57

Depositing procedure codes ..................................................................... 72DICOM ................................................................................................... 135Display windows ...................................................................................... 87Displaying icons ....................................................................................... 28Displaying raw data ................................................................................. 28Document .............................................................................................. 135Document Display .................................................................................... 77Document Navigator ................................................................................ 91Document selection ................................................................................. 78Documents

Delete ........................................................................................... 60Edit ............................................................................................. 104Export ......................................................................................... 119Exporting (DICOM files) .............................................................. 119Import .................................................................................... 39, 69Move ............................................................................................ 58Opening ..................................................................................... 101Print ........................................................................................... 111Reassign ....................................................................................... 58Sorting ......................................................................................... 86

E

Editing master data .................................................................................. 54EMR ....................................................................................................... 136Error messages ....................................................................................... 132Evaluating data, user profile ..................................................................... 15Export

All the patient’s documents .......................................................... 75Documents ................................................................................. 119Selected documents of a patient ................................................. 105

Export DICOM files ........................................................................... 75, 105Extended search function ................................................................... 30, 33

FORUM

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F

FIFO ....................................................................................................... 136Filter ......................................................................................................... 99Filter descriptions (Clinical Displays) ........................................................ 122Filtering visits ........................................................................................... 99FORUM Viewer ......................................................................................... 24

Close ............................................................................................ 26Logout .......................................................................................... 25Start ............................................................................................. 24

FORUM Workplace Plugins ....................................................................... 77Full-screen view ................................................................................ 91, 103

Close .......................................................................................... 103

G

General settingsDisplaying icons ............................................................................ 28

Glossary ................................................................................................. 134

H

Hazard Symbols .......................................................................................... 5Help ......................................................................................................... 35Hidden documents ................................................................................... 83HIS ......................................................................................................... 136HL7 ........................................................................................................ 136

I

IconsPatient Administration .................................................................. 54Remote Data ................................................................................. 67Status line ..................................................................................... 89

Image series ........................................................................................... 118Import

Data from remote FORUM systems ............................................... 65DICOM files .................................................................................. 71Documents ............................................................................. 39, 69

Import from FORUM systems ................................................................... 65Importing DICOM files .............................................................................. 71Index No. ............................................................................................... 137Index of technical terms ......................................................................... 134Information on trademark law .................................................................... 6Information security ................................................................................. 20Information symbols ................................................................................... 7Intended use ............................................................................................ 23Interfaces ................................................................................................. 10

FORUM

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L

Layer images (OPT data) ......................................................................... 107Load preview ........................................................................................... 63

M

Malfunctions .......................................................................................... 131Managing data, user profile ..................................................................... 14Manufacturer’s address .............................................................................. 2Marking favorites ................................................................................... 117Matrix ................................................................................................ 85, 92Measurements (fundus images) .............................................................. 114Modality ................................................................................................ 137Monitors, calibrated ................................................................................. 22Move (documents) ................................................................................... 58Multiple selection ..................................................................................... 31MultiSiteQuery ......................................................................................... 62

O

OCT ....................................................................................................... 138OCT scans ................................................................................................ 28OD/OS comparison ................................................................................ 109Online Help .............................................................................................. 35OPT data ........................................................................................ 107, 118Order

Automatic creation ....................................................................... 46Automatic generation ................................................................... 46Create manually ............................................................................ 47

Overview of functions ................................................................................ 8

P

PatientCreating ....................................................................................... 40Delete ........................................................................................... 57Editing master data ...................................................................... 54Merge .......................................................................................... 56Search .......................................................................................... 32Search (Clinical View) .................................................................... 76Selecting ................................................................................. 32, 76

Patient Administration ............................................................................. 50Icons ............................................................................................ 54

Patient Directory ...................................................................................... 36Patient directory, see Patient DirectoryPatient identification ................................................................................ 75PDF documents ...................................................................................... 118

FORUM

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Placeholder search ................................................................................... 34Play video ................................................................................................. 95Plugin (Definition) ....................................................................................... 6Preselection ............................................................................................ 120Presets ..................................................................................................... 77

Clinical Displays ............................................................................ 77Document Display ......................................................................... 77FORUM Workplace Plugins ........................................................... 77

Print ....................................................................................................... 111

R

Reassign (documents) ............................................................................... 58Reference entry (icon) ............................................................................... 54Reference files, temporary ........................................................................ 63Refreshes the screen contents .................................................................. 30Remote Data ............................................................................................ 62

Icons ............................................................................................. 67Import .......................................................................................... 65Load preview ................................................................................ 63

Reset filter ................................................................................................ 30Resolving conflicts .................................................................................... 55Review Software, launching ................................................................... 106Rights (user) ............................................................................................. 29

S

SaveDICOM files .................................................................................. 93Documents ................................................................................... 93

Save DICOM files ...................................................................................... 93Search function, extended ........................................................................ 33Search with placeholders .......................................................................... 34Security measures for IT systems and networks ........................................ 19Series ..................................................................................................... 138Software applications (optional accessories) ............................................. 11Software description .................................................................................. 7

Accessories ................................................................................... 11Interfaces ...................................................................................... 10Overview of functions ..................................................................... 8

SOP class ................................................................................................ 138Sorting

Documents ................................................................................... 86Lists .............................................................................................. 30Thumbnails ................................................................................... 86

FORUM

000000-2240-366-GA-GB-171117

Special functions .................................................................................... 105Comments .................................................................................. 112Context menu ............................................................................. 105Layer images (OPT data) ............................................................. 107Marking favorites ........................................................................ 117Measurements (fundus images) .................................................. 114OD/OS comparison ..................................................................... 109

Status line ................................................................................................ 89Study ..................................................................................................... 138Symbols ..................................................................................................... 5

Hazard Symbols .............................................................................. 5

T

Temporary copy (icon) .............................................................................. 54Temporary reference files ......................................................................... 63Thumbnails .............................................................................................. 82

Filtering ........................................................................................ 99Sorting ......................................................................................... 86

Toolbar .................................................................................................... 92Tools ........................................................................................................ 92Trademark information .............................................................................. 6

U

Use in accordance with the designated purpose ....................................... 23User administration (rights) ...................................................................... 29User profiles ............................................................................................. 12

CAS .............................................................................................. 13Configuring FORUM ..................................................................... 13Evaluating data ............................................................................. 15Installing software ........................................................................ 13Local system administrator ........................................................... 13Managing data ............................................................................. 14Nursing staff ................................................................................. 14Ophthalmologists ......................................................................... 15Optician ........................................................................................ 15Qualified medical employees ........................................................ 14ZEISS Service ................................................................................. 13

User rights ............................................................................................... 29User settings ............................................................................................ 27

V

Video (icon) .............................................................................................. 54Visit selection ........................................................................................... 79

FORUM

000000-2240-366-GA-GB-171117

W

Work area ................................................................................................ 84Worklist ................................................................................................... 42

FORUM

000000-2240-366-GA-GB-171117

Goeschwitzer Str. 51-5207745 JenaGermany

E-mail: [email protected]: www.zeiss.com/med

Carl Zeiss Meditec AG

5160 Hacienda DriveDublin, CA 94568USA

Toll-free: 800-341-6968Phone: 925 557-4100Fax: [email protected]/med

Carl Zeiss Meditec, Inc.