efilm ris-pacs system guide

7/17/2019 EFilm RIS-PACS System Guide

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eFilm RIS/PACS™ 2.0 User’s Guide



eFilm RIS/PACS™ User Manual Version 2.0

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This document has been prepared by Merge Healthcare for its customers. Thecontent of this document is confidential. It may be reproduced only with writtenpermission from Merge Healthcare. Specifications contained herein are subject tochange, and these changes will be reported in subsequent revisions or editions.

It is prohibited to use the software described in this document as a substitute for theknowledge, skill and experience of the competent medical personnel who are itsintended users.

Caution: U.S. federal law restricts this device to sale by, or on the order of, aphysician.

eFilm RIS/PACS™, eFilm Workstation™, and eFilm Lite™ are trademarks of MergeHealthcare. The names of other products mentioned in this document may be thetrademarks or registered trademarks of their respective companies.

Copyright © 2008 by Merge Healthcare. All rights reserved. Unauthorized use, reproduction, or disclosure is prohibited.

Merge Healthcare6737 W. Washington Street, Suite 2250Milwaukee, WI 53214

For assistance, please contact Merge Healthcare Customer Support:

• In North America, call toll free 1-877-741-5369

• Email | [email protected]

Part Number 0905-274-0002-000 Rev. 1.0



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Contents

Chapter 1: Accessing the System ................................................. 1

Accessing the System .................................................................................................. 1

Chapter 2:

System Information ..................................................... 3

System Overview .......................................................................................................... 3

Chapter 3:

Edit Functions .............................................................. 6

Accessing the Edit Functions ....................................................................................... 6

Change PW .................................................................................................................. 7

Insurances .................................................................................................................... 8

Modalities.................................................................................................................... 10

Outside Study ............................................................................................................. 11

Patients ....................................................................................................................... 13

Physicians .................................................................................................................. 15

Procedures ................................................................................................................. 17

Signature .................................................................................................................... 18

Templates ................................................................................................................... 20

User Options ............................................................................................................... 22

Chapter 4: Workflow .................................................................... 24

Using the Workflow ..................................................................................................... 24

Chapter 5: Schedule ..................................................................... 30

Using the Schedule .................................................................................................... 30



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Chapter 6:

Tools ........................................................................... 55

Accessing the Tools ................................................................................................... 55

Approve Dist., Delivery Log, Dist Mgr. ....................................................................... 56

DICOM In .................................................................................................................... 58

DICOM Out ................................................................................................................. 59

DOC Mgr..................................................................................................................... 60

Download .................................................................................................................... 61

File Mgr ....................................................................................................................... 62

Chapter 7:

Administrative Functions .......................................... 64

Accessing the Administrative Functions ..................................................................... 64

Clinics ......................................................................................................................... 65

Config ......................................................................................................................... 67

Data Mgt ..................................................................................................................... 74

DICOM Rules ............................................................................................................. 77

Email Rpts .................................................................................................................. 78

Logs ............................................................................................................................ 79

Export ......................................................................................................................... 80

Mgt Rpts ..................................................................................................................... 81

Servers ....................................................................................................................... 85

Services ...................................................................................................................... 87

Users .......................................................................................................................... 88

Utilities ........................................................................................................................ 91

Chapter 8:

Support ....................................................................... 92

Support Options .......................................................................................................... 92

Downloads .................................................................................................................. 93

Submit Ticket .............................................................................................................. 94

FAQs ........................................................................................................................... 95

Manuals ...................................................................................................................... 96

Chapter 9: Appendix .................................................................... 98




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User Quick Reference Guide...................................................................................... 99

ActiveX Web Viewer Instructions ............................................................................. 100

Adding a referring physician login ............................................................................ 118

Backing up studies using a 3rd party application ..................................................... 124

Backing up studies in eFilm™ Workstation .............................................................. 129

HIS/RIS DLL ............................................................................................................. 133

Key Images ............................................................................................................... 144

DICOM Dir/eFilm™ Lite Prefetch ............................................................................. 148

How to allow pop-ups ............................................................................................... 156

How to import studies from media to eFilm™ Workstation ...................................... 158

Referring Physician Setup ........................................................................................ 160

Quick Setup Manual ................................................................................................. 167

Modality Worklist Setup ............................................................................................ 175

HL7 Export Specifications ........................................................................................ 177

eFilm™ Workstation Setup ....................................................................................... 191



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1

Chapter 1: Accessing the System

This chapter will guide the user through accessing PACS.

Accessing the System

Type the web address into the internet browser.

Note: If you do not know the address of your PACS system, please contactyour Administrator.

Log into system:

• Username

• Password (Figure 1)

Figure1




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Chapter 2: System Information

This chapter will explain the main information screen of the system.

System Overview

Upon logging in, the user will see the main screen. There are 6 tabs (dependingon the user type) that will allow the user to perform functions and interact with thesystem. Each tab EXCEPT the “main”, “schedule” and “workflow” tab hassubmenus (sub buttons). (Figure 2)

Figure 2

The following is a brief description of the top level buttons. Each section isdetailed in the chapters of the manual.

The “Main” button displays the information center which includes a generaloverview of the system.

The “Edit” button allows access to add/change system information, e.g., patients,insurances, outside studies, procedures and modalities.

The “Workflow” button displays studies that have been received by DICOMtransactions or added as outside studies in the system. It includes severalworkflow processes including, history of the patient, viewing methods and reports

The “Schedule’ button allows access to the system RIS functions, e.g.,scheduling, EMR, billing and patient tracking.

The “Tools” button contains several system tools, e.g., document, management,DICOM transactions, file sharing, and report delivery.




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The “Support” button displays system FAQs, manuals and the support ticketsubmission.




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Chapter 3: Edit Functions

This chapter will explain the system edit functions

Accessing the Edit Functions

EDIT TAB (Figure 3)

Figure 3




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Change PW

To change the existing password, the user will choose this option. Follow theinstructions, and then click “submit” when finished. (Figure 4)

Figure 4

Note: It is recommend that passwords contain a minimum of six (6) characters,uppercase and lowercase letters and numbers/symbols. The systemrequires a minimum of 6 characters including one number and letter.




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Insurances

This section allows adding or searching for insurances in the system. To searchfor an insurance company, type all or part of the name in the search box andclick “search”. (Figure 5a) After searching, a list of all insurances that meet yoursearch criteria will display. (Figure 5b) If an additional insurance needs to beadded to the list, click the “add insurance” button (Figure 5c) and a popup screenwill show. Fill in the necessary information. The web address must containhttp:// at the beginning of the entry. After adding/modifying information, click“Save”. (Figure 5d)

Figure 5a

Figure 5b




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Figure 5c

Figure 5d




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Modalities

The system is pre-populated with several modalities. If there is a modality thatneeds to be added to the system, click the “add modality”. (Figure 6a) In thepopup, fill in the fields and click “save”. (Figure 6b)

Caution: Please note that after a modality is added to the system itcannot be deleted. Proceed with caution.

Figure 6a

Figure 6b




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Outside Study

This feature is for studies that were performed at an outside facility that will beread at your clinic. In addition, it can be used for studies that are not digital, but

need to be added to the worklist. While filling out the information for this option,the patient ID is the ID that has been assigned to the patient through the RIS.Please make a note of the patient ID before adding an outside study. RISinformation that can be added to the system will have a “add” link next to it.(Figure 7a) Also, should there be a patient that was on the schedule and itneeds to be added to the workflow but there are no images to send, the user cansimply pull the study information over from the schedule by clicking the “searchappointments” link. (Figure 7b) Once the user searches for the specific patient’sappointment, the fields will auto-fill with the information from the schedule. Whenthe user completes these fields, click “save”. (Figure 7c)

Figure 7a




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Figure 7b

Figure 7c




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Patients

To search for a patient or to add a patient into the system, use this feature. Tosearch for a patient that is already in the system, use the search field. Searchingcan be done by patient ID, patient name, or date of birth. Depending on how theuser wishes to search for the patient, that information will be entered into theblank field, and then choose the appropriate search feature from the drop downmenu.

Note: When searching for a patient by name, use ONLY the first OR the lastname, not both.

Click the search button to search. (Figure 8) If the user needs to add a patientto the system, click the “add patient” button. (Figure 9) The screen will now

show different fields to fill in with the patient’s information.

Note: By leaving the Patient ID field blank, that will allow the system toautomatically assign an ID to the patient after the information is saved to thesystem. This ID is attached to all information specific to that patient.

Once the user has the patient ID, fill in the necessary fields and click “save”.(Figure 10)

Figure 8




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Figure 9

Figure 10




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Physicians

This is where the list of referring physicians will be entered. Once a referringphysician is entered in the system, they can be attached to a patient’sappointment, the study in the workflow, the report and the user can also attach alogin which will allow the referring physicians to view their patients within thesystem. To add a physician, click “add physician” at the bottom of the page.When the Add Referring Physician window pops up, fill in the necessary fields. Ifa field has the word “skip” to the right of it, which means that it is a required fieldbut there is the option to skip that particular field. To skip a field, simply click theword skip. Once the necessary information has been added, click “save”.(Figure: add physician screen 1)




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Add Physician Screen 1

After the physician has been added to the system they will then show in the list,

once searched. (Figure: physician screen 2)

Physician Screen 2




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Procedures

This is where the different procedures that will be used for scheduling areentered. This is a list of the different procedures that your clinic performs. Once

these are entered, the user will be able to choose from the list when schedulingan appointment. If there is a procedure that is not already entered, there is theability to add one. Click the “add procedure” button. (Figure 11) Fill out thefields shown. Be sure that the “modality” field matches the type of procedure youare entering. Just because the description says “MRI”, if the modality field is notcorrect, it will not save in the system correctly. The “procedure” and “description”fields can be the same, if desired. The duration of the appointment must beentered in order to continue past this page. (i.e. if an MRI of the lumbar spinetakes an hour to perform, the duration would be 60) Once all fields arecompleted, click save. (Figure 12)

Figure 11

Figure 12




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Signature

This option allows the user to upload a JPEG image of the reading physician’ssignature. Once the image is uploaded, the signature will then appear on all

reports created by the user that uploaded the signature. The signature must bea JPG with the dimensions of 150 wide X 30 tall. (Figure: signature 1 andsignature 2)

Signature 1




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Signature 2




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Templates

Templates are equivalent to macros and are useful for normal reports, etc. If astudy is not “normal”, the user can go in and edit what you wish to change. Tosearch to see if there’s a template already entered in the system, type the nameof the template into the search field and click “search”. (Figure 13)

Figure 13

To add a new template, click the “new template” button. A new window will popup where different fields can be filled out, then click “save template”. (Figure 14)




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Figure 14




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User Options

The user options allow the user to select how many studies are returned to theworkflow page at one time. It also allows the user to set the default worklist view.Based on what is selected, that is what will be seen as the default view each timethe workflow screen is viewed. (Figure: user options)

User Options




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Chapter 4: Workflow

This chapter will explain the functionality of the Workflow.

Using the Workflow

When this tab is selected, the user will be able to view the list of patients and thestudies that have been performed. This is where the user can view whether thereport has been read, transcribed, etc. Here is a rundown of the column headersfor reference: (Figure 15)

Figure 15

ID: This is the patient’s ID that is assigned.

Acc#: This is the studies’ unique accession number..

Name: Patient’s name entered last name, first name

DOB: Date of Birth. For most studies the DOB will automatically show up. If itdoes not, the system will default at DOB of 1/1/1900. To change this, click the“edit” option on the right of the screen along the same line of the patient you areediting. (Figure 16) A popup window will open to edit the information. Deletethe current DOB and enter the correct information. When completed, click the“save” button. (Figure 17)

Figure 16




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Figure 17

Sex and DOS (date of service): This should default from the original machine thestudy was performed with.

Mod: This is modality. MR – MRI, CT – Cat Scan, PET – Positron EmissionTomography, US – Ultrasound, OT – other (i.e. x-ray) This should default aswell.

Study: This is the description of what was performed. (i.e. if a patient had an

MRI of the lumbar spine, this column would show up as “lumbar spine”)

Institution: This is the name of the facility where the study takes place.

Note: This field must be completed properly. If the institution name is notentered then the system does not know where to send the study and there couldbe a violation of privacy laws.

Ref Physician: This is the name of the physician that ordered the exam. Thisfield must be completed properly in order for the referring physician to haveaccess to the study.

Ser (series): How many different series of images there are in the study.

Img (images): How many different images there are in the study.

H/O (history of): This is a brief description of why the patient is having the exam.Click on the number in this column and a window will pop-up where you canenter the patient history.

Pre (preliminary): This is where the first copy of the radiologist’s interpretationwill be. Once there is a number under this column, the report can be viewed. To




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add a report, click on the number under this column. Select Upload Report orReport Wizard from the popup window. Once the report has been created, it canbe saved as either a preliminary or final report. Should it be saved as apreliminary report, the radiologist will then review the report and finalize it.

Fin (final): This is where the final report that has been approved by theradiologist will be. Once there is a number under this column, you can printand/or deliver the report.

Radiologist: Once the exam has been read by the radiologist, their name willappear in this column

Status: This will show as “read” or “unread”. If the status shows “read”, then thetranscriptionist should be able to transcribe the report. If it shows “unread” thenthe radiologist has not had a chance to view and dictate.

Action: This is where the user can choose to edit information by clicking the editbutton. Under the action column there is also the ability to assign more than onephysician to the patient. This is in the instance that the patient is referred toanother physician other than the one that ordered the study. The additionalphysician can log into the system (they must have a username and password todo so) and view the patient’s study and report. A study can also be markedSTAT and a user can assign a study to a reading physician. (Figure 18)

Figure 18

To assign an additional physician, click the target. In the popup screen, there willbe 2 boxes. The box on the left lists all of the referring physicians that are in thesystem. The box on the right shows the referring physicians that are assigned tothe patient. To assign a physician, simply click on the name in the left box, thenclick the “add” button. The physician’s name will now move from the left box tothe right box. Should the user need to remove a physician from being assignedto the patient, click the physician’s name in the right box and click the “remove”button. Once this is finished, click close. (Figure 19)




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Figure 19

To mark a study STAT, click the ! under the Action column. This will turn theentire row red and it will stay that way until a final report has been generated. If astudy is accidentally marked STAT that shouldn’t be, just click the ! button againand it will go back to normal. (Figure: STAT)

STAT

Assign Reading Physician

To assign a study to a particular reading physician, click the “assign study”button. A window will popup that shows a list of the different reading physiciansin the system. Select the physician you want by clicking on their name. (Figure:

Assign Reading Physician)

Once the physician’s name is selected, add any notes needed. When the

reading physician logs in, they will see studies assigned to them under the “MyStudies” filter.

Users can manually select what they wish to view by changing the filters. Thereare 3 types of filters:

1. Date Filter. The selections are: Today, Yesterday, Last 3 Days, Last 7Days, or Last 14 Days.

2. Additional Filter. This is to select what type of studies the user wishes toview. Selections are: All, Unread studies, studies that have been read but




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have no report, studies that have preliminary reports, or My Studies. The MyStudies option is mainly for radiologists to get the specific studies that havebeen assigned to them.

3. Viewing Method. This allows the user to select the default method in whichthe studies are viewed through the system. Selections are: ActiveX Web,which is the system web viewer. eFilm retrieve or eFilm Image Channel.(Figure: Filters)

Filters

If the users change the filters from their defaults, they can set them back todefault by clicking the reset button.




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Chapter 5: Schedule

This chapter explains the RIS scheduling functions.

Using the Schedule

Select the “Schedule” button.

To schedule a new patient, click the “add patient” button. (Figure 20)

Figure 20

The screen will now show different fields to fill in with the patient’s information.

Note: If the Patient ID field is left blank, the ID number will be automaticallygenerated once the demographic information is saved. This ID is attached to allinformation specific to that patient.

When filling in the Insurance field, the user has the ability to search for insurancecompanies that have already been saved to the system. To search these, clickthe “search” link. (Figure 21)




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Figure 21

Note: If the user tries to add a patient whose name and/or date of birthmatches a patient already in the system, they will be prompted to either choosefrom a list of existing patients or to continue with new patient. (Figure 22) This isto eliminate duplicate entries of the same patient.




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Figure 22

There will now be a window that says “Would you like to schedule a procedurefor this patient?” Click “schedule patient”. (Figure 23)

Figure 23

The scheduling wizard window should now appear. Under “modality” click thedropdown menu to choose the correct modality you need to schedule. (i.e. MR,CT, OT, US) Once the correct modality is selected, click the “search” button.(Figure 24)




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Figure 24

A list of the pre-entered studies under the specific modality will now be listed.Find the study description you need and click on it. (Figure 25)

Figure 25

The system will now show the screen where the date and time of theappointment is chosen. Click the date needed on the calendar then choose fromthe time slots listed. (Figure 26)




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Note: The times that are available will be shown in white. If a time is shown ingreen that means it is booked. Should the times show up in red that means thatthe particular time slot is overbooked.

Figure 26

Once the desired time is selected, the system will show the screen in thescheduling wizard to add additional information pertaining to the study. Here, the

user must enter the referring physician, CPT, ICD-9 and Insurance name byclicking the search link. (Figure 27) Enter the search criteria in the search fieldand click the search button. Find the information needed and click on it and it willfill in the field. If any fields have the word “skip” to the right of it, click “skip” and itwill allow that field to be skipped. Once all fields are completed, click “schedule”.




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Figure 27

The system will now ask if you would like to schedule another procedure. Click“schedule another” or “close”. (Figure 28)

Figure 28

To schedule an existing patient that is already in the system, click the “schedule”button. (Figure 29)




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Figure 29

Search by either the name, patient ID, or DOB, then click the “search” button”(Figure 30) Find the patient from the list and click their name.

Figure 30

Follow the same instructions above to complete the scheduling process.

Under the action column on the schedule there are different actions that canoccur. Edit, confirm appointment, verify appointment, print patient informationsheet, status and if an appointment has an insurance entered and has a webaddress, there will be a button to take you to the insurance company’s website.




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EDIT BUTTON

To delete, reschedule or edit appointment information, find the patient’sscheduled procedure and click the “edit” link. (Figure 31)

Figure 31

If the appointment needs to be deleted/cancelled, click the “delete appointment”button. (Figure 32)

Figure 32

Next, the user will be asked to select the reason for deleting the appointment.Select from the dropdown menu and then click delete and the appointment willbe deleted. (Figure: Delete Appt)




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Delete Appt

If the appointment needs to be rescheduled, click the new date and/or time onthe screen. If the appointment needs to be moved to a different time, but on thesame day, only click the new time. If the appointment needs to be moved to anew day, click the desired day on the calendar, then choose the time. (Figure 33)




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Figure 33

To search for a scheduled patient only, click the “search” button. (Figure 34)

Figure 34

Enter the patient name or ID, then click search. If the patient entered is

scheduled for a procedure, they will show here when the appointment isscheduled. (Figure 35)




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Figure 35

Click on the date/time link at the far left, and the system will be directed to theschedule for that modality and day.

To print a schedule, select the print list, print full or print all buttons. Print list willprint the schedule of the specific modality that is chosen. Print full will print abird’s eye view of the schedule for the day. Print all will print the schedule for allmodalities. (Figure 36)

Figure 36




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CONFIRM APPOINTMENT BUTTON

When the confirm appointment button is clicked, a popup will appear that showsthe appointment information along with a field to enter notes. Once notes areentered and/or confirming the appointment, click the save button. (Figure 37)

Figure 37

Once the user has clicked save, the popup will close and the confirmappointment button will change to a check-mark. If the mouse is placed over thecheckmark, a tool-tip showing the date and time the appointment was confirmed,who it was confirmed by, and any notes entered, will appear on the screen.(Figure 38)




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Figure 38

VERIFY APPOINTMENT BUTTON

When the verify appointment button is clicked, a popup will appear that showsthe appointment and insurance information along with a field to enter notes.Once notes are entered and/or the appointment is verified, click the save button.(Figure 39)

Note: This is where information regarding precertification or any insuranceverification information will be entered.




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Figure 39

Once the user has clicked save, the popup will close and the verify appointmentbutton will change to a check-mark. If the mouse is placed over the checkmark,

a tool-tip showing the date and time the appointment was verified, who it wasverified by, and any notes entered, will appear on the screen. (Figure 40)

Figure 40




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PRINT PATIENT INFORMATION SHEET

When this button is selected, it will bring up a printable page with the clinicletterhead at the top. The page will include the patient demographic information,insurance information and appointment information.

DOCUMENTS BUTTON

When this button is selected, the user can scan or upload documents to thepatient. To do this, click the “add document” button. If the user wishes to uploada document that is saved to the computer, click “upload”. From there, browse thecomputer for the document and upload it. Documents cannot be larger than 2MBand users can upload .doc, .pdf and .tif to the system. (Figure: Add Document1and Add Document2)

Note: If needing to scan a document, the PACS website must be added to thelist of trusted sites. To do this, in Internet Explorer, go to Tools/InternetOptions. (scan1) Select the ‘security’ tab, click on ‘Trusted Sites’ andclick the ‘sites’ button. (scan2) Type the web address in the top fieldand click the ‘add’ button. (scan3) Once the site has been added, userscan now scan documents.




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Scan1

Scan2




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Scan3

To scan a document, select ‘scan’. Follow the prompts to scan the document.(Figure: Add Document 1 and Add Document2)




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Add Document 1

Add Document 2

Click the ‘scan’ button. If the ‘show scanning user interface’ box is checked, thescanning interface for the installed scanner will show on the screen.




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Select the scanner from the list of sources and click ‘select’.

Click ‘scan’.

Note: Users must make sure that they are scanning in black and white in orderfor the scanned document to show properly. Scanning applicationinterfaces will vary.




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Once the document has finished scanning, it will appear on the screen. Click‘ok’.




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If an additional document needs to be added, click ‘ok’ when asked to add anadditional document. If no additional documents need to be added, click the‘cancel’ button. The scanned document is now saved.




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STATUS BUTTON

This button allows users to see when a patient arrived, was checked in, when thestudy began and when they checked out. When the patient arrives, click thebutton that looks like a door. (Figure: Arrive) The button will change to a singleline. (Figure: check-in) To check the patient in, click the single line button and itwill turn to a button with 2 lines. Once the patient is checked in, the appointmentwill turn green. (Figure: check-in green) After 10 minutes, if the status has notchanged to show that the study began the appointment will then turn orange.(Figure: check-in orange) After 20 minutes from when they were checked in, ifthe study does not show that it began the appointment will then turn red. (Figure:check-in red) Once the study has begun, click the button with 2 lines and it willchange to show 3 lines. (Figure: Start Study) Once the study is completed, clickthe button with 3 lines to check them out. Once the patient has checked out,place the mouse over the check-mark and a tool-tip will appear on the screenshowing the duration of their appointment with when they arrived, checked in,began the study and checked out. (Figure: Time Line)

Arrive

Check-In

Check-In Green

Check-In Orange

Check-In Red




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Start Study




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Time Line

INSURANCE WEBSITE BUTTON

When a patient is scheduled, if the web address for the insurance company is

entered, this button will show up on the schedule. By clicking this button, it willbring up a popup that takes you directly to the insurance website.

Note: This button will only show if the insurance company’s web address wasentered in the system.




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Chapter 6: Tools

This chapter will explain the system tools.

Accessing the Tools

Select the “Tools” button.

The tools tab is where users can manage the incoming and outgoing faxes,where users can see what studies are coming in and going out and where filescan be uploaded. For outgoing faxes, there are 3 steps.




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Approve Dist., Delivery Log, Dist Mgr.

Approve Dist., Delivery Log, and Dist Mgr allow management and interaction withthe system faxing and email delivery components

Distribution Manager

The “Dist Mgr” is where rules will added to allow a report to be auto faxed. To dothis, you will the “add rule” button. In the Referring Physician field, click thedropdown menu to select the physician the rule will apply to.

Note: The physician must already be added to the system in order for them tohave a rule. See the instructions for adding a physician above.

In the Destination Type field, click the dropdown menu and choose fax or email.In the “Destination” field, enter the fax number or email address for the physician.To ensure that a report does not get faxed out until it has been finalized, click the“On Finalize” box. If a report needs to be approved prior to it sending, click the‘require approval’ box. Once these steps have been completed, click the “save”button. (Figure 41)

Figure 41

Approve Distribution

If the “Require Approval” box was selected when adding a rule, the fax or emailwill be in the Approve Dist. page. Here, to see what the fax/email contains, clickthe patient name. The fax/email will not be sent until the user clicks “approve”. Ifthe report does not need to be sent, simply select cancel. (Figure 42)




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Figure 42

Delivery Log

The “Delivery Log” is where the status of the fax or email deliveries can beviewed. “Processed” means that it has been sent, “Awaiting Send Approval”means that the user needs to go into the Approve Dist section and click theapprove link to send it. If the system says “error”, it did not go through. (Figure43)

Figure 43




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DICOM In

All incoming DICOM transactions are recorded in the DICOM In section.

The system will display complete and in progress transactions.

DICOM In

Users can search for received studies by date or by name. To search by name,type the last name in the search field and click the ‘search’ button. Whensearching for a patient, the system will search the date listed in the date field. Tochange the date, click either the calendar button or the arrows on either side of

the button labeled ‘today’. The DICOM In screen will auto refresh. Users canset the desired refresh interval by selecting the number from the Page Refreshdropdown list.

Studies can be selected (using the check boxes) and sent to DICOM nodes byclicking on the “Push” button. A list of destination DICOM nodes will bedisplayed.




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DICOM Out

All outgoing DICOM transactions are recorded in the DICOM Out section.

Incoming studies that match DICOM rules, will display as “Receiving”.

DICOM Out

Users can search for studies sent by date or by name. To search by name, typethe last name in the search field and click the ‘search’ button. When searchingfor a patient, the system will search the date listed in the date field. To changethe date, click either the calendar button or the arrows on either side of the button

labeled ‘today’. The DICOM Out screen will auto refresh. Users can set thedesired refresh interval by selecting the number from the Page Refreshdropdown list.

DICOM stores can be cancelled and resent by selecting the options under the“Action” column.




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DOC Mgr

The Document Manager display received faxes and allows reports to beuploaded/scanned into the system.

Next to the word “unassigned” there will be a list of numbers indicatingunassigned faxes/documents. Documents that were unassigned from a patientwill also display. Clicking on the unassigned numbers, will display the document.The user can either print the document or assign it to a patient. Should the userdecide to assign the document to a patient, type the patient name in the searchfield, click “search” and list of names will display. Find the name of theappropriate patient and click “assign document”. The document is now assignedto the patient.

Figure 44




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Download

The Download section contains a log of studies downloaded using the eFilm LitePrefetch/DICOM Dir Client. The system displays downloaded studies by date.The columns can be sorted by clicking on the appropriate heading.

Download




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File Mgr

The file manager allows files and documents to be shared.

Files and documents can be uploaded and saved in the system. This is a secureplace for files to be stored. (Figure: File Mgr)

File Mgr

To upload documents, click the ‘upload files’ button: When this buttonis selected, the user can browse the computer for the file to be uploaded. Tocreate a new folder within the File Manager, click the ‘create new folder’ button:

When this button is selected, a new folder will be created and the usercan name it appropriately.

Files and documents can also be downloaded by selecting and right clicking“Download” or “Download and compress”.




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Chapter 7: Administrative Functions

This chapter will explain the system Administrative functions.

Accessing the Administrative Functions

Caution: The following section should only be completed by a qualifiedIT/IS person. If you are unsure about the setup information below, pleasecontact your systems administrator. Proceed with caution.

Click on the “Admin” Button.




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Clinics

This is where clinic information is entered. This is meant to list the differentclinics where the exams will be performed. (Figure 45).

Note: The ‘Quick Setup Manual’ located in the Appendix section, providesdetailed information on configuring your system.

Figure 45

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Under the action column, click the ‘Edit’ button denoted as double boxes. Enterthe following:

Description Entry Notes

Clinic Clinic NameEnter the full clinic name, e.g., ACMEImaging

Address Clinic Street Address

Enter the full clinic address, e.g., 123Street, Suite 105

City Clinic City Enter clinic city

State Clinic State Enter clinic state

Phone Clinic PhoneEnter clinic phone number, e.g., 555-555-5555

Fax Clinic FaxEnter clinic fax number, e.g., 555-555-5556

Prefix Clinic Prefix

Enter clinic patient ID prefix. Selectfrom the provided drop down. Thisprefix will automatically be applied topatients added to the system. For

example, if the clinic name is ACMEImaging, the prefix ‘A’ would beappropriate.

Report HeaderLogo

Clinic ReportLogo

Upload the logo that will be displayedon reports generated by the reportwizard. Click the browse button toupload the logo. (note the file must bea JPG with maximum dimensions of300px wide by 120px high)

Report FooterClinic ReportFooter

Enter clinic report footer. The footermust be entered in HTML format. Seeexample below.

Website Clinic Website

Enter clinic website address, e.g.,

|http://www.YourDomainName.com.Leave the http:// prefix provided

Note: This table is only an example. Please use your unique information.

Report footer example is provided below.

Use your favorite HTML editor to create the footer for your reports. Here is asample that may be used:

ACME

Imaging 123 Bayou Blvd., Houston, Texas 77380 |

Phone 555.555.5555 | Fax 555.555.5556 Web <ahref="http://www.YourDomainName.com">www.YourDomainName.com

</a> | Email <a

href="mailto:[email protected]">info@Your

DomaiName.com</a>




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Config

Caution: The following section should only be completed by a qualifiedIT/IS person. If you are unsure about the setup information below, pleasecontact your systems administrator. Proceed with caution.

The first area is designed to give administrative users the ability to decide whatfields are required on specific pages (Figure: Skip Options). This area lists thefield name, the page name, and the option to require and/or be allowed to skipthat particular field. If the admin users choose only the required option and NOT

the skip option that means the specific field (as described in the far left column)must be filled in, in order to proceed from that page. If the admin users choosethe option to require AND skip, then the ability to skip that field will be provided(Figure: Skip). If any of these fields are skipped, then a red flag will show on theschedule for that patient, notifying the user that information is missing. (Figure:Flag)

Skip Options




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Skip

Flag




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The next section is Clinic, Misc. Settings

Login Page Logo

Click default logo to browse/upload your logo. The image must be JPG with

maximum dimensions of 250px wide by 120px high.

eFilm ActiveX Settings

This option must be configured for the online image viewer to work. Please do

the following:

Click the hyperlink “eFilm ActiveX Settings”

Local Web URL Reference

Input your system NetBIOS name and local IP, e.g., PACSSERVER,

192.168.1.10. If you are unsure how to do this, please contact your network

administrator.

Local Image Channel IP Input your local IP, i.e., the IP of the PACS, e.g., 192.168.1.10. If you are unsure

how to do this, please contact your network administrator.

Remote Image Channel IP

Input your public IP (provided by your ISP), e.g., XXX.XXX.XXX.XXX. This must

be a public, routable IP. If you are unsure how to do this, please contact your

network administrator.

Note: The following ports MUST be forwarded to your internal PACS server:TCP 443, 3333. If you are unsure how to do this, please contact your network

administrator.

Click Save (you can always go back later to make changes)

Scanning DLL registration code

Click the hyperlink to input your registration code. To obtain your registration

code, you must email your full domain name, e.g.,

|https://pacs.YourDomainName.com to support. A registration code will be

provided within 72 hours of original email (excluding weekends/holidays). Upon

receipt of registration code, enter your full domain name, e.g.,

|https://pacs.YourDomainName.com , and registration code (provided by Merge

Healthcare) and click save.

Note: The full domain name must be included to generate a license key. If youdo not know what your domain name is, please contact your PACS

Administrator.




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Schedule Settings

Click “Schedule Settings” to specify your operation hours. For example, if open

at 8:00 a.m. and close at 5:00 p.m., select the start time of 8:00 a.m. and “9” as

the length of hours. When this is complete, click “Save”.

Clinic, Misc. Settings

DICOM Service Settings:

DICOM Image Storage Server (NetBIOS name)

Click the name and verify it matches the NetBIOS name of your server. You can

view your NetBIOS name by right click on ‘My Computer’ selecting properties,

clicking the ‘Computer Name’ tab. The NetBIOS name of your system will be

displayed adjacent to ‘Full computer name’

Note: Do not include the ‘.’ at the end of the name

DICOM Image Storage Path

Do not change this value.

DICOM Image Storage Username

Password should match your Local Administrator account username, i.e.,

Administrator. Do not change this value.

DICOM Image Storage Server Password

Password should match your Local Administrator account password.

Modality Worklist Path

Do not change this value. It defines the path of the modality worklist files.

Modality Worklist Sending Server (DICOM Modality Worklist Server)

Do not change this value. Default = EFILMRISPACSWL




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DICOM Service Settings




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Key Image Convertor Service:

Key Image Layout

Select the number of columns/rows of key images on reports.

JPEG Path

Do not change this value. It defines the path of the key images directory.

Accession Separator (in powers of 10)


Default Command Line Arguments


SOPClassUID Exceptions


Key Image Converter Server Settings

Fax Service Settings

Local Area Codes (Area codes for which adding the dialing prefix '1' will not be

necessary.)

Enter area codes that do not require ‘1’ to fax. Separate values by a comma,

e.g., 936,832,713, etc.

Report Wizard URL

Do not change this value

Report Document URL


Update Status URL


FTP Path





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Fax Service Settings

Backup/Restore Settings

This is the maximum number of studies that can be archived/restored for asubmitted job. Based on the number selected, the system will archive/restore upto that many studies. It is recommended that these values not be changed as itcan affect the performance of the server if the number is too high. If the valuemust be increased, it is recommended that it be done after hours.

Backup/Restore Settings




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Data Mgt

The Data Management section allows DICOM studies to be Backed Up orRestored from local online media.

Select the Data Mgt button and then backup or restore (Figure: Data Mgt).

Data Mgt

Backup Function

Generate a Media ID for your backup job, e.g., MEDXX-XX-XXXX.

Enter the local destination. The drive letter and path of your media device isrequired. This information can be obtained by locating your media drive letterand folder via “My Computer” in Windows.

Enter the desired dates in the format displayed, e.g., XX/XX/XXXX andXX/XX/XXXX. These dates define the date of service for the backup job (Figure:Backup).

Backup




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Backup Job History displays the history and status of archived studies.

Backup Job History

Selecting the links under the ‘Status’ column will display details of the backup job.

Backup Job History Details

Restore Function

The restore function allows studies to be loaded back into the system. Search byany of the displayed fields (Figure: Restore).

Restore




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Restore Job History displays the history and status of restored studies.

Restore History

Select the target studies to restore and click the ‘Retrieve’ button.

Restore and Retrieve Selection




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DICOM Rules

DICOM Rules allow automated DICOM Store rules to be created.

When a study is received it will show in the DICOM In page (Figure: DICOMRules).

DICOM Rules

To add a rule, click the ‘Add Rule’ button. The AE Title is based on the AE Titlefrom studies received. In the Target Server field, select from the list of serverslisted in the dropdown. This list is populated from the list of servers saved under

Admin/Servers. Select the priority (low, medium, high) and click ‘save’.

Note: The list of servers is populated from the entries made under Admin/Servers. DICOM node destinations must be added before creating aDICOM rule.




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Email Rpts

The email reports section allows the user to designate the SMTP servercredentials for referring physician report notification emails.

This page is where admin users will enter the clinic’s email server information, aswell as the clinic’s email address and password for the email. This information isused for the email distribution of reports. When a referring physician receives anemail notification that they have a report to review, it will come from the emailinformation that is saved in this page (Figure: Email Rpts).

Email Rpts

Note: Referring physician report email notifications DO NOT contain any

identifiable patient information. The email provides the referring physician with anotification of a new report/images to review.




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Logs

HIPAA and PHI require health information systems to audit and recordtransactions within the software, e.g., access, editing, additions, deletions,viewing, etc. The logs section contains detailed information regarding the accessand use of the system. The logs are displayed by date and include audits ofaccess to the system, modifications, viewing of images, errors, etc. The columns(DateTime, User, Event, and Comment) can be sorted. The system also allowssearching by ‘User’. Figure: Logs

• DateTime – Date and Time of event

• User – User that performed the action

• Event – Type of action

• Comments – Details of action

Logs




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Export

The system allows HL7 compliant flat files to be created. These files can beused for billing or data sharing between other HL7 compliant systems.

Note: It is the responsibility of the clinic to determine if new or existing systemsare capable of importing HL7 flat files.

To export appointment information, select the desired date or date range. A listof the appointments will generate on the screen. Click the export button and itwill prompt you to save the exported file. The file is saved to the specifiedlocation. Cash patients can exclude from the flat file by selecting “Exclude Cash

Appointments”.

Export

Note: Detailed information on the HL7 Export standard are included in the Appendix/HL7 Export Specifications.




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Mgt Rpts

The system includes several useful management reports to aid administrators inmanaging the system and the practice (Mgt Rpts1). Each report can viewed in abrowser or opened in a PDF file.

Mgt Rpts1

Modality Report

The modality report gives a breakdown of the number of studies separated bymodality. Users can select a specific date, date range, or full month to view(Figure: Modality Report).

Modality Report




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Referring Physician Report

The referring physician report gives a breakdown of the number of studies eachphysician referred. Referring physicians can be searched by name, by typing thelast name in the search field. The system will return search results based on thedate selected. Users can select a specific date, date range, or full month to view.

(Figure: Ref Phy1)

Ref Phy1

By clicking on the physician name, a more detailed report will be providedshowing a breakdown of studies by modality (Figure: Ref Phy2).

Ref Phy2




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Cancelled Appointment Reports

This report gives a list of all appointments cancelled/deleted from the schedule.Cancelled appointments can be searched by specific date, date range or fullmonth view (Figure: Cancelled Appt Report).

Cancelled Appt Report

Reading Physician Studies By Modality Report

This report will list all reading physicians/administrative users on the system andthe number of studies they have marked read, broken down by modality (Figure:Reading Phy1).

Reading Phy1

If the user clicks on the number listed under the modalities for each readingphysician, detailed information regarding the studies read will be displayed(Figure: Reading Phy2).




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Servers

The system is capable of performing a DICOM Store (DICOM Push) to otherDICOM compliant systems.

The list of DICOM destinations is displayed (Figure: Servers1)

Servers1

To add a new server to the list, click the ‘add new server’ button (Figure:Servers2).

Servers2

Fill in the fields listed. The description field will be what you will call the entry. AE title is the AE title of the destination. Hostname is the IP address of thedestination. Server limit will be how many studies can send simultaneously to




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the same place. We suggest no more than 3 for the server limit. Retry limit ishow many times the system will retry to send the study if it is not successful.Retry time is the amount of time between retries. Once the new serverinformation is added, click save.




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Services

The system allows management and configuration of the core DICOM services,i.e., DICOM Store Server, DICOM Query/Retrieve Server, Image ChannelServer, DICOM Modality Worklist Server (Figure: Services).

This is where the different services can be started or stopped.

Services

It is recommended that these values are not changed. If the values are changed,a restart of the specified server is required.

It is highly unlikely the services will need to be stopped or restarted.

Caution: Managing the services should only be completed by a qualifiedIT/IS person. If you are unsure about the setup information, please contact

your systems administrator. Proceed with caution.




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Users

This is where users to the system are added. There are 6 different user types:

• Administrator – Unlimited functionality, access to all features

• Reading Physician – Basic functionality, ability to mark studies read

• Referring Physician – Limited functionality, view reports, images, and keyimages explicitly assigned to him/her.

• Technologist – Basic functionality, tailored workflow for technologist

• Transcriptionist – Basic functionality, tailored workflow for transcriptionist

• User – Basic functionality

To add a user click “add new user”. A popup box will appear. Fill in therequested fields and be sure that the appropriate role for the user you are adding

is selected. This field determines what information the user can see. Click ‘next’. Add the username and password and click ‘finish’.

User 1




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User 2

If the user that was just added is for a referring physician, go back to thePhysician page under the Edit menu and assign the login to the referringphysician. To do that, find the referring physician’s name and click edit. In theRef Phy Login field, click the dropdown menu and select the name of the loginthat you want to attach. Once the login is saved to the referring physician, theRef Phys Login field should now be filled in.

Note: It is imperative that the correct login is selected. If a login is attached tothe incorrect referring physician it could create a HIPAA violation, as the user willthen be able to view information they shouldn’t.

Note: It is recommend that passwords contain a minimum of six (6) characters,uppercase and lowercase letters and numbers/symbols. The systemrequires a minimum of 6 characters including one number and letter.




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Ref Phy 1

Ref Phy 2




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Utilities

The system Utilities section displays the current study capacity used.

The total studies allowed are based upon the agreement between the customerand the sales team. The Utilities screen displays the total studies allowed, thetotal studies stored, and the remaining number of studies allowed. Once the totalnumber of studies allowed is reached, the system will start deleting studies,starting with the least recent accessed study. This means that studies will bedeleted starting with the study that has been dormant for the greatest amount oftime. When studies are deleted, only the images are deleted. All reports,documents and information will remain.

Utilities

Note: To increase the number of Total Studies Allowed, please contact theSales team.




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Chapter 8: Support

This chapter will explain the system support functions including downloads, ticket

submission, FAQs and Manuals.

Support Options

Click on the “Support” button.




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Downloads

The system will display available downloads. Add-ons and additional modulesare included. Click the file name to download.




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Submit Ticket

The Submit Ticket option allows a support ticket to be submitted to the supportteam.

Fill in the email address and phone field and choose the appropriate supportissue from the dropdown menu. Fill in the describe issue field and click “submitticket”. The more information provided to the Support staff the easier it will be toresolve the issue. (Figure 46)

Figure 46




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FAQs

Under the FAQ tab, there is a list of commonly asked questions. Locate andclick on the desired FAQ. The system will provide the appropriate answer.




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Manuals

The manuals section provides user documentation.

System manuals are provided in PDF and HTML format. These can be printedor saved to the computer, if desired.




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98

Chapter 9: Appendix

The appendix contains ancillary documents for the system.




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User Quick Reference Guide

Edit Menu

Insurances: Add new insurance by clicking ‘add insurance’ button. Enter insurance informationin the fields and click ‘save’. Users can search for existing entries by typing the name in thesearch field and click the ‘search’ button.

Outside Study: Patient/study information is entered for patients without films. Fill in each fieldand click ‘save’. Information will then show on the workflow screen.

Physicians: Add new referring physician by clicking ‘add physician’ button. Enter referringphysician information in the fields and click ‘save’. Users can search for existing entries by typingthe last name in the search field and click the ‘search’ button.

Procedures: Add procedures for each modality by clicking ‘add procedure’. Users must ensurethat they have the correct modality selected when adding a procedure to ensure that the

procedure is saved for the correct modality. Existing entries can be searched by selecting themodality from the drop down list looking at the list on the screen.

Templates: Add new templates by clicking the ‘new template’ button. Fill in fields and click save.Existing entries can be searched by typing the name in the search field and click ‘search’.Templates are like macros and can be used in lieu of transcription.

Workflow

Search for studies on the workflow by typing the first OR last name in the search field and click‘search all dates’. Alternatively, studies can be searched just by date by selecting single or daterange and selecting the date(s). Add histories by clicking the number under the H/O column.

Add/upload documents by clicking the number under the Pre or Fin column. Add/uploaddocuments by clicking the number under the Doc column. Under the Action column, users canedit study information, assign additional referring physicians, assign studies to reading physiciansand mark a study STAT.

Schedule

Search for existing scheduled appointments by clicking the ‘search’ button. Scheduleappointments for existing patients by clicking the ‘schedule’ button. Schedule appointments fornew patients by clicking the ‘add patient’ button. Once appointments are scheduled, documentscan be uploaded/scanned by clicking the documents button.

Tools

Dist Mgr: Reports can be delivered to referring physicians based on rules entered in the system.Click ‘add rule’ and fill in the fields and click ‘save’ to save a delivery rule.

Approve Dist: If reports require approval to be delivered, they will appear on this page. Toapprove reports to be delivered, click the ‘approve’ link at the far right. If the report does not need

to be delivered, click the ‘cancel’ link.

Delivery Log: Reports that have been delivered are listed here. Users can view the progress ofthe delivery of the report and resend reports. This serves as a confirmation page.

Doc Mgr: If the system is used to answer incoming faxes, they will appear here. Incoming faxesand other documents uploaded to the Doc Mgr will show as a number next to the word‘unassigned’. Documents/faxes can be assigned to existing patients on the system by typing thelast name of the patient in the search field to the left, then click the word search. Select thepatient you wish to assign the document to by clicking on the name once, then click the ‘assign’button.




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ActiveX Web Viewer Instructions

The ActiveX component allows studies to be securely viewed via InternetExplorer. The following section will describe the application.

In the workflow, click the patient name to view in the ActiveX component.

Note: The viewing method must be “ActiveX Web” to use the component.

After clicking the patients’ name, the ActiveX Web Viewer will open. To view andmanipulate the study, use the buttons at the bottom of the screen. (Figure 1)

Note: The series with the green border is the current focus of the tools you

specify. To change to the other series, click your mouse on the desired cell

To select different images or series, use the arrow buttons. and will

allow select the previous or next image. and will select the previousor next series of images. Also, there are ‘hot keys’ on the keyboard that can beused as well. The Pg Up key on the keyboard can be used to take the user tothe previous image and the Pg Down key will take the user to the next image.The ‘End’ key on the keyboard will take the user to the last image in the currentseries. The ‘Home’ key on the keyboard will take the user to the first image inthe current series.




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To flip the image from left to right, or right to left, click the “flip horizontal” button.

will flip the image 180 degrees along the horizontal axis. (example Figure2)

Figure 2

To flip the image from top to bottom, or bottom to top, you will click the “flip

vertical button. This will flip the image 180 degrees along the verticalaxis. (example Figure 3)




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Figure 3

To rotate the image to the left 90 degrees, click . (example Figure 4)

Figure 4

To rotate the image to the right 90 degrees, click . (example Figure 5)




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Figure 5

To have the web viewer automatically cycle through all the images in a particular

series, click the cine button .

To hide or display the study header information in the window, choose the “toggle

overlay button. (example Figure 6)




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Figure 6

To invert the color of the image to show black on white or white on black, use the

“invert” button. By default, the low intensity pixels are dark and highintensity pixels are light on the screen. By choosing this option, you are allowingthe low intensity pixels show light and the high intensity pixels show dark. Byselecting the invert button again, it will reset the image to its original view.(example Figure 7)




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Figure 7

By choosing the “auto window level” button , the image will automaticallyadjust to show optimum window/level settings. If the brightness and/or contrasthave been manipulated, by choosing this button, it will reset to the original view.

The “stack” buttons, left and right respectively, - allows the user tomanually scroll through the images within a series. The “L” and “R” in the uppercorner of the buttons tell the user which mouse key the button corresponds to.

When any button with the “L” or “R” in the upper corner are chosen, or active,

they will be gold - As long as the buttons appear gold, that is thecurrent tool the corresponding mouse key will use. Choosing two differentbuttons for the mouse buttons to use, you eliminate having to go back and forthchoosing the tool you need and can assign one tool to the left mouse key andanother tool to the right, or vice versa. While these buttons are still gold, otherbuttons that do NOT show “L” or “R” in the upper corner can still be used.

To adjust the window level of the image, use the or . This allows theuser to change or adjust the brightness and/or contrast of the image beingviewed. To adjust the brightness of an image, place the cursor over the image

needing to be adjusted, right click and drag the cursor up or down over theimage. When the mouse button is released, the new values will be applied to allthe images within the specific series. The new values are displayed in the lowerleft corner of each image. To adjust the contrast of the image, follow the samesteps, but drag the cursor left and right over the image. The adjustment of thebrightness, the new values will be displayed in the lower left corner of eachimage. (example Figure 8) Using the left, right, up and down arrow keys on thekeyboard will accomplish the same task.




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Figure 8

The pan tool allows the user to move the image around the selectedwindow. When choosing this tool, it will assign to the left mouse key – when

assigned it will look like this: . To use this tool, position the cursor over theimage needed to be moved, click and drag the cursor around the pane to movethe image. When the mouse button is released, the image remains where it waspositioned. (example Figure 9)




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Figure 9

The probe tool, , when chosen , will give a pixel coordinate for agiven point. To use, click anywhere on the image and hold the mouse buttondown to view the value of that specific point. (example Figure 10)

Figure 10




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The magnifying tool when selected will be assigned to the right mouse

button and look like this: . This allows the user to zoom in or out of theimage being viewed. Hold the right mouse button down and move the mouseaccordingly. If the cursor is moved up, the image will zoom in. If the cursor is

moved down, the image will zoom out. (example Figure 11)

Figure 11

To measure a linear distance, use the “measure line tool” or when chosen

it will look like this: This will measure in centimeters, from point A to pointB. Choose where to start the measure by clicking a point. Next, drag the mouseto where the measurement will stop. When the mouse button is released, thefinal measurement will show on the image in green. Should the measurementneed to be stretched, right click either end of the existing measurement line, dragthe cursor and drop where the measurement needs to end. To move the linecompletely to another area of the image, right click anywhere on the line, dragand drop to the new point of interest. The actual measurement will appear in agreen box called the “caption” on the measurement line. To move themeasurement caption, right click and drag to the desired location. (exampleFigure 12)




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Figure 12

The area measurement tool is used to measure an elliptical region of

interest. When chosen it will look like: . To use this tool, position thecursor at the starting point of interest, right click and drag to the ending point ofinterest. When the mouse button is released, the measurement caption will showin green, with the Area, Mean, and Standard Deviation. To stretch the ellipse,right click one of the corner markers (+), drag and drop to desired location. Tomove the ellipse, right click anywhere on the ellipse and drag and drop to desired

location. To move the measurement caption, right click the caption and drag anddrop to desired location. ***An ellipse that shows in green is the selected ellipseand is able to be manipulated. If the ellipse is orange, it is an unselected ellipse.(example Figure 13)




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Figure 13

Angles can also be measured . The angle measurement will appear ingold, if it has been selected. (example Figure 14)

Note: This tool will only work if there are 2 intersecting lines.

Figure 14




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To clear the last measurement (linear, elliptical, or angle), click the “clear

measurement” button. To clear ALL measurements on an image, click the

“clear all measurements” button. (example Figure 15 and 16)

Figure 15




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Figure 16

To show only the current reference line on an image, choose the “toggle current

reference line” button. (example Figure 17)

Figure 17

To show only the first and last reference line on an image, choose the “toggle

first and last reference line” button. (example: Figure 18)




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Figure 18

To show all reference lines on an image, choose the “toggle all reference lines”

button. (example Figure 19)

Figure 19

Note: While scrolling through the different images, the reference lines willchange accordingly. Users can view the first and last reference lines and thecurrent reference lines at the same time




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To be able to view more than 2 images on the screen, choose the “add column”

or “add row” button. To view images on the additional spaces, rightclick the mouse and choose the series that need to be viewed in the additionalpane. (example Figure 20 and 21)

Figure 20

Figure 21




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To reset the series/image back to its original settings, click the “reset image”

button.

To improve viewing performance, select the “download all” button. Thisfunction will cache the entire study to the system. After selecting the “downloadall” button, the following screen will be displayed:

Note: After selecting “download all”, do not take the focus off of the progressscreen. If users go to another Internet window or another program, thedownloading process will be interrupted, resulting in a partial download of thestudy.

Download All

Upon completion, close the progress window and to scroll through each image.

If the study has key images, select the key image button . A new windowwill open and if there are key images they will appear to be displayed. If there

are no key images, a message will be displayed “No Key Images Available”.

When reviewing of the study is complete, click the “close and return”button.




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Note: If the user viewing the study is a READING PHYSICIAN, once the “closeand return” button is clicked, they will be asked if they would like to mark thestudy as “read”. Choose yes or no.




117




118

Adding a referring physician login

This section describes the process of allowing secure remote access to referringphysicians.

To access images, key images and reports, the referring physician must beexplicitly defined in the system. Referring physicians can be added underEdit/Physicians.

On the Referring Physicians page, click “Add Physician”.

Enter in the requested information and click “save”. The referring physician isnow saved in the Referring Physician List.




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If the referring physician is already saved in the physician list, search for thephysician by typing in the last name and clicking “search”.

Add a username/password for the referring physician by going to Admin/Users.




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In the Users page, click “Add User”.

Enter in the requested information.

Note:

It is imperative that when selecting the “role” that “referring physician” isselected from the dropdown list. If this field is not filled out properly, thephysician trying to access the system will be unable to view his/her patients’studies.

After completing the appropriate fields, click “Next”.

Next, enter the username and password for the new user and then click “Finish”.




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The new user will now show in the list on the Users page.

After a login for the referring physician has been added, it must be assigned tothe appropriate referring physician login in the physician list. Go toEdit/Physicians and search for the target physician.

After searching and selecting the physician, click the edit button.

When the physician information opens, click the dropdown menu next to RefPhys Login. Search for the name of the username needed to assign to thereferring physician. After finding the physician, select and click the “save” button.*** It is extremely important that the correct login is selected from the dropdownlist. If a login is assigned to the wrong referring physician, the physician that logsin will be able to view studies/patients not referred by them. ***




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Once the login is selected, the Ref Phys Login field will now be populated andthe referring physician can now login and view their patients.




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124

Backing up studies using a 3rd party application

This section describes how to backup studies using a 3 rd party application inconjunction with eFilm.

Open eFilm

When backing up studies using the medical grade media – DVD, go toEdit/Properties.

Go to the preferences tab and change the Max. Capacity size to 4000 MB andclick OK.




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Select a date range. It’s recommended that only a week is selected at a time.Selecting a larger date range may cause eFilm to freeze. Once the date range isspecified, highlight all of the patients. Click the ‘Burn CD’ button.

Under CD Title, type in the title for what is being backed up. It may be best tosimply use the date range for the title. Under CD Packager Options, chooseDICOMDIR with eFilm Lite. Do NOT select the Burn CD option. Click theContinue button.




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Once the images are packaged, it will show where they are located. (Thereshould be a shortcut on the tech workstation desktop) Click the OK button.

Open the “shortcut to eFilm CDs” files on the desktop.

Open the CD burning program, e.g. Nero.

Under “what would you like to burn”, choose “data”, then “data disk”.

Click the “add” button then in the “select files and folders” window that pops up,choose the correct file needed to burn.

Once the date range name that you need is found, click the name to highlight it,and then click the “add” button.

Click the “next” button.




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In the “disk name” field, enter what the disk will be named, (we recommend thesame thing that you used in eFilm) then click the “burn” button.




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Backing up studies in eFilm™ Workstation

This section explains how to backup a study using eFilm™ Workstation.

Begin by opening eFilm™.

When backing up studies using the medical grade media – DVD, go toEdit/Properties.

Go to the preferences tab and change the Max. Set the capacity size to the sizeof the backup media and click OK.




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Select a date range. It’s recommended that only a week is selected at a time.Selecting a larger date range may cause eFilm to freeze. Once the date range isspecified, highlight all of the patients. Then click the ‘Burn CD’ button.

Under CD Title, type in the media name for the backup job. It may be best tosimply use the date range for the title. Under CD Packager Options, chooseDICOMDIR with eFilm Lite. Select the Burn CD option. Click the Continue

button.




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Once the images are packaged and copied to the DVD, click the OK button.




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HIS/RIS DLL

The purpose of the HIS/RIS Interface is to facilitate eFilm™ and PACS tocommunicate, thereby streamlining your workflow and expedite the reading ofstudies.

Begin by logging into the PACS. Browse to Support/Download. Click ‘eFilmHIS/RIS Interface Installer’ and save the application do the desktop. (Note: If thefile is not saved to the desktop, please note where the file is located).

Browse to downloaded application. Double-click to install application.




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Installation wizard opens. Click Next

Select ‘Everyone’ and click ‘Next’.




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The application will install.

Click close to complete installation.




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Open eFilm™ Workstation.

On the menu, click on Edit/Properties.

The properties screen is displayed.

Select the ‘HIS/RIS Interface’ tab.




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Click ‘Browse” button and navigate to C:\Program Files\MergeHealthcare\eFilmRISPACSInterface-Network. Select and open‘eFilmRISPACSInterface.dll’.

Click the ‘Settings” button.




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Input your Username, Password and Web Server address. Select ‘Enable OpenStudy Prompts’, ‘Enable Close Study Prompts and ‘Enable NetworkConnections’. Set ‘Network Timeout’ to 30 seconds. Click ‘OK’. Close eFilm™Workstation.

Note: If you do not know your username, password and/or web server address,

please contact your system administrator.

Reopen eFilm™ Workstation.

Return to Edit/Properties/HIS/RIS Interface.




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Click the ‘Verify’ button. Click ‘OK’ upon successful verification. (Note: If theverification fails, please contact your system administrator to verify yourusername, password and web server address.)

In eFilm™ Workstation, go to ‘Local Studies’ tab and click ‘Clear Filter’ and thenthe ‘Search’ buttons. The study status and user name fields will now update.




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The ‘Status’ column will display the current status of the study. ‘UNREAD’ willdisplay if the study has not been interpreted. ‘READ’ will be displayed if thestudy has been interpreted and marked ‘READ’ by a physician. ‘STAT’ will bedisplayed if the study is ‘UNREAD’ and marked as a ‘STAT’ in the system.

The ‘User’ column will be either blank or display a username. If a username

appears next to a study, it has been marked ‘Read’. If the row is blank, the studyhas not been ‘Read’.

Open a study and the initial prompt is displayed. Click ‘OK’ to view the study.Click ‘History’ to view the patient history (if it exists).

Study will now open. Click the ‘Create Report’ button to create a report for thestudy. The browser will open to the Report Wizard.




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Click the ‘View Report’ button to open the eFilm RIS/PACS™ toolbar. The‘History’ button will display the patient’s history if it exists. The ‘Documents’button will display any documents associated with the patient. The ‘Priors’ buttonwill display priors for the patient if they exists. The ‘View Rpt’ Button will showany reports for the patient if they exist. The ‘Create Rpt’ button will open theReport Wizard to generate a new report. The ‘Close’ button will close thetoolbar. When a button is selected, the browser will open to display the selectedinformation.

Upon closing a study the system will prompt the user to ‘Mark’ the study as read.If the current user is not displayed under ‘User’, select the ‘New User’ button.

Note: It is extremely important that the user checks to make sure who thecurrent user is in eFilm. If they are not listed as the current user and choose the“current user” button, then whoever IS the current user will be whose name hasmarked the study “read”. To check to see who the current user is, look justabove the “current user” button and it will be listed.




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To change the current user, input the ‘User Name’ and ‘Password’ of the currentuser. If you would like to save the new user as default, select the check box nextto ‘Set this as default user?’ and click ‘OK’.

Go to ‘Local Studies’ and click ‘Clear Filter’ and then the ‘Search’ buttons. Thestudy status and user name fields will now update.

The ‘Status’ column will display the current status of the study. ‘UNREAD’ willdisplay if the study has not been interpreted. ‘READ’ will be displayed if thestudy has been interpreted and marked ‘READ’ by a physician. ‘STAT’ will bedisplayed if the study is ‘UNREAD’ and marked as a ‘STAT’ in the system.

The ‘User’ column will be either blank or display a username. If a usernameappears next to a study, it has been marked ‘Read’. If the row is blank, the studyhas not been ‘Read’.




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Key Images

The system allows key images to be selected and created for final reports andweb viewing. The DICOM files are converted to JPEG for web viewing. Thissection describes the process of creating and accessing key images.

eFilm Workstation™ Key Image Creation

The user selects and views a study in eFilm Workstation. To select key images,the user checks the box at the bottom right corner of each image/series. eFilmwill retain the manipulations made to key images, e.g., pan, zoom,measurements, annotations, etc.

While viewing a study in eFilm, mark the appropriate images as ‘key images’ byclicking the image marker in the lower right corner of the image. Once an image

is selected, the marker will fill in yellow. Figure: Key Image 1

Key Image 1

Upon selection of all key images, click the ‘create scrapbook’ button. Figure: Key

Image 2




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Key Image 2

When the Create Scrapbook window opens, be sure that the scrapbook typeselected is WYSIWYG (What You See Is What You Get) and click the ‘create’button. When asked ‘Do you wish to send the scrapbook images?’, click ‘Yes’.Select the Store Server entry to send the images back to eFilm RIS-PACS.(Please refer to the eFilm Workstation Setup for more information on how to

setup the Store Server in the Remote Devices as a send-to destination)

After sending the key images to eFilm RIS-PACS, the images are accessible inseveral methods.

1. In the ActiveX Web viewer, click the key button. (Please refer to the ActiveXWeb Viewer Instruction on more information regarding the buttons). The keyimages are also available as a series.

2. View the printable report for the study with key images. The key images willshow on the pages following the text of the report. Figure: Key Image 3




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Key Image 3

3. The referring physician can view the key images by clicking on the ‘KeyImage’ button. The key images are also available in the ActiveX viewer andon the report.




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DICOM Dir/eFilm™ Lite Prefetch

The DICOM Dir/eFilm application allows studies to be securely received byremote clients. This section describes installation and use of the software.

Download Application

Download the installer from Support/Downloads. On the Download page, clickon DICOM Dir Installer.

Click ‘save’ to retrieve the file to your computer.




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Select the location to save the file, e.g., C:\Apps, and then click ‘save’.

Once the download is complete click ‘close’.

Install Application

Browse to where the file is saved and unzip. Once the file is unzipped, open thetarget folder (where you unzipped the file) to access the installer.

To install, double click on the installer.

Click ‘next’

Select ‘everyone’ and click ‘next’.




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Click ‘next’

The user will be prompted to enter the server name, username and password.

• The server name is URL (web address or IP) of the PACS.

• The username/password is the same as the PACS login. Select the ‘set asdefault’ button.

• Click ‘save’ to confirm the settings. Click the X to close the window.

Leave the folder name as the default and click ‘save’.




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When the user receives the prompt to wait while eFilm view is being copied, click‘ok’.

Note: This may take several seconds.

Once the viewer is copied, click ‘ok’. After the settings are saved successfully,click ‘ok’.




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Close the window by clicking the X. Upon completion of installation, click ‘close’.

Setup Application

The prefetch can first be accessed by going to Start/All Programs. After clickingthe icon, it willshow in the system tray. To access the settings, right click on the icon in thesystem tray.

Launch eFilm Lite, will open the eFilm Lite viewer.

DICOMDir Directory shows the path of the directory. If you select ‘cleanup

DICOM Directory,it will delete all the files copied to the directory. If this is selected,

the user will then need to again copy the eFilm Lite Viewer. This can be doneby clicking the button on this screen.




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Configuration allows the user to enter changes to the server name, usernameand password.

Watermark allows the user to change/set the percentage of studies allowed tostay in the DICOM directory. When the high watermark is triggered, it will startdeleting the studied until it reaches the low watermark setting.

Interval determines the amount of time the application will wait before checkingfor new studies.

Status shows the progress of the studies being transferred from the server to theeFilm Lite Prefetch viewer.




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‘About’ displays the version and copyright information of the application.

Once studies are retrieved from the server to the eFilm Lite viewer, the icon inthe system tray will turn white.




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Icon Statuses:

• No new studies

• New studies

Double click on the icon to open the eFilm Lite viewer.




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How to allow pop-ups

To use the system, pop-ups must be enabled. This section describes theprocess of allowing pop-ups in Internet Explorer.

Go to the tools menu, choose ‘pop-up blocker, ‘pop-up blocker settings’.

Enter the site name of where pop-ups need to be allowed, e.g.,|https://www.YourDomainName.com, and click ‘Add’.

Once the site has been added, click ‘Close’.




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How to import studies from media to eFilm™Workstation

This section describes the process of restoring DICOM files to eFilm™Workstation.

Install your media device.

In eFilm, go to File/Import/DICOM Images

Select the appropriate media drive from the list (this is where you are importingthe images from). Double click on the drive, the click on the patient folder thatshows. Then click ‘ok’.

Once the ok button is clicked, the user will see the transfer of images. After that,select the date of service that patient was seen and the user should be able tonow see the patient on the study list.




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Referring Physician Setup

This section describes the process of setting up a referring physician to accessthe system. Authenticated referring physicians are able to securely view theirreports and images.

Type the web address into you internet browser

Log into system

• Username

• Password (see Figure 1)

Figure 1

Make sure that the pop-up blocker is turned off. If the pop-up blocker is turnedon, the referring physician will have problems viewing the system.

Follow these instructions to turn the pop-up blocker off.

To turn the pop-up blocker off, go to the tools menu in Internet Explorer, choose“Pop-up Blocker”, and then choose “Pop-up Blocker Settings”.




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Enter the name of the site where pop-ups should be allowed, then click the “add”button.

Once the site has been added, click the “close” button at the bottom of thewindow.

Click on the Workflow tab. Find the study date that needs to be reviewed or theuser can search by name. To search by name type the last name in the PatientSearch field and select “search all dates”. (see Figure 2)

Note: The user may be prompted to install an ActiveX program. If prompted,please select “OK”




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Figure 2

Click on the patient’s name whose study needs to be reviewed. (Figure 3)

Figure 3

Web viewer will open.

Note: The user may be prompted to install two (2) ActiveX programs. If prompted, please select “OK

When the web viewer opens, click the question mark (?) should the user need touse the ActiveX user guide. (Figure 4) Once the user has completed reviewingthe study, click “close and return”.




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Figure 4

To view the corresponding report, click on the number under Fin. This stands forFinal Report. (Figure 5)

Figure 5

Click the report(s) needed to be viewed.

Note: Adobe Acrobat Reader must be installed to view the reports

If there are key images that the radiologist selected, they can be viewed 1 of 3ways. By clicking the key button while in the web viewer. (Figure 6) a newwindow will open and if there are key images they will be here. If there are nokey images it will say “No Key Images to Display”.




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Figure 6

When viewing the report, the key images will appear at the end of the report.

Click on the key button in the Action column. A new window will open and ifthere are key images they will be here. If there are no key images it will say KeyImages Not Available.




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Key Images Action Button




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Quick Setup Manual

Thank you for purchasing eFilm RIS/PACS™. We appreciate your business andlook forward to working with you. The manual herein will serve as a guide tosetting up the system. We have made every effort to provide an easy quicksetup, however some items may require a qualified system administrator. If youhave any questions, please contact support or your system administrator. If youcontact support through the ticketing system or email, be sure to include yourname, company name, phone, fax, email and order number, so we can provideprompt support. We also recommend you study the full system manual tobecome familiar with the system.

Caution: The following quick setup manual should only be completed by aqualified IT/IS person. If you are unsure about the setup information below,

please contact your systems administrator. Proceed with caution.

Hardware Setup

1) Unpack server and hardware components

2) Plug server into a battery backup (minimum of 1000VA)

3) Plug network cable into server

4) Install any peripherals, e.g., mouse, keyboard, LCD, etc.

5) If applicable plug fax line into the line in port on the modem

Server Setup

1) Power on server2) Press control/alt/delete

3) Login to server with username/password provided (default =

Administrator/fusion123)

Note: Do not change the system password. It is required for the system tofunction.

4) Click start/control panel/network connections

5) Right click on Local Area Network1 and click properties

6) Select TCP/IP and click properties

7) Enter an available private IP address, subnet mask, gateway, primary DNS,secondary DNS

Note: DO NOT join the system to a domain. Any available IP on your localsubnet may be used. If you unsure about the IP settings of the system, pleasecontact support or your system administrator.

8) Click ok, ok and close




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9) Setup Modem(s):

• Click start/control panel/phone and modem options

• Input your local area codes and any prefix required for outbound dialing

10) Install a SSL certificate (https encryption for HIPAA privacy requirements):

Note: Customers are responsible for purchasing and obtaining an SSL certificate.If you have questions about how to obtain a SSL certificate, please contact yoursystem administrator or Internet Service Provider (ISP). An example of a securecertificate is |https://pacs.YourDomainName.com. This will require a certificatefrom a certificate authority and a DNS A record for your domain.

• Click start/control panel/administrative tools/internet information services

(IIS)manager

• Click the “+” next to your server name

• Click the “+” next to websites

• Right click on the “default website”

• Click properties

• Click the directory security tab

• Click server certificate

• Click next

• Click “create a new certificate”

• Click next

• Click “prepare the request now, but send it later”

• Type the name of your website that you are requesting a certificate for,

e.g., pacs.YourDomainName.com

• Leave bit length at 1024 and “select cryptographic service provider

(CSP)” unchecked

• Click next

• Type in your organization name, e.g., ACME Imaging

• Type in your organization unit, e.g., Diagnostic Imaging

• Type in your common name, e.g., pacs.YourDomainName.com. Please

note this must be a fully qualified domain name that you own.

• Click next

• Select your country, state and city

• Click next

• Select where you would like to store the request, e.g., c:\certreq.txt.

Make sure to note where you store the file. You will need the file/text to

order your secure certificate.

• Click next, next, finish

• The file is now available for you to request the certificate.

• Contact your system administrator/ISP/domain name authority to order

the certificate

• Upon receipt go back to the IIS services/default website as described

above

• Under the directory security tab, click server certificate

• Click next

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• Select “process the pending request and install the certificate”

• Click next

• Locate and install the file provided by your certificate authority

• Click next, next finish

• Your certificate is now installed

Note: Upon successful installation of your certificate and the appropriateDNS settings, outside users can securely access the system by usingthe https protocol (TCP 443), e.g., |https://pacs.YourDomainname.com.

PACS Access Setup

1) Using a computer on your local area network, open Internet Explorer

2) In the address bar, type the assigned local IP of the PACS server (as defined

above), e.g., |http://192.168.10.1. If a certificate is installed and the

appropriate DNS entries are made, you can access your system remotely by

using the domain name, e.g., |https://pacs.YourDomainName.com

3) The PACS login screen will be displayed

4) Type in the administrator username/password (default =

admin/yourpassword) See the note below for information on your unique

password.

Note: The unique password for accessing your system is provided in the travelerthat was included in the original shipment.

5) Begin by adding clinics. Navigate to Admin/Clinics

•

Add Clinic demographic information• Select the Prefix for your patient IDs. This is used to identify your

facility. For example if you are “ACME Imaging”, you may want to

select “A”.

• Upload logo for Reports by clicking browse (note the file must be a

JPG with maximum dimensions of 300px wide by 120px high)

• Use your favorite HTML editor to create the footer for your reports.

Here is a sample that may be used (copy and paste into a HTML

editor):

ACME

Imaging 

123 Bayou Blvd., Houston, Texas 77380 | Phone555.555.5555 | Fax 555.555.5556 

Web <a

href="http://www.acmeimaging.com">www.acmeimaging.c

om</a> |

Email <a

href="mailto:[email protected]">info@acmeimaging

.com</a>




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• Add website information as defined above, e.g.,

|https://pacs.YourDomainName.com.

• Click “Save”.

6) Add your email server information by going to Admin/Email Rpts. This page

allows you to specify your mail server information to send support requests

and report notifications by email. Please note that report notifications sent by

email DO NOT contain patient identifiable information. They are provided to

notify referring physicians of a new report/images to review. Here are

sample entries and their descriptions:

• From email address: |[email protected]

(This will be displayed as the sending email address)

• Email username: |[email protected] (This is your

username for your SMTP server specified below)

• Email password: 123468 (This is your password for your SMTP

server specified below. Please note the characters/numbers will be

“masked”)

• SMTP server: mail.YourDomainName.com (This is the full DNS

address for your SMTP, i.e., outgoing server)• Web Server Address: |https://pacs.YourDomainName.com (This

address will be included on report/support notices as a hyperlink to

login and access reports/images)

7) Setup systems preferences under Admin/Config

• Required Fields

o Select the demographic fields that will be required and/or “skippable”

(able to be temporary bypassed by users) by going to

Admin/Options

• Clinic, Misc. Settings

o Login Page Logo

a. Click default logo to browse/upload your logo. The imagemust be JPG with maximum dimensions of 250px wide by

120px high.

• eFilm ActiveX Settings

a. This option must be configured for your online image viewer

to work. Please do the following:

b. Click the hyperlink “eFilm ActiveX Settings”

c. Local Web URL Reference: Input your system NetBIOS

name and local IP, e.g., PACSSERVER, 192.168.1.10. If

you are unsure how to do this, please contact your network

administrator.

d. Local Image Channel IP: Input your local IP, i.e., the IP of

the PACS, e.g., 192.168.1.10. If you are unsure how to dothis, please contact your network administrator.

e. Remote Image Channel IP: Input your public IP (provided by

your ISP), e.g., XXX.XXX.XXX.XXX. This must be a public,

routable IP. If you are unsure how to do this, please contact

your network administrator.

f. Please note that the following ports MUST be forwarded to

your internal PACS server: TCP 443, 3333. If you are




171

unsure how to do this, please contact your network

administrator.

g. Click Save (you can always go back later to make changes)

8) Scanning DLL registration code

Click the hyperlink to input your registration code. To obtain your registration

code, you must email your full domain name, e.g.,

|https://pacs.YourDomainName.com to [email protected]. A

registration code will be provided within 72 hours of original email (excluding

weekends/holidays). Upon receipt of registration code, enter your full

domain name, e.g., |https://pacs.YourDomainName.com , and registration

code (provided by Merge Healthcare) and click save.

9) Schedule Settings

• Click “Schedule Settings” to specify your operation hours. For example,

if open at 8:00 a.m. and close at 5:00 p.m., you would select the start

time of 8:00 a.m. and “9” as the length of hours. When you are

complete, click “Save”.

9) DICOM Service Settings

DICOM Image Storage Server (NetBIOS name)10) Click the name and verify it matches the NetBIOS name of your server.

You can view your NetBIOS name by right click on ‘My Computer’ selecting

properties, clicking the ‘Computer Name’ tab. The NetBIOS name of your

system will be displayed adjacent to ‘Full computer name’ (Note: Do not

include the ‘.’ at the end of the name)

11) DICOM Image Storage Path


12) DICOM Image Storage Username

Password should match your Local System Administrator account username,

i.e., Administrator. Do not change this value

13) DICOM Image Storage Server Password

Password should match your Local Administrator account password, e.g.,

fusion123

14) Modality Worklist Path

Do not change this value. It defines the path of the modality worklist files.

15) Modality Worklist Sending Server (Modality Worklist AE Title)

Do not change this value. Default is EFILMRISPACSWL

16) Key Image Convertor Service

Key Image Layout

• Select the number of columns/rows of key images on reports

17) JPEG Path

Do not change this value. It defines the path of the key images directory.

18) Accession Separator (in powers of 10)Do not change this value.

19) Default Command Line Arguments


20) SOPClassUID Exceptions


21) Fax Service Settings

Local Area Codes (Area codes for which adding the dialing prefix '1' will not

be necessary.)




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Enter area codes that do not require ‘1’ to fax. Separate values by a comma,

e.g., 936,832,713, etc.

22) Report Wizard URL


23) Report Document URL


24) Update Status URL


25) FTP Path


26) Add any DICOM target servers that studies will be sent to by going to

Admin/Servers. These devices are known as DICOM hosts or nodes.

Specify the description, AE (Application Entity) Title, Hostname (IP), Port,

Server Limit (number of concurrent connections to server), Retry Limit

(number of retries upon fail), Retry Time (amount of time between retries)

and type of host. All DICOM devices that will be “pulling” using the

query/retrieve method must be in this list. See the eFilm™ Workstation

Setup below for further information. If you are unsure how to do this, pleasecontact your network administrator.

27) Setup your DICOM Servers Services by going to Admin/Services. Click the

edit button under the action column to make changes. This page is helpful to

see the status of the DICOM services and restart them if necessary. (Note:

We recommend that you do not change these values).

• DICOM Store Server: Specify the AE Title and port for this DICOM store

server (AE Titles ARE case sensitive). The DICOM store server is used

by modalities and other devices to send, store or “push” studies to the

PACS server.

• DICOM Query/Retrieve Server: Specify the AE Title and port for this

DICOM Q/R server (AE Titles ARE case sensitive). The DICOM Q/R

server is used by modalities and other devices to query and “pull” studies

to the PACS server. It also is used to manually/automatically transfer

studies.

• DICOM Image Channel Server: Specify the AE Title and port for this

DICOM IC server (AE Titles ARE case sensitive). The DICOM IC server

is used by devices to compress and “pull” studies from the PACS server.

• DICOM Modality Worklist Server: Specify the AE Title and port for this

DICOM modality worklist server (AE Titles ARE case sensitive). The

DICOM modality worklist server is used by modalities and other devices

to query and obtain patient scheduling information and demographics.

This is useful for productivity and data integrity, i.e., data is entered only

once. Note that modality worklist must be supported by the modality. Ifyou are unsure about the capabilities/programming of your modalities,

please contact your modality/network engineer. (Note: We highly

recommend you do not change these values).

28) Add users by going to Admin/Users. Users can be managed in this section.

You can add, edit, activate/deactivate users, and reset passwords based on

your organization needs. For more information on user types and policies,

please refer to the system manual.




173

29) Admin/Utilities will allow you to view the storage watermarks of your system.

When storage reaches the high watermark, i.e., number of licensed archived

studies, the “last accessed/last viewed” studies will be removed until the “low

watermark, i.e., number of licensed archived studies is reached. For more

information, please consult the System Manual.

30) Edit/Password will allow users to change their passwords.

31) Add Modalities by going to Edit/Modalities (Note: If you have more than one

clinic or modalities of the same type, be sure that you provide unique names

for your modalities). The system is pre-populated with several modalities.

Please refer to the system manual for more information on setting up your

modalities. (Note: After a modality has been added it CANNOT be removed.

Proceed with caution).

32) Add Procedures and schedule time durations by going to Edit/Procedures.

The system is pre-populated with several common procedures. Please refer

to the system manual for more information on setting up your procedures.

33) Add any known referring physicians by going to Edit/Referring Physicians.

Please refer to the system manual for more information.

34) Add any known insurances by going to Edit/Insurance. Please refer to thesystem manual for more information.

35) Add/modify report templates/macros under Edit/Templates. The system is

pre-populated with several common templates. This section is used to

create “normals” and frequently used reports to aid in operational efficiency.




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Modality Worklist Setup

The PACS System is capable of providing DICOM Modality Worklist forModalities that are capable of this function. DICOM Modality Worklist allowsModalities to query the server for Schedule/Patient information, thereby negatingduplicate data entry and ensuring data integrity. Go to Admin/Services to locatethe AE Title and port. Record the modality worklist settings.

Modality Worklist Settings

The default information for DICOM Modality Worklist is:

AE Title: EFILMRISPACSWLPort: 106

Note: DICOM Modality Worklist is a feature of some Modalities. Please contactyour Modality manufacturer to determine if your modality is DICOM ModalityWorklist capable. In some cases the modality will not support this function or itwill require an upgrade that will result in additional costs by your modalitymanufacturer. These costs are not included as part of the PACS. If the modalityis capable, it may be necessary to have the Modality Engineer program thesystem to use this feature. Programming the modality may also result inadditional fees by your modality manufacturer. These costs are not included aspart of the PACS.

The IP of the server is also necessary to use the Modality Worklist server.Please contact your system administrator if you are unsure of the IP.

Friendly Name Hostname/IP AE Title Port

Modality Worklist 192.168.10.45 EFILMRISPACSWL 106


Modality Worklist Sample Information Table




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177

HL7 Export Specifications

eFilm RIS/PACS™ HL7 Export Specifications

Introduction

This document defines the Health Level Seven (HL7) interface specifications ofeFilm RIS/PACS ™’s HL7 Export feature. eFilm RIS/PACS™’s appointments areexported as ADT A01 messages.

Document Sources

• HL7 standard version 2.3 and 2.3.1

• Integrating the Healthcare Enterprise (IHE) technical framework year 2

Abbreviations and Symbols

The following symbols and abbreviations are used:

• ADT Admission, Discharge and Transfer System

• DICOM Digital Imaging and Communications in Medicine

• HIS Hospital Information System

• HL7 Health Industry Level 7 Interface Standard

• IHE Integrating the Healthcare Enterprise

• LLP Lower Layer Protocol

• PACS Picture Archiving and Communications System

• RIS Radiology Information System

• TCP/IP Transmission Control Protocol/Internet Protocol

• UID Unique Identifier

Functional Situations

eFilm RIS/PACS ™’s exports ADT A01 message which contains patient, study,guarantor and insurance information.

These messages are imported by other HL7 compliant applications, e.g., BillingSystems, Hospital Information System, and Radiology Information System.

HL7 Message SpecificationMessage Export: ADT ^ A01

FunctionalSituation Message Event Description

Admission ADT/ACK A01 Admit a patient




178

Message definition

Segments relevant to ADT A01 enumerated hereafter.

Admission, Discharge and Transfer

Segment Name Required

MSH Message Header R

PID Patient Identification R

NK1 Next of Kin

GT1 Guarantor

IN1 Insurance

ACC Accident

DB1 Disability

IN2 Insurance




179

The following defines fields and if they are required in each segment. All requiredfields will be present in the output message.

MSH Segment

Name Field No Field Name Required

MSH MSH-1 [Field Separator] R

MSH-2 [Encoding Characters] R

MSH-3 [Sending Application] R

MSH-4 [Sending Facility] R

MSH-5 [Receiving Application] R

MSH-6 [Receiving Facility] R

MSH-7 [Message Date/Time] R

MSH-8 [Security]

MSH-9 [Message Type] R

MSH-9-1 [Message Type]

MSH-9-2 [Trigger Event]

MSH-10 [Message Control ID] R

MSH-11 [Processing ID] R

MSH-12 [Version ID] R

MSH-13 [Sequence Number]




180

PID Segment


PID PID-1 [Set ID] R

PID-2 [Patient ID External] R

PID-3 [Patient ID Internal]

PID-4 [Alternate Patient ID]

PID-5 [Patient Name] R

PID-6 [Mothers Maiden Name]

PID-7 [Date of Birth] R

PID-8 [Sex] R

PID-9 [Patient Alias]

PID-10 [Race]

PID-11 [Patient Address] R

PID-12 [County Code] R

PID-13 [Home Phone] R

PID-14 [Business-Phone] R

PID-15 [Language] R

PID-16 [Marital Status] R

PID-17 [Religion] R

PID-18 [Account Number] R

PID-19 [SSN Number] R




181

PV1 Segment


PV1 PV1-1 [Set ID] R

PV1-2 [Patient Class] R

PV1-3 [Assigned Patient Location] R

PV1-4 [Admission Type]

PV1-5 [Preadmit Num]

PV1-6 [Prior Patient Location]

PV1-7 [Attending Doctor] R

PV1-8 [Referring Doctor] R

PV1-8-1 [ID Num]

PV1-8-2 [Family Name & Last Name Prefix]

PV1-8-3 [Given Name]

PV1-8-4 [Middle Initial or Name]

PV1-8-5 [Suffix]

PV1-9 [Consulting Doctor]

PV1-10 [Hospital Service]

PV1-11 [Temporary Location]

PV1-12 [Pre-Admit Test Indicator]

PV1-13 [Re-Admit Test Indicator]

PV1-14 [Admit Source]

PV1-15 [Ambulatory Service]

PV1-16 [Vip Indicator]

PV1-17 [Admitting Doctor]

PV1-18 [Patient Type]

PV1-19 [Visit Number]

PV1-20 [Financial Class]




182


PV1-21 [Charge Price Indicator]

PV1-22 [Courtesy Code]

PV1-23 [Credit Rating]

PV1-24 [Contract Code]

PV1-25 [Contract Effective Date]

PV1-26 [Contract Amt]

PV1-27 [Contract Period]

PV1-28 [Interest Code]

PV1-29 [Transfer To Bad Debt Code]

PV1-30 [Transfer To Bad Debt Date]

PV1-31 [Bad Debt Agency Code]

PV1-32 [Bad Debt Transfer Amount]

PV1-33 [Bad Debt Recovery Amount]

PV1-34 [Delete Account Indicator]

PV1-35 [Delete Account Date]

PV1-36 [Discharge Disposition]

PV1-37 [Discharged To Location]

PV1-38 [Diet Type]

PV1-39 [Servicing Facility]

PV1-40 [Bed Status]

PV1-41 [Account Status]

PV1-42 [Pending Location]

PV1-43 [Prior Temporary Location]

PV1-44 [Admit Date/Time] R

PV1-45 [Discharge Date/Time] R

PV1-46 [Current Patient Balance]




183

ACC Segment


ACC ACC-1 [Accident Date/Time] R

ACC-2 [Accident Code]

DB1 Segment


DB1 DB1-1 [Set ID]

DB1-2 [Disabled Code]

DB1-3 [Disabled Person ID]

DB1-4 [Disabled Indicator]

DB1-5 [Disability-Start-Date]

DB1-6 [Disability End Date]

DB1-7 [Return to Work Date] R

DB1-8 [Unable To Work Date] R

DB1-9 []

EVM Segment


EVM EVN-1 [Event Type Code] R

EVN-2 [Date/Time of Event] R

EVN-3 [Date/Time Planned Event]

EVN-4 [Event Reason Code]

EVN-5 [Operator ID]

EVN-6 [Event Occurred]




184

GT1 Segment


GT1 GT1-1 [Set ID]

GT1-2 [Guarantor Number]

GT1-3 [Guarantor Name] R

GT1-4 [Guarantor Spouse Name]

GT1-5 [Guarantor Address] R

GT1-6 [Guarantor Phone - Home] R

GT1-7 [Guarantor Phone - Business] R

GT1-8 [Guarantor Date Of Birth]

GT1-9 [Guarantor Sex]

GT1-10 [Guarantor Type]

GT1-11 [Guarantor Relationship]

GT1-12 [Guarantor SSN]

GT1-13 [Guarantor Date - Begin]

GT1-14 [Guarantor Date - End]

GT1-15 [Guarantor Priority]

GT1-16 [Guarantor Employer Name]

GT1-17 [Guarantor Employer Address] R

GT1-18 [Guarantor Employer Phone] R

GT1-19 [Guarantor Employee ID Num] R

GT1-20 [Guarantor Employment Status] R

GT1-21 [Guarantor Organization]




185

IN1 Segment


IN1 IN1-1 [Set ID]

IN1-2 [Insurance Plan ID]

IN1-3 [Insurance Co ID] R

IN1-4 [Insurance Co Name] R

IN1-5 [Insurance Co Address] R

IN1-5-1 [Street Address]

IN1-5-2 [Other Designation]

IN1-5-3 [City]

IN1-5-4 [State Or Province]

IN1-5-5 [Zip or Postal Code]

IN1-6 [Insurance Co Contact Person] R

IN1-7 [Insurance Co Phone]

IN1-8 [Group Number] R

IN1-9 [Group Name] R

IN1-10 [Insurance Group Employer ID]

IN1-11 [Insurance Group Employer Name]

IN1-12 [Plan Effective Date]

IN1-13 [Plan Expiration Date]

IN1-14 [Authorization Info] R

IN1-15 [Plan Type R

IN1-16 [Name of Insured] R

IN1-17 [Insured Relationship To Patient] R

IN1-18 [Insured Date of Birth] R

IN1-19 [Insured Address] R

IN1-20 [Assignment Of Benefits]




186


IN1-21 [Coordination Of Benefits]

IN1-22 [Coord of Benefits Priority]

IN1-23 [Notice of Admission Code]

IN1-24 [Notice of Admission Date]

IN1-25 [Report of Eligibility Code]

IN1-26 [Report of Eligibility Date]

IN1-27 [Release Info Code]

IN1-28 [Pre-Admit Certification]

IN1-29 [Verification Date]

IN1-30 [Verification By]

IN1-31 [Type of Agreement Code]

IN1-32 [Billing Status]

IN1-33 [Lifetime Reserve Days]

IN1-34 [Delay Before L R Day]

IN1-35 [Company Plan Code] R

IN1-36 [Policy Number] R

IN1-37 [Policy Deductible]

IN1-38 [Policy Limit - Amount]

IN1-39 [Policy Limit - Days]

IN1-40 [Room Rate - Semi-Private]

IN1-41 [Room Rate - Private]

IN1-42 [Insured Employment Status]

IN1-43 [Insured Sex] R

IN1-44 [Insured Employer Address]




187

Sample HL7 ADT Export Files

MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADTÂ01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|0000003|||PATIENT3||19700101|F|||ADDRESS||||ENG|A|PEN|000000003|PV1|1|O|||||PHYSICIAN|Smith^John^^^M.D.||||||||||||||||||||||||||||||||||||8/21/20077:00:00 AM|8/21/2007 7:00:00 AM|GT1|||husband|||||||||||||retired|||||IN2||||Medicare|P.O. Box 4444^^Dallas^TX^12222||1-888-200-5120||205|||||||self||19700101|||||||||||||||||||||||||F|

ACC||DB1|||||||||

MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADTÂ01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|0000007|||PATIENT7||19700101|M|||ADDRESS||||ENG|A|PEN|000000

007|PV1|1|O|||||PHYSICIAN|Jacobson^John^^^M.D.||||||||||||||||||||||||||||||||||||8/21/20077:45:00 AM|8/21/2007 7:45:00 AM|GT1|||||||||||||||||||||IN2||||Self Pay|^^^^|||||||||||||19700101|||||||||||||||||||||||||M|

ACC||DB1|||||||||

MSH|^~\\&|eFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADTÂ01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|0000006|||PATIENT6||19700101|M|||ADDRESS||||ENG|A|PEN|000000

006|PV1|1|O|||||PHYSICIAN|Smith^John^^^M.D.||||||||||||||||||||||||||||||||||||8/21/20078:00:00 AM|8/21/2007 8:00:00 AM|GT1|||||||||||||||||||||IN2||||CASH|^^^^|||||||||||||19700101|||||||||||||||||||||||||M|

ACC||DB1|||||||||

MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADTÂ01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|0000001|||PATIENT1^^^^||19700101|M|||ADDRESS||||ENG|A|PEN|000

000001|PV1|1|O|||||PHYSICIAN|Doe^John^^Dr.̂ ||||||||||||||||||||||||||||||||||||8/21/2007 8:30:00 AM|8/21/2007 8:30:00 AM|GT1|||SELF|||||||||||||JOB|||||IN2||||Aetna|P.O. Box 123^^Blue Bell^PA^19422||1-800-666-6666||11235|||||||self||19700101|||||||||||||||||||||||||M|

ACC||DB1|||||||||




188

MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADTÂ01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|0000002|||PATIENT2^^^^||19700101|M|||ADDRESS||||ENG|A|PEN|000000002|PV1|1|O|||||PHYSICIAN|Doe^John^^Dr.̂ ||||||||||||||||||||||||||||||||||||8/21/2007 9:45:00

AM|8/21/2007 9:45:00 AM|GT1|||SELF|||||||||||||n/a|||||IN2||||BCBS|P.O. Box 660044^^Dallas^TX^77000||1-800-555-5555||59903|||||||self||19700101|||||||||||||||||||||||||M|

ACC||DB1|||||||||

MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADTÂ01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|0000004|||PATIENT4||19700101|M|||ADDRESS||||ENG|A|PEN|000000004|PV1|1|O|||||PHYSICIAN|Washington^George^^^D.O.||||||||||||||||||||||||||||||||||||8/21/20

07 10:00:00 AM|8/21/2007 10:00:00 AM|GT1|||||||||||||||||||||IN2||||CASH|^^^^|||||||||||||19700101|||||||||||||||||||||||||M|

ACC||DB1|||||||||

MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADTÂ01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|0000005|||PATIENT5||19700101|M|||ADDRESS||||ENG|A|PEN|000000005|PV1|1|O|||||PHYSICIAN|Jacobson^John^^^M.D.||||||||||||||||||||||||||||||||||||8/21/2007

10:30:00 AM|8/21/2007 10:30:00 AM|GT1|||SELF|||||||||||||HISD|||||IN2||||cigna|1263 main^^houstonÂL^77007||713-457-5632||33599|||||||self||19700101|||||||||||||||||||||||||M|

ACC||DB1|||||||||

MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADTÂ01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|000000009|||Leventhal^Lesli^^^||19780101|F|||ADDRESS||||ENG|A|PEN|000000021|

PV1|1|O|||||PHYSICIAN|Doe^John^^Dr.̂ ||||||||||||||||||||||||||||||||||||8/21/2007 11:00:00 AM|8/21/2007 11:00:00 AM|GT1|||||||||||||||||||||IN2||||Aetna|P.O. Box 123^^Blue Bell^PA^19422||1-800-666-6666|||||||||||19780101|||||||||||||||||||||||||F|

ACC||DB1|||||||||




189

MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100||ADT^A01|1077301446|P|2.3|EVN|A01|200708221100|||2018670553|PID|0001|0000002|||PATIENT2^^^^||19700101|M|||ADDRESS||||ENG|A|PEN|000000013|PV1|1|O|||||PHYSICIAN|Doe^John^^Dr.̂ ||||||||||||||||||||||||||||||||||||8/21/2007 4:30:00PM|8/21/2007 4:30:00 PM|GT1|||SELF|||||||||||||--|||||IN2||||Aetna|P.O. Box 123^^Blue Bell^PA^19422||1-800-666-6666||--|||||||--||19700101|||||||||||||||||||||||||M|

ACC||DB1|||||||||.




190




191

eFilm™ Workstation Setup

The following information will guide you through setting up eFilm Workstation tointeract with the PACS Server.

1) Open eFilm

2) Go to Utility/Process Manager

3) Click ‘Settings’

4) Record AE Title

5) Record Port

6) Click Ok

7) Close the Process Manager

8) Go to Start/Run9) Type “cmd”

10) In the black command box, type ‘ipconfig’

11) Click enter

12) Record your IP address (Note: All eFilm workstations must have a static IP)

13) Close the command prompt

14) Create a spreadsheet to define your eFilm Workstations (see Table 1)

Caution: Patient information is considered protected. If you are unsureabout how to setup DICOM nodes, please contact support or your PACSAdministrator. Proceed with caution.




192

Friendly Name Hostname/IP AE Title Port Type

Radiology WS 1 192.168.10.45 RADWS1 4006 Workstation

Radiology WS 2 192.168.10.46 RADWS2 4006 Workstation

Tech Review

WS192.168.10.47 TECHWS1 4006 Workstation

Backup Archive 192.168.10.48 BACKUP1 4006 Server


Table 1

15) Open eFilm

16) Click Edit/Properties

17) Go to the Remote Device tab

18) Enter the Store Server information:

a. Description – Enter the “friendly” name of your server, e.g.,EFILMRISPACS-STORE (choose a name that is easily identifiable)

b. AE Title – Application Entity Title for your server, e.g.,

EFILMRISPACS (Note: AE Titles are case sensitive)

c. Hostname – Enter the IP address of your server, e.g., 192.168.1.10

d. Port: Enter the server port for your server, e.g., 104

e. Type: Select Server

f. Default: Leave unchecked

g. Click ‘Add’

h. Select the server you entered

i. Click ‘Verify’

j. If the server does not verify, please repeat and verify the informationabove.

19) Enter the Query/Retrieve QR Server information:

a. Description – Enter the “friendly” name of your server, e.g.,

EFILMRISPACS-QR (choose a name that is easily identifiable)


EFILMRISPACS_QR (Note: AE Titles are case sensitive)


d. Port: Enter the server port for your server, e.g., 105

e. Type: Select Server

f. Default: Check this box

g. Click ‘Add’

h. Select the server you enteredi. Click ‘Verify’

j. If the server does not verify, please repeat and verify the information

above.

20) Select the Image Channel tab

21) Enter the IC Server information:

a. Description – Enter the “friendly” name of your server, e.g.,

EFILMRISPACS-QR (choose a name that is easily identifiable)




193


EFILMRISPACS_QR (Note: AE Titles are case sensitive)


d. DICOM Port: Enter the Q/R server port for your server, e.g., 105

e. IC Port: Enter the IC port for your server, e.g., 3333

f. Timeout: Leave at 5 seconds

g. Default: Check this box

h. Click ‘Add’

i. Select the server you entered

j. Click ‘Verify’

k. If the server does not verify, please repeat and verify the information

above.

22) Select the Modality Settings tab

23) Select Advanced

24) Select ‘CR’ from the drop down menu

25) Check the ‘While Stacking’ box

26) Repeat this process for each modality by using the drop down list

27) Close the Properties Screen28) Repeat this process for each eFilm workstation (Please note that each eFilm

Workstation must have a different AE Title and IP address. The port can be

the same)

29) Login to the Server via Internet Explorer

30) Go to Admin/Servers

31) Add each eFilm Workstation to the server list per the spreadsheet you

created above. Refer to section PACS Setup #9 above for more information on

adding servers (DICOM destinations)

DICOM Transactions (sending, pushing, pulling studies) Figure 1

You are now ready to test your DICOM setup. We provide many differentmethods for moving DICOM data. The information below will describe theseprocesses.

1) Manual DICOM Store, i.e., DICOM Push, from Server

a. Open the PACS interface using IE

b. Go to the ‘Workflow’

c. Select the study(s) you wish to send by checking the far right check

box (Note: you can select multiple studies or all by clicking the top

check box)

d. Scroll to the top of the Workflow

e. Click ‘Push’

f. Select the target friendly name of the deviceg. You will be prompted to select additional destinations

h. Close

i. Go to Tools/DICOM out to view the progress of your DICOM job.

(Note: You can click refresh to update the progress, you can also

sort the columns by clicking on their headings)

j. Go to the target device and verify the study was received

2) Auto DICOM Store, i.e., DICOM Push, from Server using auto-routing

(DICOM Router) rules




195

b. Option 2 – Using the PACS workflow

i. Open the PACS interface using IE

ii. Go to the ‘Workflow’

iii. Verify the ‘Viewing Method’ in the bottom right hand corner is

‘eFilm Retrieve’

iv. Click the patient name to view the study (Note: The Q/R

server must be selected as default in

eFilm/Edit/Properties/Remote Devices. For more

information, refer to eFilm Workstation Setup #9 above.)

v. eFilm will now open the Image Channel tab and

stream/display the study

6) eFilm ActiveX Web Viewing

a. Open the PACS interface using IE

b. Go to the ‘Workflow’

c. Verify the ‘Viewing Method’ in the bottom right hand corner is

‘ActiveX Web’

d. Click the patient name to view the study (Note: You must allow the

website in your pop-blocker list)7) eFilm Lite Prefetch

a. Download and install the eFilm Lite Prefetch from

Support/Downloads

b. Start the application by clicking on the Desktop Icon or by going to

Start/Program Files/Startup/eFilm Prefetch

c. Right click on “sep” icon in task tray

d. Configure menu per below

i. Launch eFilm Lite™

1. Opens eFilm Lite Application

2. Select study to view

3. Click view

ii. DICOMDR Directory

1. Folder Name: Default is C:\dt. Do not modify

2. Cleanup DICOM Directory: Delete all files in C:\dt

3. Copy eFilm Lite Viewer: Copies all necessary eFilm Lite files

to C:\dt

4. Save: Save settings

iii. Configuration

1. Server: Enter the IP or domain of your server, e.g.,

|https://pacs.YourDomainName.com

2. UserName: Enter your PACS username

3. Password: Enter your PACS password

4. Set as Default: Use above login credentials as default5. Prefetch Images Till: Studies before this date will be ignored

6. Verify Connection: Verify connection/credentials with server

7. Save: Save settings

iv. Watermark

1. Low Watermark: Defines percentage of disk space that will

remain upon High Watermark is hit.

2. High Watermark: Defines percentage of disk space that will

initiate space cleanup




196

v. Interval

Server Interval Check (Minutes): Defines amount of time

client queries server for new downloads

vi. Status

Shows current download progress

vii. About

Software information

viii. Quit

Quit application

If you have any questions, please contact support. Be sure to include your

name, company name, phone, fax, email and order number, so we can provideprompt support. We also recommend you study the full system manual tobecome familiar with the system.