REF4.09-80_iSite PACS Admin Practicum Outline

(1)

iSite PACS Admin Practicum

Outline

Reference

REF4.09-80

Revision: 2014 Feb 05

(2)

1 Purpose

To supplement the training received in the off-site training sessions, an iSite PACS practicum is to be performed by the Applications Consultant. This document provides an outline to be used throughout the practicum. The outline is to be used by the Philips Applications

Consultant to assist the customer’s PACS Administrator with the configuration and preparation of iSite PACS in anticipation of end-user training and clinical go-live.

2 Background

and

Scope

The Applications Specialist should engage the customer in dialogue early in the

implementation process regarding items on the practicum checklist. It is the customer’s responsibility to make any final decisions and/or configuration changes that can be completed prior to the on-site visit by the Applications Specialist.

3 Operational

Responsibilities

The Applications Specialist is to serve as a facilitator to this process and is not responsible for performing actual system configuration changes. The on-site practicum session is the culmination of the dialogue between the customer and the Applications specialist throughout the implementation.

4

References and Related Documents

Term Meaning

ECD Exam Code Dictionary ISE iSite EnterprISE ISR iSite Radiology

PACS Picture Archiving and Communication System SMR Series Matching Rules

6

System Setup and General Information

6.1

“Q”,”P”, “?” icons.

iExport Queue, Preferences, Help buttons located in the upper right portion of the screen. These are part of what is referred to as the “Control Strip.”

6.2

User Preferences

Many preference settings can be imported and exported to facilitate setting up User and System Preferences. The User Preferences that can be imported and exported are: Window Width/Center and Filters. To import or export, select the preference group from the

preference tree by left-clicking, then right click and choose desired option from the pop-up menu.

6.2.1 General

Preferences

 Main Exam Monitor Layout – allows user to specify the diagnostic monitor to display the main exam.

 Canvas Page Mode – exams can be organized by Patient or by Exam (usually Exam based is best choice).

 Mouse Schemes – There are two mouse schemes Standard and Enhanced mouse. Standard mouse keeps the standard mouse actions and cursor.

Enhanced changes the cursors shape to indicate their action. Double clicking on the middle mouse button will cycle through the cursor modes

 Automatically open next exam from active filter after marking read.  Show Tips at startup – if disabled, user can enable it here. Especially useful

(7)

 Disable Navigation Rectangle Splitting – disables splitting of Canvas Page Navigational Rectangles (not usually checked).

 Show Measurements Palette – To display measurement palette automatically when viewing images.

 Display Key Image Stack – Displays key images (if any) as a separate series at the beginning of each study rack. Displays all key images from various series within a single study. The Key Image Stack supports all image viewing tools EXCEPT the following:

 Show Scout Lines

 Clone  Play Cine Tool  Linking

 Adding New Key Images (space bar will delete key images)  Sort/Split

 Open user’s most recent presentation state – When selected, the user’s most recent presentation state will take precedence over any other presentation state including the “Marked Read” presentation state.

 Automatically save presentation state after mark Read – Select if you want the presentation state to be saved after marked read.

 Axial/Oblique CT: Anatomical right on left side of image window – Checked if user wants iSite PACS to automatically display axial and oblique CTs such that the anatomical right is displayed on the left, regardless of the initial orientation of the image. (Visibility of this option is dependent on the general System Preferences set by the iSite PACS Administrator.)

 Change Password.

6.2.2 Window

Width/Center

Initially displays Window Width/Center values set in System Preferences. User may edit these values to suit their personal viewing needs.

6.2.3 Keyboard

Shortcuts

Gives the user the ability to map specific keys and key combinations to Philips PAC’s actions.

6.2.4 Image

Processing

Detailed alterations to the method, degree and properties of each image processing option (Edge Enhance, Edge Detect, Median Filter, and CLAHE) can be made in these menus. Usually editing is limited to the degree of Edge Enhance, if needed. Degree can also be changed on the fly using the “,” and the “.” keys to

(8)

6.2.5 Filters

Ability to add user-specific filters to customize patient worklists. The use of

Subspecialty fields in the ECD can facilitate the creation of custom filters that would otherwise be difficult or impossible to obtain (i.e. All Fluoro Unread Exams – modality can be CR or RF, however if the subspecialty for these exams is FLUORO, a filter can be created to isolate only these exams in a single worklist).

6.2.6 Display Preferences.

 Screen Overlay Font Size – Large, Medium, Small.

 Cine Playback Resolution – Lower playback resolution allows the clip to load faster because less data is retrieved from the server, but the quality will be lower. Image quality can be improved on the fly by pressing the <F9> hot-key.

 Default Cine Rate – Default is 15 fps, but can be altered to any number between 1 and 45. The default cine rate is only applied when images don’t have the DICOM ‘Recommended Cine Rate’ (tag 00082144) or DICOM ‘Cine Rate’ (tag 00180040) specified in their metadata sent from the modality. (User may wish to change the default cine rate to a low number for large CT scans to allow them to cine through the stack rather than using the scroll wheel.)

 Scout Line Mode - Single, Bracket or All.

 Localizer Mode- No scout lines or show scout lines to be displayed.

 Magnifying Glass- Allows the ability to zoom into a small portion of the image using a pre-configured magnification factor

6.2.7 Hanging Protocols (ISR only)

Hanging protocols are created and edited from within the ISR Canvas Page. The hanging protocol preferences area allows the user to view the ISR Hanging Protocols and to delete them if necessary. Hanging Protocols may also be imported or

exported here.

6.2.8 Hanging Protocol Sequences (ISR only)

Hanging protocol sequences are created and edited from within the ISR Canvas Page. The hanging protocol sequence preferences area allows the user to view the ISR Hanging Protocol sequences and to delete them if necessary

6.2.9 Canvas Page (ISR only)

(9)

6.3 System

Preferences

The System Preferences that can be imported and exported are: Window Width/Center, Filters, Annotations, DICOM Sources, Screen Overlays, Paper Printing, Organization Directory, Location Dictionary, and Body Part Dictionary.

6.3.1 General

Preferences

 Logon welcome message. Customize to include the site’s name.

 Image/Series Linking. Default is 5 degrees. Generally this should be set to 25 degrees to allow linking of series performed with varying degrees.

 Allow DICOM query from Exam Timeline. Select if prior exams are stored on an archive and retrieval is permitted.

 Automatically apply VOI LUT when available. View Of Interest Look Up Tables (VOI LUT) are DICOM values which modalities use to define specific processing algorithms for diagnostic presentation of x-ray images. The benefits of VOI LUTs are multifaceted and include post processing corrections for detector defects, enhancement of the image by reducing noise, and altering the dynamic range by a number of methods ultimately improving the visibility of specific pathologies. Selecting this option will apply the first VOI LUT included with an image as the default display. VOI LUT display can be disabled on the fly or another VOI LUT applied when multiple VOI LUTs are sent from the modality by selecting VOI LUT Options from the Image Pop-up menu.

 Allow Exams to be marked read more than once. This option is useful in teaching hospitals with Residents who are permitted to mark an exam read to remove it from the unread worklist prior to a Radiologist over-read.

 Allow series matching rules auto creation. Advised not to use this option at this time. When selected, SMRs are auto-created based on unique Series Descriptions (or Series Number when Series Description is not present) whenever any exam is opened on the Canvas Page by any ISR user.  Image Orientation. Can enable user preference for automatically flipping of

Axial/Oblique CT images or can select automatic flipping of anatomical right on left side of image window for all users. .

 Clinical Info Source. Allows you to set whether the User Preference for Patient Comments and Patient History come from DICOM or the RIS. From DICOM, the headers displayed on the Canvas Page are: Patient Comments and Patient History. From RIS, the headers displayed are Admitting Comments and History.

6.3.2 Window

Width/Center

Set up using the window widths/centers that are currently used on the CT scanner or stand-alone workstation.

6.3.3 Image

Processing

(10)

6.3.4 Filters

Create usable system filters primarily for Radiologists and Technologists. Criteria for System Filters are very dependent on workflow. Use the Subspecialty field as needed. If Radiologist workflow is not apparent during iSite PACS Administrator training, create filters for the following to facilitate end-user training and modify as proper workflow is identified:

All In Progress CT Unread

All Unread MR Unread

All Today US Unread

STAT Unread PT Unread

CR/RF Unread XA Unread

NM Unread

Special care must be taken with the generation of filters or the results may omit important exams. Each filter created should be tested thoroughly.

Limit is 100 system filters.

6.3.5 Annotations

Used to prevent frequent typing. Review and make changes as needed.

Limit of 10 annotations allowed.

6.3.6 DICOM

Sources

Used for stacking multiple images. Often works for stacking US, XA and RF images. Other primary uses are: to set a default Window Width/Level, to split series based on a particular tag, and for sorting of series on the rack and images within a series.

6.3.7 Screen

Overlays

Review and set up per modality in addition to the default. (Hint: Export finished overlays to desktop so they can be imported and used as a baseline for print overlays.) See Appendix A for recommended Tags by modality.

6.3.8 Paper

Printing

Add/Edit print configurations and overlays as needed.

6.3.9 iExport

(11)

6.3.10 iQuery

The iSite PACS mechanism that allows archived exams to be imported into the iSite PACS Server for viewing with iSite PACS.

6.3.11 Organization Dictionary

If “Organization” is used in the exam records, this option allows the user to specify the various organizations present. The listing is then used as a pull-down option in Patient Directory exam searches. The names listed in this dictionary must match the information coming from the HIS/RIS exactly for searches to work correctly.

6.3.12 Location Dictionary

If “Location” is used in the exam records, this option allows the user to specify the various locations present. The listing is then used as a pull-down option in Patient Directory exam searches. The names listed in this dictionary must match those present in the HIS/RIS system exactly for searches to work correctly.

6.3.13 Plug-Ins

This preference allows the user to create links in the Folders and Shortcut Lists that point to other web interfaces or web sites. For example, if the institution’s lab results are available from an in-house server, the server link can be displayed in the Folder List. This option is also used to set-up APIs for programs such as PACSGEAR and VOXAR that, if present, are available in the pop-up menus of the Canvas and/or Image Pages.

6.3.14 DICOM Print

Configure printers to which exams and images will be printed using ISR. To properly configure and validate, information and assistance may be needed from the printer vendor. Images that have an Image Processing Filter applied to them cannot be printed to a DICOM device. Import screen overlays for each configuration and modify as needed.

6.3.14.1 Considerations for Life-Size Printing:

Philips strongly recommends that you ask for assistance from your printer vendor when configuring the Life-Size printing option for a specific printer, and that you validate the correctness of the configuration by verifying that the Life-Size Print option is indeed printing life-sized, after completing the configuration.

Due to the inherent nature of projection radiography, when using iSite PACS for measurement or life-size printing, Philips strongly recommends the use of an appropriately placed object of known size for determining what magnification factor has been applied to the image.

6.3.14.2 Setting up Life-Size Printing

(12)

 Using the information provided by the printer vendor, please enter values in millimeters for the ImageBox height and ImageBox width based on the desired Orientation, Landscape or Portrait.

 When the films are printed, they will display a tag that reads "iSite Life Size Print" in the upper left-hand corner above the screen overlays.

6.3.15 Body Part Dictionary

Can configure body part equivalents to allow exams with different but “equivalent” body parts to be listed in the Relevant Exam section of the Canvas Page.

6.3.16 Hanging Protocols (ISR only)

Hanging protocols are created and edited from within the ISR Canvas Page. The hanging protocol preferences area allows the user to view the ISR Hanging Protocols and to delete them if necessary. Hanging Protocols may also be imported or

exported here.

6.3.17 Hanging Protocol Sequences (ISR only)

Hanging protocol sequences are created and edited from within the ISR Canvas Page. The hanging protocol sequence preferences area allows the user to view the ISR Hanging Protocols and to delete them if necessary

6.4 Machine

Preferences

Options for setting up preferences specific to the machine you are currently working on. Must have security codes ISTUSERPREF and ISTMPREF to access machine preferences.

6.4.1 Display

Monitors

The monitor listed is the one for which the settings will apply. The Screen Resolution of the monitor is displayed at left. In the Font Sizes menu you can control the size of the fonts displayed on your monitors and in pop-up menus. To designate a monitor as your Navigation Console, highlight that monitor and select "ROP" from the Monitor Functions pull-down menu at bottom left.

6.4.2 Plug-ins

Plug-Ins can be created for an individual machine for integration purposes. This may be useful when configuring a plug-in with a fixed (not floating) license.

6.4.3 General Preference.

 DICOM Print. AE Title: STENTOR_SCP

 Overlay Brightness. The Overlay Brightness option allows you to set how bright the textual information presented with diagnostic images will be. Often, when set at the default 50%, overlays are displayed in black font. When this occurs, the Overlay Brightness must be set > 50% for the overlays to display white.

(13)

 Cache Size. This option refers to how the machine handles two key features, Local Exam Caching and Multi-Planar Reformation. If you wish to restrict the size of the local cache, check the box and specify the Maximum Cache Size in

megabytes. The "Percentage of the Cache used for volumes (%)" refers to how much of the Cache can be used when MPRs are created. Depending on the size of the series in question, the creation of MPRs can require large amounts of the cache. If there is insufficient cache available when you try to create an MPR, the system will display the following message: "'Insufficient memory available to reconstruct the volume." If this occurs, the percentage should be increased as necessary and any cache size restrictions should be removed.

 The Navigation Console Size can be adjusted. If you set the size to anything but Full Screen, iSite Radiology displays icons that allow you to minimize the application.

 Override Access Group Auto logout. If you need to override the Access Group-based Auto Logout times for your institution on this machine, you can set a machine-specific auto-logout time in the "Override Access Group Auto Logout" dialog. This time is set in seconds. If you do not want the machine to auto-logout, enter "0" for the auto-logout time.

6.4.4 Scanner Preference (ISR only)

Add and configure a bar-code scanner if your institution uses them for reading exams. The scanner settings portion of the window provides options for the

connection of the bar-code reader to the ISR machine. If the "Mark Read and Close" option is checked, when a new exam is scanned with the bar-code reader, the previously viewed exam will automatically be marked "Read" and closed. If you only want the previous exam to be closed and not marked "Read", leave this checkbox unchecked.

6.4.5 Remote

Reading

To enable Remote Reading Mode at login, check the "Enable remote reading" box and the Remote Reading option will appear on the iSite Radiology login page. The Remote Reading Settings allow you to specify the number of exams to cache in advance as well as the number of relevant priors to cache with each unread exam. You can also stipulate the maximum file size in MBs and whether or not to include the locking and/or caching of exams labeled STAT.

6.4.6 Network

Testing

(14)

6.5 Shortcuts

Single left click and drag the most commonly used tools, filters, and folders into the shortcut bar. (Keep in mind; you cannot drag exams directly into a folder on the shortcut bar.)

To organize, you can create shortcut groups by right-clicking on the body of the Shortcuts Bar and selecting “Add New Group” from the pop-up menu.

Especially useful when there are multiple hospitals/orgs sharing an iVault. Doctors can organize shortcuts by hospital if it fits their workflow.

Can rename groups or shortcuts using pop-up menu options.

6.6 Folder

List

6.6.1 CD

Manager

 Ability to copy a list of studies with an embedded iSite PACS viewer to a folder which can then be written to a medium such as a CD or DVD.

 CD Manager with the Windows XP Operating System can write directly to the CD writable drive.

 Left-click on a study and drag into the CD Manager folder

 Supports password security for login to the iSite PACS Viewer, designed to protect patient confidentiality.

 Diagnostic reports and Presentation States, if available, will be exported along with the studies.

 DICOM format is the raw, unadulterated DICOM Part 10 data from the modality.  If you logout with exam links in the CD Manager, those links will be lost and must

be recompiled when you log back in.

6.6.2 DUPUID

Cases

 Provides a list of the DUP UID cases within iSite PACS so administrators do not have to constantly monitor their emails for notifications.

 iSite PACS will flag any incoming image/series/study with a Study UID which already exists in the iSite PACS system with another study if it has patient demographics (MRN, Name or DOB) that differ from the existing study.

6.6.3 Exception

Handler

 For handling exception resolution.

 Cannot view images while in ISE Exception Handler.  See Data Management tools for more detailed info.

(15)

6.6.4 Local Exam Cache

 Allow users to select studies to be cached to the local machine (C Drive) so images are pulled from the local hard disk instead of from the iSite PACS server when viewing. The purpose of this feature is to speed up access to patient exams when iSite PACS is being used remotely (not from Main Location).  Displays studies that have been cached to the local machine.

 Displays caching progress with percentage and completion status.  All images are cached in encrypted format.

 If there is not enough room in hard drive for a given study to be downloaded, the oldest downloaded study is deleted. If there is still not enough disk space

available, then user is notified there is not enough space.

 If new images for a given study arrives after the study is cached to the local machines, the new images are available for viewing but they will not be cached.

6.6.5 My

Filters

 Ability for users to customize patient worklist using modality types, body parts, date ranges, etc.

 User must have ISTUSRFLTR security code in order to have “My Filters” enabled.

 These filters are only available to the user who created them.  See User Preferences above.

6.6.6 My

History

A list of the 100 most recently viewed exams as well as the viewed date/time and indication of whether the study was marked read by the current user.

6.6.7 Patient

6.6.8 Statistics

Provides iSite PACS Administrators statistical information about the volume of users and general usage of the system

The statistics models provide the following information:

 Usage Statistics: - This query allows you to generate a report of iSite PACS usage. The report can be filtered by date range and the columns displayed can be selected. The available fields are:

 Modality  Station

(16)

 Received Images

 StudySize (MB)

 vVewed Studies  Archived Studies

 Viewed Studies (ISE Only) - Studies which were viewed on ISE only  Viewed Studies (ISE) - Studies which were viewed on ISE (includes studies

which might have ALSO been viewed on ISR)

 Viewed Studies (ISR) - Studies which were viewed on ISR only

 Received Exams

 Archived Exams

 Viewed Exams (ISE Only) - Exams which were viewed on ISE only

 Viewed Exams (ISE) - Exams which were viewed on ISE (includes exams which might have ALSO been viewed on ISR)

 Viewed Exams (ISR) - Exams which were viewed on ISR only  isPrior - If a study's date/time is more than 96 hours before the study

received date/time.  Manufacturer  ipAddress  aeTitle

 Institution - This field populates from the DICOM “Institution Name” tag (0008,0080)

 Department - This field populates from the DICOM “Institution Name” tag (0008,0140)

 Model

For the purposes of the statistics, studies are defined as DICOM imaging events and exams are RIS order events including the viewing of reports. Also, it is important to note that the Usage Statistics accounts for a study regardless of whether it is an exception. The statistics do not record deleted studies.

The chronology of the usage statistics is as follows. Studies are logged only on the date that they are sent from the modality to iSite PACS, not when they were captured at the modality. The "Daily" Summary Statistics include all activity from 12 AM to 12 PM.

The statistics database at each iSite PACS installation contains the UID for each study reported in a billing cycle. The billing report transmitted to the Philips Finance Department groups the studies by the DICOM source info (AE title, IP Address, modality, etc.), i.e. for each unique DICOM source, the system reports the number of studies acquired (archived, etc.).

When results have been generated, you can download the report by clicking the "download report" link.

(17)

Patient MRN, Accession #, Modality and Body Part. These results are linked and cross-referenced allowing you to see other users who viewed the same patient.  Audit by Patient: This query allows you to audit which iSite PACS users have

viewed a particular patient. Results are given with Access Date, Time, Accession #, Modality, Body Part and User. These results are linked and cross-referenced allowing you to see which patients an iSite PACS user has viewed. Patients are identified by MRN and not patient name in accordance with HIPAA regulations.  iExport Statistics: This query allows you see how many studies have been

exported using the iExport feature. You can filter results by Date, Export Method (Auto, Manual, QRSCP or All), and Status.

 iExport Summary: This section of the Statistics area allows you to create a report of exported studies. The report can be filtered by date range and export method (Auto, Manual, QRSCP or All).

 Deleted Images: This section of the Statistics area allows you to audit deleted and recovered images. The report can be filtered by date range, modality, MRN, Accession Number, Study UID and User ID.

6.6.9 Study

Lookup

Used to search for a study by Study UID

6.6.10 System Filters

 Customized Filters that are shared among all users who have the security code: ISTSYSFLTR

 See System Preferences above.

6.6.11 Personal and Public Folders

 Folders are designed to enable quick display of studies without having to search for them individually (i.e. rounds, teaching files, seminars, etc.).

 Personal folders are accessible only by the user who created them.

 Public folders are accessible by all users but may not be edited by individual users unless they have the proper security.

 Limitations: A folder cannot contain more than 500 exam-links or 25 sub-folders. The folder tree cannot be more than 4 levels deep.

 Anonymous: Allows patient information associated with exams in Personal and Public folders to become anonymous. When anonymous, the patient name, MRN, and accession number are substituted with randomly generated information and the folder becomes blue in color

6.7

Series Matching Rules (ISR only)

Set up Series Matching Rules (SMR) for MR, CR and, if possible, CT. Review how important it is that the techs do not type anything in the Series Description field at the modality.

(18)

6.8

Hanging Protocols (ISR only)

Set up default System hanging protocols for each modality that merely split the monitors. Suggestions for splitting monitors for System hanging protocols by modality:

 MR. Split monitors in 4.

 CT. Split monitors in half horizontally (2H)  US. Stack-tile 3x3.

 ALL other modalities display images full screen (no split).

Review how to create user hanging protocols using SMRs. With the exception of CR CHEST, it is not good practice to create system level hanging protocols by body part. Review the precedence hierarchy of hanging protocols between System and User and by modality, body part, and hanging protocol group.

6.9

Hanging Protocol Sequences

Allows multiple hanging protocols configured for an exam to be ordered in position and selected by the user via the arrows underneath the monitor representations on the timeline in the canvas page.

6.10 Presentation

States

The type of presentation state the user selects will determine the weight of the presentation state in terms of automatic display in ISR and ISE. For example, if no presentation states have been created, the initial presentation state displayed is the 'Original DICOM' state. If a technologist has created a presentation state, that will be presented initially instead of the Original DICOM. If an intern has created a presentation state, it will be displayed initially instead of the technologist's presentation state. If a radiologist has created a presentation state, that will trump the other presentation state and will be presented initially instead of the technologist's presentation state.

If new images have been added to a particular exam while a presentation state is being created, the user will be unable to save the presentation state and will have to reload the exam and begin again.

In addition, if the user opens an exam that has a Technologist or Pre-Read Presentation State, the Presentation State will override certain features of the Hanging Protocol for the exam. The Hanging Protocol settings Invert, Clones, and WW/WL will not be applied. If a Hanging Protocol is selected, edited or created for this type of exam, all of the Hanging Protocol features will be applied, regardless of any Presentation States.

(19)

6.11 Conference Presentation States (ISR only)

When a conference presentation state is loaded, the monitor layout will display the images in the exact same way in which they were saved. This includes any image manipulation such as zoom, pan, flip, rotate, measurements, the series rack order, monitor layout, and any annotation.

A conference presentation state can be saved to an exam, a folder or both.

A conference presentation state can only be opened within ISR

6.12 Export via DICOM

This option is available from the Filter and Patient Directory results up, the Timeline pop-up, thumbnail pop-pop-up, and the Canvas side-bar menus. It is used to send exams or images to a DICOM device such as a 3-D imager or a CD-ROM burner. Use the iExport System Preference for setting up connections to external devices.

After executing an export, click on the iExport Queue button (Q) to check on the export status.

6.13 Delete/Recover Deleted Images

Discuss and decide which users (if any) will be authorized to remove images from iSite PACS by clicking the corresponding images in the Exam Racks. Images may need to be to be deleted for any number of reasons, some of which are listed below:

 Since all US images are usually displayed in a stack, it is not feasible to assign a new SUID to the single images in the scan the US tech sent (or acquired) accidentally. This option is especially useful for US techs to easily remove single images they never would have printed prior to iSite PACS implementation.

 Sometimes an image, series or part of a series needs to be rescanned due to imaging or patient problems such as mechanical problems, overexposure, underexposure, patient movement, or incorrect patient position, etc.

 Sometimes test images are created at the beginning of a procedure and accidentally end up in iSite PACS.

Once images have been deleted using this feature, they can be recovered using the Recover Deleted Image(s) option located on the Canvas side-bar menu. However, all presentation states, measurements and annotations will be lost.

When an image(s) is deleted, iSite PACS keeps a record of the following information:  iSite User ID

 Date

 Deletion Time  Modality  Accession #

 MRN

(20)

 Series/Image Description/Number  Reason for Deletion

These audits can be viewed by the iSite PACS System Administrator in the Statistics page.

6.14 Mark exams unread

This option is used when a user marks an exam read prematurely. This feature is only available from the Patient Directory and NOT from a filter list. Select the appropriate exam from the Patient Directory results list, hold down the CNTL and ALT keys and double-click on the exam. Select the MARK UNREAD button.

7

Data Management Tools

The PACS Administrator must be able to identify the procedure steps to validate data; as well as the manual reconciliation tools used if and when the automatic data validation fails.

7.1 Exam

Linking

This is a manual Exam Linking function to associate multiple exams (accession numbers) with a single study (Study Instance Unique Identifier) when image service requests are not “bundled” or “consolidated”.

 Used in an environment where multiple exams (Accession numbers) are created for a single study. For example: CT Chest, Abdomen, Pelvis.

 This feature does not link reports. A report must be sent to PACS for each Accession Number.

 This feature does not link Exam Memos. Use caution when creating exam memos for exams using this feature, since they can contain life critical information that could be missed during interpretation or review resulting in incorrect diagnosis, delayed diagnosis, or delayed treatment.

 Without using this feature, exams not associated to a study will show on the patient history timeline with an ‘X’ and there is no indication to the user to look for the images under another exam. Once linked, those exams will have the same image reference.  Philips recommends this as a Technologist Responsibility, performed using the

Technologist Worklist option.

 Review how to set up the Technologist Worklist, how to find and link exams.  Also review other features within the Technologist Worklist such as:

 Clicking on Patient Name displays all Exams in iSite PACS for the patient (including cancelled exams)

(21)

 Changing the search criteria and performing resources for the Technologist Worklist results.

 If present, review Active Exceptions portion of Technologist Worklist.

7.2 Exception

Occurrence

An exception is a study that contains patient or exam information from the modality which does not match patient demographic information residing within the iSite PACS database for this patient or exam. Exceptions are studies that fail the automatic validation process and are identified with (!) an exclamation point in the Patient Directory.

 iSite PACS uses an interface (ConnectR) to automatically validate studies into the database

 ConnectR looks at DICOM Metadata for images and validates the images with the corresponding exam ordered by the RIS.

 The Image DICOM Metadata information that ConnectR uses for validation in a RIS integrated environment are: MRN (0010,0020) and ACCN # (0008,0050).

 In a RIS integrated environment, the iSite PACS database is populated with patient records and exams by HL7 messages.

 The record from the RIS is the record that iSite PACS will consider the Gold Standard.  DICOM Metadata, including MRN and ACCN #, do not match the iSite PACS database

Gold Standard.

 All studies from modalities need to be validated prior to registration into the iSite PACS database.

 Exception studies require a MANUAL process to validate them into the database.  Exceptions occur more frequently when DMWL is not used for some reason.

 Exceptions can be resolved using iSuite or iSite EnterprISE. However, if using ISE is used, the images cannot be viewed from the Exception Handler. Also, technologists and super users will NOT have the Exception Handler in their folder list. Instead, they have the Technologist Worklist. With proper permissions, Active Exceptions displayed in the Technologist Worklist, can be resolved from the Technologist Worklist.

 Philips recommends this as a Technologist responsibility. However, it is also a daily responsibility of the iSite PACS Administrator.

 Review how to set up the Exception Handler Worklists, resolve exceptions, and remove exceptions, find patient/exam. For non-RIS (auto-create) sites, review create

patient/exam option.

(22)

7.3 Patient

Linking

Used for Multi-Organization architecture only. This feature eliminates the potential of multiple Organizations having conflicting Medical Record Numbers and Accession Numbers while having the capability to "Link” Patient records across Organizations. Patient Linking may be necessary in an environment with multiple Medical Record issuers (ex: multiple Hospital Information Systems).

 iSite PACS may automatically “match” patients across Organizations if the following information EXACTLY MATCHES for both patients to be linked:

 Last Name

 First Name

 Date of Birth  Sex

 If the patient records fail the automatic patient link, a manual process may be required to link the patients using the “Merge Patient” tool in iSuite. (see below)  When patients are linked, BOTH MRNs are preserved. All orders, studies, and

reports from all organizations are available on the Patient History Timeline.

7.4 Patient

Merge

The Merge Patient tool in iSuite is primarily used to merge patient records within the same Organization. (The exception to this is when performing a manual merge of patients within a multi-organization environment and the automatic patient linking failed.) In a single

organization, when patients are Merged, only one MRN is preserved. All orders, studies, and reports are retained under the merged patient.

 A patient Merge scenario occurs when two patient records (two different MRNs) reference the same real world person.

 A Patient Merge is often referred to as duplicates records and occurs because:  A patient is initially unidentified (as in a trauma case).

 A patient is misidentified.

 System downtime due to system maintenance

 The Merge List in iSuite references patients that are likely candidates for a patient merge.

 Patients may be listed on the Merge List because either:  PACS has received and HL7 “Merge Message.”

 Based on a complex merge algorithm which weighs various similarities and discrepancies between two individual patient listings.

(23)

 Philips recommends the Merge Patient functions be limited to iSite PACS Administrators since any incorrect patient merges CANNOT be undone.

 Review the Merge Patient and Merge Patient List features in iSuite.

7.5 Demographic

Mismatch

This is also called a Duplicate Study Instance Unique (DUP SUID) Identifier. This is an event where a single study (as identified by a single SUID) has more than one set of associated patient demographics. The DICOM standard dictates no two studies should have the same UID. Upon detection of this error, notification is presented to the iSite PACS Administration Team.

 A demographic mismatch can occur from one of the following scenarios:

 Noncompliant modalities. When certain modalities are upgraded, the SUID counter may be reset causing any new SUID generated to be a duplicate of a previous one prior to the upgrade.

 Technologist Workflow errors. A technologist scanned in a patient with the wrong patient demographics and sends the study it iSite PACS with a specific SUID. The Technologist realizes the mistake and corrects the patient demographics on the modality console prior to resending the study with maintains the previous SUID.  Less frequently due to new US scanner features, an US tech begins a patient but

does not “end” the exam prior to beginning the next patient. The Tech enters in new patient demographics and continues the scan. One SUID is assigned to all images for both patients since the scanner did not “know” the prior exam was ended.  Images are merged into a single study.

 iSite PACS Administrators perform one of the following whenever there are merged studies with patient demographic discrepancies due to Demographics Mismatches:  Delete any series which do not belong to the study.

 Assign New Unique Study UID to the specific series which do not belong with the rest of the study. If necessary, use Dig Img Mgmt to detach the images and Exception Handler to resolve them to the appropriate patient and exam.

NOTE: Frequently, iSite PACS will have enough information concerning the images to automatically perform one or more of the above steps.

 Remove Demographics Mismatch. Used to accept existing study’s patient demographics and merge the duplicate UID series.

 Hide Demographics Mismatch. For end users to temporarily turn off the warning message while navigating the study.

(24)

7.6

Digital Image Management

This iSuite feature is used to detach image(s) from a Study.

 It may be necessary to detach all images from a study for the following reasons:

 When a study is performed under the wrong exam. For instance, a tech chooses the wrong exam from the DMWL, performs the exam, and sends the images to iSite PACS. In this case, all images can be detached from the study. Since they will no longer be associated with an exam, they will become an exception in the Exception Handler. The Tech can then resolve the exception to the correct patient’s exam.  The tech wishes to resend an entire Study. Many modalities will re-send images

preserving the original unique identifiers (study, series, and image). iSite PACS will only accept an image once if all three identifies match EXACTLY. To resend, the tech must first detach the images from the exam and delete the exception from iSite PACS using the REMOVE option in the Exception Handler. (Since it is permanent, often the REMOVE privilege is only given to Super Users and administrators.)

 Following are reasons why you may need to detach one or more (but not all) images/series from a study:

 A tech performs two or more separate exams using the same Accession

number/order. For instance, a tech performs a Hand and a Foot x-ray on the same patient, but only selects the Hand exam from the DMWL and sends all images to iSite PACS under that Accession number. Images of the Foot will need to be removed from the Hand exam and resolved to the Foot exam.

 A tech repeats an image but already sent the original “bad” image to iSite PACS, and wishes to detach and remove the “bad” image from iSite PACS.

 A tech digitally scans paperwork to the wrong patient. The paperwork must be detached from the exam and either removed from the system or resolved to the correct patient.

 To detach ALL images from an exam in Digital Image Management, the user can select all images and click on the DETACH button. A message appears informing the user the images will become an exception in the Exception Handler. The user must then go to the Exception Handler and decide whether to remove or resolve the exception.

 To detach one or more image/series from an exam, it may be necessary to first assign a new unique study identifier. Images are grouped in iSite PACS by SUID. Digital Image Management only allows all or no images to be removed for a particular SUID. In order to “isolate” image(s) for removal, the user must first view the images on the ISE Canvas Page (can access from Dig Img Mgmt), select the images they wish to assign a new SUID, and select the Assign New Unique Study UID option from the thumbnail pop-up menu. Upon returning to Digital Image Management, the user will need to REFRESH the screen to view all SUIDs now associated with the study and select the one(s) they wish to detach. Again, they must then go to the Exception Handler and remove or resolve the resulting exception.

(25)

8

System Security

One of the configuration management tasks of an iSite PACS Administrator is to create user accounts and manage security.

 iSite PACS provides role based access control based on the Access Groups in which a user is a member.

 An Access Group represents a collection of users who perform similar tasks in iSite PACS and, therefore, require similar access permissions known as Security Codes.  If a user is assigned more than one Access Group, the user receives the total

permissions of all Access Groups.

 Access Groups may be related to an Organization in order to prevent specific Access Groups from viewing or managing exams in Organizations in which they do not have clinical privileges.

 iSite PACS can also provide access to all Organizations for specific user Access Groups in which continuity of care is a concern. Users assigned to Access Groups in the

“EnterprISE” Organization will have access to patients, exams, and results in all Organizations.

 iSite PACS Administrators may reset passwords to the default (User ID).  Users may not re-use previous 10 passwords

 Minimum password length = 3 characters.

 There are NO maximum log-in attempts with ISE. iSuite has a 3 maximum log-in attempt.  Session timeouts are assigned to Access Groups. Auto Logouts may also be assigned to

individual workstations using Machine Preferences in ISE or ISR. This is particularly useful for workstations requiring lengthy periods of inactivity (i.e. OR suites). Auto logout overrides Session Timeout.

 A list of all security codes and their descriptions available in iSite PACS is provided in Appendix C.

 Review Access groups/codes. Ensure all groups are created and their permissions match their iSite PACS responsibilities. It is a good idea to create a TEST User ID, assign it one access group at a time, logon to ISE, ISR and iSuite to verify the user can perform the appropriate functions.

9 System

Control

Occasionally a Radiologist will get logged out of ISR unnaturally with one or more exams locked. When this occurs, the exams will remain locked under the original user’s session and must be manually unlocked in order for the “Mark Read” button to be available. To manually unlock an exam, the iSite PACS Administrator can perform one of the following:

(26)

 Using iSuite, select Sys Admin, and then System Control. In the drop down Option box, select System Locks and Continue. In the drop down Lock Type box, select IL – Exam Read and Search. Provided is a list of all iSite Radiology Users that have exams locked for reading. Select the appropriate user and Delete.

 Less frequently, you may need to remove locks on exams for other reasons such as EX-Exception Resolution, or EC-Exam Changes.

 System Control also has a tab for displaying all logged on users.  Block Monitor and Report Monitor are not used in iSite PACS.  Review unlocking exams in both ISE and iSuite.

10

Dictionaries

iSite PACS Dictionaries are found under the Sys Admin tab in iSuite. The primary

dictionaries used are: Exam (ECD), Anatomy, and Subspecialty dictionaries. These are the responsibility of the iSite PACS Administrator to keep up-to-date. The Hanging Protocol Group dictionary is used as needed to either group or isolate exams for use by specific hanging protocols.

10.1 Exam

Dictionary

This is the loaded version of your ECD from the Excel spreadsheet. Often, exams are

missed or added after the final version of the ECD is submitted. If an exam enters the system and does not have a corresponding ECD entry, iSite PACS will auto-create an entry. The entry will then need to be edited to add the Anatomy (body site) and the Subspecialty (if used).

Since there is no manual Create or Add feature associated with the Exam Dictionary, it is recommended that each time a new code is added in the RIS, a test exam is sent to iSite PACS. Upon receipt of the test exam, an Exam entry is auto-created. At that time, it should be edited to include the body site/subspecialty fields. Any exams that enter the system using this new code may not have the correct body site/subspecialty until the edit is completed.

Changes made to the Body Site in the Exam Dictionary are NOT retro-active. However, the ability to manually change individual exam body sites to the corrected body site is possible in iSuite. The following steps describe this procedure:

 Find the procedure in the Exam Dictionary, correct the body site field, and save.  Select the Patient/Exam tab (upper left portion of screen.)

 Select the Enter/Edit Exam tab.  Find and select patient.

 Find and select exam, then continue.

 Using the look-up button, re-enter the same exam code displayed in the search field and select it from the results.

(27)

The corrected body site will now display on the Patient History Timeline.

Entries in the Exam dictionary cannot be deleted; however, they can be inactivated. An exam sent on an inactive entry will not cause another entry to auto-create. Rather it will error out in ConnectR. There are times when this is desirable, for instance, when an MR LSPINE is routinely ordered with another exam for MR RECON. All images are acquired under the MR LSPINE exam. In this case, the MR RECON exam will display on the Patient History

Timeline, but with an X indicating no images. It’s not sensible to link these exams since the MR RECON would never be needed as a prior. If a customer feels it’s presence on the timeline is unnecessary AND the customer is certain there would NEVER be images associated with the procedure, the exam should be set to inactive in the Exam Dictionary. Since inactive exams error out in ConnectR, they never enter iSite PACS and, therefore, would not be displayed on the Patient History Timeline.

All exams in the Exam Dictionary that will NEVER have images associated with them should be considered for inactivation.

It is suggested that the Exam Dictionary be reviewed to ensure all body sites are correct and that no new entries have been auto-created since its initial load.

10.2 Anatomy

Dictionary

The anatomy dictionary stores the various Body Sites used in the Exam Dictionary. Body Sites must exist in the Anatomy dictionary before they can be used in the Exam Dictionary. Entries can be manually added. There is no delete function; however, entries can be inactivated.

10.3 Subspecialty

Dictionary

The Subspecialty dictionary stores the Subspecialties used in the Exam Dictionary.

Subspecialties are used primarily by filters. Examples of using Subspecialty in filters include:  Assigning all Fluoro exams the subspecialty of FLUORO to all a filter to be generated for

all Fluoro exams regardless of whether they are associated with CR or RF modalities.  Assigning all exams read by Cardiologists the subspecialty of CARDIO in order to create

a filter specifically for these exams.

Subspecialties must exist in the Subspecialty dictionary before they can be used in the Exam Dictionary. Entries can be manually added. There is no delete function; however, entries can be inactivated.

10.4 Hanging Protocol Groups

(28)

Hanging Protocol Groups can also be created to “group” many exams with different body sites together, enabling one Hanging Protocol to be created for all exams in the group. An example is to create a Hanging Protocol Group for all CR exams with > 8 images (bone surveys, mets surveys, etc.) This would allow the user to create one hanging protocol for all of these types of exams that would split the screens in small numbers and allow most or all images to hang in one hanging.

11 Workflow

Workflow must be reviewed to ensure the Applications Consultant is properly prepared for end-user training. The following questions should be asked to determine what topics should be discussed during workflow review:

 Will the Technologists be responsible for fixing exceptions and will they have permissions to detach images from exams?

 Will you be using document scanners?

 How are priors going to be handled? Digitized, migrated, archived, or film  Do you have Residents? If so, need to discuss how they will read and how the

Radiologists will over-read.

 What type of dictation system will you have?  Do you plan to store Preliminary Reports?

 Which types of exams will need to be linked? (CT CHEST/ABD/PELVIS? US TRANSVAG/PELVIC? Any others?)

 Do you have written MR Protocols?

 Do your Radiologists plan to read from a remote location?

 Do you plan to use the Memo Feature? If so, who will be using it? Techs, Rads, or ER Docs?

 Do the Rads read ALL exams – or are they assigned to specific modalities per day?  Are exams being sent to iSite PACS that the Radiologists are not responsible for

reading? If so, which exams and who reads them? Do the Physicians reading the exams use the same dictation system? If not, will the reports be sent to iSite PACS?

 Do you plan to use the CD burning capabilities in iSite PACS?

(29)

Appendix A: Screen Overlays

These are provided as general guidelines only. DICOM Tags used may differ per manufacturer. Also, Radiologists should be consulted to ensure all needed fields are displayed and unnecessary fields are omitted.

 Default Overlay  MR Overlay  CR Overlay  CT Overlay  MG Overlay  NM Overlay  RF Overlay  US Overlay  XA Overlay

Default Overlay

Name Value

Upper Left: Name ((00100010))

MRN MRN: ((00100020))

DOB/Age DOB: ((00100030)) Age: ((00101010))

Accession Number ACC: ((00080050))

Bottom Left: Series Description ((0008103e)) ((00400254))

Upper Right: Institution Name ((00080080))

Image Date/Time ((00080023)) ((00080033))

Image # of Total Image ((00200013)) of ((00071004))

Bottom Right: WW/WL ww/wl: ((0071002))/((0071003))

Zoom Factor Zoom: ((0007100a))

(30)

MR Overlay

Name Value

MRN MRN: ((00100020))

DOB/Age DOB: ((00100030)) Age: ((00101010))

Bottom Left: Repetition Time TR: ((00180080))

Echo Time TE: ((00180081))

FOV/Recon Diameter DFOV: ((00181100)) mm

NSA NSA: ((00180083))

Series Description ((0008103e)) ((00400254))

Image Date/Time ((00080023)) ((00080033))

Slice Thickness Thick:((00180050)) mm

Slice Location Pos: ((00201041))

Image of Total Image ((00200013)) of ((00071004))

Bottom Right: Key Image ((00071009))

(31)

CR Overlay

Name Value

MRN MRN: ((00100020))

DOB DOB: ((00100030))

Bottom Left: Sensitivity S#: ((00186000))

Series Description ((0008103e)) ((0018400))

Image Date/Time ((00080023)) ((00080033))

Image Number Image ((00200013))

(32)

CT Overlay

Name Value

MRN MRN: ((00100020))

DOB/Age DOB: ((00100030)) Age: ((00101010))

Bottom Left: KVP KVP: ((00180060))

Xray Tube Current MA: ((00181152))

FOV/Recon Diameter DFOV: ((00181100)) mm

Contrast Contrast: ((00180010))

Image Date/Time ((00080023)) ((00080033))

Slice Thickness Thick: ((00180050)) mm

Slice Location Loc: ((00201041))

(33)

Key Image ((00071009))

MG Overlay

Name Value

MRN MRN: ((00100020))

DOB/Age DOB: ((00100030)) Age: ((00101010))

Bottom Left: Series Description ((0008103e))

Image Date/Time ((00080023)) ((00080033))

Key Image ((00071009))

(34)

NM Overlay

Name Value

MRN MRN: ((00100020))

DOB/Age DOB: ((00100030)) Age: ((00101010))

Bottom Left: Comments Comments: ((00401002))

Series Description ((00540400))

Image Date/Time ((00080022)) ((00080032))

(35)

RF Overlay

Name Value

MRN MRN: ((00100020))

DOB/Age DOB: ((00100030)) Age: ((00101010))

Image Date/Time ((00080023)) ((00080033))

(36)

US Overlay

Name Value

Upper Right: Image of Total Image ((00200013)) of ((00071004))

(37)

XA Overlay

Name Value

MRN MRN: ((00100020))

DOB/Age DOB: ((00100030)) Age: ((00101010))

Image Date/Time ((00080023)) ((00080033))

(38)

(39)

Appendix B: Suggested Series Matching Rule Names for MR

and CT

MR:

AX T1

AX T1 POST

AX T1 THIN

AX T1 FS POST

AX T1 THIN POST

AX T1 UPPER

AX T1 LOWER

AX T2

AX T2 THIN

AX T2 ANG

AX T2 UPPER

AX T2 LOWER

AX PD

AX PD FS

AX FLAIR

AX GRE

AX 3D TOF

CR:

PA/AP

LATERAL

OBLIQUE

OBLIQUE 2

LEFT OBLIQUE RIGHT OBLIQUE INTERNAL EXTERNAL L5-S1 SPOT TUNNEL AX DIFF AX ADC AX EAD AX DWI AX STIR COR T1

COR T1 POST

COR T1 FS POST

COR T1 THIN POST

COR T2

COR T2 FS

COR T2 THIN

COR PD

COR PD FS

COR FLAIR COR STIR SAG T1 Y VIEW AXIAL ODONTOID SWIMMERS NAVICULAR KUB UPRIGHT CALDWELL WATERS PAPERWORK

SAG T1 THIN

SAG T1 POST

SAG T1 THIN POST

SAG T1 FS POST

SAG T2

SAG T2 FS

SAG T2 THIN

SAG FLAIR

SAG STIR

SAG PD

SAG PD FS

SCOUT

COUNTING LOC

PAPERWORK

(40)

CT: PRE

POST

EXPIRATION

HR

PRONE

ARTERIAL

VENOUS

DELAYED

RECON 1

RECON 2

RECON 3

REFORMAT 1

REFORMAT 2

REFORMAT 3

LOCATOR

SCOUT AP

SCOUT LAT

SCREEN SAVE

DOSE REPORT

PAPERWORK 1

PAPERWORK 2 MPR

(41)

Appendix C: Security Codes

Below is a list of all security codes that come hard-coded within iSite PACS accompanied by their respective descriptions.

ADDDELPERF

Allows user to add or delete performing providers to an exam in the following options: Scheduling, Complete Exam, Enter/Edit Exam, Transcription, Results Reporting, MAM Findings and Interventional Procedures. (secondary security code)

DCTBODYSIT System Administration module, Dictionaries option: Allows access to the Anatomy dictionary (stores codes representing particular areas of the body)

DCTDOCTYPE

System Administration module, Dictionaries option: Allows access to the Document Type dictionary (define various document types for Document Management)

DCTEQUIPMT System Administration module, Dictionaries option: Allows access to the Equipment dictionary (define pieces of equipment used at an organization)

DCTEXAM System Administration module, Dictionaries option: Allows access to the Exam dictionary (define information regarding exams performed at an organization)

DCTHPGROUP System Administration module, Dictionaries option: Allows access to the Hanging Protocol Group dictionary

DCTLOCATON System Administration module, Dictionaries option: Allows access to the Patient Location dictionary (define patient locations)

DCTMODALTY System Administration module, Dictionaries option: Allows access to the Modality dictionary (stores information about modalities used by an organization)

DCTPROVIDR System Administration module, Dictionaries option: Allows access to the Provider dictionary (define providers who use the Imagecast system)

DCTREASON

System Administration module, Dictionaries option: Allows access to the Reason dictionary (define reasons used in several Imagecast activities; for example, patient delayed, radiologist canceled, and so on)

(42)

DCTRESCGRP System Administration module, Dictionaries option: Allows access to the Resource Group dictionary (define groups of resources at an organization)

DCTSUBSPEC System Administration module, Dictionaries option: Allows access to the Sub-Specialty dictionary (stores medical sub-specialties that apply to providers)

DTDMemo Full access to Document Type Memo

DTRMemo Read-only access to Document Type Memo

EXHACCESS Exceptions Handler option: Allows user to view exceptions list (patient or exam information entered at a modality that does not match information in Imagecast)

EXHCLNOTE Image Management, Exceptions Worklist: Allows access to the Clinical Exam Notes window

EXHWINACT Exceptions Handler option: Allows user to remove exceptions from the Exceptions Handler list

EXHWRESEX Exceptions Handler option: Allows user to resolve exceptions

IMGDIGMGMT Image Management module: Allows access to Digital Image Management option

IMGLINKFUL Application-wide: Allows ability to link exams beyond Completed status

IMGLINKLIM Application-wide: Allows ability to link exams in Scheduled, In-Progress and Completed status

IMGSREFAUD Worklist module, Referring option: Suppresses break glass auditing (access to another provider's patients or worklist is denied) (secondary security code)

IMGSREFDEN

Worklist module, Referring option: Suppresses break glass access denial (allows and audits access to another provider's patients or worklist) (secondary security code)

IMGULKSUID Image Management module, Digital Image Management option: Allows unlinking of a study from an exam (secondary security code)

IMGUNLKFUL Application-wide: Allows ability to unlink exams in all exam statuses (expands upon the privileges granted by IMGUNLKLIM)

(43)

IMGVUEIMG Application-wide: Ability to view images for all exams

ISTACCESS EnterprISE Access/Radiologist Workstation: Allows providers to view images for exams in P (Preliminary) or F (Finalized) status for their patient's only

ISTANYPAT EnterprISE Access/Radiologist Workstation, Patient List: Allows user to view images for any patient in the database

ISTANYPHYS EnterprISE Access/Radiologist Workstation, Referring Physician Worklist: Allows user to view images from worklist

ISTBYMRN EnterprISE Access, Patient List: Allows ability to view any patient by MRN

ISTDICTATE Radiologist Workstation: Allows user to mark an exam read (dictated)

ISTEXCEPT EnterprISE Access/Radiologist Workstation, Patient List: Allows ability to query and view exceptions from the Patient List

ISTHPSTD EnterprISE Access/Radiologist Workstation: Allows access to Hanging Protocol Series Types Dictionary

ISTIEXP EnterprISE Access/Radiologist Workstation, Patient worklist: Allows access to iExport Queue functionality (send DICOM images to a third-party device)

ISTIMGDEL EnterprISE Access/Radiologist Workstation: Allows ability to delete images from a study

ISTLCACHE EnterprISE Access/Radiologist Workstation: Allows access to the local exam caching feature

ISTMEDEXP EnterprISE Access/Radiologist Workstation, Allows access to media export

ISTMPRACC EnterprISE Access/Radiologist Workstation: Allows access to the MPR/slab feature

ISTMPREF EnterprISE Access/Radiologist Workstation: Allows users access to the machine preferences

ISTNOREP EnterprISE Access, Patient worklist: Allows ability to view images before diagnostic report is available

(44)

ISTPLUG2 EnterprISE Access/Radiologist Workstation, Generic plug-in security code 2

ISTPRNT EnterprISE Access/Radiologist Workstation: Allows printing of images to paper

ISTPRNTFLM Radiologist Workstation: Allows printing of images to film

ISTPSTATE EnterprISE Access/Radiologist Workstation: Allows user to define presentation states

ISTPUBFLDR EnterprISE Access/Radiologist Workstation, Patient List: Allows write-access to public shared folders

ISTPUBFLRO EnterprISE Access/Radiologist Workstation, Patient List: Allows read-access to public shared folders

ISTQUERY EnterprISE Access/Radiologist Workstation: Allows access to iQuery functionality (DICOM query/retrieve against third-party archives)

ISTRAD Radiologist Workstation: Allows access to the Radiologist Workstation

ISTRDUPID EnterprISE Access/Radiologist Workstation: Allows ability to clear DUP UID Warning Message

ISTRGUID EnterprISE Access/Radiologist Workstation: Allows ability to Assign New Unique Study UIDs

ISTSHOWLOC Allow Location display - Patient Lookup

ISTSUPPORT Provides ability for an iSite EnterprISE User to access the statistics tab.

ISTSYSFLTR EnterprISE Access/Radiologist Workstation, Patient List: Allows access to system-defined filters

ISTSYSHP EnterprISE Access/Radiologist Workstation: Allows ability to save system hanging protocols

(45)

ISTUSRFLDR EnterprISE Access/Radiologist Workstation, Patient List: Allows access to user-defined folders

ISTUSRFLTR Ente

REF4.09-80_iSite PACS Admin Practicum Outline

iSite PACS Admin Practicum

Revision: 2014 Feb 05

Table of Contents

1 Purpose

Scope

References and Related Documents

Term Meaning

System Setup and General Information

6.2.1 General

6.2.2 Window

6.2.4 Image

6.2.6 Display Preferences.

6.2.7 Hanging Protocols (ISR only)

6.2.9 Canvas Page (ISR only)

6.3.2 Window

6.3.5 Annotations

6.3.7 Screen

6.3.9 iExport

6.3.12 Location Dictionary

6.3.14.1 Considerations for Life-Size Printing:

6.3.15 Body Part Dictionary

6.3.17 Hanging Protocol Sequences (ISR only)

6.4.1 Display

6.4.3 General Preference.

6.4.4 Scanner Preference (ISR only)

6.4.6 Network

6.6 Folder

6.6.2 DUPUID

Handler

Filters

History

6.6.8 Statistics

6.6.9 Study

Series Matching Rules (ISR only)

Hanging Protocol Sequences

6.11 Conference Presentation States (ISR only)

6.13 Delete/Recover Deleted Images

6.14 Mark exams unread

Linking

7.2 Exception

7.3 Patient

7.4 Patient

7.5 Demographic

Digital Image Management

System Security

9 System

Dictionaries

10.2 Anatomy

10.4 Hanging Protocol Groups

Appendix A: Screen Overlays

Name Value

MR Overlay

Name Value

CR Overlay

Name Value

CT Overlay

Name Value

MG Overlay

Name Value

NM Overlay

Name Value

RF Overlay

Name Value

US Overlay

Name Value

XA Overlay

Name Value

Appendix B: Suggested Series Matching Rule Names for MR

AX T1 POST

COR T1 FS POST

SAG T2 FS

DOSE REPORT

Appendix C: Security Codes

ADDDELPERF

DCTREASON

IMGSREFDEN