Service Manual. ModLink 1.0: Automate Numeric Dictation PACSGEAR PG-DOC-ML1.0-SM-EN-REVA

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1 Service Manual ModLink 1.0: Automate Numeric Dictation PACSGEAR PACSGEAR 4309 Hacienda Drive, Suite 500 Pleasanton, CA USA T F support@pacsgear.com

Copyright All rights reserved. The information contained herein is confidential and is the sole property of PACSGEAR.

expressly authorized by contracts or other agreements between PACSGEAR and its customers.

Sweeper are trademarks of PACSGEAR in the United States and/or other countries.

2 Copyright All rights reserved. The information contained herein is confidential and is the sole property of PACSGEAR. None of the information may be reproduced, copied and/or redistributed electronically, manually, or otherwise to any person without advance written permission from PACSGEAR, except as may be expressly authorized by contracts or other agreements between PACSGEAR and its customers. Trademarks MediaWriter, MediaUploader, ModLink, PacsConnect, PACSGEAR, PacsSCAN, PacsSCAN Film, PacsSCAN Video, PACSGEAR Image Exchange, PACSGEAR Media Server, Print2PACS, GEARView, ScopeCap and Sweeper are trademarks of PACSGEAR in the United States and/or other countries. Acrobat, Adobe, Bravo, Discproducer, DUET, efilm Lite, Elesys, EPSON, Intelerad, MERGE, Microsoft, M*Modal, Nuance, Primera, Windows, and other trademarks, registered trademarks, or service marks referred to in this document are the property of their respective owners. The publisher and the authors make no claim to these trademarks. While every precaution has been taken in the preparation of this document, the publisher and the authors assume no responsibility for errors or omissions, or for damages resulting from the use of information contained in this document or from the use of programs and source code that may accompany it. In no event shall the publisher and the authors be liable for any loss of profit or any other commercial damage caused or alleged to have been caused directly or indirectly by this document. Printed: 2014 in Pleasanton, CA, USA Use of Fictitious Patient Data Patient demographics appearing in this manual are examples only. No actual patient study data were used in the preparation of this manual. Any similarities to persons living or deceased is purely coincidental. Indications for Use ModLink is intended to be used by healthcare personnel to automate numeric dictation information. ModLink is not labeled for diagnostic use. PACSGEAR 4309 Hacienda Dr. Ste. 500 Pleasanton, CA USA EMERGO EUROPE Molenstraat BH, The Hague The Netherlands T F

3 iii Contents 1 Welcome Starting and Exiting ModLink Licensing ModLink Setting Up ModLink Using ModLink Translations Tab Editing Templates Running ModLink Understanding the Create Unique Value Definition Screen Other Functions Support... 18

1 ModLink 1 Welcome Congratulations on adding ModLink to your PACS system. Measurement data is generated often in large amounts by modalities in various formats.

VR Application Raw data (DICOM, SR, HL7) Value 1 Value 2 Value 3 ModLink Template Template ID 1 Template ID 2 Template ID 3 Report Template Custom field 1 Custom field 2 Custom field 3 ModLink

4 1 ModLink 1 Welcome Congratulations on adding ModLink to your PACS system. Measurement data is generated often in large amounts by modalities in various formats. Technologists can spend significant amounts of time isolating relevant data and manually dictating it into worksheets and forms for clinical documentation. US, DEXA, MRI, etc. VR Application Raw data (DICOM, SR, HL7) Value 1 Value 2 Value 3 ModLink Template Template ID 1 Template ID 2 Template ID 3 Report Template Custom field 1 Custom field 2 Custom field 3 ModLink automates much of this process by acquiring measurements in the form of messages from the modality, categorizing these messages into meaningful groups that can be assigned to templates, and mapping the template IDs (fields) to custom fields previously configured on a voice recognition application. By auto-populating reports, ModLink greatly increases efficiency by reducing radiologist dictation time. For more information, please contact us: Americas, Asia-Pacific Europe, Middle-East, Africa PACSGEAR PACSGEAR 4309 Hacienda Drive, Suite 500 Balanstrasse 73 Pleasanton, CA USA Munich, Germany T T +49 (0) F F +49 (0) support@pacsgear.com support@pacsgear.com

5 2 Glossary of Terms and Symbols The following terms and symbols are used in PACSGEAR manuals. Consult instructions for use. Appears on the product CD. Conformité Européenne. Indicates that the product complies with the requirements of the 93/42/EEC Medical Device Directive. Symbol for manufacturer. Symbol for European authorized representative. Click to view a video tutorial. Caution. Messages that alert you to conditions that could result in equipment failure, equipment damage, or data loss. WARNING. Messages that alert you to conditions that could result in death or serious injury. Accession number AE AMD AST Burner CR DICOM DOB DCA DX EMR EHR HIPAA LDAP Media A tracking or order number for patient studies. Application entity. A local or remote DICOM service. Automatic marker detection. Automatic detection of markers to identify mammography image orientation. Auto segmentation technology. PACSGEAR s proprietary technology for converting sectional films into a stack or cine loop. A digital recording device such as a CD recorder that stores data on media. DICOM modality abbreviation for computed radiography. Digital imaging and communications in medicine. A networking standard for the medical industry. Date of birth. Dynamic contrast algorithm. PACSGEAR s proprietary technology for displaying mammography film priors with a digital look and feel. DICOM modality abbreviation for digital radiography. Electronic medical records. Electronic health records. The Health Insurance Portability and Accountability Act. A law that stipulates transferability of health insurance coverage, standardizes aspects of electronic medical records, and protects patient confidentiality with regard to health information. Lightweight directory access protocol. Used for looking up network services and addresses. Electronic storage media, such as CD-ROM and DVD.

6 3 ModLink MG Modality MRN PACS PacsSCAN PGMS PIE PIES QC RIS UID WADO DICOM modality abbreviation for mammography. Sources of data, such as from ultrasonography, MRI, PET, and CT. Medical record number. Sometimes referred to as the patient ID number. Picture archival and communication system. General term for any of the PacsSCAN products (PacsSCAN Film, PacsSCAN Video, etc.) PACSGEAR Media Server. Software that enables enhanced workflow, optimized for video/audio distribution. PACSGEAR Image Exchange. PACSGEAR Image Exchange Server Quality control. A process of correcting errors and inconsistencies in imaging studies. Radiology information system. A system used to order radiology studies. Unique identifier. A manufacturer-specific identification string that is assigned by modalities to images, series, or studies. Web Access to DICOM Objects. A service that makes DICOM images and reports available via a Web browser. Operating Procedure Conventions Operating procedures employ the following conventions. Convention Boldface type Italic type Courier font Indicates Names of buttons. Names of on-screen objects other than buttons (such as menu commands). Text that the user types. > Sequence of procedures.

4 1.1 Starting and Exiting ModLink ModLink consists of a client program for configuration and monitoring, and a Windows service that performs the main functionality.

7 4 1.1 Starting and Exiting ModLink ModLink consists of a client program for configuration and monitoring, and a Windows service that performs the main functionality. Start and exit the ModLink client as you would any Windows program. When starting, a splash screen appears with the product name. If the splash screen does not appear, please contact PACSGEAR Support. The ModLink service starts automatically when Windows starts. You can also start, stop, or restart the service manually from the client s File menu, or from the Windows control panel. 1.2 Licensing ModLink To start using ModLink, you must obtain and enter a license key as follows. 1 Start ModLink. If a license key has not been previously entered (such as the first time you run the program), the license key entry dialog box (see figure below) appears. Write down the value that appears in the System ID box. To display the dialog box manually at any time you can click Help > About > Change. 2 Request a license key by contacting PACSGEAR support via at key@pacsgear.com, telephone at , or the support section of our Web site at Provide the following information to PACSGEAR: Hospital Name, City, State, Country, Product Name, System ID, and Department/Workstation. If your license is for Demo mode only, select the Click to activate demo check box. 3 Enter your license key and expiration date and click OK. Figure 1.1 License key dialog box

5 ModLink 2 Setting Up ModLink Before using ModLink you must enter the settings described below. Ports Click Settings > Ports to open the Ports dialog box (see figure 2.

At least one port must be configured, but any number of ports can be matched to any number of modalities. To remove a port, select the port and click Remove.

8 5 ModLink 2 Setting Up ModLink Before using ModLink you must enter the settings described below. Ports Click Settings > Ports to open the Ports dialog box (see figure 2.1) that shows all ports that are currently configured. To add a port, click New and enter settings in the Add New Port dialog box (figure 2.2). At least one port must be configured, but any number of ports can be matched to any number of modalities. To remove a port, select the port and click Remove. Adding ports lets you assign incoming data to different templates. For example, if you have modalities from different manufacturers with identical study descriptions, create a new port that matches on AE title to differentiate between them. Figure 2.1 Ports dialog box Figure 2.2 Add New Port dialog box The Ports dialog box displays the following. Port number Use the port number configured on the modality. Type The type of data sent by the modality. Matching criterion The criterion used to match incoming studies to a mapping template. For example, the Study Description matching criterion groups all incoming studies by study description, allowing you to map study values in a particular way for each type of study. Change status Select a port in the Ports dialog box and click Change status to toggle between Enabled (ready to receive data) and Disabled.

9 6 Forwarding Click Settings > Forwarding to open the Forwarding dialog box (see figure 2.3). In this dialog box, enter the location and credentials for the voice recognition application (such as M*Modal or PowerScribe 360). Note that one instance of ModLink can only support one instance of a voice recognition application. RawCapture Figure 2.3 Forwarding dialog box Click Settings > RawCapture to open the RawCapture dialog box (see figure 2.4). Select the check box of a port and click Toggle status to turn RawCapture ON and OFF for the selected port. RawCapture writes unstructured DICOM data to files in the RawCap subfolder of the ModLink installation directory. RawCapture should only be enabled when working with a PACSGEAR representative for troubleshooting purposes. Figure 2.4 RawCapture dialog box

10 7 ModLink AE Title Click Settings > AE Title to open the AE Title dialog box (not shown). Enter the AE title used by ModLink. Custom Fields Click Settings > Custom Fields to open the Custom Fields dialog box (see figure 2.5). When using ModLink, you can add, edit, or remove custom fields for use in the voice recognition application. Chapter 3 describes how to map values from modalities to these fields. Figure 2.5 Custom Fields dialog box

8 3 Using ModLink When you launch the ModLink client, the main screen opens displaying the Translations tab. 3.1 Translations Tab The Translations tab contains the following components.

11 8 3 Using ModLink When you launch the ModLink client, the main screen opens displaying the Translations tab. 3.1 Translations Tab The Translations tab contains the following components. B A C D Figure 3.1 Main screen, Translations tab A: Message Groups area Displays sources (modalities) that sent messages to the indicated ports. Select a source to display information about those messages in the Matching Groups area (C). B: Refresh button Click the Refresh button to update information in the Message Groups and Matching Groups areas. C: Matching Groups area All messages coming from the message group selected on the left are arranged into matching groups which are displayed in this area, one group on each line. The following information is displayed. Matching Criterion Messages are grouped by the value that matched the criterion specified in the Ports dialog box. In the example in figure 3.1, messages are grouped by study description. Messages The number of messages matching the criterion. Template The ModLink template used to map the message s values to fields in the voice recognition application. Status Only values from enabled groups are forwarded to the voice recognition application.

2 Matching group context menu Change Status Select to toggle the matching group between Enabled and Disabled. Edit Template Opens the Edit Template screen (see below).

12 9 ModLink D: Search area To search for messages, type either a complete accession number or MRN in the appropriate field and click Search. Click Clear to redisplay all messages. Matching group context menu The matching group context menu contains the following commands. Figure 3.2 Matching group context menu Change Status Select to toggle the matching group between Enabled and Disabled. Edit Template Opens the Edit Template screen (see below). You can also open the screen by double-clicking a matching group. Change Template Opens the Change Template dialog box, allowing you to choose a different template for the matching group. Figure 3.3 Change Template dialog box

10 3.2 Editing Templates The main purpose of the Edit Template screen is to configure how the template maps modality values in messages by adding or removing template fields.

13 Editing Templates The main purpose of the Edit Template screen is to configure how the template maps modality values in messages by adding or removing template fields. However, you can also select a different template from the Templates list, create a new template by clicking New, or duplicate the existing template by clicking Copy (for purposes of creating a new but similar template). Figure 3.4 Edit Template screen The Message area in the left half of the screen shows the values in a message from a modality. The Template area in the right half of the screen shows the fields to which values are mapped for the voice recognition application. The following controls are available in this screen. Add to template If you want to add more value-field mappings to the template, select a value in the Message area and click Add to template. The Create Unique Value Definition screen opens, allowing you to add the template field and specify more accurately which modality values are mapped to it. For detailed instructions, see section 3.4. Edit format Click to display the Format Output dialog box (not shown), where you can specify how values appear in the voice recognition application. You can convert and show/hide units, change date formats, and perform mathematical conversions. Remove from template Select a field in the Template area and click Remove from template. Resend message After making changes in this screen, you can test your changes by clicking Resend message. The data is resent to the voice recognition application for your review. Save Click when you are finished making changes in this screen.

11 ModLink Figure 3.5 Edit template context menu Edit template context menu The edit template context menu provides a convenient shortcut to functions available elsewhere in the program.

14 11 ModLink Figure 3.5 Edit template context menu Edit template context menu The edit template context menu provides a convenient shortcut to functions available elsewhere in the program. The menu contains the following commands. Format Output Opens the Format Output dialog box (see Edit format above). Remove from Template Removes the selected field from the current template. Additional Modifier Lets you change the additional modifier to Value, Last, or First. See section 3.4 for details on modifiers. Modifier Lets you add or remove modifiers. See section 3.4 for details on modifiers. Show Value in SR Click to highlight values in the Message area that map to the selected field.

15 Running ModLink When all settings have been correctly configured and all template mappings have been assigned, you can exit the ModLink client (the main application). ModLink will begin translating DICOM modality values and forwarding them to the voice recognition application as long as the following conditions are met: The modality is outputting data to ModLink on the correct port. The ModLink service is running. To confirm, click Control Panel > System and Security > Administrative Tools > Services. At least one port and one template are enabled in the ModLink Translations tab. The voice recognition application is receiving data from ModLink at the correct address. ModLink file maintenance When ModLink is installed an automatic maintenance task is scheduled in Windows that deletes aging files. Administrators may want to monitor this task to ensure that it is executed as scheduled. See Control Panel > System and Security > Administrative Tools > Task Scheduler.

16 13 ModLink 3.4 Understanding the Create Unique Value Definition Screen The Create Unique Value Definition screen (hereinafter, the Definition screen) appears when you select a value in the Edit Template screen and click Add to template. The purpose of the Definition screen is to precisely define which incoming DICOM values are mapped to a particular template field. This may be necessary when a set of measured values contains multiple values with the same definition. Unless you specify otherwise, ModLink considers a value s definition to be its name (in the figure below, Height is the name of the value 47.6 mm ). Occasionally you want to map all values with the same definition to a single field, but most of the time you only want one specific value to be mapped. In this case, you need to change the definition to make it unique. Figure 3.6 Create Unique Value screen Take a look again at figure 3.4, where we have selected the value mm, defined as Length. However, there is another value in the current message that is also defined as Length (128.2, indicated by the red box). If we click Add to template, these two values appear in the Output value area of figure 3.6 above (indicated by the blue and red boxes, respectively), and the Not Unique warning is displayed. Since we only want the first value to be mapped and not the second, we need to change the definition to make it unique to the first value.

14 To do that, look at figure 3.4 again and determine how these two values differ in terms of their parents and children in the DICOM structured report hierarchy.

Therefore to create a unique definition for our value, we need to add the laterality to its definition. We do that simply by selecting the Laterality row as shown in figure 3.7.

17 14 To do that, look at figure 3.4 again and determine how these two values differ in terms of their parents and children in the DICOM structured report hierarchy. In this case, their parent, Laterality differs: the first value has a laterality of Left, while the second value has a laterality of Right. Therefore to create a unique definition for our value, we need to add the laterality to its definition. We do that simply by selecting the Laterality row as shown in figure 3.7. When we select Laterality -- Left, the second value disappears from the Output value area, and the message Unique appears. What has happened? Figure 3.7 Value made unique by changing its definition Before selecting the laterality row, the value definition was Name = Length, and there were two values in the message s set of measurements that had that definition. After selecting the laterality row, the value definition was changed to Name = Length AND Laterality = Left, and only one value in the set of measurements has that definition, making it unique. By making value definitions unique in this way, you can ensure that ModLink will always capture and translate the correct value. Selecting multiple parents and children If selecting a parent or child is not sufficient, it may be possible to achieve a unique value definition by selecting multiple parents and/or children. For multiple selection hold down the Ctrl key while clicking items. Using Modifiers In the figure below, two values are defined as Left Ovary Height (in this example both values happen to be the same 17 mm but they won t necessarily be the same in future data sets). Because they have the same parents (Ovary, Finding Site, and Findings), it is not possible to make the definition of the selected value unique by specifying one of its parents. Figure 3.8 Edit template screen messages area

9 Selecting a modifier in the Definition screen Additional modifiers In the figure below neither parents and children, modifiers, nor any combination of these is sufficient to create a unique

18 15 ModLink Use modifiers to assign unique values. In our example, select Mean value chosen to make the definition unique. In other cases, you may need to select both parents and modifiers to create uniqueness. Figure 3.9 Selecting a modifier in the Definition screen Additional modifiers In the figure below neither parents and children, modifiers, nor any combination of these is sufficient to create a unique definition. Fortunately, we can use an additional modifier to hone in on the selected value. Figure 3.10 Edit template screen messages area In the Select additional modifier area of the Definition screen we can select Last item in list to tell ModLink to only map the last value received. In the example above, the last value received for measurements of the gestational sac diameter was 33.9 mm, so that is the value that will be mapped. Figure 3.11 Selecting an additional modifier in the Definition screen Raw output The Raw output area shows the definition of the current value in code that is intended for use only by PACSGEAR service personnel for troubleshooting purposes.

16 Applying the new value definition Once you have created a satisfactory definition for the selected value, click Apply to assign the value to a custom field for use in the voice

19 16 Applying the new value definition Once you have created a satisfactory definition for the selected value, click Apply to assign the value to a custom field for use in the voice recognition application. The Select Custom Field dialog box appears. Select a field from the list, or select Add New Value to create a new field. Figure 3.12 Select Custom Field dialog box

20 17 ModLink 4 Other Functions Controlling the ModLink Service Click File > Service to restart, stop, or start the ModLink service. Getting Help Click Help > Service Manual (PDF) to view the service manual (this manual). Viewing and Changing Product and License Information Click Help > About to view product version and license information. Click Help > About > Change to change the license key. Viewing the Server Log From the main screen, click the Server Log tab to view the server log. Figure 4.1 Server Log tab

21 18 5 Support At PACSGEAR, your success is our success. If you have any questions or problems, please do not hesitate to contact us. Customer Support (Americas, Asia-Pacific): (8:00 am to 5:00 pm Pacific Time). support@pacsgear.com Customer Support (Europe, Middle East, Africa): +49 (0) (08:00 to 17:00 Central European Time). support@pacsgear.com

User's Manual. PACSGEAR Image Exchange Server 1.0 PACSGEAR PG-DOC-PIES1.0-UM-EN-REVB

User's Manual. PACSGEAR Image Exchange Server 1.0 PACSGEAR PG-DOC-PIES1.0-UM-EN-REVB User's Manual PACSGEAR Image Exchange Server 1.0 PACSGEAR PACSGEAR 4309 Hacienda Drive, Suite 500 Pleasanton, CA 94588 USA T +1 925 225 6100 F +1 925 225 6195 support@pacsgear.com www.pacsgear.com Copyright