Perceptive Content VNA for Healthcare

Transcription

1 Perceptive Content VNA for Healthcare Exercise Guide Enterprise Software Education Services

2 2017 Lexmark. All rights reserved. Lexmark, the Lexmark logo, AccessVia, Acuo, AcuoStore, Claron, Code Dash, Interact, ImageNow, InContext, LearnMode, Pacsgear, Perceptive, Perceptive Evolution, Perceptive Software, Pretrieve, and Saperion are trademarks or registered trademarks of Lexmark International, Inc. or its subsidiaries in the United States and/or other countries. All other trademarks are the property of their respective owners.

3 Table of Contents Prerequisites Disable User Account Control Confirm User Account Control is Disabled in the Registry Configure Microsoft Distributed Transaction Coordinator... 1 Software Installation Install System Prerequisites Install Host Server Install AcuoStore Service Install AcuoMed Service... 2 Software Configuration Prior to VNA Configuration Install AcuoStore Database Create File Share Folders for Image Cache and DILIB Configure Sharing and Security for each Folder Create and Configure Managed Shares Create and Configure Applications Start AcuoStore Services Install AcuoMed Database Configure AcuoMed Dilib Connection Enter Feature Key Moving Images into and out of the VNA Install DICOM Database Create a VNA Destination for the DICOM Database Start AcuoMed Services Test Configuration of the Local Destination Create a Route to the Local Destination Configure DICOM Service Class Provider (SCP) Configure SCP Called AE Name Create a Default Calling AE Title Create External DICOM Device (External Destination) Create a Route to the External DICOM Device (External Destination) Create a Route View pointing to the External DICOM Device s (External Destination) Route Create a Move/Route Map... 17

4 30. Open Activity Log Move Images from Instructor Database Verify Images Queued in the Batch Move and Batch Store Manager Verify Images are in Local DICOM Database Review Exercises Pushing Images Patient Management & Batch Management Propagation Route Attach Propagation Route to Local DICOM Database Edit Patient Name within MMC Review Edit in Batch Update Manager View Update to Patient Record Merge Patient with Patient Review Merge in Batch Update Manager Merge Study with Patient Review Merge in Batch Update Manager Edit Patient ID with a Merge Review Merge in Batch Update Manager View DICOM Dump Recycle Bin Recycle Bin Deleting Multiple Patients Patient Management MMC Patient Management MMC Modifying Patient Management MMC Review Create New Physical Share on C: drive Create Managed Share in AcuoStore Create Application in AcuoStore Install a DICOM Database in AcuoMed/SQL Create a New AcuoMed DICOM Database Destination in AcuoMed Create a Route to Connect to the new Local DICOM Database Tag Rule Routing Tag Rule Routing Federation Edit Patient Name... 27

5 59. Create a Route pointing to the Local DICOM Destination and the External DICOM Destination Create a Route View pointing to the Local and External DICOM Databases Reconciliation Configure HIS/RIS Connection Tag Rule Routing settings must be reconfigured Reconfigure the Called AE Install and Configure Reconciliation Create Reconciliation Database Create Destination Create Route to Reconciliation Database Configure Called AE Name for Reconciliation Review Reconciliation Event Manager Create a Stat Route SCU Authorization Turn Reconciliation Off Create an External SCU Authorization WADO Install and Configure WADO Add AcuoService User to Administrator s Group Add WADO Snap-In to MMC View Images using WADO ADAM Migration Configure and Run Discovery for Migration Configure ADAM Route Configure ADAM for Migration Phase I Query Phase II Edit Mode Begin Phase III Create Batch Move Jobs for Migration Phase III Complete Troubleshooting SOP Class Mismatch Transfer Syntax Mismatch Study UID Conflict Exact Match Name... 36

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7 Prerequisites 1. Disable User Account Control User Account Control (UAC) is a security component that enables an administrator to enter credentials during a non-administrator s user session to perform occasional administrative tasks. User accounts that are members of the local group named Administrators run most applications as standard users. By separating user and administrator functions, UAC helps users move toward using standard user rights by default. 1) Right-click the Windows icon in lower left corner, and select Search. 2) In the search box, type MSCONFIG. 3) In the System Configuration dialog box, select the Tools tab. 4) Select Change UAC Settings. Click Launch. 5) Confirm the slide bar is set to Never Notify. Click OK. NOTE: The UAC is now disabled. A restart is not necessary. 2. Confirm User Account Control is Disabled in the Registry 1) Right-click the Windows icon, and then select Run. 2) In the box, type Regedit. 3) Navigate to: HKEY_LOCAL_MACHINE\SOFTWARE\Microsoft\Windows\CurrentVersion\policies\system 4) Select the EnableLUA option and confirm the status is 0 (disabled). 3. Configure Microsoft Distributed Transaction Coordinator Without Microsoft Distributed Transaction Coordinator (MSDTC) access enabled, applications can only use transactions that run on the local computer. For example, transactions cannot flow from a local computer to a database that runs on a separate computer if network Distributed Transaction Coordinator (DTC) access is disabled. To enable and configure the DTC, follow the steps below. 1) Single-click the Windows icon in the bottom left, select Server Manager. 2) In the upper right-hand corner, select Tools > Component Services. 3) Expand Component Service\MyComputer\Distributed Transaction Coordinator\Local DTC. 4) Right-click Local DTC, and then click Properties. 5) In the Local DTC Properties window, select the Security tab. 6) In the Security Settings sections, select the Network DTC Access check box. 7) In the Transaction Manager Communication section, select the Allow Inbound and Allow Outbound check boxes. 8) Click OK. A message displays stating the service will be stopped and restarted. 9) Click Yes to restart MSDTC service. 10) Click OK. 11) Close Administrative Tools > all Control Panel items > Component Services. 1

8 Software Installation 4. Install System Prerequisites The Prerequisite installer checks the system, displays a list of Microsoft products, and then updates those that are needed on the system. 1) On the desktop, double-click the VNA Installers folder to open. 2) Navigate to System Prereqs, right-click Setup.exe and Run as Administrator. 3) Click Install. 5. Install Host Server The Host Server Setup installs registry settings, icons, installation tools, product common objects, and AcuoMed and AcuoStore backup tools. 1) Navigate back to the VNA Installers folder. 2) Navigate to Host Setup, right-click Setup.exe, and then select Run as Administrator. 3) Click Next. 4) Accept the License Agreement. 5) Confirm setup type Complete is selected, and then click Next. 6) Click Install. 7) Click Finish when your installation completes. 6. Install AcuoStore Service 1) Navigate back to the VNA Installers folder. 2) Open AcuoStore, right-click Setup.exe, and then select Run as Administrator. 3) Click Next. 4) Accept the License Agreement. 5) Follow the install wizard, and then click Typical. 6) Click Install. 7) Click Finish when your installation completes. 7. Install AcuoMed Service 1) Navigate back to the VNA Installers folder. 2) Open AcuoMed, right-click Setup.exe, and select Run as Administrator. 3) Accept the License Agreement. 4) Follow the install wizard, and then click Typical. 5) Select Install. 6) Click Finish when your installation completes. 2

9 Software Configuration 8. Prior to VNA Configuration 1) Select File Explorer from the task bar. 2) Double-click the C: drive. 3) Right click and select New > Folder. 4) Name the folder SQL Data Logs. 5) Close File Explorer. NOTE: The SQL Data Logs folder is used to house the.mdf and.ldf files used for all databases created. 6) On the desktop, in the Acuo Technologies folder, open the Acuo Technologies MMC shortcut. 7) Click File > Save As. 8) Navigate to the desktop. 9) Add your initials to the beginning of the suggested file name located in the File Name field and click Save. This saves the MMC to your desktop. 9. Install AcuoStore Database The AcuoStore Database houses all the configurations built within the AcuoStore service. Configurations include upcoming Managed Shares, Applications, and Archive Device. Complete the following steps to create the AcuoStore database in Microsoft SQL. 1) From the already opened MMC, expand AcuoStore Digital Asset Manager, right-click Digital Asset Manager Server, and then click Install Database. 2) Configure the following SQL Server Connection settings: Server/Instance: APPSVR1(default) Confirm Windows user authentication using your credentials is selected. 3) Configure the following DICOM Database Parameters. Database Name: AcuoSDb 4) Configure the new Database Directories by clicking Browse and selecting the following folders: Database: C:\SQL Data Logs Log: C:\SQL Data Logs 5) Click Finish to install the AcuoStore Database. 3

10 6) In the MMC Console, complete the following steps to confirm the databases are installed: a) Click AcuoStore Digital Asset Manager. b) In the right pane, confirm the Configuration Database Status is Connected. 7) Select Server SQL Management Studio in lower task bar and verify the following settings to confirm the AcuoStore Database is in Server SQL Management Studio. Server name: APPSVR1 Authentication: Windows Authentication Connect Expand the Databases directory Confirm AcuoSDb is available. 10. Create File Share Folders for Image Cache and DILIB Images are located in the File Shares. For training purposes, you will create the File Shares on the C: drive. In an actual production environment, you can create Image Share folders on any drive or storage device accessible by the server hosting AcuoStore. 1) Select File Explorer from the task bar. 2) Double-click the C: drive. 3) Right-click and select New, and then click Folder. 4) Name the file Radiology_share. 5) Repeat step 3 and name the new file DILIB_share. NOTES: The share in the folder names indicates that this is the file share. This will help identify it later in class. The Radiology_share folder is the image cache storage location. This is the image cache endstorage for DICOM images sent into the VNA. The DILIB_share is the temporary repository for images coming into the VNA. No images are stored in this file long term. 4

11 11. Configure Sharing and Security for each Folder 1) In File Explorer, right-click the C:\Radiology_share folder > Properties. 2) On the Sharing tab, click Advanced Sharing > Share. 3) Click Permissions, and then deselect the Everyone group. 4) Click Add, and then click Advanced. 5) Click Find Now. 6) From the search results, click Authenticated Users then click OK. 7) Click Authenticated Users under Group or User Names. 8) Click the Allow checkbox to Allow for Full Control permissions. 9) Click Apply, and then click OK. 10) Click OK again to close Advanced Sharing. 11) Click the Security tab, and then click Edit. 12) Click Add, select Advanced, and then select Find Now. 13) From the search results, hold down the CTRL key and click Acuo Administrators, Acuo Power Users, and Acuo Users, and then click OK. 14) Click OK again to close Select Users or Groups window. 15) From Permissions for New Folder, complete the following steps for Acuo Administrators and Acuo Power Users. No change is required for Acuo Users because they will remain with read and execute permissions. 16) In the Group or User Name list, select Acuo Administrators. 17) In the Permissions for Acuo Administrators, for Full Control select the checkbox for Allow. 18) In the Group or User Name list, click Acuo Power Users. 19) In the Permissions for Acuo Power Users, for Full Control click the checkbox for Allow. 20) In the Group of User Name list, click Acuo Users. 21) No change is required. In Permissions for Acuo Users, verify the Allow box is marked for Read & Execute. 22) Click Apply, and then click OK to close the Security window. 23) Click Close to close the New Folder Properties window. 24) Repeat this procedure to configure sharing and security for the DILIB_share. 12. Create and Configure Managed Shares You use Managed Shares to attach the physical image folder to the application. The application is what AcuoMed and the DICOM databases use to attach to the physical images through AcuoStore. 1) If the MMC is not open, open the shortcut you created called xx ATConsole. 2) From the MMC, expand AcuoStore Digital Asset Manager > Digital Asset Manager Server. 3) Right-click Managed Share, click New, and then click New Share. 4) From the Share Properties dialog box, on the General tab, in the Share Properties window, enter Radiology_mgshare. NOTE: The mgshare in the entry indicates this is a Managed Share. 5) In the Network Share tab, click the Share drop-down menu and select Radiology_share. 6) Click Add, and then click OK. 7) To create the Managed Share for the temporary cache, repeat the previous steps using DILIB_mgshare for the name. 5

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13 13. Create and Configure Applications Applications provide the point at which AcuoMed makes contact with AcuoStore. Through AcuoMed, subscribers interface to an application and the application then either grants or denies the subscribers access to the managed share that houses their digital assets. 1) Expand console AcuoStore Digital Asset Manager > Digital Asset Manager Server > Applications. 2) Right-click Applications, click New, then New Application. 3) On the Main tab, in the Application name box, enter Radiology_application. 4) On the Managed Shares tab, select Radiology_mgshare. Move to Allocated Managed Shares. 5) Repeat the previous steps to create and configure the DILIB_application. 7

14 14. Start AcuoStore Services To synchronize your updates from the MMC back to SQL, complete the following steps to start services in the MMC. 1) From the MMC, click Services. 2) Click the AcuoStore, and then click Start. NOTE: The AcuoMed installation process is covered next. 8

15 15. Install AcuoMed Database The AcuoMed Database contains all the configurations built within AcuoMed. Configurations include DICOM Database Destinations, Routes, Called AEs, and so on. This is similar to the AcuoStore Database when installed in exercise ) Expand AcuoMed Image Manager, right-click Image Manager Server, and click Install Database. 2) Enter the following parameters into the Database Installation Authentication settings: SQL Server/Instance: APPSVR1 Windows user authentication using your credentials Confirm Database Name: AcuoMed 3) Enter the following parameters in the Configuration Database Directories section: Database: C:\SQL Data Logs Log: C:\SQL Data Logs 4) Enter the following parameters in the IHE Audit Database Directories section: Database: C:\SQL Data Logs Log: C:\SQL Data Logs 5) Click Finish. If you receive a Not Responding or Feature Key violation message, disregard the message. 6) Click AcuoMed Image Manager and in the right pane, confirm the Configuration Database Status displays Connected. 9

16 16. Configure AcuoMed Dilib Connection 1) Cycle AcuoStore Services. 2) Right-click Image Manager Server and click Properties. 3) Click the Storage Server DILIB Connection tab and enter the following information: Server Name: APPSVR1 Application Name: DILIB_application 4) Click Test to confirm AcuoMed is able to connect with the dilib file share. 5) Click Apply. Click OK. 17. Enter Feature Key 1) Expand AcuoMed Image Manager > Image Manager Server > Feature Validation. 2) Copy the Feature Key from the text file and paste it into the Feature Key field. NOTE: The Feature Key is located in the VNA Installers on the desktop in the Feature Keys.txt file. This exercise requires the first key listed at AcuoMed Installation Exercise. 3) Click Apply. 4) Verify the feature key successfully applied on the screen by selecting a different MMC node and then back on the Feature Validation node. The key displays in the Feature Key field instead of INVALID KEY. 10

17 Moving Images into and out of the VNA 18. Install DICOM Database A DICOM database contains the patient administrative, study, series, and image record information that describes the images that are physically present in Physical Share. Tag data in the DICOM database is extracted from each image prior to DICOM database storage. You can have one-to-several DICOM Databases depending on your facilities preference. 1) Expand AcuoMed Image Manager > Image Manager Server > Router Configuration > Destinations. 2) Click AcuoMed DICOM Databases, right-click, and select Install a DICOM Database. 3) Configure the DICOM Database as shown below. Server/Instance: APPSVR1 Windows user authentication using your credentials 4) Under DICOM Database, configure Database Name: Radiology 5) Under New Database Directories, set the following parameters: Database: C:\SQL Data Logs Log: C:\SQL Data Logs NOTE: An update does not display in the MMC console tree. Installing the DICOM database creates only a SQL database. 6) Select Microsoft SQL Server Management Studio located in Task Bar, and then verify the following settings to confirm the Radiology Database is in SQL Server 2014 directory: Server name: APPSVR1 Authentication: Windows Authentication Connect Expand the Databases tab and confirm Radiology is now a Database, also notice the AcuoMed and AcuoMedIHEAudit Databases as well. 11

18 19. Create a VNA Destination for the DICOM Database Connect the MMC to the SQL Database you created by creating an AcuoMed DICOM Database Destination. The Destination connects the AcuoMed DICOM database located on the MMC to the SQL database. 1) Expand AcuoMed Image Manager > AcuoMed Image Manager Server > Router Configurations > Destinations. 2) Right-click AcuoMed DICOM Database and click New > New AcuoMed DICOM Database Destination. 3) Click the DICOM Database Connection tab. 4) Enter the following information in the designated fields: DICOM Database Destination: Radiology_Images Server/Instance: APPSVR1 Database Name: Radiology 5) To verify the connection, click the Test button. 12

19 6) Click the Storage Server Connection tab and confirm the following information in the designated fields. Server Name : APPSVR1 Application Name: Radiology_application NOTE: Connecting the local DICOM Database Destination to the Application we created in exercise 11.1 is the process of attaching the AcuoMed service to the AcuoStore service. 7) To verify the connection, click the Test button, click the DICOM Database Settings tab, and confirm the database type is Permanent. 8) Click Add. 20. Start AcuoMed Services To synchronize your updates from the MMC back to SQL, start services within the MMC. 1) From the MMC, click Services. 2) Click the AcuoMed service, and then click Start. 21. Test Configuration of the Local Destination Test your setup and configuration to see if you can connect to the Local DICOM database. 1) Navigate to AcuoMed Image Manager > Image Manager Server > Patient Management. 2) Expand DICOM Database Management. 3) Click Radiology_Images. 4) In Study View, perform a Search. 5) If your configuration is correct, you receive a No records were found message, verifying that connectivity exists to an SQL database. 22. Create a Route to the Local Destination The purpose of creating a Route is to provide a connection to one or more local and external destinations. Complete the following steps to create a route connecting to the local DICOM database. 1) Expand AcuoMed Image Manager > Image Manager Server > Router Configuration > Routes. 2) Right-click Routes and click New, and then click New Route Name. 3) Click the Route Definition tab and enter the following information: Name: To_Radiology_Images Type: Basic Level: Study 4) Click the DICOM Database Destination tab. 5) Click the arrow to move Radiology_Images from Available Destinations to Current Destinations. 6) Click Add, and then click OK. 13

20 23. Configure DICOM Service Class Provider (SCP) For AcuoMed to store images from external DICOM systems, configure the Acuo VNA as a Service Class Provider (SCP). By configuring this connection, you create a window for external systems to send their DICOM images in for archiving. Like with any DICOM handshake, you need to configure the three DICOM negotiation parameters: IP Address, Port number, and AE Title. 1) Expand AcuoMed Image Manager > Image Manager Server>DICOM Configuration. 2) Right-click the selection named Any IP Address, and then click New, then New SCP. 3) In the SCP Properties dialog box, set the Port to ) Click Add. 5) Click OK. 24. Configure SCP Called AE Name 1) Expand AcuoMed Image Manager > Image Manager Server > DICOM Configuration > Any IP Address. 2) Right-click SCP [Listening Port: 104], click New, Called AE. 3) From the Called AE Main tab, configure the following information: a) Ask Instructor for your Student number. b) Called AE Name: STUDENT x (x is your Student number: STUDENT1 or STUDENT11) c) Default Route Name: To_Radiology_Images d) Select the SOP Configuration tab and confirm the All box is checked. This selects all SOP Classes (Abstract Syntax) and Transfer Syntaxes for this SCP. NOTE: You will use the default settings on the remaining tabs. 4) Click Add. 5) Click OK. 25. Create a Default Calling AE Title Creating a Default Calling AE Name prepopulates your Calling AE name within the External DICOM Device Properties. Each External DICOM Device gets the same standardized Calling AE Name. 1) Right-click Image Manager Server and click Properties. 2) Click the Options tab. 3) Enter your first name as Default External Calling AE Name. 14

21 26. Create External DICOM Device (External Destination) To connect to at outside DICOM Device, such as a PACS or modality, we must create an External DICOM Device Destination, that points to that DICOM system. The parameters needed to connect two DICOM devices are AE Title, IP Address, and Port #. An External DICOM Device defines the parameters for query/retrieve from and sending images to an outside DICOM system. 1) Expand AcuoMed Image Manager > Image Manager Server > Router Configuration > Destinations. 2) Right-click External DICOM Devices, click New. Click New External DICOM Device. 3) From the External DICOM Device Main tab configure the following fields: SCP Destination Name: Instructor_Rad Called AE Name: INSTRUCTOR_RAD (Instructor s AE Title/Name) IP Address: (Instructor s IP address) SCP Listening Port: 104 (Instructors Port #) Calling AE Name: This will default to your first name from the previous step. 4) Leave all other defaults. 5) To verify the connection, click Test. NOTE: To confirm communication with an external DICOM device, as a test, send a C-Echo Request from your instance of the VNA to the external destination. 6) Click Add, and then click OK. 27. Create a Route to the External DICOM Device (External Destination) Now that we have created a second destination that is located outside of our VNA, create a route that points to that outside destination. This process is the same as creating a route to a local database. Use the External DICOM Device Destinations tab to select the destination. 1) Expand AcuoMed Image Manager > Image Manager Server > Router Configuration. 2) Right-click Routes. 3) Click New. 4) Click New Route Name. 5) Click the Route Definition tab and configure the following: Name: To_Instructor_Rad Type: Basic Level: Study 6) Click the External DICOM Device Destinations tab. 7) Move Instructor_Rad from Available SCP Destinations to Current SCP Destinations 8) Click Add, and then click OK. 9) Restart AcuoMed Services 15

22 28. Create a Route View pointing to the External DICOM Device s (External Destination) Route Route View Management enables you to Query/Retrieve from all destinations assigned to a route. You have already created an external DICOM device that points to the Instructors VNA named Lemark_Radiology. Additionally, you created a route that points that external DICOM device. With Route View Management, you can query (Issue C-Find Requests) any external DICOM device. The only requirement is the external DICOM device must support C-Commands. 1) Within the MMC, expand the Patient Management node. 2) Right-click Route View Management and click Add Route Views. Click Route Name To_Instructor_Rad. 3) Click OK. 4) In the Route View Management window, click To_Instructor_Rad. 5) Click Search to query the Instructor s external radiology database. 6) To save Route View Management, go to File and click Save. If you do not File/Save, you need to add the Route-to-Route View Management again. NOTES: Querying the To_Instructor_Rad route, issues a C-Find Request to the External DICOM Device you defined earlier. The query, or C-Find Request, comes in through the instructor s Called AE and queries the DICOM Database(s) attached to that Called AE s Route. In this scenario, you, the Service Class User (SCU), just requested that the instructor, the Service Class Provider (SCP), provides you with a list of patients. The records returned are from the instructor s local DICOM database. You have queried and returned a set of results. No records were moved. 16

23 29. Create a Move/Route Map You have created a local image cache (DICOM Database) on your VNA to store images and an external DICOM device containing images that you can query. Next, you build the Move/Route Map. A Move/Route Map enables you to move (C-Store) images to and from the VNA. 1) Expand AcuoMed Image Manager > Image Manager Server and right-click Move/Route Mapping. 2) Click New, and then click New Move Name. 3) From the Move Route Assignment tab, configure the following fields. Move Route Name: Pull_to_Radiology_Images Destination: STUDENT x, where x is your student number used to create you Called AE. Route Name: To_Radiology_Images 4) Click Add, and then OK. 5) Restart AcuoMed Services. 30. Open Activity Log The activity log enables you to monitor command-related activities that are associated with DICOM connections. This includes commands such as association (DICOM connection) C-FIND, C-MOVE, C- STORE, and C-ECHO. By monitoring these commands, you can determine how many images were stored, how many images were moved, which devices are sending and receiving messages from the Acuo System, and startup and tear down. 1) Double-click Acuo Technologies > AcuoMed Utilites. 2) Open AcuoMed Activity Log. 31. Move Images from Instructor Database 1) Expand Patient Management > Route View Management. 2) If To_Instructor_Rad does not exist, right-click and add the route. NOTE: This step is required if the MMC was not saved during previous exercises. 3) Select the To_Instructor_Rad route, and then click Search. 4) From the query results, highlight any four studies, right-click and select Move Patients. 5) In the Destination AE Name drop-down list, select Pull_to_Radiology_Images. 6) Click OK. 7) Notice your personal Activity Log and the Instructor s Activity Log. 17

24 32. Verify Images Queued in the Batch Move and Batch Store Manager 1) Expand AcuoMed Image Manager/Image Manager Server/Batch Processing Managers/Batch Move Manager list, and confirm the jobs are present. 2) Check the Status column and confirm the jobs are Completed. 3) Complete one of the following steps: a) If there is an error, contact your instructor. b) If your Batch Move jobs have all completed successfully, continue to the next step to check your Batch Store Manager. 4) Expand AcuoMed Image Manager/Image Manager Server/Batch Processing Managers/Batch Store Manager. 5) Under Batch Store Manager, make note of the DICOM Database you created named Radiology_Images. 6) Expand the Radiology node to reveal all of the Patients sent to this specific database. 7) Select a patient to display all of the images moved for that specific patient. 8) Check the Status column and confirm the job Completed. If there is an error, contact your instructor. NOTES: The Batch Move Manager defines a patient as a job. The Batch Store Manager defines an image as a job. You will need to refresh the Batch Manager Node to see updates; it does not refresh and update dynamically as changes arrive to the queue. 33. Verify Images are in Local DICOM Database 1) Expand Patient Management > AcuoMed DICOM Databases > Radiology_Images. 2) Perform a Search for the moved studies. 18

25 34. Review Exercises Pushing Images Create a second External DICOM Device to point to a second Instructor DICOM Database named Instructor_Card. 1) Complete the following steps to create the External DICOM Device. a) SCP Destination Name: Instructor_Card b) Called AE: INSTRUCTOR_CARD c) IP: d) Port: 104 e) Calling AE: (should be prepopulated) f) Test to confirm your C-Echo has created an association with the Instructor s Called AE. 2) Complete the following steps to create a Route pointing to the External DICOM Device a) Route Name: To_Instructor_Card b) External DICOM Device Destinations: Instructor_Card 3) Click Add. 4) Complete the following steps to create a Move/Route Map that enables you to send images to the External DICOM Device. a) Move Route Name: Push to Instructor Card b) Destination AE Name: INSTRUCTOR_CARD c) Route Name: To_Instructor_Card 5) Restart AcuoMed Services. a) Test Pathway to External DICOM Device Lexmark Cardiology. b) In the MMC, expand Patient Management and display your local database. c) Right-click any patient and select Move (either Patient or Study) this creates a Batch Move Job. i) Source Route Name: To_Radiology_Images (1) Source is where the images are coming from. ii) Destination - AE Name: Push to Instructor Card (1) Destination is where the images are going. This is actually mislabeled. You select the Move/Route Map you have created instead of just an AE Name. d) Verify a new Batch Move job displays in the Batch Move Manager and has completed successfully. e) Important. Press F5 to refresh your view. The MMC does not auto-refresh. f) Verify the new Batch Store jobs displays in the Batch Store Manager and has completed successfully. g) Important. Press F5 to refresh your view. The MMC does not auto-refresh. h) If everything has completed successfully, you have just deposited images from your local DICOM database into the instructor s local DICOM database. 19

26 Patient Management & Batch Management 35. Propagation Route 1) Expand AcuoMed Image Manager > Image Manager Server > Router Configuration > Routes. 2) Right-click Routes and click New. 3) Click New Route Name. 4) Click the Route Definition tab and configure the following parameters: Name: Prop_to_Instructor_Card Type: Propagation 5) From the External DICOM Device Destinations tab, select Instructor_Card and click the >> button. 6) Click Add, and then click OK. 36. Attach Propagation Route to Local DICOM Database 1) Expand AcuoMed Image Manager > Image Manager Server > Router Configuration > Destinations > AcuoMed DICOM Databases. 2) Right-click Radiology_Images, then click Update. 3) Click the DICOM Database Settings tab, under the Change Management Routes, and then click the Fix-It Propagation Route drop down and select Prop_to_Instructor_Card. 4) Click Finish. 5) Restart AcuoMed services. 37. Edit Patient Name within MMC 1) Expand AcuoMed Patient Management > DICOM Database Management. 2) Click Radiology_Images, and then click Search. 3) Leave all fields blank. This tells the system to return all records. 4) Click OK to acknowledge the warning message. NOTE: In your production environment, do not perform a search for all records. In class, it is acceptable to search all records due to the lower number of records in the system. 5) To move to Patient View, clear the Study View check box. 6) Select the patient you sent to Instructor_Card in the previous exercise, right-click, and click Edit Existing Patient. 7) A warning displays telling you that any edit, merge, or deletes will propagate along the attached propagation route. Select, Yes. 8) In the Patient Info dialog box: a) Given Name: Add any first name b) Family Name: Add any last name 9) Click OK. 20

27 38. Review Edit in Batch Update Manager 1) Expand Batch Processing Managers. 2) Click Batch Patient Update Manager. 3) From the pane to the right, verify that your edit request has completed. NOTE: The request is the highest number item in the list. If the update does not immediately appear, click the Refresh icon on the toolbar. 39. View Update to Patient Record 1) Expand Patient Management > Route View Management. 2) Right-click Route View Management and add To_Instructor_Card. 3) Click To_Instructor_Card. 4) Query for the edited patient. 40. Merge Patient with Patient 1) Query a patient within Patient Management > DICOM Database Management > Radiology_Images. 2) Right-click a patient name and then click Merge Patient With. 3) Select Yes for the propagation Warning. 4) In the Merge Patient to Patient dialog box, on the far right, select the ( ) ellipsis. 5) In the Search Engine dialog box, search for patients, then choose any patient. 6) Click OK. NOTE: Selecting random patients is not a production example, but since this is an exercise to demonstrate functionality, any patient will work. 7) In the Merge Patient-To-Patient dialog box, click Merge. 8) This will merge the Source patient (first patient selection) INTO the Destination patient. 41. Review Merge in Batch Update Manager 1) Expand Batch Processing Manager>Batch Patient Update Manager and verify that the merge has processed by confirming the status in the right pane of the MMC. 21

28 42. Merge Study with Patient 1) Query a patient within Patient Management > DICOM Database Management > Radiology_Images. 2) Expand to the Study-Level. 3) Right-click a Study, and then click Merge Study With. 4) Select Destination Patient. 5) Click OK. NOTE: Selecting random patients is not a production example, but since this is, only an exercise to demonstrate functionality any patient will work. 6) In the Merge Patient To Patient dialog box, select Merge. 43. Review Merge in Batch Update Manager Expand Batch Processing Manager>Batch Patient Update Manager and verify that the Merge has processed by confirming the status in the right pane of the MMC. 44. Edit Patient ID with a Merge If you need to modify a Patient ID, you must use the Merge function. 1) Query a patient within Patient Management > DICOM Database Management > Radiology_Images. 2) Right-click a patient name in Patient View and click Merge Patient With. 3) In the Merge Patient to Patient dialog box, select New button, and then Enter the Patient ID to create a new PID. This PID must not already exist. 4) Click Merge. 45. Review Merge in Batch Update Manager 1) Expand Batch Processing Manager > Batch Patient Update Manager and verify that the Merge has processed by confirming the status in the right pane of the MMC. 46. View DICOM Dump DICOM Dump button generates a dump of the tag detail of an ASIFF file (the physical image) and displays them in the default text editor (Notepad for example). 1) Query a patient within Patient Management > DICOM Database Management > Radiology_Images. 2) Query database, select a patient and expand down to the image level. 3) Right-click any image and select View DICOM Dump. 22

29 Recycle Bin 47. Recycle Bin 1) Search for a patient in local database. 2) From the list, select a patient, right-click and select Delete Single Patient. 3) Click Yes to confirm the deletion. 4) Within Patient Management, click IHE Audit/Recycle Bin Manager. 5) Select the Acuo Audit/Recycle Bin Search tab. 6) Find the patient image you deleted and select the check box. NOTE: Each image still exists even if you delete the patient. 7) To restore all images, select each image. 8) Select Restore Selected Images. 9) In the Restore Images dialog box, enter the following information. AE Title: STUDENT x, where x is your student number. Port: ) Click Start. 11) Within the local database, search for the restored record in the DICOM database. 48. Deleting Multiple Patients 1) Right-click the Patient Management node and select Properties. 2) Check the Allow Deletion of Multiple Items when in Patient View box. 3) Delete all the patients from your Radiology_Images database. 23

30 Patient Management MMC 49. Patient Management MMC Create a shortcut to the Patient Management MMC on the desktop. This prevents any changes made to the MMC from being lost during an AcuoMed upgrade. 1) From the desktop, open the Acuo Technologies folder. 2) Right-click the Patient Management MMC > Sent To > Desktop to create a shortcut. 50. Modifying Patient Management MMC Create a custom MMC by adding frequently used Snap-Ins. 1) Double-click the Patient Management MMC on the desktop. 2) Click File; Add/Remove Snap-In, then AcuoMed Batch Process Manager. 3) Click Add, OK, File, then Save As. 4) Navigate to the desktop and enter a new name. 5) Click Save. 24

31 Review 51. Create New Physical Share on C: drive 1) Physical Share Folder: legacy_radiology_share NOTE: Configure Sharing and Security on this new folder. 52. Create Managed Share in AcuoStore 1) Name: legacy_mgshare 2) Network Share: legacy_radiology_share 53. Create Application in AcuoStore 1) Application Name: legacy_application 2) Managed Share: legacy_mgshare 54. Install a DICOM Database in AcuoMed/SQL 1) Server\Instance: APPSVR1 2) Use Windows Authentication 3) Database Name: Legacy_Radiology 4) Database: C:\SQL Data Logs 5) Log: C:\SQL Data Logs 55. Create a New AcuoMed DICOM Database Destination in AcuoMed DICOM Database Connection 1) DICOM Database Destination: Legacy_Radiology_Images 2) Server\Instance: APPSVR1 3) Database Name: Legacy_Radiology 4) Test 5) Keep all other defaults. Storage Server Connection 6) Server Name: APPSVR1 7) Application Name: legacy_application 56. Create a Route to Connect to the new Local DICOM Database 1) Route Name: To_Legacy_Rad 2) DICOM Database Destination: Legacy_Radiology_Images 3) Restart All Services. 25

32 Tag Rule Routing 57. Tag Rule Routing Tag Rules redirect where the images are stored based on the pre-defined rules for tag values of the inbound image. NOTE: Anything storing in this AE will go by the rules as established in the Tag Rule. 1) Expand AcuoMed Image Manager > Image Manager Server > DICOM Configuration > Tag Rules > Routing Tag Rules. 2) Right-click New > New Tag Rule, and enter the name: Route by Study Date. 3) Right-click AcuoRoute Rule Version=6.0 and select New Tag Rule. 4) From the drop-down list: Tag: Study Date Operator: < Values: <Date> 1/1/2002 5) Click Add Rule. 6) From the Tag Rule Route Mapping tab: Move <IPAddress= ><Port=104><AEName=STUDENT x, where x is your student number, from Configured AEs to Selected AEs. Move To_Legacy_Rad from Configured Routes to Selected Routes. 7) Click OK. Verify the tag rules are in the configuration. 8) Under the CalledAE for STUDENT x, where x is your student number, right-click and select Update: Collaborative Routing Default Route Name: No Route Defined Verify the tag rule Route by Study Date displays. Add a Tag Failure Route: To_Radiology_Images 9) Click Finish to apply changes. 10) Restart the AcuoMed service. 11) From the Patient Management MMC, verify Tag Rule is working by querying the instructor destination. 12) Move a study using the following information. Study date: < 1/1/2002 Source Route Name: To_Instructor_Rad Destination AE Name: Pull_to_Radiology_Images 13) Verify the images store to Legacy_Radiology_Images 14) From the Patient Management MMC, verify Tag Failure Route is working by querying the instructor destination. Study with a study date: > 1/1/2002 Source: To_Instructor_Rad Destination AE Name: Pull_to_Radiology_Images Verify the images are storing and that jobs exist in Batch Store for the dest: Radiology_Images NOTE: There should be one image in each database. 26

33 Federation Federation is the act of query/retrieving from multiple database destinations simultaneously. To create a Federated Route, add more than one destination to the Route. 58. Edit Patient Name 1) Query the Legacy_Radiology_Images database. 2) Edit the patient name to your name. 59. Create a Route pointing to the Local DICOM Destination and the External DICOM Destination 1) Create a new route named: Federated_Legacy_&_Radiology 2) External DICOM Device Destination: Instructor_Rad 3) DICOM Database Destination: Legacy_Radiology_Images 4) Click Add. 5) Restart AcuoMed Services. 60. Create a Route View pointing to the Local and External DICOM Databases 1) Create a Route View: Federated_Legacy_&_Radiology 2) Query the Route View. NOTE: Notice that the system returns results from both databases: Legacy_Radiology_Images (your name) and all of the patients located on the Instructor_Rad database. Also, notice that the VNA has returned a consolidated result. The image that you edited to your name is the only result returned. 27

34 Reconciliation 61. Configure HIS/RIS Connection 1) Expand AcuoMed Image Manager > Image Manager Server > HIS/RIS Connections. 2) Right-click HIS/RIS Connections and click New. Click New HIS/RIS Connection. 3) In the HIS/RIS Connections Properties dialog box, on the Connectivity tab, complete the following options. HIS/RIS Name: AcuoRis 4) Connection Dicom Tag Info: HIS/RIS Type: MedSemantix-es 5) Click OK. Verify the HIS/RIS connection displays correctly for AcuoRis. NOTES: Verification for Reconciliation takes place after the Reconciliation database installed, configured, and the REM is populated. For Post/Prefetching, there is no verification for the creation of Batch Move jobs in this exercise because we do not have a live HL7 feed. 62. Tag Rule Routing settings must be reconfigured 1) Expand AcuoMed Image Manager > Image Manager Server > Dicom Configuration > Tag Rules > Routing Tag Rules. 2) Select Route by Study Date. 3) Right-click Route by Study Date > Update. 4) In the Tag Rule Route Mapping tab, remove <IPAddress= ><Port=104><AEName=STUDENT x, where x is your student number, from Selected AEs. 5) Click OK. 6) On the warning message page, click OK. 63. Reconfigure the Called AE 1) Expand AcuoMed Image Manager > Image Manager Server > DICOM Configuration > Any IP Address > Scp [Listening Port: 104] 2) Right-click STUDENT x, where x is your student number, select Update, and change the following parameters: Collaborative Routing Default route Name: To_Radiology_Images Tag Failure Route: No Route Defined 3) Restart AcuoMed Service. 64. Install and Configure Reconciliation 1) The Feature Key is located in the VNA Installers on the desktop in the Feature Keys.txt file. This exercise requires the second key listed at Reconciliation Installation Exercise. 2) Expand AcuoMed Image Manager > Image Manager Server > Feature Validation. 3) Enter the Feature Validation Key. Click Apply. 4) After you select Apply, the Reconciliation Installation Wizard starts. 28

35 65. Create Reconciliation Database The installation wizard creates the Reconciliation database. Enter the following parameters: 1) SQL Server Connection Type SQL Server Instance: APPSVR1 2) Database Connection Type Database Name: DicomRec 3) New Database Directories Database: C:\SQL Data Logs Log: C:\SQL Data Logs 4) Click Finish. 66. Create Destination 1) The Installation Wizard creates the Reconciliation Destination. 2) Review tabs for Create Database Destination. The wizard auto populates all fields. 3) Click Test to verify the connection. 4) Click Add, and then click OK twice. 67. Create Route to Reconciliation Database 1) The Installation Wizard creates a new internal route to the Reconciliation database. Review the tabs but keep the defaults. 2) Click Add, and then click OK. 68. Configure Called AE Name for Reconciliation 1) Expand AcuoMed Image Manager > Image Manager Server > DICOM Configuration > Any IP Address > SCP [Listening Port:104], and select STUDENT x, where x is your student number. 2) Right-click and select Update. 3) Click the Reconciliation tab. 4) Under Reconciliation Master, select Use Below Setting for Reconciliation. Reconciliation: HIS/RIS 5) Verify the Database Instance Selection is Local Instance. 6) Click Test Connection, Apply, and Finish. 7) Restart AcuoMed services. 69. Review Reconciliation Event Manager 1) Navigate to Patient Management > Route View Management. 2) Query using the To_Instructor_Rad. 3) Select a study and move the study locally. 4) Review the corresponding Batch Processing Managers to view the job as it completes. 5) Under Patient Management, click Reconciliation Event Manager (REM). 6) Verify the following occurred when the images failed reconciliation: Batch Store job points to REM instead of DICOM database A new event appears for the images stored Patient Metadata is also present in the REM Acuo Event and audit log showing each image failed Reconciliation 29

36 70. Create a Stat Route Create a stat route to move images to an external destination and bypass the reconciliation feature. 1) Navigate to Router Configuration > Routes. 2) Create a New Route: Route Type: Stat Route Name: REM_STAT External Device: Instructor_Card 3) Modify the STUDENT x, where x is your student number, calledae. Stat Route: REM STAT 4) Restart AcuoMed Service. 5) Query using To_Instructor_Rad. 6) Select and move a study. AE Name: Pull_to_Radiology_Images 7) Verify the corresponding Batch Processing Managers to view a job as it completes to the External Destination for To_Instructor_Rad. 8) Verify the REM event pushed the image to the external location Instructor_Card. 30

37 SCU Authorization 71. Turn Reconciliation Off 1) Expand AcuoMed Image Manager > Image Manager Server > DICOM Configuration > SCP > STUDENT x, where x is your student number. 2) Under the Reconciliation tab, select Do not perform Reconciliation for AE Name. 72. Create an External SCU Authorization Perform this exercise to create an External SCU device as an authorized device to communicate with a Dicom SCP CalledAE. Security is set at the CalledAE inbound C-Store. The CalledAE rejects any other association request. 1) Expand AcuoMed Image Manager > Image Manager Server > DICOM Configuration. 2) Right-click External SCUs, click New, and then click New External SCU. 3) In the External SCU Properties dialog box, enter the following information. Calling AE Name: Instructor IP Address: ) Click Add. 5) Under DICOM Configuration, update the Called AE named STUDENT x, where x is your student number. 6) Change Stat Route Name to No Route Defined. 7) Click External SCU Authorization. 8) Add Instructor to Authorized External SCU s. 9) Click Finish. 10) Restart AcuoMed Services. 11) To test, perform a query and retrieve for the instructor. Validate from the Activity Log or Batch Store the association was accepted and you received images for the retrieve request. 31

38 WADO WADO is a non-diagnostic tool available within AcuoMed to view images. 73. Install and Configure WADO 1) Click Services. Stop and Disable all Acuo Services: o Right-click AcuoAudit, AcuoMed, and AcuoStore. o Click Properties. o From the Startup Type list, select Disabled. o Click OK. 2) Important: Close all MMCs. a) Check task manager. i) Click the Desktop dropdown at the top of the screen. ii) Select Send Ctrl-Alt-Del. iii) Select Task Manager, and then More Details at the bottom of the pop-up. iv) Confirm the Microsoft Management Console is not running under Processes. 3) From the desktop, double-click the VNA Installers file. 4) Navigate to WADO, right-click setup.exe and run as administrator, and complete the following: Accept the terms of the License Agreement. Service User Name and Password: Leave Defaults Setup Type: Complete Install. 5) Open your MMC and enable and start Acuo Store > AcuoMed > Acuo Audit. NOTE: The WADO service does not start at this point. Additional configuration is required. 74. Add AcuoService User to Administrator s Group 1) Right-click Windows icon. 2) Click Control Panel. 3) Click User Accounts. 4) Click Manage another account. 5) Click AcuoServiceUser. 6) Click Change Account Type. 7) Click Administrator. 8) Close. 32

39 75. Add WADO Snap-In to MMC 1) Click File and click Add/Remove Snap-in. 2) Move Acuo WADO Configuration from Available to Selected. 3) In the MMC Console, click Acuo WADO Configuration. Accept all default settings except for the following: AcuoStore Application Name: DILIB_application 4) Click Apply. NOTE: Clicking Apply does not provide a visual cue that your changes are applied. 5) Right-click Image Manager Server > Properties. 6) Click the Patient Management tab and enter the following parameters: Server Name: APPSVR1 Port: 9000 Confirm Legacy WADO is selected. 7) Click Apply. 8) Click OK. 9) Stop Acuo Audit > AcuoMed > AcuoStore. 10) Start Acuo Store > AcuoMed > Acuo Audit > Acuo WADO Service. 76. View Images using WADO 1) Within Patient Management, search for a patient using Patient View. 2) Expand the patient Arm1 all the way to the image level. NOTE: Patient03 also has actual images associated with it. 3) Right-click the image and select View Image. 33