ETIAM Nexus. Administrator's Guide.

ETIAM Nexus Administrator's Guide www.etiam.com

ETIAM Nexus Administrator's Guide Product Version: 5.42 Documentation Update: June 2015

User License IMPORTANT: Before using this solution, you should read the user license agreement. To display it, click the icon in the top area of Nexus Web interface, and then click About. In the window that displays click Read the file beside License. All trademarks and registered trademarks herein are the property of their respective owners.

Warning ETIAM Nexus features a medical image viewer. It is not labeled for diagnostic use. Cybersecurity ETIAM Nexus must be deployed and used according to the requirements and recommendations specified by ETIAM.

Table of Contents Introduction...1 Nexus architecture and operation... 1 Administrator's Tasks and Tools... 1 Administering Nexus Using a Web Browser... 2 Manage your Preferences...3 Install new versions of Nexus...5 Conver cases older than version 5.00...7 Configure Nexus for communicating with remote institutions... 9 Configure the local institution... 9 Declaring Nexus Networks...10 Declaring a central Nexus server...10 Declare remote institutions...11 Declare remote sites from electronic directories automatically...11 Declare a remote institution manually...14 Edit a remote institution...16 Disable/Enable a remote site...16 Disable a site...16 Enable a site...16 Remove a remote site...16 Configure Nexus for communicating with an information system... 17 Manage users using an LDAP directory (version 5.40)... 18 Configure Nexus/LDAP interfacing...19 Manage user rights...21 Create a user profile...22 Edit a user profile...26 Remove a profile...26 Manage user communities...27 Create a community...28 Edit a community...30 Disable/Enable a community...30 Disable a community...30 Enable a community...30 Remove a community...30 Manage user accounts...31 Customize a user account...31 Manage users without an LDAP directory... 34 Manage user rights...34 Create a user profile...34 Edit a user profile...37 Remove a profile...37 ETIAM Nexus Administrator's Guide i

Manage user communities...37 Create a community...38 Edit a community...40 Disable/Enable a community...40 Disable a community...40 Enable a community...40 Remove a community...40 Manage user accounts...41 Create a user account...41 Edit a user account...46 Disable/Enable a user account...46 Disable a user account...47 Enable a user account...47 Remove a user account...47 Define message templates for notifying of sent and received cases...48 Configure DICOM attribute editing...51 Create a QA/QC template...51 Configuring Exam Sharing...53 Manage the local site DICOM applications...54 Declaring DICOM Applications...54 Remove a DICOM application...56 Manage Nexus storage spaces...57 Manage sending of cases...58 Customize case sending...58 View the sending list...59 Manage Nexus...60 Manage Nexus AE Titles...60 Display Nexus AE Titles...60 Edit Nexus default AE Title...60 Monitor Nexus events...61 Tracing ATNA Events on Nexus...62 Enable ATNA traceability...62 Configure ATNA record storage...62 Start and Stop Nexus Application...63 Shut down and reboot Nexus Server...63 Edit network information for Nexus server...63 Statistics...65 Enable Nexus activity export to the central server...65 Create a dashboard...66 Create a view...66 Actions on views...66 Actions on dashboards...67 ii ETIAM Nexus Administrator s Guide

Appendix...68 ETIAM Nexus Administrator's Guide iii

Introduction ETIAM Nexus has been developed to make it possible for healthcare professionals to easily make teleconsultations, tele-expertise and teleassistance. With Nexus, physicians (emergency physicians, doctors, nurses ) can send requests for second opinions or interpretations to specialists (radiologists, neurologists, neurosurgeons, cardiologists ) at remote sites. And, clinical and imaging data is sent between sites securely. Nexus architecture and operation Nexus is connected on one hand to the institution's network that links other equipment supporting medical imaging production or manipulation applications, and on the other hand to Internet to enable exchanges with other institutions. Exams and cases exchanged between two institutions with a Nexus server are carried all along their way over a secured Internet connection and pass through an interconnection server before routing them to their final destination. Administrator's Tasks and Tools As an administrator you are responsible for configuring Nexus, and also for managing its operation and usage. Your tasks: Declare the remote sites that will exchange with your institution through Nexus. Declare the users in your institution who will be allowed to use Nexus. Create communities to group users (for example, one community per clinical department) and thus enable users to share information and perform actions in the name of the community(ies) they are members of. For each user community, create a storage space for exams sent from DICOM applications (such as imaging modalities). Declare the institution DICOM applications (imaging modalities, diagnostic workstations and PACS) which will communicate with Nexus, and the operations they will be authorized to perform. The tools: Nexus maintains a log for you to monitor exchanges of exams and cases precisely. You can also access the complete list of cases (except medical information) for all Nexus users. Nexus includes a statistics module for analysis of exchange activity. ETIAM Nexus Administrator's Guide 1

Administering Nexus Using a Web Browser To access Nexus configuration settings, you need to log in as an administrator using a login and a password. You can log out Nexus at any time by clicking Log out in your name s menu. 2 ETIAM Nexus Administrator s Guide

Manage your Preferences You can set preferences and customize them at any time according to your way of using Nexus. 1. Click your name in the top right corner of the screen, and then click My preferences. 2. In the Credentials section you can edit your password for example. ETIAM Nexus Administrator's Guide 3

3. In the Settings section select the page you want to display when you log in to Nexus. Also select the view to use by default in the Exams and Cases pages (the Shared exams page is only available in basic view). 4. In the Notifications for cases section specify at which e-mail address(es) you want to receive notifications for the cases you send and receive, and select the matching checkboxes. To remove an e-mail address click the cross 5. Click the Save button. at the end of the line. 4 ETIAM Nexus Administrator s Guide

Install new versions of Nexus When the following icon is displayed in the top area of the screen it means that a new version of ETIAM Nexus is available: To install it, do the following: 1. Click the icon, write the complete version number down, and then click Install new version. 2. In the the Login to Webmin tab that displays enter nexus in the Username and Password fields, and then click the Login button. 3. In the top left corner of the screen click Software Package Updates. 4. Below the package list click the Update Selected Packages button. 5. On the line for the etiam-nexus package check that the displayed version number matches the one you wrote down at step 1. ETIAM Nexus Administrator's Guide 5

If an etiam-repo package is shown in the list you must install it before the etiam-nexus package. Ensure you select only the etiam-repo package, and then click the Save button. Then, go back to step 5 to install your etiam-nexus package. 6. Ensure that etiam-nexus is the only package checked, and then click the Save button. 7. Wait a few minutes while the new version if being installed. When install complete displays at the bottom of the screen the new version is ready for use. The users will be notified that a new version has been installed when they log into Nexus. If you encounter problems when installing contact ETIAM Support department. 6 ETIAM Nexus Administrator s Guide

Conver cases older than version 5.00 Since version 5.00 the structure of cases has changed to offer more exchange capabilities. If you have updated your Nexus 3.00 to 4.40 to version 5.00 or later it is required to convert existing cases to the new format otherwise they will no longer be accessible. Conversion is required only for cases that already exist when updating from a version earlier than version 5.00. Cases with the old structure created after the update are converted to the new format automatically. When you first log into Nexus after an update a message displays to notify that there are cases to be converted to the new format. To access the conversion interface click the Access conversion button. On the Case conversion tab click the Start button. While converting you can exit the Case conversion tab and proceed with your work. If you want to hide this tab once conversion has been completed, you ll have to click the Finish button that will display on the Case conversion tab. If you want to cancel conversion, click the Abort button. This will hide the Case conversion tab and it will no longer be possible to convert cases. ETIAM Nexus Administrator's Guide 7

You can interrupt conversion by clicking the Suspend button and resume it later by clicking the Resume button. If you don t resume conversion in the current session a message will display the next time you log in to remind you that conversion isn t complete. 8 ETIAM Nexus Administrator s Guide

Configure Nexus for communicating with remote institutions Configure the local institution 1. In the administration click the Local site tab. 2. In the General information section enter the contact information for your site. 3. In the Send notifications section you can enter one or more email addresses (use the comma as a separator) for the IT department in charge of Nexus. Messages will be sent to these addresses to notify of all exams sent to remote institutions ETIAM Nexus Administrator's Guide 9

4. In the Contact administrator section enter the email address and phone number of the person to contact when users experience operation issues with Nexus. 5. In the Home page message field you can enter a message to display on the login page. 6. Click the Save button. Declaring Nexus Networks At setup a default teleimaging network was declared. A teleimaging network groups several institutions that can communicate with one another. If your institution is connected to additional imaging networks, you should declare them as well. To do this, contact your distributor. If for some reason you do not need to use a given teleimaging network, instead of removing it from Nexus configuration, you can simply disable the Check the network gateway state checkbox (Teleimaging tab, Networks page, Gateway Info tab) in order not to generate errors in the event of problems with that network gateway. Declaring a central Nexus server Your site might be connected to a network with a central Nexus server used to gather data on the activity of the connected sites in order to produce statistics and/or manage an on call schedule to transfer to the appropriate staff the cases sent to on-call communities. The central server is used for these purposes in networks where sites exchange cases in point-to-point mode. A central server can also be used as a relay between sites for case exchanges and to store a copy of cases exchanged by each site. 1. In the administration click the Other and Teleimaging tabs, and then the Networks page 2. Select the teleimaging network you want, and then click the Update button. 10 ETIAM Nexus Administrator s Guide

3. On the Platform tab fill in the following fields: Name: Enter a meaningful name for the server (no more than 32 characters). Full name: Enter the server s full name. Security gateway: Enter the security gateway of the Nexus network that the server is associated with. IP address: Enter the IP address of the server that will receive activity data. Port number: Click the button to assign a port number for DICOM exchanges automatically. WebServices port number: Click the button to automatically assign a port number where the server will receive activity data. Public AE Title: Enter the public AE Title provided to the institutions connected to the central server for DICOM exchanges. 4. Preferably, select the Export activity data checkbox, and specify a weekly export interval. Note: If you want to test exporting activity data without waiting until the date and time you have specified, click the Export now button. 5. Click the Save button. Declare remote institutions You need to declare the remote institutions that will be allowed to exchange exams and cases with your institution through Nexus. You can either declare each remote institution manually or load the institutions listed in the electronic directory for the network(s) your institution is connected to, which is simpler and quicker. Declare remote sites from electronic directories automatically Before performing this operation, ensure that automatic synchronization with the remote directory is enabled for each network that uses a remote directory. Perform the following procedure for each teleimaging network: 1. In the administration click the Other and Teleimaging tabs, and then the Networks page. 2. Select the teleimaging network you want, click the Update button. 3. On the Directory tab select the Allow automatic synchronization with the network remote directory checkbox, and then click the Save button. Now you can declare remote institutions automatically. ETIAM Nexus Administrator's Guide 11

12 ETIAM Nexus Administrator s Guide

4. On the Teleimaging tab click Remote Institutions, and then click the Synchronize button. 5. Click the Synchronize button to load the list of remote institutions. All available institutions are displayed dimmed and in italic type. It means that they are disabled, that is, Nexus cannot send any exams or cases to these institutions. However, Nexus can receive exams from all remote institutions whether they are enabled or not. Important: NEVER edit the Gateway, IP address, Port number and Public AE Title fields for the remote institutions downloaded from electronic directories. To enable the remote institutions, double-click their names in the list. They will then change from dimmed to black. Only enable the appropriate institutions so users cannot send any exams to remote institutions you do not want to communicate with. Note: If you want to update the list of remote institutions on a daily basis automatically, click the Synchronize button again, and then in the window that displays select the Synchronize with remote directories automatically checkbox, enter a time of low activity on the Nexus server, and then click the Save button. ETIAM Nexus Administrator's Guide 13

Declare a remote institution manually 1. In the administration click the Site directory tab, and then click the Add a site button.. 2. In the General information section enter the site contact information. 3. In the Settings section fill ou the following fields: Public AE Title: Enter the public AE Title provided to other sites by the remote site for exam exchanges. IP address: Enter the IP address of the Nexus server that will receive exams sent to the remote institution. 14 ETIAM Nexus Administrator s Guide

Port: This field can be set to two different values depending on whether you use a security gateway or not: With a security gateway: Click the button to assign a port number for DICOM exchanges automatically. or Without a security gateway: Enter the IP port number used on the remote institution s ETIAM Nexus server for receiving and sending exams. WebServices port: This field can be set to two different values depending on whether Nexus uses a security gateway or not: With a security gateway: Click the button to assign a port number for non-dicom exchanges. or Without a security gateway: Enter the IP port number used by the remote institution Nexus server to be queried and return its users' identification information. RTC port: Fill out this field for using videoconferencing with users at the remote site. This field can be set to two different values depending on whether you use a security gateway or not: With a security gateway: Click the button to assign a port number for real-time video exchanges automatically. or Without a security gateway: Enter the port number used by the Nexus server at the remote site to receive video information. Network: If you use a security gateway, select the network to which the site is connected. Otherwise, leave this field empty. Security gateway: If you have filled out the Network field, enter the name of the site s security gateway. 4. In the Private relay AE Title field enter the AE Title that your site s DICOM applications will use for sending exams to this remote site. ETIAM Nexus Administrator's Guide 15

5. In the Private query AE Title enter the AE Title that your site s DICOM applications will use to get the list of exams received by Nexus from this remote site. 6. Click the Save button. Edit a remote institution If you cannot connect to a remote institution it might be due to changes made to its configuration. Perform a synchronization operation with electronic directories. If this does not fix the problem contact the manager of the remote institution. 1. On the Site directory tab select the name of the remote institution you want to update. 2. Modify the appropriate settings, and then click the Save button. Disable/Enable a remote site Instead of removing a site you can disable it. So, if you need to communicate with the site again in the future you will only need to enable it instead of declaring it from scratch. When a site is disabled it is no longer visible in the directory. Disable a site On the Site directory page click the message. The button changes to red. button for the site, and then click Yes in the confirmation Enable a site On the Site directory page click the button for the site, and then click Yes in the confirmation message. The button changes back to grey. Remove a remote site Important: You can remove a remote site provided that there are no exams received from that site left on the Nexus server. On the Site directory tab click the message. button for the site, and then click Yes in the confirmation 16 ETIAM Nexus Administrator s Guide

Configure Nexus for communicating with an information system If an information system is available in your institution, you can configure Nexus to receive messages that notify changes made to patient demographics (name, sex and date of birth) and identifiers on the information system. This enables to make patient demographics and identifiers for exams stored on Nexus server consistent with up-to-date data on the information system. This complies with IHE/PIR (Patient Information Reconciliation) profile. The information system sends two types of HL7 messages to Nexus: ADT (Admission, Discharge and Transfer) A08: Update of patient/visit information. A40: Merge of two patient records. ORM (ORder Management) O01: New order, order cancellation or exam status change. 1. In the administration click the Other tab. 2. Click the HL7 tab, and then the Edit button. 3. In the Name filed enter a meaningful name for the information system. 4. Fill out the other fields with the information provided by the information system s administrator. 5. Select the Acknowledgement receipt checkbox if the information system requires that Nexus returns acknowledgement receipts when receiving HL7 messages. 6. Click the Save. ETIAM Nexus Administrator's Guide 17

Manage users using an LDAP directory (version 5.40) If your institution uses a LDAP directory you can interface Nexus with it to import and update LDAP user accounts into Nexus automatically. Then, you don t need to create and update in Nexus manually, and users can log into Nexus with the login/password they use for other applications. Depending on the directory organization it is alos possible to match LDAP user groups with the profiles and communities defined in Nexus. If neede, you can also customize user accounts imported from the LDAP directory, in particular, rights granted to users. If LDAP directory schema doesn t make it possible to match LDAP user groups with Nexus profiles and communities you can manually associate profiles and communities to users individually. For more information, please see the Manage user accounts section on page 41. Here is an exemple of LDAP directory: For example, to match the Radiology community defined in Nexus with the LDAP directory Radiology user group you would specify the path (DN, Distinguished Name) to the group in the directory tree as follows: cn=radiology,ou=departments,ou=groups,dc=uhospital_a,dc=com When entering paths start with the lower-level item in the directory tree. 18 ETIAM Nexus Administrator s Guide

Configure Nexus/LDAP interfacing 1. In the administration click the LDAP directory tab. 2. In the Server section select the LDAP server enabled checkbox. 3. Fill out the Name and Diretory type fields. 4. In the Hostname field enter the IP address or hostname for the LDAP server. 5. In the Port field enter the LDAP server default port number (in general, 389) or a dedicated port number if Nexus will connect to the server through an encrypted access. If so, select the SSL connection checkbox. 6. In the Identifier field enter the identifier that Nexus will use to connect to the LDAP server and enter the matching password in the Password field. 7. In the LDAP schema section specify where Nexus will import user account information from. Fill out the following fields: Base DN Base: The root distinguished name (DN) to use when running queries against the LDAP server (dc=uhospital_a,dc=com in our example). Additional Group DN: This value is used in addition to the base DN when searching and importing user groups. If no value is supplied, the subtree search will start from the base DN (ou=groups in our example). ETIAM Nexus Administrator's Guide 19

Additional User DN: This value is used in addition to the base DN when searching and importing users (ou=users in our example). If no value is supplied, the subtree search will start from the base DN. 8. In the Group schema section enter the name of the class used for the LDAP user group object (groupofnames in our example). 9. In the User schema section enter the name of the class used for the LDAP user object (Person in our example). 10. In the Filter section you may enter a value to restrict user account import. For example, if you enter the (&(objectclass=person)(cn=*son)) filter, Nexus will only import users with a name that finishes with the son letters (for example, Patterson, Robertson, Johnson, etc.). 11. In the following fields enter the LDAP attributes that match the user account fields in Nexus. 12. For the Email address attribute option specify if case notifications should be sent to the e-mail addresses specified in the LDAP directory. 13. Specify if you want to add users to the Default community and thus allow them to access to all the exams stored on Nexus server. 14. Specify if you want users to be visible from other users and communities in your institution and/or from remote institutions. When a user is not visible no cases can be sent to them. 20 ETIAM Nexus Administrator s Guide

After importing user accounts into Nexus you can customize the following options for individual user accounts in Nexus: Use for notifications by default, Add the user to the Default community by default, Publish the user in the local directory by default and Publish the user in the public directory by default. 15. Click the Save button. Manage user rights To make it easier to create and manage user accounts you can predefine rights on per user category basis in user profiles. Then, instead of specifying for each account which actions the user will be allowed to perform you will simply need to select the appropriate profile for the user. This operation can be performed automatically if the LDAP directory schema matches Nexus organization in communities and profiles. Otherwise, you will need to associate users with profiles and communities manually in Nexus. For more information, please see the Manage user accounts section on page 41. Here is an example of Active Directory LDAP directory that shows how to match the directory with Nexus profiles: ETIAM Nexus Administrator's Guide 21

Create a user profile 1. In the administration click the Users tab, the Profiles button, and then click the Create a user profile button. 2. Fill out the Name field. 3. In the LDAP Group DN field enter the distinguished names (DN) for the LDAP user group(s) that match the profile. In our example, the value is cn=radiology Operator,ou=Titles,ou=Groups,dc=UHospital_A,dc=com. With this value, all the users in the LDAP Radiology Operator group would be associated with the Nexus Radiology Operator profile. If you enter more than one user group use the (ALT+0124) character as a separator. 22 ETIAM Nexus Administrator s Guide

4. In the Rights section specify if you want the users to have an administrator s role and like you edit Nexus configuration. Otherwise select the No option. 5. If you want to allow users to view all the cases sent and received by your institution select the Yes option beside Supervisor. Depending on case types the Supervisor role enables to perform specific operations such as transferring a STAT case that has not yet been processed to an available physician. ETIAM Nexus Administrator's Guide 23

6. Select the rights you want to assign to the users. Right category Right Description Rights on exams Add View Download to computer Delete Send Edit DICOM attributes (reconcile) View in the advanced viewer Schedule and create exams Import exams from image servers (PACS) or directories into Nexus server. View exam images in Nexus viewer. Download exams to the user s computer or a network directory as a ZIP archive for review on a workstation or in ETIAM Viewer Lite (as from version 5.40). Remove exams stored on Nexus server. Transfer exams from Nexus to image servers or interpretation workstations. Before sending exams to a server or an interpretation workstation edit information in images, for example, to reconcile patient information with data in the information system or the PACS, or to anonymize images View exam images in a diagnostic viewer. Schedule exams for patients registered at the institution and create exams by importing images, video and documents, or by converting exams uploaded to Nexus over the Internet. Rights on cases Create View Contribute Initiate cases: complete the request form, add DICOM exams and documents. Open cases and view their contents: forms (or steps ) and also DICOM exams and attachments. Take part in (add steps, for example, answer the request, 24 ETIAM Nexus Administrator s Guide

Right category Right Description transfer the request depending on the case type) cases sent to users or to their communities. Delete Send Select outside contacts Convert attached documents to DICOM Export Remove cases created and received by users or members of their communities. Send cases. Select contacts outside the institution. This right is useful for users who take part in cases but who aren t allowed to send them. If you want to allow users to send cases both inside and outside the institution make sure you also check this right. Convert ZIP attachments to DICOM format. Export case forms to HTML or PDF format, and also DICOM exams and documents attached to cases in their original format. Administration rights Access administration Customize user rights defined in user profiles Create/Edit user profiles Configure and administer Nexus. When creating a user account adjust rights in the selected profiles for the individual user. Create and edit user profiles. Videoconference Organize videoconferences Organize videoconferences with authorized Nexus users (as from version 5.40 optional). 7. Click the Save button. ETIAM Nexus Administrator's Guide 25

Manage user communities Nexus makes it possible to group users in communities so they can share information and perform actions in the name of their community(ies) such as send cases to request advice and reply to requests. A community is an individual entity that groups users who log into Nexus using their own user account, thus making it possible to trace actions performed by each user. If the LDAP directory schema matches Nexus organization in communities and profiles it is possible to associate user accounts with the appropriate Nexus communities automatically. Otherwise, you will need to associate users with communities manually in Nexus. For more information, please see the Manage user accounts section on page 41. Here is an example of Active Directory LDAP directory that shows how to match LDAP user groups with Nexus communities: ETIAM Nexus Administrator's Guide 27

Create a community 1. In the administration click the Communities tab. 2. Click the Create a community button. 3. Fill out the Name field. 4. If needed, edit the default AE Title to refer to the community. This is the AE Title used internally by imaging modalities to send exams to the community. 5. In the LDAP Group DN field enter the distinguished names (DN) for the LDAP user group(s) that match the community. In our example, the value is cn=radiology,ou=departments,ou=groups,dc=uhospital_a,dc=com. With this value, all the users in the LDAP Radiology group would be associated with the Nexus Radiology community. If you enter more than one user group use the (ALT+0124) character as a separator between DNs. 28 ETIAM Nexus Administrator s Guide

6. In the Directories section specify if you want the community to be visible from the users and other communities within the site and/or from remote sites. When a community is not visible no exams nor cases can be sent to it. 7. If you have filled out the LDAP Group DN field you do not need to add members since they will be added to it from the LDAP directory automatically. However, you can also add to the community user accounts created manually in Nexus. After importing user accounts from the directory you can edit the community to appoint individual users as delegate administrators to allow them to add and remove members from the community. (User accounts imported from the directory cannot be removed.) 8. In the Case templates section add the case template(s) that address the community s needs. 9. If needed, in the QA/QC templates section add the reconciliation template(s) that specify the rights to edit DICOM attributes when sending exams to a local server or to the PACS. 10. In the DICOM applications section add the DICOM applications from which the community members will be allowed to add exams to Nexus or to which they will be allowed to send exams from Nexus. 11. In the Notifications for cases section specify if you want Nexus to send an email notification to all the members of the community and/or to other persons for each case sent or received in its name. Then, the members won t have to log into Nexus to check if cases created in the name of the community were sent successfully or if the community has received new cases. ETIAM Nexus Administrator's Guide 29

12. In the Exam routing section you can specify to which local server(s) exams contained in cases should be automatically routed. Also, specify for each server if routing applies to cases sent and/or received by the community. 13. Click the Save button. Edit a community 1. On the Communities tab click the button for the community to edit. 2. Edit the settings as appropriate, and then click the Save button. Disable/Enable a community Instead of removing a community, you can disable it. Then, if you need to use the community again later you will only need to enable it instead of recreating it from scratch. Disable a community On the Communities tab click the button for the community to disable, and then click Yes in the confirmation message. The button changes to red. Enable a community On the Communities tab click the button for the community to enable, and then click Yes in the confirmation message. The button changes back to grey. Remove a community You can remove a local user community provided that it has not received any cases, or that all the cases previously received have been deleted first. On the Communities tab click the button, and then click Yes in the confirmation message. 30 ETIAM Nexus Administrator s Guide

Manage user accounts Nexus automatically synchronizes with the LDAP directory at regular intervals. If needed, you can also launch a synchronization process at any time by clicking the Synchronize with LDAP button on the administration Users tab. You can customize user accounts imported from the LDAP directory and create accounts manually to address specific needs. For more information on creating user accounts please see the Manage user accounts section on page 41. Customize a user account In Nexus accounts imported from the LDAP directory are shown in blue. These cannot be removed. 1. In the administration, clik the Users tab, and then click the for the account to customize. ETIAM Nexus Administrator's Guide 31

2. In the General information section you can edit the fields that aren t dimmed that is those that weren t imported from the LDAP directory. 3. In the Rights section, if you are allowed, you can customize the user s rights for the selected profile(s) whether they were imported from the LDAP directory or that you added them manually. However, you can t remove LDAP profiles. 4. In the Settings section specify which page the user will access by default when logging into Nexus. 32 ETIAM Nexus Administrator s Guide

5. In the Directories section specify if you want the user account to be visible from other users and communities in your institution and/or from remote institutions. When a user is not visible no cases can be sent to them. 6. In the Communities section select the community(ies) that the user will be a member of, if applicable. Specify for each community if the user will be a delegate administrator (allowed to add users to/remove users from the community). 7. In the Notifications for cases section Nexus can send an email notification to the user for each case they send or receive. Then, the user won t have to log into Nexus to check if their cases were sent successfully or if they have received new cases. 8. In the Exam routing section you can specify to which local server(s) exams contained in cases should be automatically routed. Also, specify for each server if routing applies to cases sent and/or received by the user. 9. Click the Save button. ETIAM Nexus Administrator's Guide 33

Manage users without an LDAP directory Manage user rights To make it easier to create and manage user accounts you can predefine rights on per user category basis in user profiles. Then, instead of specifying in each account which actions the user will be allowed to perform you will simply need to select the appropriate profile for the user. And if you need to adjust the rights in the profile you customize them for the user (provided that you are allowed to perform this operation). Also, if you need to edit the rights for a given user category you simply need to edit the matching profile, and the changes you ve made will be automatically applied to all the user accounts associated with the profile. Create a user profile 1. In the administration click the Users tab, the Profiles button, and then click the Create a user profile button. 2. Fill out the Name field. 3. In version 5.40 if the LDAP Group DN field is shown, leave it blank. 4. In the Rights section specify if you want the users to have an administrator s role and like you edit Nexus configuration. Otherwise select the No option. 5. If you want to allow users to view all the cases sent and received by your institution select the Yes option beside Supervisor. Depending on case types the Supervisor role enables to perform specific operations such as transferring a STAT case that has not yet been processed to an available physician. 34 ETIAM Nexus Administrator s Guide

Edit a user profile If you edit a user profile that is already used by users their rights will be modified accordingly. However, rights customized in user accounts will remain unchanged. 1. On the Profiles page click the button for the user profile to edit. A warning message displays if the profile is already used by user accounts. Click Yes to access the Edit user profile window. 2. Edit the settings as appropriate, and then click the Save button. Remove a profile If you remove a profile that is used by user accounts the users will lose all the rights specified in the profile. If you want the users to keep rights edit the profile instead of removing it or assign another profile to the users. On the Profiles page click the confirmation message. button for the user profile to remove, and then click Yes in the Manage user communities Nexus makes it possible to group users in communities so they can share information and perform actions in the name of their community(ies) such as send cases to request advice and reply to requests. A community is an individual entity that groups users who log into Nexus using their own user account, thus making it possible to trace actions performed by each user. You can either create communities, and then create user accounts and associate them with the appropriate community(ies), or create user accounts first, and then create communities and select the appropriate user accounts for each of them. ETIAM Nexus Administrator's Guide 37

Create a community 1. In the administration click the Communities tab. 2. Click the Create a community button. 3. Fill out the Name field. 4. If needed, edit the default AE Title to refer to the community. This is the AE Title used internally by imaging modalities to send exams to the community. 5. In version 5.40 if the LDAP Group DN field is shown, leave it blank. 6. In the Directories section specify if you want the community to be visible from the users and other communities within the site and/or from remote sites. When a community is not visible no exams nor cases can be sent to it. 7. In the Member users section search for and select the appropriate users. 38 ETIAM Nexus Administrator s Guide

If you haven t yet created all the user accounts that you want to add to the community you can select the community when creating the user accounts. 8. In the Case templates section add the case template(s) that address the community s needs. 9. If needed, in the QA/QC templates section add the reconciliation template(s) that specify the rights to edit DICOM attributes when sending exams to a local server or to the PACS. 10. In the DICOM applications section add the DICOM applications from which the community members will be allowed to add exams to Nexus or to which they will be allowed to send exams from Nexus. 11. In the Notifications for cases section specify if you want Nexus to send an email notification to all the members of the community and/or to other persons for each case sent or received in its name. Then, the members won t have to log into Nexus to check if cases created in the name of the community were sent successfully or if the community has received new cases. ETIAM Nexus Administrator's Guide 39

Manage user accounts Reminder: To comply with traceability regulations, each user must have their own user account. If you want to group several persons on the same account, create a user community. To make it easier to create and manage user accounts you can predefine rights on per user category basis in user profiles. Then, instead of specifying in each account which actions the user will be allowed to perform you will simply need to select the user profile with the appropriate rights for the user. And if you need to adjust the rights in the profile you customize them for the user (provided that you are allowed to perform this operation). So, before creating user accounts, define the user profiles you need. For more information please see the Manage user rights on page 34. Create a user account 1. In the administration click Users, and then click the Create a user button. 2. In the General information section enter the user s credentials, and define a login and password for the user to enter when logging into Nexus. It is recommended to fill out the Department, Phone number and Email fields since this information will be useful to the user s contacts. ETIAM Nexus Administrator's Guide 41

3. In the Rights section do one of the following: Manually select the rights you want to assign to the user. You can t assign a user account more administration rights than your own rights. Also, only a super-administrator can create administrator accounts. If a profile matches the rights you want to assign to the user, add it. If the user has more than one occupation you can add several profiles. If you have the necessary right you can customize the rights in the added profile(s). You can t add a user profile with administration rights that you don t have yourself. 42 ETIAM Nexus Administrator s Guide

Right category Right Description Rights on exams Add View Download to computer Delete Send Edit DICOM attributes (reconcile) View in the advanced viewer Schedule and create exams Import exams from image servers (PACS) or directories into Nexus server. View exam images in Nexus viewer. Download exams to the user s computer or a network directory as a ZIP archive for review on a workstation or in ETIAM Viewer Lite (as from version 5.40). Remove exams stored on Nexus server. Transfer exams from Nexus to image servers or interpretation workstations. Before sending exams to a server or an interpretation workstation edit information in images, for example, to reconcile patient information with data in the information system or the PACS, or to anonymize images View exam images in a diagnostic viewer. Schedule exams for patients registered at the institution and create exams by importing images, video and documents, or by converting exams uploaded to Nexus over the Internet. Rights on cases Create View Contribute Initiate cases: complete the request form, add DICOM exams and documents. Open cases and view their contents: forms (or steps ) and also DICOM exams and attachments. Take part in (add steps, for example, answer the request, ETIAM Nexus Administrator's Guide 43

Right category Right Description transfer the request depending on the case type) cases sent to users or to their communities. Delete Send Select outside contacts Convert attached documents to DICOM Export Remove cases created and received by users or members of their communities. Send cases. Select contacts outside the institution. This right is useful for users who take part in cases but who aren t allowed to send them. If you want to allow users to send cases both inside and outside the institution make sure you also check this right. Convert ZIP attachments to DICOM format. Export case forms to HTML or PDF format, and also DICOM exams and documents attached to cases in their original format. Administration rights Access administration Customize user rights defined in user profiles Create/Edit user profiles Configure and administer Nexus. When creating a user account adjust rights in the selected profiles for the individual user. Create and edit user profiles. Videoconference Organize videoconferences Organize videoconferences with authorized Nexus users (as from version 5.40 optional). If you select/deselect rights after adding one or more user profiles they are shown in bold type to distinguish them from the rights predefined in the selected profile(s). If you want to cancel your changes and reapply default user profile rights click the Restore user profiles button. 4. If you want to allow the user to view all the cases sent and received by the institution select the Yes option next to Supervisor. 44 ETIAM Nexus Administrator s Guide

Depending on case types the Supervisor role enables to perform specific operations such as transferring a STAT case that has not yet been processed to an available physician. 5. In the Settings section specify which page the user will access by default when logging into Nexus. 6. In the Directories section specify if you want the user account to be visible from other users and communities in your institution and/or from remote institutions. When a user is not visible no cases can be sent to them. ETIAM Nexus Administrator's Guide 45

7. In the Communities section select the community(ies) that the user will be a member of, if applicable. Specify for each community if the user will be a delegate administrator (allowed to add users to/remove users from the community). 8. In the Notifications for cases section Nexus can send an email notification to the user for each case they send or receive. Then, the user won t have to log into Nexus to check if their cases were sent successfully or if they have received new cases. 9. In the Exam routing section you can specify to which local server(s) exams contained in cases should be automatically routed. Also, specify for each server if routing applies to cases sent and/or received by the user. 10. Click the Save button. Edit a user account 1. On the Users tab click the button for the user you want. 2. Edit the settings as appropriate, and then click the Save button. You can t edit the rights defined for your own account. Also, you can t assign to other accounts administration rights that you don t have yourself. Disable/Enable a user account Instead of removing a user account, you can disable it. Then, if user needs to use their account again later you will only need to enable it instead of recreating it from scratch. 46 ETIAM Nexus Administrator s Guide

Disable a user account On the User tab click the button for the user account to disable, and then click Yes in the confirmation message. The button changes to red. Enable a user account On the Users tab click the button for the user account to enable, and then click Yes in the confirmation message. The button changes back to grey. Remove a user account You can remove a user s account provided that they have not received any cases, or that all the cases they have received have been deleted first. On the Users tab click the message. button for the account to remove, and then click Yes in the confirmation User accounts imported from the LDAP directory can t be removed. ETIAM Nexus Administrator's Guide 47

Define message templates for notifying of sent and received cases Nexus enables to send e-mail messages to users to notify them when they send or receive cases. You can customize notification message templates: edit the subject, delete unwanted information in the body of messages or add information including free text and variables. Below is the list of variables (enclosed in %) that can be specified in message subjects and body, along with their description: Variable %XCASEUID% %PATIENTSNAME% %PATIENTID% %PATIENTSBIRTHDATE% %PATIENTSBIRTHTIME% %PATIENTSSEX% %OTHERPATIENTIDS% %OTHERPATIENTNAMES% %ETHNICGROUP% %EXAMINSTANCEUID% %EXAMDATE% %EXAMTIME% %ACCESSIONNUMBER% %EXAMID% %REFERRINGPHYSICIANSNAME% %EXAMDESCRIPTION% Description Case UID Patient's name Patient's ID Patient's birth date Patient's birth time Patient's sex Other patient's IDs Other patient's names Patient's ethnic group Exam instance UID Exam date Exam time Accession number Exam ID Referring physician's name Exam description %ADMITTINGDIAGNOSESDESCRIPTION% Admitting diagnosis description %PATIENTSAGE% %PATIENTSSIZE% %PATIENTSWEIGHT% %OCCUPATION% %OTHEREXAMNUMBERS% %INTERPRETATIONAUTHOR% Patient's age Patient's size Patient's weight Occupation Other exam numbers Interpretation author 48 ETIAM Nexus Administrator s Guide

Variable %SUBJECT% %FROM_FULLNAME% %FROM_NAME% %FROM_FIRSTNAME% %FROM_POSITION% %FROM_LOGIN% %FROM_EMAIL% %FROM_PHONENUMBER% %FROM_AET% %FROM_INSTITUTIONNAME% %TO_FULLNAME% %TO_NAME% %TO_FIRSTNAME% %TO_POSITION% %TO_LOGIN% %TO_EMAIL% %TO_PHONENUMBER% %TO_AET% %TO_INSTITUTIONNAME% %CASE_TYPE% %CASE_CODE% Description Case subject Sender's full name (Name^Firstname^^Title) Sender's name Sender's firstname Sender's title Sender's login Sender's e-mail address Sender's phone number AE Title of sender's institution Name of sender's institution Recipient's full name (Name^Firstname^^Title) Recipient's name Recipient's firstname Recipient's title Recipient's login Recipient's e-mail address Recipient's phone number AE Title of recipient's institution Name of recipient's institution Case type Case status ETIAM Nexus Administrator's Guide 49

1. In the administration click the Other and Management tabs, and then click the Message Templates page. 2. In the Select a message template list select the template you want, and then click the Update button. 3. To edit the message subject enter your modifications directly in the Subject field. 4. To add a variable click Help in the bottom of the page to access the complete list of variables, select the variable you want, and then press CTRL+C. Return to the message body, position the pointer where you want to paste the variable and press CTRL+V. Note: To avoid typos it is recommended to copy and paste variables rather than entering them manually. 5. You can also enter fixed text and reorganize the body of the message. 6. Click the Save button. 50 ETIAM Nexus Administrator s Guide

Configure DICOM attribute editing When sending exams authorized users can edit information in images for example to reconcile patient information with data available on your institution RIS or PACS (storage and archive server), or to anonymize images. You can define DICOM attribute edit rights depending on user profiles, speed up reconciliation, reduce typing errors, etc. by creating QA/QC templates and assigning them to user communities. Create a QA/QC template 1. In the administration interface, click QA/QC, and then click Create a template. 2. Enter a name and a description for the template. 3. In the Attributes to reconcile section click the Add button to add and preset an attribute, and then do the following: Enter the attribute display name, and then enter the attribute DICOM identifier in the Group and Element fields. ETIAM Nexus Administrator's Guide 51

In the list select Remove if you want to delete the attribute from exams or select Edit and do the following: To Enter Select/Deselect Editable Remove the attribute value No value Deselect Provide a preset value and allow users to edit it A value Select Provide a non-editable value A value Deselect Provide users with information on filling out the attribute A value (e.g. YYYYMMDD for the date of birth attribute) Select To check if the value entered by the user is consistent with the original attribute value and notify any inconsistencies, select the Verified checkbox. This can be helpful to reduce typing errors. To make the attribute mandatory, select the Required checkbox. 4. In the Additional actions section do the following for each option: To Always disable the option Always enable the option Let the user choose To Select/Deselect Deselect Checked by default and Editable by user Select Checked by default and deselect Editable by user Select/Deselect Checked by default and select Editable by user Select/Deselect Save original attribute values: To keep in dedicated attributes the old values of the DICOM attributes edited by users, and add them to private attributes in image DICOM files. Generate new UIDs: To generate new UIDs (Unique IDentifiers) for objects (also called instances ) when transferring images. It is very useful to generate new UIDs in the following cases for example: original image identifiers are incorrect; you want to send modified images to a server that stores the original images and not overwrite them. Remove private attributes: To delete all the proprietary attributes from the image DICOM files. To anonymize images, it might be useful to enable this option as it makes it more difficult to find the patient s name in these attributes. 5. Add the community(ies) you want to allow to use the QA/QC template. 6. Click the Save button. 52 ETIAM Nexus Administrator s Guide

Configuring Exam Sharing Exam sharing enables Nexus users to make exams available to patients and healthcare professional outside your institution for download to their PC. Add healthcare professionals You can declare the healthcare professionals that users will share exams with. 1. In the administration click Other. 2. Click the Exam Sharing tab, and then click the Add button. 3. Enter the healthcare professional s e-mail address, and then click the Search button to check if they already exist on ETIAM-Connect platform (common to all the institutions that use Nexus). If no matches are found, fill in the fields manually. 4. Select the Send a notification mail for each exam shared checkbox if you want users to receive a notification each time they share a exam. 5. Click the Save button. Configure the exam viewer The people who view exams shared from Nexus connect to your server to display images. Since images in DICOM format are large in size, it is recommended to prevent from displaying them if your network bandwidth is limited and/or if many exams are shared. In that case, images are displayed in JPEG format. When DICOM images are not displayed, it only prevents from using the windowing feature (for changing brightness/contrast). If you allow the display of DICOM images, you can request automatic loading of these images without user intervention. On the Viewer page on the Study Sharing tab select or deselect the checkboxes as needed. ETIAM Nexus Administrator's Guide 53

Manage the local site DICOM applications DICOM applications hosted on DICOM equipment (imaging modalities, diagnostic workstations, etc.) are each identified uniquely using an Application Entity Title (AE Title). A single DICOM equipment can host more than one DICOM application. To make it possible for a DICOM application to communicate with Nexus, you need to declare its AE Title in Nexus. You also need to declare Nexus AE Title on that application. Declaring DICOM Applications 1. In the administration, click the Other and DICOM tabs. 2. Click the DICOM tab, Local Applications, and then the Add button. 3. On the Application Info tab fill in the following fields: Name: Enter a meaningful name for the DICOM application. IP address: Enter the DICOM application IP address. Port number: Enter the DICOM application port number. Note: If you declare the application as a Store SCU and/or a QnR SCU, the port number is optional. AE Title: Enter the DICOM application AE Title. 4. Specify the DICOM services provided by the DICOM application and that Nexus will support: Store SCP: The DICOM application can receive exams, and you want to allow Nexus to send images to the application. This service is required in particular on workstations to which exams attached to cases will be transferred. Store SCU: The DICOM application can send exams, and you want Nexus to accept exams received from the application. This service is required in particular on imaging modalities that will send exams to Nexus. 54 ETIAM Nexus Administrator s Guide

ETIAM Nexus Administrator's Guide 55

QnR SCU: The DICOM application can query Nexus for exams and request to send them to a declared DICOM application. QnR SCP: The DICOM application can be queried to transfer exams to the Nexus server in your institution or to remote institutions. This service is required on the PACS servers that will be queried from Nexus. Worklist SCP: The DICOM application can be queried by Nexus to return patient and exam information. Commit SCU: The DICOM application can request Nexus to confirm it has received exams sent by the application. 5. Click the Test button to check the connection to the DICOM application. Generally, an error occurs if the application is not available, or if the IP address or IP port number is wrong. 6. On the Communities tab select the communities that the DICOM application will be allowed to send exams to and/or it will be allowed to query according to the configuration specified in step 3. 7. Click the Save button. Remove a DICOM application If you remove a DICOM application AE Title, send or receive, or Query and Retrieve operations between that application and Nexus will no longer be possible. On the Local Applications page select the DICOM application for the AE Title you want to remove, and click the Remove button, and then OK in the confirmation message that displays. 56 ETIAM Nexus Administrator s Guide

Manage Nexus storage spaces Nexus includes two separate storage spaces that store exams received from your institution DICOM applications and exams received from remote institutions respectively. You can manage Nexus storage spaces by specifying watermarks for disk space recycling. However, adding a storage space to those declared at Nexus setup is a maintenance operation that you cannot perform yourself. 1. In the administration click the Other and Storage tabs, and then click the Storage Spaces page. 2. Select the storage space you want, and then click the Update button. 3. Point and drag the colored cursors to adjust watermarks: Red cursor (high watermark): Drag the cursor until you reach the fill ratio that will trigger off automatic deletion of less recently accessed exams from the storage space or moving them to the next storage space (if any). Blue cursor (low watermark): Drag the cursor until you reach the fill ratio where Nexus will stop deleting exams. 4. Click the Save button. If Nexus manages several storage spaces repeat this procedure for each of them. The order of the storage spaces displayed in the list is the order in which Nexus manages them. So, the storage space displayed last in the list is considered as the last space by Nexus and is managed accordingly. ETIAM Nexus Administrator's Guide 57

Manage sending of cases Nexus sends cases to outside destinations according to their priority: urgent cases take priority over routine cases. For example, if routine cases are waiting to be sent and that a user sends an urgent case, that case is moved to first position in the waiting list. Nexus can send multiple cases simultaneously and retry to send failed cases. You can adjust how Nexus manages case sending based on your institution s network capacity. Customize case sending 1. In the administration click the Case sending management tab, and then click the button. 2. Fill out the following fields: Max. number of concurrent XDS sendings: XDS channels are used to send case forms. Max. number of concurrent DICOM sendings: DICOM channels are dedicated to exams and other documents in DICOM format attached to cases. For example, if you enter 3 in both fields Nexus will be able to send no more than three cases (forms + exams) simultaneously. Time before recovery (seconds): Waiting period between a failed case and a new attempt to send it. Max. number of recoveries: If a sending fails, maximum number of new attempts. 3. Click the Save button. 58 ETIAM Nexus Administrator s Guide

View the sending list On the Case sending management tab in the administration you can see case sending progress in real time. Sendings are sorted in reverse chronological order. If a case is sent to several destinations an entry is shown per destination. You can display all sendings whatever their status, or hide successful and failed sendings. The different statuses are depicted using the following icons: The case is waiting to be sent. The case failed to be sent. A new attempt is going to be made. All the attemps to send the case have failed. The case is being sent. The case was sent successfully. ETIAM Nexus Administrator's Guide 59

Manage Nexus Manage Nexus AE Titles Display Nexus AE Titles Nexus local AE Titles include a default local AE Title defined at setup, and the AE Titles used as relays for exams received from or sent to remote institutions. To view these AE Titles, in the administration click the Other and DICOM tabs, and then click the ETIAM Nexus AE Titles page. Edit Nexus default AE Title When installing Nexus, a local AE Title is proposed by default (generally NEXUS). You can change it to a name that conforms to the naming conventions enforced in your institution. If you change the local AE Title make sure you also implement the new AE Title on all the devices that communicate with Nexus. 1. In the administration click the Other and DICOM tabs, and then click the ETIAM Nexus AE Titles page. 2. Click the Update button beside Nexus AE Title, replace the displayed name with the name you want in the window that appears, and then click OK. 60 ETIAM Nexus Administrator s Guide

Monitor Nexus events The Events page on the Management tab shows events related to Nexus operation and usage. You can filter events using various filters. To access the Events page, in the administration, click the Other and Management tabs. Event types are identified using the following icons: Information Warnings Errors When you have fixed errors or viewed warnings, you can acknowledge them by clicking the Acknowledge log button. This will assign them the "Information" status and thus will make it easier to identify future errors and warnings for example. At any time, you can empty the log by clicking the Clear log button. ETIAM Nexus Administrator's Guide 61

Tracing ATNA Events on Nexus The ATNA feature has been implemented in Nexus to follow IHE recommendations for the Audit Trails and Node Authentication integration profile and thus meet the requirements defined in the HIPAA (Health Insurance Portability and Accountability Act) regulation enforced in the United States. You need to enable this feature if you want Nexus to produce XML messages. This feature enables to log events defined by ATNA that occur on Nexus. Here are a few examples: Starting and stopping the Nexus application User connections and disconnections Users viewing exams Receiving and sending exam images Adding, modifying and deleting user accounts Audit trails enable to determine both events that occur on Nexus and the names of users who initiated them. When the ATNA feature is enabled, events are logged into XML messages stored in a dedicated space. Then it is possible to audit stored records with an appropriate tool in order to identify symptoms of inappropriate activity. The content of XML messages is reformulated in a legible form on the Events page on the Management tab. Enable ATNA traceability 1. Click the Management tab, and then ATNA. 2. Select the Enable Audit Trail and Node Authentication option, click OK in the confirmation message Configure ATNA record storage By default, Nexus stores ATNA records on an internal server. If your institution has a central storage server such as defined by IHE you have to edit Linux system configuration on Nexus server. To do this contact the system administrator 62 ETIAM Nexus Administrator s Guide

Start and Stop Nexus Application You might need to stop the Nexus application (the software) for maintenance purposes or after a problem has occurred. To stop the application, click the Other tab. On the Management tab click the Stop button on the Application page. To start the application, click the Start button on the Application page. Shut down and reboot Nexus Server You might need to restart the Nexus server (the hardware machine) after updates for example. You can perform this operation from the Web interface without physically going to the machine. You can also stop the server the same way. To reboot the server, click the Restart button on the Server page. To stop the server, click the Stop button on the Server page. To restart it, you will need to press the On/Off button on the server machine itself. Edit network information for Nexus server On the Network page on the Management tab you can define or modify the network configuration for the Nexus server. If you know the server network configuration you can connect remotely to edit settings. After the changes have applied you will have to use the new settings to access the server. If you do not know the server network configuration you will need to connect locally using a screen and a keyboard in order to edit settings. Launch the desktop and enter the http://localhost URL in the Web browser. To modify a network interface configuration settings: 1. In the Network devices list select the network interface you want, and click the Update button. ETIAM Nexus Administrator's Guide 63

2. If your network features a DHCP server, select the Automatically get IP address setting with DHCP checkbox. Otherwise, click the Save button. 3. The changes will take effect when you reboot the server. If you want to apply the changes straight away, click OK in the message prompting you to restart the server now. 64 ETIAM Nexus Administrator s Guide

Statistics Nexus makes it possible to produce statistics to monitor and analyze the activity relating to case exchanges for your institution s Nexus or a network featuring a central Nexus server. For example, you can produce a statistic that shows as a stacked histogram the number of cases sent disaggregated by destination institution for a given period of time. It is also possible to export to Excel format (CSV) statistics produced in Nexus for analysis. Enable Nexus activity export to the central server If your institution s Nexus is connected to a central server you have to enable export of your institution s activity to make it possible to produce statistics on the central server. 1. In the administration click the Other and Teleimaging tabs, and then click the Networks page. 2. Select the network, and then click the Update button. 3. Select the Export activity data and specify a weekly export interval. If you want to test export of activity data without waiting until the date and time you have specified, click the Export now button. 4. Click the Save button. ETIAM Nexus Administrator's Guide 65