MIDMARK ECG, SPIRO & HOLTER The PCM/Midmark interface supports Midmark IQmark Digital ECG, Midmark IQmark Digital Spirometer and Midmark IQmark Digital Holter Setup Requirements Midmark Controls.msi set up must be installed prior to using this interface If using RDP connection (for ECG and SPIRO ) there is an additional Midmark RDP Client software requirement which must be purchased from Midmark o If you do not wish to purchase the RDP Client software from Midmark; PCM full networked client or full VPN Client is required For Holter users, until Midmark changes this requirement, PCM full networked client or full VPN Client is required. o The Holter security key (dongle) must be installed on the local workstation o Analyzing and Editing of Holters must be done from the workstations where the Holter security key (dongle) is installed Note: this is a Midmark Requirement; on 08/02/2016 PCS sent a formal request to Midmark for the removal of this requirement, Reference Ticket # 248321 PCM TS Client is no longer supported for use with this interface Important Information a. The Midmark Interface can be launched from the desktop using the PCM Midmark shortcut or from within PCM. We recommend launching the interface while logged into PCM with a chart open this way the files are readily accessible in the open chart. This document contains instructions for this. b. When the physician/signer is finished reviewing each digital file, an option comes up for generating a PDF Summary, each completed test performed will contain two entries, a digital file and a PDF file. o The Digital Reports will have a comment of Digital Report The PDF file for Holter will have a comment of Full Report The PDF file for ECG and SPIRO will have a comment of Summary Report c. Storing the digital (.car) files is necessary to allow for editing and re-editing of the test. d. The digital files can be edited by the physician/signer on the same day the file was created, even if the PDF Report was already signed. o If any changes are made to the digital file, the physician/signer will have the option to reprint the PDF on exiting the digital file, the new PDF will overwrite the existing PDF to reflect any changes that were made. e. The digital files can be deleted by the physician/signer at any time f. Auto-signing for the PDF Reports is currently not an option; o After clicking on the Sign doc option, manually clicking on the PDF where you want the signature to appear is recommended o You may also enable the option to automatically place the signature on the last page, bottom right corner, but this may cover data on the PDF document. Updated 09.09.16 AB Page 1 of 18
Using Midmark ECG Interface The most common workflow scenario is that a non-provider user is logged in to initiate the process, once the digital files are created; the physician/signer will open the digital file for review and on closing will print a PDF Report. 1. Log into to PCM 2. Open the patient s chart 3. Click on the Midmark ECG, Spiro, Holter button 4. The following information is auto-populated into the ECG acquisition screen but may be manually entered if it is missing o The patient s Race o Vitals o The Technician s name is populated with the logged on user s name 5. Select the Requesting Physician and enter any Medications or History, if necessary o If the physician is logged in, the Req. Physician s name will be automatically populated 6. Click on the button; Perform ECG, Start Spirometer or Capture Holter Data Updated 09.09.16 AB Page 2 of 18
ECG Technician Workflow (non-physician/signer) 1. Click on Analyze button 2. Click on the Review button Simulated ECG 3. Close the ECG Acquisition Screen 4. A Digital Report will be created in the ECG MM Chart Tab 5. A copy of the digital file is sent to the physician/signer s mailbox for review Updated 09.09.16 AB Page 3 of 18
Physician Workflow (physician/signer) 1. Log in as the Physician/signer 2. Open the mailbox or patient s chart 3. Double click on the ECG file to open 4. Review the ECG and edit as necessary 5. Click on Exit(Save Comments if necessary, on exiting) ECG Digital Report 6. If you are finished, click OK to create a PDF Summary Report 7. The Summary Report will be filed in the chart under the ECG MM tab 8. When the PDF Report file is created, it is sent to the physician/signer s mailbox for signing, at the same time, the digital report.car file will be removed from the physician/signer s mailbox, at this time the digital file is internally signed. Updated 09.09.16 AB Page 4 of 18
9. Sign the PDF Summary Report, the PDF Summary report may be signed from the open chart or mailbox Note: Auto-signing for the PDF Reports is currently not an option; a. After clicking on the Sign doc option, manually clicking on the PDF where you want the signature to appear is recommended b. You may also enable the option to automatically place the signature on the last page, bottom right corner, but this may cover data on the PDF document. Additional ECG Screen Shots: Digital ECG Details ECG PDF Summary Report Updated 09.09.16 AB Page 5 of 18
Spirometry Technician Workflow (non-physician/signer) 1. Enter the Smoking History 2. Click on Close 3. Click on Start a New Test Simulated Spirometry Test Updated 09.09.16 AB Page 6 of 18
Simulated Spirometry Test 4. Click on Yes to perform another test or No to accept the current test Updated 09.09.16 AB Page 7 of 18
5. Review and make any necessary changes 6. When finished, click on Save Review and 7. Close the ECG Acquisition Screen 8. A Digital Report will be created in the SPIRO MM Chart Tab 9. A copy of the digital file is sent to the physician/signer s mailbox for review Physician Workflow (physician/signer) 1. Log in as the Physician/signer 2. Open the mailbox or patient s chart 3. Double click on the SPIRO file to open 4. Review the SPIRO and edit as necessary 5. Click on Exit (Save Comments if necessary, on exiting) Spirometry Digital Report Updated 09.09.16 AB Page 8 of 18
6. If you are finished, click OK to create a PDF Summary Report 7. The Summary Report will be filed in the chart under the SPIRO MM tab 8. When the PDF Report file is created, it is sent to the physician/signer s mailbox for signing, at the same time, the digital report.car file will be removed from the physician/signer s mailbox, at this time the digital file is internally signed. 9. Sign the PDF Summary Report, the PDF Summary report may be signed from the open chart or mailbox Note: Auto-signing for the PDF Reports is currently not an option; a. After clicking on the Sign doc option, manually clicking on the PDF where you want the signature to appear is recommended b. You may also enable the option to automatically place the signature on the last page, bottom right corner, but this may cover data on the PDF document. Updated 09.09.16 AB Page 9 of 18
Holter Technician Workflow (non-physician/signer) 1. Click on Analyze button 2. After verifying the Recording information, Click Acquire & Analyze button 3. On the Analysis Restuls screen, Click on Exit Updated 09.09.16 AB Page 10 of 18
4. Close Holter analyze & Review screen 5. Close the ECG Acquisition screen 6. A digital file will be created in the Holter Chart Tab 7. A copy of the digital file is sent to the physician/signer s mailbox for review Updated 09.09.16 AB Page 11 of 18
Physician Workflow (physician/signer) 1. Log in as the Physician/signer 2. Open the mailbox or patient s chart 3. Double click on the Holter file to open 4. Select the option to Open the selected holter file for furthter review 5. Choose the Edit option 6. Edit the Interpretation/Comments OR make any other changes as necessary in the Analysis Results 7. Click on Exit (Save Comments if necessary, on exiting) Updated 09.09.16 AB Page 12 of 18
8. If you are finished, Click OK to create a PDF Full Report 9. Close Holter analyze & Review screen 10. Close the ECG Acquisition screen 11. The Full PDF Report will be filed in the chart under the Holter Chart Tab a. Note: if the Holter s raw data (.zip) file is missing from the chart, the PDF will be generated, but with a comment of 'Summary Report' instead of the Full Report. Updated 09.09.16 AB Page 13 of 18
12. When the PDF Report file is created, it is sent to the physician/signer s mailbox for signing, at the same time, the digital report.car file will be removed from the physician/signer s mailbox, at this time the digital file is internally signed. 13. The physician/signer can sign the PDF Summary report from the open chart or mailbox Note: Auto-signing for the PDF Reports is currently not an option; a. After clicking on the Sign doc option, manually clicking on the PDF where you want the signature to appear is recommended b. You may also enable the option to automatically place the signature on the last page, bottom right corner, but this may cover data on the PDF document. Editing/Reanalyzing Holter Files Editing and reanalyzing of digital Holter files can only be done by the physician/signer on the same date the file was created, and only if the Holter s raw data (.zip) file exists inside the patient s chart. Remember, this must be done on the full networked workstation or via a VPN connection where the Holter security key (dongle) is installed, this is a Midmark requirement If you try to edit a file that was not created on today s date, the following message comes up: 1. Logged in as the physician/signer 2. Double click on the Holter file (that was created today) from the patient s chart 3. Click on the option Open the selected holter file for further review Updated 09.09.16 AB Page 14 of 18
4. Select either the Edit or Reanalyze option 5. The Holter digital file will be open in edit mode If any changes are made to the digital file, you will have the option to re-print the PDF Report once again on exiting the digital file, the new PDF will overwrite the existing PDF to reflect any changes that were made. Note: Only editing of the 'Full Report' is supported, there are no more summary reports, as those will not have all the pages needed; except in the situation where the Holter s raw.zip file is missing. Holter Full Report Updated 09.09.16 AB Page 15 of 18
Updated 09.09.16 AB Page 16 of 18
Additional Holter Screen Shots Holter Data Review Holter ST Trend Updated 09.09.16 AB Page 17 of 18
Additional Information Exporting Chart or documents When using the Copy to file or Chart Export options; if the PDF Report file is found, it will be copied or exported, if a PDF Report file is not found; a summary is extracted and copied from the digital.car file Note: the list of documents Doc Date must be left in descending order; otherwise two copies of the PDF Report may be generated per digital file. Convert to Tif option Use the right click Convert to Tif option to create a Tif copy of the digital or PDF Holter, ECG, or SPIRO Printing Holter Files These files will only print to the computer's default printer; and cannot be set to print to the PCM document printer. Audit Trail The Audit Trail logs whenever a raw Holter file has been either viewed or annotated Auto-hide the Task Bar Auto hide your task bar to allow full ECG Screen; on your desktop; rt. click on your task bar, select properties, check Auto-hide the task bar other wise some buttons at the bottom of the screen will be hidden while the report screen is open in full screen mode. Updated 09.09.16 AB Page 18 of 18