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  MedCommons User Manual  
  DICOM On Demand User Manual
June 26, 2009
CONTENTS
Copyright © 2009 MedCommons, Inc.

Initial Registration


The first user to register picks a name for the practice.








Check your email for your Dropbox link and a registration confirmation

Your Web Dropbox is at https://ci.myhealthespace.com/9002333833323331/upload

Please copy this link and use it on your practice web site or in emails to referring physicians and even your patients. Anyone who uses this link will be able to send you imaging and associated health records in minutes with only 4 clicks.

This link can also be found on the Settings > Group tab after you sign-in.



Use the Dropbox to receive health records for your practice

After email verification, a private, HIPAA-compatible group will be created for your practice. Invitations will be sent to any users you listed to allow them to create their own passwords for HIPAA-compliance.

Once you Sign In, you will be able to see a live patient list and manage access by your practice colleagues to this list.

Every user can see the HealthURL and images directly in their Web browser or iPhone.

Optionally, users that have a DICOM professional workstation or PACS can have patients automatically appear on the workstation by installing a receiving DICOM Data Liberator (DDL). On the receiving side, (1) you install DDL and (2) set it up to automatically send to a DICOM destination. The receiving DDL can also be set to automatically run when the hosting computer is restarted and the user logs in (3). Please see DICOM Workstation and PACS Options.



DICOM Networking


1 - Get the DICOM parameters for your workstation or PACS
  • Each system hides these differently. You may need to contact your PACS administrator.
  • The three parameters to remember are:
    • AETitle  (e.g.: OSIRIX_AG-M_ADRI)
    • Port      (e.g.: 11112)
    • IP Address or Host Name   (e.g.: 192.168.101.38)
  • Many PACS and some workstations do not accept DICOM from strangers.
    • They will need to be configured with the DICOM parameters of the DDL.
    • These parameters are displayed by the Configure DDL screen as Hostaddress, dicomLocalAeTitle, dicomLocalPort (see Fig 8).




2 - Select Configure DDL
  • DDL installation and startup are automatic and take about a minute. Check and accept any security warnings that pop up.
    • If installation seems to take too long, check your desktop for hidden Java windows asking for permission.
  • If there are already Orders on the queue the DDL Poller will grab them before you have a chance to configure DICOM. This will be improved in a future release.
  • The DDL icon will be in the system tray (PC) or the system bar (Mac).




3 - Set the DICOM Remote Parameters to match your workstation or PACS (from Step 1)

  • Enter the parameters
    • dicomRemoteAeTitle gets AETitle
    • dicomRemoteHost gets IP Address
    • dicomRemotePort gets Port
  • Set the exportMethod
    • CSTORE
  • Click Update Configuration
  • When the page refreshes, DICOMEcho should report success.




Automatic Routing to a DICOM Destination



Optionally, users that have a DICOM professional workstation or PACS can have patients automatically appear on the workstation by installing a receiving DICOM Data Liberator (DDL). On the receiving side, (1) you install DDL and (2) set it up to automatically send to a DICOM destination. The receiving DDL can also be set to automatically run when the hosting computer is restarted and the user logs in (3). Details below...



1 - Start Automatic Poll


  • Shut down any existing DDL - find the DDL icon in your System tray and right click / select 'Shutdown'
  • Go to  https://healthurl.medcommons.net/acct/login.php
  • Log In
  • Click on 'Settings' link in the top section of the page
  • Click on Group Tab
  • Click on the 'local service' link:


This will start a DDL poller pointed at timc.medcommons.net.



2 - DICOM Configuration

This should point to your workstation or PACS.

http://dicomondemand.com/instructions_dicom_networking.php

Free, open source workstations are available for both PC (ClearCanvas, K-PACS) and Macintosh (OsiriX). OsiriX is particularly full-featured and available in FDA-cleared and supported versions.



3 - Auto Restart

Auto DDL Restart is available on WinXP or Vista. Run at Startup is enabled by default (see below). 

Also notice the Pause icon. Use this to pause polling temporarily while you test an alternate poller that might conflict or if you are testing related PACS workflows. Uploaded studies that were not downloaded by another poller will be downloaded as soon as Pause us un-checked.

Stop will disable polling while leaving DDL oprerational for uploads or manual downloads. You will need to reload DDL by signing into your Group and requesting the Polling DDL again in order to restart polling.




Customized Upload Forms are Available for your Workflow


Practices with high volumes or special workflows can deploy Web droboxes with custom forms in support of teleradiology, laboratory services and integration with legacy health records and practice management systems. Please contact us at info@medcommons.net

A typical example, designed to serve a 3D image processing service for oncology specialists is shown below. Referring physicians or patients that place orders using the service's interactive web site:

  • Select CD
  • Select a CD or DICOM folder and click Open or Choose (as below, lower right corner)




  • Check the demographics - override any mismatch if appropriate
  • Accept the upload of the entire study if appropriate
  • Click Upload

Here is the custom DOD Upload Form as it appears after a successful transfer:


Numbers (above) indicate the sequence of activity on the Upload Form:

  1. Select the image source (select CD even if you intend to send a DICOM folder)
  2. Notice the patient's name as read from the DICOM Study
  3. Review the match between the DICOM info and the custom order info
  4. Click Upload to confirm the match
  5. Note progress. You do not need to wait for 100%. Close this form anytime.
  6. Close the form. Print is optional if you would like a receipt.
  7. Click here to report problems. Tell us how to reach you if you want to be contacted.


That's it. The study is on it way and, if a Polling DDL is enabled as in Steps 1-3, it will automatically appear on the destination workstation or PACS.

Click the MedC link on the TIMC Order Page to see a status report. Notice the four separate status transitions that are logged as Order History (below) by a succesful transfer.




System Requirements


DICOM On Demand uses a Java-based utility, the MedCommons DDL, to connect DICOM protocol to a HealthURL in the Cloud. DDL will install automatically on most Windows, Mac and Linux computers. To ensure continuity of large transfers, DDL will continue running in the system tray even if the Web browser is closed. DDL will not restart automatically.

DDL Requires Java 6 (aka 1.6) or later.

Macintosh Java 1.6 Installation

    • Intel Mac, 64-bit capable (Core 2 or later) only, OS X 10.5 or later




  • Check the current version with Java Preferences




  • Navigate to the Apple Java for Mac OS X 10.5 Upgrade page




  • Download and Install

  • Navigate to Applications > Java Preferences and make sure Java 6 is at the top of both lists. You can drag Java SE 6 to the top of the list if necessary.



Now try DICOM On Demand!

Attach PDF Documents, Photos or CCR-standard Health Records



Click the Access URL link near the bottom of the upload form:


Click the Edit link on the HealthURL upper right corner:



Select ADD PDF Document:


Select the file to attach. PDF documents, PNG and JPEG photos can also be attached.



The document is added as a CCR Reference. The message in red is an optional reminder to verify that the correct document was attached. Click the ! to view the document. Note: You can Save an un-confirmed attachment but the warning will remain.



The new document will be displayed in context. Click the ! to complete verification.



The warning will be removed and the updated health record will be saved - ready to share or download.



If the hospital or clinic provides a clinical summary in standard CCR format, use the Import > CCR command to update the patient's Current CCR.




Download all Documents (DICOM, PDF, CCR) to Your Computer



The recipient of the Voucher:


Claims the contents using the one-time PIN:



Sets a password and gains access to the voucher page:


Download all Documents sends a standard compressed file:



The file expands to a simple folder with health records, documents and DICOM imaging:


The links in the Utils folder can display CCR files in your Web browser and the DICOM folder can be imported by any standard workstation or PACS. Backup or burn a CD of your voucher contents at any time.
  

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© MedCommons Inc. 2009