225H VistA Imaging Calling All CACs

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225H- VistA Imaging Calling All CACs

• Mel Sharer
• Lead CAC
• Orlando VAMC
• Michele Krajewski
• Vista Imaging System Manager
• Philadelphia VAMC

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Objective

• Be able to troubleshoot some basic Imaging issues
  as they relate to CACs
• If the tools available to you in this class are
  usually handled by the Imaging Site Coordinator
  at your site, then you will at least be able to
  assist in identifying the problems to your
  Imaging Coordinator.

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Format for the Session

• You will troubleshoot 7 scenarios
• You will have 2-3 hints per scenario
• The new hint will be displayed every 3 minutes
• The solution will be shown following the hints
• There may be several alternate methods of
  repairing the problem

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How to proceed

• You will log into the accounts using the log-in
  information at your workstation
• The tools for repairing the problem are available
  for your user account
• If you have problems, raise your hand and a room
  assistant will help you.

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Case 1

• A scanner/indexer calls and states he/she is
  getting a server error whenever the VistA Imaging
  Capture Client is launched from her shortcut.
  She can only view images with the Display Client
  through CPRS not from the shortcut on the
  desktop.

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Case 1

• Scenario
• A scanner/indexer calls and states he/she is
  getting a server error whenever the VistA Imaging
  Capture Client is launched from her shortcut.
  They can only view images with the Display
  Client through CPRS and not from the shortcut on
  the desktop.
• Hint 1
• Check the CPRS Tools Menu settings

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Case 1

• Scenario
• A scanner/indexer calls and states he/she is
  getting a server error whenever the VistA Imaging
  Capture Client is launched from the shortcut.
  They can only get into to view images with the
  Display Client through CPRS not from the shortcut
  on the desktop.
• Hint 2
• Check the information on the screen when
  launching the Capture Client

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Case 1

• Scenario
• A scanner/indexer calls and states he/she is
  getting a server error whenever the VistA Imaging
  Capture Client is launched from the shortcut.
  They can only view images with the Display Client
  through CPRS and not from the shortcut on the
  desktop.
• Hint 3
• Check the workstation configuration login
  settings on the Display Client that opens from
  CPRS

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Case 1

• Solution
• In the Workstation settings of the Imaging
  Workstation Configuration for the login options
  check to see what the Local Vista and/or Local
  Vista port information is set to.
• Change the brokerserver/port information to your
  vista server information.
• Users must have the MAG SYSTEM key to access the
  System Manager options within the Display/Capture
  Client
• If unable to access through Imaging can edit the
  Local Vista and Local Vista port fields in the
  Mag308.ini file directly

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Case 1
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Case 1
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Case 2

• You have set up a new Consult to interface with
  Imaging for the Tele-Retinal Program. The staff
  tries to pull up the work list in but the
  patients name never appears for the order.

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Case 2

• Scenario
• You have set up a new Consult to interface with
  Imaging for the Tele-Retinal Program. The staff
  tries to pull up the work list but the patients
  name never appears for the order.
• Hint 1
• Did someone set a meeting for consults and
  forget to invite imaging?

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Case 2

• Scenario
• You have set up a new Consult to interface with
  Imaging for the Tele-Retinal Program. The staff
  tries to pull up the work list but the patients
  name never appears for the order.
• Hint 2
• DICOM files are sometimes so managable (or is
  that managerable?).

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Case 2

• Solution
• Check the DICOM Healthcare Providers Service file
  (File 2006.5831) to see if the consult service is
  in the file. This file is a pointer to the
  Request Services file (File 123.5)
• Need to make sure the Requested Service matches
  the consult
• Need to have the Service Group match a specialty
  for the service this puts like consults on the
  same work list for one instrument
• Need to have the Service Division set to the
  division where the consult is being performed.

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Case 2

• OUTPUT FROM WHAT FILE DICOM HEALTHCARE PROVIDER
  SERVICE//
• Select DICOM HEALTHCARE PROVIDER SERVICE
  REQUESTED SERVICE DIABETIC TELERETINAL
• STANDARD CAPTIONED OUTPUT? Yes// (Yes)
• Include COMPUTED fields (N/Y/R/B) NO// - No
  record number (IEN), no Computed
• Fields
• REQUESTED SERVICE DIABETIC TELERETINAL IMAGING
• SERVICE GROUP OPTOMETRY SERVICE
  DIVISION Your Division
• CLINIC Your Clinic

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Case 3

• Scenario
• User is not seeing all the images his co-worker
  is seeing. When he went to another co-worker,
  that view was the same as his other co-worker. He
  wants to see all the Images.

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Case 3

• Scenario
• User is not seeing all the images his co-worker
  is seeing. When he went to another co-worker,
  that view was the same as his other co-worker. He
  wants to see all the Images.
• Hint 1
• That is really a personal one sided view of
  things.

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Case 3

• Scenario
• User is not seeing all the images his co-worker
  is seeing. When he went to another co-worker,
  that view was the same as his other co-worker. He
  wants to see all the Images.
• Hint 2
• I some times make things too complicated and
  specific viewpoints are misunderstood.

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Case 3

• Scenario
• User is not seeing all the images his co-worker
  is seeing. When he went to another co-worker,
  that view was the same as his other co-worker. He
  wants to see all the Images.
• Hint 3
• Sometimes it is hard to filter through the dates
  we select for meetings.

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Case 3

• Solution
• The User has set a Personal Filter that is either
  too restrictive or not restrictive enough.
• If the user wishes to see Radiology Exams, but
  only from a particular specialty, then that can
  be set in the filter.
• If the user wishes to see all radiology exams, an
  other filter would be set.
• The Date range on the personal filter is what is
  limiting seeing exams that are outside the date
  range settings.
• See Personal Filter screens on following pages.

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Case 3

• Solution

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Case 3

• Solution

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Case 3

• Solution

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Case 3

• Solution

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Case 3

• Solution

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Case 3
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Case 4

• Scenario
• User calls and says that they can see the
  clinical images in the Display Client but none of
  the administrative documents. The user also
  states that they are having a problem scanning
  any document whether clinical or administrative.

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Case 4

• Scenario
• User calls and says that they can see the
  clinical images in the Display Client but none of
  the administrative documents. The user also
  states that they are having a problem scanning
  any document whether clinical or administrative.
• Hint 1
• It wont be long and Ill have to un-lock my
  glasses to see.

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Case 4

• Scenario
• User calls and says that they can see the
  clinical images in the Display Client but none of
  the administrative documents. The user also
  states that they are having a problem scanning
  any document whether clinical or administrative.
• Hint 2
• I need this card key to get into my room at the
  hotel.

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Case 4

• Solution
• Check the users account for the Magdisp Admin
  key for viewing of administrative documents
• Check for the MagCap keys needed for the
  appropriate types of documents

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Case 4

• Capture-related Security Keys
• MAG CAPTURE - Allow capture of images without an
  associated specialty (i.e. 'NONE' on the Imaging
  Capture configuration window).
• MAGCAP ADMIN - Allow capture of images associated
  with the Admin Document specialty.
• MAGCAP CP - Allow capture of Clinical Procedure
  images.
• MAGCAP LAB - User can capture Laboratory images
  from the Imaging Capture workstation.
• MAGCAP MED C - User can capture Cardiology images
  from the Imaging Capture workstation.

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Case 4

• MAGCAP MED G - User can capture GI images from
  the Imaging Capture workstation. MAGCAP MED GEN
  User can capture Generic Medicine images from
  the Imaging Capture workstation.
• MAGCAP MED H - User can capture Hematology images
  from the Imaging Capture workstation.
• MAGCAP MED HI -User can capture Internal
  Medicine / Hematology images from the Imaging
  Capture workstation.
• MAGCAP MED I - User can capture Internal Medicine
  images from the Imaging Capture workstation.
• MAGCAP MED N - User can capture Neurology images
  from the Imaging Capture workstation.
• MAGCAP MED P - User can capture Pulmonary /
  Endoscopy images from the Imaging Capture
  workstation.

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Case 4

• MAGCAP MED PF - User can capture Pulmonary
  Function Test images from the Imaging Capture
  workstation.
• MAGCAP MED R - User can capture Rheumatology
  images from the Imaging Capture workstation.
• MAGCAP MED Z - User can capture Consult images
  from the Imaging Capture workstation.
• MAGCAP PHOTOID - User can capture Photo ID images
  from the Imaging Capture workstation.
• MAGCAP RAD - User can capture Radiology images
  from the Imaging Capture workstation.
• MAGCAP SUR - User can capture Surgery images from
  the Imaging Capture workstation.
• MAGCAP TIU - User can capture TIU images from the
  Imaging Capture workstation.

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Case 5

• Scenario
• A user is complaining that their system is very
  SLOW when they change patients in CPRS and
  bunches of images are flying all over the screen
  when the patient chart is opened. User states
  they dont need to see images.

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Case 5

• Scenario
• A user is complaining that their system is very
  SLOW when they change patients and all these
  images are displayed when the patient chart is
  opened. I dont need to see these images.
• Hint 1
• Image display???

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Case 5

• Scenario
• A user is complaining that their system is very
  SLOW when they change patients and all these
  images are displayed when the patient chart is
  opened. I dont need to see these images.
• Hint 2
• Green Print on Image Display??

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Case 5

• Scenario
• A user is complaining that their system is very
  SLOW when they change patients and all these
  images are displayed when the patient chart is
  opened. I dont need to see these images.
• Hint 3
• Not Sure yet?????

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Case 5

• Solution
• The configurations in the Remote Images view
  setting are set to Remote Images enabled. This
  will increase performance.
• In the Image Display Client, go to Options/View
  preferences/Remote Image tab and set the check
  box to Sites in local VISN.
• To fix the flying images, uncheck the boxes for
  the automatic display of the image types. They
  are still selectable on the main Display Client.
  

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Case 5

• Solution

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Case 5

• Solution

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Case 5

• Solution

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Case 6

• Scenario
• A user calls and is trying to scan documents
  using the VistA Imaging Capture Client. They
  always use the buttons to pick settings for
  scanning specific documents. The button for the
  Patient Transfer Note is not allowing the user to
  scan and attach to the providers note.

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Case 6

• Scenario
• A user calls and is trying to scan documents
  using the VistA Imaging Capture Client. They
  always use the buttons to pick settings for
  scanning specific documents. The button for the
  Patient Transfer Note is not allowing the user to
  scan and attach to the providers note.
• Hint 1
• Review Display Client Screens

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Case 6

• Scenario
• A user calls and is trying to scan documents
  using the VistA Imaging Capture Client. They
  always use the buttons to pick settings for
  scanning specific documents. The button for the
  Patient Transfer Note is not allowing the user to
  scan and attach to the providers note.
• Hint 2
• Button, button, who has the button?

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Case 6

• Scenario
• A user calls and is trying to scan documents
  using the VistA Imaging Capture Client. They
  always use the buttons to pick settings for
  scanning specific documents. The button for the
  Patient Transfer Note is not allowing the user to
  scan and attach to the providers note.
• Hint 3
• I dont like being associated to buttons!

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Case 6

• Solution
• Configuration of the buttons were initially set
  to the Association of TIU but were changed to
  Patient(Clinical) and then saved. This replaced
  the original settings with the new settings. The
  user cannot change the buttons but would have to
  change the association at the beginning of the
  scan session.
• Click on the button and then click on Association
  to change the association to Progress Notes.

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Solution for 6

• You will need to reset any of the Hold values by
  click on Configurations on the tool bar then
  Select Hold Values. On the Hold Values window
  either check or uncheck the fields then click OK.
• Once all the fields are correct click on
  Configurations on the tool bar then Save
  Configuration. On the Save Configuration window
  make sure it is set to the right configuration
  then click OK. When asked if this is okay to
  overwrite click OK.

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Case 6
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Case 6
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Case 6
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Case 6
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Case 7

• Scenario
• User contacts you to say they cannot get EKGs in
  Imaging on the PC that are using in Clinic. They
  could see them yesterday but they were in a
  different exam room.

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Case 7

• Scenario
• User contacts you to say they cannot get EKGs in
  Imaging on the PC that are using in Clinic. They
  could see them yesterday but they were in a
  different exam room.
• Hint 1
• A happy display client isnt complete without an
  EKG

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Case 7

• Scenario
• User contacts you to say they cannot get EKGs in
  Imaging on the PC that are using in Clinic. They
  could see them yesterday but they were in a
  different exam room.
• Hint 2
• A workstation is setting a MUSEing falsehood

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Case 7

• Scenario
• User contacts you to say they cannot get EKGs in
  Imaging on the PC that are using in Clinic. They
  could see them yesterday but they were in a
  different exam room.
• Hint 3
• The key to good viewing of EKGs is MAGnificent
  access

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Case 7

• Solution
• In the Workstation settings of the Imaging
  Workstation Configuration Setting check to make
  sure the MUSE Enabled setting is set to TRUE.
• Users must have the MAG SYSTEM key to access the
  System Manager options within the Display/Capture
  Client
• If unable to access through Imaging can edit the
  MUSE Enabled field in the Mag308.ini file
  directly

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Case 7
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Case 7
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QUESTIONS