252H VistA Imaging Calling All CACs

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252H- VistA Imaging Calling All CACs

• Jeannie Jernigan
• Imaging PACS Coordinator
• Fayetteville, NC VAMC
• Michele Krajewski
• Chief Vista Operations
• 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
• A document scanner calls and says I dont like
  the Radiology window opening whenever I log in.
  Make it go away.

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Case 3

• Scenario
• A document scanner calls and says I dont like
  the Radiology window opening whenever I log in.
  Make it go away.
• Hint 1
• Windows are everywhere

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Case 3

• Scenario
• A document scanner calls and says I dont like
  the Radiology window opening whenever I log in.
  Make it go away.
• Hint 2
• Do you have a preference?

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Case 3

• Solution
• Users can set up their preferences for the
  windows
• Users can open any window when needed if not set
  to open automatically in their preferences
• User can also set the remote image viewing from
  the same preference settings window

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• Solution
• Users can access the View Preferences settings
  either from the icon on the toolbar or from the
  Options drop down menu.

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Case 3

• Solution
• Uncheck the windows on the View Preferences
  window.

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Case 4
Scenario User unable to administratively scan
and sign documents in VistA Imaging
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Case 4

• ScenarioUser unable to administratively scan and
  sign documents in VistA Imaging
• Hint 1
• Capture what???

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Case 4

• ScenarioUser unable to administratively scan and
  sign documents in VistA Imaging
• Hint 2
• eFiling makes life easier

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Case 4

• Solution
• Check for the MagCap keys needed for the
  appropriate types of documents need MagCap
  Admin to scan administrative documents
• Check for MAG NOTE EFILE key needed to file
  notes without entering your electronic signature

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SOLUTION
Case 4
Allocate MAG NOTE EFILE key to user
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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).
• MAG NOTE EFILE User can electronically file
  notes without an electronic signature from the
  Imaging Capture workstation.
• 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 decrease performance due to pulling images
  from all remote sites.
• 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 6

• Scenario User is trying to scan an Advance
  Directive and is getting an error message

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Case 6

• Scenario User is trying to scan an Advance
  Directive and is getting an error message
• Hint 1
• Whats the type of Image???

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Case 6

• Scenario User is trying to scan an Advance
  Directive and is getting an error message
• Hint 2
• Oh my what was that note again?

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Case 6
SOLUTION
Scan to Advance Directive Note Title (CWAD
triggers in CPRS)
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Case 6

• When capturing an image to a NOTE of Title
  ADVANCE DIRECTIVE, the application will require
  that the Doc/Image Type is also ADVANCE
  DIRECTIVE.
• When capturing an image that has a Doc/Image
  Type of ADVANCE DIRECTIVE the application will
  require that the association is Progress Note and
  that the Title of the Note is ADVANCE DIRECTIVE.

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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