# Presentation: 172061

## 225H- VistA Imaging – Calling All CACs

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

## Objective

- Be able to troubleshoot some basic Imaging issues as they relate to CAC’s
- 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.

## 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

## 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.

## 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.

## 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

## 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

## 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

## 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

## Case #1

## Case #1

## 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 patient’s name never appears for the order.

## 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 patient’s name never appears for the order.
- Hint #1
- “Did someone set a meeting for consults and forget to invite imaging?

## 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 patient’s name never appears for the order.
- Hint #2
- DICOM files are sometimes so managable (or is that ‘managerable’?).

## 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.

## 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

## 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.

## 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.

## 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.

## 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.

## 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.

## Case #3

- Solution

## Case #3

- Solution

## Case #3

- Solution

## Case #3

- Solution

## Case #3

- Solution

## Case #3

## 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.

## 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 won’t be long and I’ll have to ‘un-lock’ my glasses to see.

## 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.

## Case #4

- Solution
-  Check the user’s account for the Magdisp Admin key for viewing of administrative documents
-  Check for the MagCap keys needed for the appropriate types of documents

## 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.

## 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.

- 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.

- 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.

- 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.

- Case #4

## 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 don’t need to see images.

## 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 don’t need to see these images.
- Hint #1
- Image display???

## 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 don’t need to see these images.
- Hint #2
- Green Print on Image Display??

## 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 don’t need to see these images.
- Hint #3
- Not Sure yet?????

## 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.

## Case #5

- Solution

## Case #5

- Solution

## Case #5

- Solution

## 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 provider’s note.

## 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 provider’s note.
- Hint #1
- Review Display Client Screens

## 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 provider’s note.
- Hint #2
- Button, button, who has the button?

## 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 provider’s note.
- Hint #3
- I don’t like being associated to buttons!

## 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.

## 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.

## Case #6

## Case #6

## Case #6

## Case #6

## Case #7

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

## Case #7

- Scenario
- User contacts you to say they cannot get EKG’s 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 isn’t complete without an EKG

## Case #7

- Scenario
- User contacts you to say they cannot get EKG’s 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 MUSE’ing falsehood

## Case #7

- Scenario
- User contacts you to say they cannot get EKG’s 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 EKG’s is MAGnificent access

## 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

## Case #7

## Case #7

## QUESTIONS