============================================================================= Run Date: FEB 07, 2017 Designation: MAG*3*167 Package : MAG - IMAGING Priority: Mandatory Version : 3 SEQ #127 Status: Released Compliance Date: MAR 10, 2017 ============================================================================= Subject: IMAGING DISPLAY Category: - Other Description: ============ Associated Patches: This patch must be installed after MAG*3.0*162. ================== Subject: VISTA IMAGING CLINICAL DISPLAY ======= Category: OTHER ======== Description: =========== This document describes MAG*3.0*167, a patch that includes a new MUSE Patient Study Viewer. This version of the MUSE Patient Study Viewer will connect to MUSE Systems that are running MUSE v8 SP2 and later. The electrocardiograms (EKGs) and other data types displayed in this viewer are MUSE generated Portable Document Format (PDF) images of the patient tests. Additionally, MAG*3.0*167 will have communication with Clinical Capture for Annotation of Patient Images. In MAG*3.0*151, the Annotation components were taken out of Clinical Capture. Users of Clinical Capture 151 have the option to open newly captured images in Clinical Display patch MAG*3.0*167. Images are opened in a separate window, so the user can annotate the image using the Annotation components of Clinical Display. Patch Components: ================ This patch includes software and documentation files. This document, MAG3_0P 167_Patch_Description, provides an overview, explains the changes, and outlines the installation for this patch. MAG3_0P167_README.txt, if present, is an informative file associated with the patch. Software: ======== File Name Description MAG3_0P167.KID - Kernel Installation KIDS build for Patch 167 and Distribution System (KIDS) MAG3_0P167_CLINICAL_DISPLAY_SETUP.EXE Clinical Display Installation File MAG3_0P167_CLINICAL_DISPLAY_INSTALL.MSI Clinical Display Installation File Documentation: ============= This document, MAG3_0167_Patch_Description, provides an overview, explains the changes, and outlines the installation for this patch. Files & Fields Associated: ========================= There are no files or fields associated with this patch. Forms Associated: ================ There are no forms associated with this patch. Mail Groups Associated: ====================== There are no mail groups associated with this patch. Options Associated: ================== There are no options associated with this patch. Protocols Associated: ==================== There are no protocols associated with this patch. Security Keys Associated: ======================== There are no security keys associated with this patch. Templates Associated: ==================== There are no templates associated with this patch. Additional Information: ====================== New Service Requests (NSRs): =========================== There are no new service requests addressed in this patch. Patient Safety Issues (PSIs): ============================ There are no patient safety issues associated with this patch. Defect Tracking System Ticket(s) & Overview: =========================================== 1. Defect 194658 (Trouble Ticket (Remedy) INC000000995412) Cannot Add ===================================================================== Annotations to Images ===================== Problem: In the current version of the Clinical Display application, it is not possible to add Annotations to images that have a status of Quality Assurance (QA) Reviewed. This needs to be changed so that Annotations can be added to images that have a status of QA Reviewed. Resolution: The function that determines if an Image can be annotated was incorrect. This function has been fixed to allow annotations to images with a status of QA Reviewed. 2. Defect 359102 (Trouble Ticket INC000001219914) Enable Communication ====================================================================== from Clinical Capture to Allow Users to Annotate Images ======================================================= Problem: In Clinical Capture MAG*3.0*151, the annotation functionality was removed due to issues it was causing in the capture process. Resolution: This patch enables communication between Clinical Capture and Clinical Display. Users of Clinical Capture MAG*3.0*151 can select a newly captured image and have it open in a separate window of Clinical Display MAG*3.0*167 for annotation. 3. Defect 291827 MUSE API Update ================================ Problem: General Electric (GE) has developed a new Application Programming Interface (MUSE API 3). The use of the new API will be mandatory for the upcoming MUSE Version 9. Clinical Display Electrocardiogram Viewer currently uses an older MUSE API that will not communicate with MUSE 9. Resolution: The VistA Imaging Clinical Display application has been modified to use the new MUSE API 3 to interface with GE MUSE Systems. This change will enable VistA Imaging Display to interface with MUSE Systems starting with MUSE v8 SP2 and later. MUSE Systems older than MUSE v8 SP2 will no longer be supported. 4. Defect 359130 (Trouble Ticket (NSD) R6629905FY16) Help Menu Items ===================================================================== (continued from Patch 151) ========================== Problem: Users do not have access to the latest Display User Manual. The Help menu option needs to link to the current user manual on the VistA Imaging SharePoint site. Resolution: A new menu item has been added to the Help menu on the Clinical Display main window: VistA Imaging Display User Guide. This is a link to the VistA Imaging SharePoint site. Click this menu option to open the latest Clinical Display User Manual in your browser. 5. Defect 291819 (Trouble Tickets INC000000947908, ==================================================== INC000001006100, and INC000001067134) Image Goes Black ====================================================== Problem: When scrolling through the images on the Radiologic viewer with the Telereader for Teleretinal Imaging, the images go black. Users have to logout of the VistA Imaging Display client and log back in to make them viewable again. Resolution: In the current design of Clinical Display, whenever a 24 bit color image is viewed, it is automatically separated into Red, Green and Blue (RGB) color channels. The memory used to store these images was not being cleared when the image was cleared, so continually viewing 24-bit color images would eventually lead to the application running out of memory. There is a two part resolution for this issue: 1) The memory used for the separate color channels is now being cleared when the image is cleared. 2) Users can choose to disable the automatic separation of color channels for 24-bit color images. By disabling the automatic separation, color images will load and display faster. When disabled, the user can choose to show color channels on an image by image basis. To disable atomatic color channels, from the Main window or from the Image List Window, check the Options | Disable Automatic Color Channel menu option . To view color channels when automatic color channel is disabled, select the Image | Enable Color Channel for Current Image menu option. Then use the RGB toolbutton as you normally would. 6. Defect 377985 (Trouble Ticket I7668256FY16) Typos on VistA Imaging ===================================================================== Banner ===== Problem: The box that displays after the user enters an electronic signature for printing or copying images (titled: "VistA Imaging: Physcian Agreement for Downloaded Images.") has two misspellings. The word "physician" was misspelled and there should not be a period at the end of the title bar. Also, the word "capability" in the second line is also misspelled. Resolution: The two spelling errors were fixed and the extra period was removed. 7. Defect 291820 (Trouble Tickets INC000001057750 and INC000001248569) ====================================================================== Image Displaying as Black Vertical Strip ======================================== Problem: Ophthalmic images are coming across distorted. The images come up in Clinical Display as a black vertical strip. To view full size, clear images, users need to click on the 1:1 option. Resolution: During the display of DICOM images, a secondary calculation is performed to compute the image resolution based on pixel spacing data contained in the DICOM header. Sometimes the data is incomplete. When the data for the vertical pixel spacing is incomplete, the secondary calculation results in an image that is dramatically skewed vertical. The image displays as a vertical line. The application function that calculates the image height and width has been modified. When data for pixel spacing is incomplete, the secondary calculation will not be executed. The verical line issue was noticed when viewing images from the vendor TopCon. The user can optionally stop resolution calculations for all TopCon images. From the System Manager menu, select "Workstation Configuration window.". In the Workstation Configuration window, select the Demo Options section. Under "Demo Options" set the value for SkipTopConResolution to "TRUE". 8. Defect 291822 (Trouble Tickets I6260205FY16 and I10071786FY16) RGB ===================================================================== Button ====== Problem: In VistA Imaging Clinical Display, the Red/Green/Blue (RGB) button becomes inactive while viewing patient images. This issue was not limited to a specific patient, workstation, or user. The user has to stop Clinical Display and restart the application and then the RGB button works again. Resolution: The issue of application memory leak in Issue 6 above happens during the separation of the color channels for 24-bit color images. This symptom of the RGB button (the color channel button) becoming inactive is related to Issue 6 above (Defect 291819) and is also fixed by the modification for Issue 6. 9. Defect 410457 (Trouble Ticket R6752847FY16) Cannot Reassign Images ===================================================================== Captured to Wrong Record ======================== Problem: This change is intended to alleviate the cumbersome process that is needed now when an image is attached to the incorrect patient or incorrect TIU note. Sites will no longer have to Print the Image, take it to the scanning clerks, have the image scanned and attached to the correct patient and/or correct TIU Note. Resolution: A new menu item, Options | Copy Image (before Delete) for Re-Association in Clinical Capture, enables users to copy an image to a local user directory before the image is deleted. HIMs personnel can then use Clinical Capture to import the image from the local user directory to a new patient or to the same patient and with different index values. Note: Image Groups and DICOM Study Groups cannot be copied as a Group. For Image Groups (Non-DICOM), select each image for deletion from the Group Abstract window, then copy each image before deletion. DICOM Study Groups need to be re-associated through the DICOM Gateway. MUSE Interface Changes ====================== Overview: The new MUSEAPI 3 is a Service-Oriented Architecture (SOA) based on Windows Communication Foundation (WCF). Clinical Display acts as a client and 'consumes' services from the MUSE System. The client submits an Hypertext Transfer Protocol (HTTP) request to the server; the server returns a response to the client. The EKGs and other data types displayed in this viewer are MUSE generated PDF images of the patient tests. Because of these changes, the VistA Imaging MUSE configuration has changed. \VistA\Imaging\MUSE Folder ========================= Previous versions of Clinical Display made use of MUSE Dyamic Link Libraries (DLLs). When Clinical Display was installed on a workstation a '\Vista\Imaging\Muse' folder was created and several DLLs were installed in that folder. The \Vista\Imaging\Muse folder and the DLLs contained in that folder are no longer used. That folder and DLLs will be deleted in a future patch. Network Location File (#2005.02) =============================== Physical Reference: Previously the physical reference was the server name, and 'vol000' Example: \\VHAxxxMUS1\vol000\ The interface to MUSE Systems no longer requires server name and volume. A Server Address and Port number are needed now. Server address should be a Fully Qualified Domain Name (FQDN). See FQDN section for examples. The Port should be 8100 unless your site needs to use a different port. Example \\server address\port\ VistA Imaging will use Port 8100 if 'vol000' is part of the Physical Reference. By defaulting to 8100 this way, the current entries in the Network Location File should continue to work when MAG*3.0*167 client is installed. The server address should be entered in FQDN notation. The Port is configured on MUSE Systems as 8100. The Display Client will default the Port to 8100. If your site needs to use a different port to communicate with the MUSE Systems. Then you need to put the Port number as the Volumn. Example \\ vhahunclu2a.v09.domain.ext \\ Muse Version #: Example current value : v7// This value is an entry in the MUSE VERSIONS File. It was necessary in previous versions to distinguish between different versions of MUSE systems that will be accessed. Starting with MAG*3.0*167, it is no longer required to select a MUSE version. This field is now ignored and will be deleted in a future patch. Note: This field is no longer used when connecting to MUSE Servers and will be deleted in a future patch. Fully Qualified Domain Name (FQDN) ================================== Example: VHAHUNCLU2A.V09.DOMAIN.EXT Host Name + Domain Name = FQDN VHAxxxCLU4 Vyy.domain.ext VHAxxxCLU4.Vyy.domain.ext VHAxxxIMMJB1 Vyy.domain.ext VHAxxxIMMJB1.Vyy.domain.ext xxx = 3 character site code, and yy=VISN number MAG.INI Changes =============== The VistA Imaging Configuration file has changed to reflect the new VistA Imaging MUSE EKG Viewer. Users with the MAG SYSTEM key can change these entries as always from the System Manager menu on the Clinical Display Main window. [VISTAMUSE] Section Entries =========================== DEBUG (FALSE) New entry for MAG*3.0*167. When TRUE, more messages are displayed in the message panel of the MUSE EKG Viewer window. Also an optional Debug Window can be displayed. The Debug window will show the details of the HTTP Requests and the HTTP Responses that were used in the 4 previous communications with the MUSE Server. The Debug window is primarily for support personnel GRIDON (TRUE) This entry is no longer used; it will be removed in a future version. Controls if gridlines are added as a background to displayed EKGs. TEXT OVERLAYON (TRUE) This entry is no longer used; it will be removed in a future version. Determines if text overlay information is displayed. ShowDotted GridDlg (TRUE) This entry is no longer used; it will be removed in a future version. If GRIDON is TRUE, determines if gridlines are shown as solid or dotted lines. PrintDottedGrid (TRUE) This entry is no longer used; it will be removed in a future version. Determines if dotted or solid gridlines are included in a printed EKG. SiteNumber (0) This entry is no longer used; it will be removed in a future version. When set to 0, the workstation will use the MUSE Site Number stored in the Imaging Site Parameters File (#2006.1). If an individual workstation must use a site number other than the one stored in #2006.1, this value can be changed as directed by Customer Support. Background - MUSE site numbers are assigned to each facility that uses the EKG database. Where multiple facilities use the same database, more than one site number will be present. Each site number is stored in a separate folder on the MUSE Server under the VOL000 share. Folders are given names starting with "Site" (i.e., Site01, Site02, Site03). MUSE EKG Display ================ The new window is a copy of the Full resolution window modified to work with images that are not referenced in the IMAGE File (#2005). The functionality of the toolbar buttons and the image viewer is the same as in the Full Resolution Viewer. The Images displayed in this viewer are MUSE generated PDF images of the patient tests. Changes between previous EKG Display (prior to Patch 167) and the new Display window: 1. If you are connecting to multiple MUSE Systems, the number of studies from each MUSE System is displayed in this panel. Clicking on the panel will display connection information about each system. 2. Click "Size" to increase/decrease the height of the list. Click "List" to show/hide the list of studies. 3. The MUSE study data is displayed on the header panel of each image. The overlay function is no longer available. 4. If the study is not confirmed, then "UNCONFIRMED" is displayed in a second header panel. The overlay of "UNCONFIRMED" is no longer available. Menus ===== File: Open in alternate viewer All Images are PDFs; this option will open the PDF image in the alternate viewer for PDF files. Options: Show messages: If checked, a text panel will be displayed at the bottom of the window. Users can scroll through the history of messages. Show List: Check or uncheck this option to show or hide the list of EKG Studies. Debug: If the DEBUG setting in the MAG.INI file is True, this menu option, and sub-menu options will be visible. Close all Connections: Closes all connections to MUSE Systems. Open all Connections: Opens all connections to MUSE Systems. Get Patient Tests: Gets all tests for selected patient Show Debug Window: Displays the Debug window. Image, View, Layout, Page and Help menu items have the same sub-menu options as the Full Resolution window. MUSE Debug Window ================= If the Debug setting in the MAG.INI file is True, support personnel will be able to view this window. Note: Debug is always set to False when Clinical Display opens. A user with the MAG SYSTEM Key can set this value to True from the System Manager menu. If a site is reporting issues with the MUSE EKG Display window, support personnel and the Imaging Site manager can use the Debug window to display the full HTTP Request and Response for the last five items. Repeating the steps to reproduce the issue with the Debug window open will help support personnel to find the issue. The top two panels are the request and response in Extensible Markup Language (XML) format. Test Sites: ========== The following sites are test sites for this patch: Veteran's Administration (VA) Heartland (Eastern Kansas: Topeka and Leavenworth) Ralph H. Johnson VA Medical Center (VAMC) - Charleston, SC VA Pittsburgh Healthcare System Cheyenne VA Medical Center Software and Documentation Retrieval Instructions: ================================================= Software being released as a host file and/or documentation describing the new functionality introduced by this patch is available. The preferred method is to retrieve files from download.vista.domain.ext. This transmits the files from the first available server. Sites may also elect to retrieve files directly from a specific server. Sites may retrieve the software and/or documentation directly using Secure File Transfer Protocol (SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices: Albany: domain.ext Hines: domain.ext Salt Lake City: domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Note: Information about last-minute changes to this patch will be provided in a readme file. If present, this file will also be located in the MAG3_0P167 directory. Title File Name SFTP Mode _______________________________________________________________________ VistA Imaging Clinical Display mag_display_user_manual.pdf (binary) Workstation User Manual VistA Imaging System Installation Guide imginstallgd_f.pdf (binary) Patch Installation: ================== Pre/Post Installation Overview: ============================== MAG*3.0*167 must be installed on the VistA System and on 64-bit workstations on which the VistA Imaging Applications will be used. This patch must be installed by the compliance date. This patch may be installed with users on the system although it is recommended that it be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 5 minutes to install. Pre-Installation Instructions: ============================= Verify that the patches listed in the Associated Patches section of this document have been previously installed. Note: All released VistA Imaging patches must be installed on the VistA system before installing MAG*3.0*167. VistA System (KIDS) Installation Instructions ============================================= Installation Steps ================= KIDS installation will take less than one minute. 1. On the VistA system, access the Kernel Installation and Distribution System Menu [XPD MAIN]. 2. Run the Installation option [XPD INSTALLATION MENU]. 3. Load the KIDS file by performing the following steps: a. Run the Load a Distribution option [XPD LOAD DISTRIBUTION] to load the KIDS distribution. b. When prompted, enter the path and file name (MAG3_0P167.KID) of the Patch 167 KIDS file. c. When prompted to continue with the load, enter "YES". A Distribution OK! message will be displayed when the load is complete. 4. After loading the KIDS file, use the following options to verify the contents of the patch and to back up any affected routines. a. Verify Checksums in Transport Global [XPD PRINT CHECKSUM] - Run this option if you want to ensure the integrity of the routines in the patch. b. Compare Transport Global to Current System [XPD COMPARE TO SYSTEM] - Run this option if you want to view all changes that will be made when the patch is installed. All components (routines, options, and so on) in the patch will be compared. c. Backup a Transport Global [XPD BACKUP] - Run this option if you want to create a backup message of any routines exported with the patch. It will NOT back up any of the other changes. 5. After performing the load and any optional verification steps, install the KIDS file by performing the following steps: a. Run the Install Package(s) [XPD INSTALL BUILD] option. b. When prompted for the install name, enter "MAG*3.0*167". c. Answer "NO" to the following prompts: Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO// Want KIDS to INHIBIT LOGONs during the install? NO// Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// 6. When installation is finished, an Install Complete message will be displayed. KIDS Installation Example This example shows the output when the KIDS file is installed for the first time. If you have already installed the patch and are installing the KIDS file in a namespace on which it has previously been installed, your output may be different. Select INSTALL NAME: MAG*3.0*167 8/2/16@20:08:36 => VistA Imaging V3 - Patch 167 - MUSE Update MUSE API 3 ;Created on Aug This Distribution was loaded on Aug 02, 2016@20:08:36 with header of VistA Imaging V3 - Patch 167 - MUSE Update MUSE API 3 ;Created on Aug 02, 20 16@19:27:12 It consisted of the following Install(s): MAG*3.0*167 Checking Install for Package MAG*3.0*167 Install Questions for MAG*3.0*167 Want KIDS to INHIBIT LOGONs during the install? NO// Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// Enter the Device you want to print the Install messages. You can queue the install by enter a 'Q' at the device prompt. Enter a '^' to abort the install. DEVICE: HOME// HERE Aug 02, 2016@20:08:46 Running Pre-Install Routine: PRE^MAGIP167 Running Post-Install Routine: POS^MAGIP167 Post Install Mail Message: Aug 02, 2016@20:08:46 Updating Routine file... Updating KIDS files... MAG*3.0*167 Installed. Aug 02, 2016@20:08:46 Not a production UCI NO Install Message sent 100% Install Completed Vista Imaging Clinical Display Client Installation Instructions =============================================================== The Clinical Imaging Display client software can be updated using one of the methods outlined below: Manual installation Automatic installation using other methods (SMS, PSexec, etc.). Note: The Clinical Display Application is only supported on a Windows 7 operating system; other operating systems are not officially supported. Clinical Display is distributed as an MSI and EXE installation. The MSI is intended for sites that want to do a push installation (using SCCM or another tool). The EXE is intended for use to install on a single workstation. After client installation is complete, log in to an updated workstation and use the Help | About menu option to verify that the version number is 3.0.167.8. Manual Installation =================== The MAG3_0P167_Clinical_Display_Setup.exe file can be installed manually on workstations as described in Section "Single Workstation Installation" in the VistA Imaging System Installation Guide. Auto-update Installation ======================== VistA Imaging Auto-update functionality is no longer supported. Add VA Facility Subnet to MUSE ACL to Allow Communication on Port 8100 ====================================================================== To ensure that all the proper ports are open and that the MUSEAPI service is running, users may have to add their VA facility subnet to the MUSE ACL. 1. Log on to the MUSE server and open services.msc. Verify that the MUSEAPI3 service is installed and running. If the MUSEAPI3 service is not installed GE can assist the MUSE POC. 2. Log on to the MUSE server and open a cmd prompt and run netstat -a. One of the returned entries should show 8100 in the local address list with the state "Listening". 3. Submit a ticket to have the MUSE ACL modified to allow all 10.xxx.xxx.xxx (i.e., 10.152.0.0 0.0.255.255) traffic on port 8100. Each site will have to have their subnet added to the MUSE ACL. Add MUSE Service Account ======================== This new interface does not require or use the share. The user credentials being passed into MUSEAPI3 need to have a matching MUSE user account. Users will need to set up a MUSEIU account on the MUSE server. Use the MUSEIU account; not the VA Service Account. Change the account designated in your BP Queue Processor > Network Location Manager > EKG >User Name column to the new MUSEIU account user name and password (i.e., MUSEIU\[MUSEIU password]). For more information, please see the MUSET v9 Cardiology Information System Operator's Manual 2059568-009. There is a sub-section (under System Settings section) on adding users to MUSE. Contact the VA Bio Medical team for help installing. For any other questions, please contact your GE representative. Uninstalling Clinical Display Client MAG*3.0*167 ================================================ If it is necessary to uninstall the MAG*3.0*167 client, use the Uninstall option from Windows Control Panel to Uninstall: "VistA Imaging Clinical Display". Then install the previous version of Clinical Display which was included in MAG*3.0*161. Routine Information: =================== This section lists modified routines for the VistA KIDS build. For each routine, the second line will contain the following information: ;;3.0;IMAGING;**[Patch List]**;Mar 19, 2002;Build 3;Aug 2, 2016 CHECK1^XTSUMBLD is used to generate the checksums. Routine Checksum Checksum Patch List Before After MAGGTU4D 5312177 5313965 93, 94, 106, 117, 122, 131, 149, 138, 156, 161, 167 MAGIP167 NA 11436109 167 MAGGTID 83741782 85911502 8, 59, 93, 118, 150, 138, 167 MAGSIXG3 81619873 84985360 93, 117, 150, 138, 16 Routine MAGIP167 is an installation routine that is automatically deleted after the KIDS installation. Routine Information: ==================== No routines included. ============================================================================= User Information: Entered By : Date Entered : NOV 24, 2015 Completed By: Date Completed: JAN 30, 2017 Released By : Date Released : FEB 07, 2017 ============================================================================= Packman Mail Message: ===================== No routines included