============================================================================= Run Date: APR 25, 2011 Designation: MAG*3*106 Package : MAG - IMAGING Priority: Mandatory Version : 3 SEQ #74 Status: Released Compliance Date: MAY 26, 2011 ============================================================================= Associated patches: (v)MAG*3*54 <<= must be installed BEFORE `MAG*3*106' (v)MAG*3*94 <<= must be installed BEFORE `MAG*3*106' (v)MAG*3*114 <<= must be installed BEFORE `MAG*3*106' Subject: TELEDERMATOLOGY Category: - Routine - Enhancement (Mandatory) - Data Dictionary - Other Description: ============ Patch 106 Overview: =================== This document describes VistA Imaging Patch 106, Teledermatology, which provides enhancements to support teledermatology. This patch enables the VistA Imaging Clinical Capture to convert images into DICOM format and then associate the images for viewing on the TeleReader worklist. Specifically, this patch supports: * The capture of images and their conversion to DICOM format before storing * The use of TeleReader in a Thin Client environment, controllable by site administrators * Consults that are discontinued, no longer appearing in TeleReader For detailed information, refer to the change summary section. Note: All sites running VistA Imaging 3.0 must install all components in this patch. Distribution of Software: ========================= This patch can be downloaded from: ftp.imaging.med.va.gov/Software/Released_Software/Mag3_0P106 Installation instructions are included in this document. Note: Any late-breaking news about this patch will be found in a readme file. If present, this file will also be located in the MAG3_0P106 directory. Patch Contents: =============== This patch includes the following files: Software: ========= MAG3_0P106.KID - KIDS (Kernel Installation & Distribution System) package to be installed on the VistA System MAG3_0P106_Install.exe - Installation file for Clinical Display, Clinical Capture, and TeleReader client software MagAUShare.zip - Zip file containing files used by Autoupdate sites. Contains MagASet.exe, MagSetup.exe, and magnet.ini MagInstall.msi - Installation file for sites using SMS or similar software Documentation: ============== The following documentation is available for MAG*3.0*106 Teledermatology: MAG3_0P106_Patch_Description.pdf - Patch Description MAG3_0P106_Clinical_Capture_User_Manual_Changes.pdf MAG3_0P106_Install_Guide_Changes.pdf MAG3_0P106_Security_Guide_Changes.pdf MAG3_0P106_Technical_Manual_Changes.pdf Associated Patches: =================== Before Patch 106 is installed, the following patches must be installed: MAG*3.0*114 TeleReader Configurator MAG*3.0*54 DICOM Maintenance IV MAG*3.0*94 Clinical Capture Maintenance II For a list of all released Imaging (MAG) patches, refer to the patch_list.txt file available on the Imaging FTP server (go to ftp://ftp.imaging.med.va.gov, then navigate to the \Docs\Imaging_Docs_Latest folder). Test Sites: =========== The following sites are test sites for this patch: Charleston, SC (Large) Fayetteville, NC (Large) San Diego, CA (Large) West Haven HCS, CT (Integrated) West Los Angeles HCS, CA (Integrated) Remedy Calls: ============= There are no Remedy help desk calls addressed in this patch. National Service Requests: ========================== 20080404 VistA Imaging Enhancements to Support Teledermatology Patch 106 Changes: ================== Patch 106 contains changes to the following Imaging components: * VistA Imaging TeleReader * VistA Imaging Clinical Capture * VistA Imaging-related changes on the VistA System Note: The VistA Imaging Clinical Display software is included in this patch, but is not altered by this patch. VistA Imaging TeleReader Changes: Discontinued orders will not display in TeleReader. Teledermatology Support: Dermatology images acquired using the Patch 106 Clinical Capture can be associated with consults allowing them to appear on the TeleReader worklist. Thin Client Support: Sites will be able to configure whether or not TeleReader will be able to access and read images on a workstation that accesses VistA Imaging through a Thin Client. VistA Imaging Clinical Capture Changes: Clinical Capture provides the capability to acquire dermatology images that can be remotely read using Inter-Facility Consults (IFCs) and TeleReader. To support this capability, a new association has been added to Clinical Capture called "TeleReader Consult". JPEG and TIFF dermatology images saved to VistA using this new association will be converted into DICOM format before storing in VistA Imaging. The images will then be viewable in Clinical Display. The DICOM Header Data Entry dialog box, shown below, is new in Clinical Capture. This dialog box is used to add additional DICOM Header information about an image, specifically on what part of the body the image was captured. The body part is identified by selecting the Body Part Examined (e.g., skin of abdomen or skin of back) and the Laterality (Right or Left) of the image site. WARNING: ======== There is an option in the Clinical Capture batch capture process that allows for the automatic deletion of image files from the import directory after they have been captured. Prior to using this option for Teledermatology images, it is recommended that several single and/or groups of images be captured successfully using each camera that will be used to capture Teledermatology images. This is to ensure the images are viewable before they are deleted. Once the process is confirmed to work properly, deleting image files from the import directory can be enabled if desired. VistA System Changes: ===================== KIDS File Changes: ================== Data Dictionaries: Note: The following files are arranged in numerical order and contain new, modified, or deleted fields in this patch: IMAGE file (#2005) change: ACA cross-reference - removed IMAGE AUDIT file (#2005.1) change: ACA cross-reference - removed IMAGING DICOM FIELDS file (#2005.71) new: Contains information for imaging DICOM fields that will be displayed when an image is captured in Clinical Capture. SOP field (#.01) - SOP type for the image being converted MODULE field (#2) - a multiple field; sub-file with the following: MODULE field ( #.01) - DICOM module that contains multiple DICOM elements ELEMENT TAG field (#2) - a multiple field with sub-file with the following: ELEMENT TAG field (#.01) - an ordered pair of numbers (a Group Number followed by an Element Number) that uniquely identifies each DICOM element ELEMENT NAME field (#2) - descriptive name of the DICOM data element VALUE MULTIPLICITY field (#3) - the number of values that can be encoded in the Value field of a DICOM data element VALUE REPRESENTATION field (#4) - code value for the "Value Representation" of the DICOM element GUI CONTROL field (#5) - Delphi control type that will be used to present DICOM elements IMAGE INDEX FOR BODY PART file (#2005.99) new: Contains the body part index term for the images captured by VI and also contains the corresponding values in the ICD, LOINC, SNOMED CT, and DICOM standard. The information is stored in the DICOM header during the conversion of image files from JPEG or TIFF formats to image files in DICOM format. NAME field (#.01) - the name of the body part that relates best to the image REGION/SYSTEM field (#1) - Region or System that the body part belongs to SNOMED CONCEPT ID field (#2) - the ID of the SNOMED CT Concept that best describes the body part SNOMED CODE VALUE field (#3) - the SNOMED Code Value of the DICOM standard of the body part DICOM BODY PART EXAMINED field (#4) - the name of the body part examined as defined by the DICOM standard DICOM CODE MEANING field (#5) - the body part DICOM code meaning as defined by the DICOM Standard. ICD TOPOGRAPHY field (#6) - the International Classification of Diseases (ICD) body part LOINC SYSTEM field (#7) - the body part value in LOINC standard DICOM UID ROOT file (#2006.15) new: OWNER field (#.01) - a string that identifies the organization to which the UID root code that is stored in this record is assigned UID ROOT field (#1) - a string that represents this organization's UID root code LAST DATETIME UID GENERATED field (#2) - field indicating the date and time when the last DICOM UID (unique identifier) was generated TICK field (#3) - field that is incremented every time a new DICOM UID is generated. This field is reset to one (1) daily when a new DICOM UID is generated for the first time during the day. This field supplements LAST DATETIME UID GENERATED field (#2) to prevent duplicate DICOM UIDs within one second interval of UID generation requests. Security Keys: ============== There is a new security key "MAGCAP TRC". A user with this new key can capture images associated with a "TelerReader Consult" from the Imaging Capture workstation. Remote Procedures: ================== The following new remote procedures are included in this patch: MAG3 DICOM CAPTURE GE LIST - returns all records in the IMAGING DICOM FIELDS file (#2005.71) per SOP type (e.g. "TELEDERM") MAG3 DICOM CAPTURE SOP CLASS - returns SOP CLASS UID per SOP type (e.g. "TELEDERM") MAG3 TELEREADER CONSULT LIST - returns not completed consults for a patient where TO SERVICE is set up in the TELEREADER ACQUISITION SERVICE file (#2006.5841) MAG3 TELEREADER DICOM SER NUM - generates the DICOM Series Number MAG3 TELEREADER DICOM UID - returns a new TELEREADER DICOM Study, Series, or SOP Instance UID MAG3 TELEREADER READ/UNRD ADD - adds a consult and image pointers to the UNREAD/READ LIST file (#2006.5849) and DICOM GMRC TEMP LIST file (#2006.5839) MAG3 TR THIN CLIENT ALLOWED - checks for thin client settings by User (DUZ) Menu Options: ============= There are no new menu options for this patch. Templates: ========== There are no new or modified templates included in this patch. Parameter Definition: ===================== There is a new parameter definition: MAG TR ALLOW THIN This parameter controls whether a user is allowed to view images in TeleReader using thin client; parameter changes are implemented by a system administrator. Allowance can be controlled at the user, service, division, and system levels. Installation: ============= This patch is to be installed on the VistA System and on the Clinical workstations. If you have a choice of installing on Clinical Workstations with a Network Administrator account or a local Administrator account, it is recommended that you use the local Administrator account. This patch may be loaded while VistA Imaging System is active. The KIDS installation will take approximately one minute. Installation Prerequisites: =========================== Before installing this patch, you will need to download the Patch 106 files from the Imaging FTP site to a local storage location. Verify that the patches listed in the Associated Patches section have been installed. VistA System (KIDS) Installation: ================================= Installation Steps: 1. 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_0P106.KID) of the Patch 106 KIDS file that you downloaded from the Imaging FTP server. 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. Verify Checksums in Transport Global [XPD PRINT CHECKSUM] - run this option if you want to ensure the integrity of the routines in the patch. 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. 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*106. c. Answer NO to the following prompts: Want KIDS to Rebuild Menu Trees Upon Completion of Install? No//NO Want KIDS to INHIBIT LOGONs during the install? No//NO Want to DISABLE Scheduled Options, Menu Options, and Protocols? No//NO 6. When installation is finished, an Install Completed message will be displayed. KIDS Installation Example: ========================== Select Installation Option: INStall Package(s) Select INSTALL NAME: MAG*3.0*106 2/28/11@15:10:07 => VistA Imaging V3.0 - Patch 106 - 02/28/2011 12:34PM ;Created This Distribution was loaded on Feb 28, 2011@15:10:07 with header of VistA Imaging V3.0 - Patch 106 - 02/28/2011 12:34PM ;Created on Feb 28, 2011@12:34:03 It consisted of the following Install(s): MAG*3.0*106 Checking Install for Package MAG*3.0*106 Will first run the Environment Check Routine, MAGIP106 Install Questions for MAG*3.0*106 Incoming Files: 2005.71 IMAGING DICOM FIELDS (including data) 2005.99 IMAGE INDEX FOR BODY PART (including data) 2006.15 DICOM UID ROOT 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// TELNET Install Started for MAG*3.0*106 : Feb 28, 2011@15:10:16 Build Distribution Date: Feb 28, 2011 Installing Routines: Feb 28, 2011@15:10:17 Running Pre-Install Routine: PRE^MAGIP106 Installing Data Dictionaries: Feb 28, 2011@15:10:17 Installing Data: Feb 28, 2011@15:10:17 Installing PACKAGE COMPONENTS: Installing SECURITY KEY Installing REMOTE PROCEDURE Installing PARAMETER DEFINITION Feb 28, 2011@15:10:17 Running Post-Install Routine: POS^MAGIP106 Attaching RPCs to the 'MAG WINDOWS' option... MAG3 DICOM CAPTURE GE LIST MAG3 DICOM CAPTURE SOP CLASS MAG3 TELEREADER CONSULT LIST MAG3 TELEREADER DICOM SER NUM MAG3 TELEREADER DICOM UID MAG3 TELEREADER READ/UNRD ADD MAG3 TR THIN CLIENT ALLOWED RPCs have been successfully attached. Updating Routine file... Updating KIDS files... MAG*3.0*106 Installed. Feb 28, 2011@15:10:17 Install Completed Imaging Clinical Workstation Installation: ========================================== The Clinical Imaging client software (Display, Capture, and TeleReader) can be updated using one of the methods outlined below: * Manual Installation * Autoupdate Installation using VIIS (VistA Imaging Installation Service) * Automatic Installation using other methods (SMS, PSexec, etc.) 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 3.0.106.13. Manual Installation: The MAG3_0P106_Install.exe file can be installed manually on workstations as described in Section 2.5.5.1 in the Clinical Imaging Installation Guide. Autoupdate Installation: These steps assume Autoupdate has already been implemented. For information about setting up Autoupdate, see Section 2.5.6 in the Clinical Imaging Installation Guide. 1. Download MagAUShare.zip and MAG3_0P106_Install.exe from the Imaging FTP server to a local storage location. 2. Rename the MAG3_0P106_Install.exe file to MagInstall.exe 3. Copy the new MAG3_0P106_Install.exe file to the location specified in magautoupdate.bat. (magautoupdate.bat is typically stored in Program Files\VistA\Imaging\InstallationService on the system where VIIS is installed). 4. Perform the following steps to allow the new software to be pushed to designated test workstations: a. Extract the contents of the MagAUShare.zip file to the UPDATE\TEST folder. b. In the UPDATE\TEST folder, open magnet.ini and change the placeholder for "InstallService" to reflect the server (or cluster name) where VIIS is installed. [update_mode] ForceUpdateAll=FALSE InstallFile=MagSetup.exe InstallService=http:///imaging/install.asmx =TRUE 5. Run Clinical Display and Clinical Capture on the test workstations for a period of time to insure there are no problems with the software at your site. 6. When it is verified that the software is running properly, extract the contents of the MagAUShare.zip file to the UPDATE\DISTRIB folder. 7. In the UPDATE\DISTRIB folder, open magnet.ini and change the placeholder for "InstallService" to reflect the server (or cluster name) where VIIS is installed. All workstations will be updated the next time Clinical Display or Clinical Capture is run. Other Automatic Installation Methods (SMS, PSexec, etc.): The following methods are available to push updated software to multiple workstations: * Remote push of MAG3_0P106_Install.exe using PSexec and an administrator s account: For details, see section 2.5.5.3 in the current Clinical Imaging Installation Guide. * Remote push using Microsoft SMS or similar remote installation software: Either MAG3_0P106_Install.exe or magInstall.msi can be used for this. Installation specifics will vary from site to site. Routines: ========= For each routine, the second line will contain the following information. Please note that the "before" checksum may differ if any test software has been installed. ;;3.0;IMAGING;**[patch list]**;Mar 19, 2002;Build 2002; Feb 28, 2011 The MAGIP106 routine will be automatically deleted after the installation is completed. Routine Information: ==================== The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: MAGDHWC Before: B46762790 After: B48238555 **10,51,46,54,106** Routine Name: MAGGSIA1 Before: B40524442 After: B41835903 **7,8,85,59,93,106** Routine Name: MAGGTIA Before: B42431443 After: B47129366 **8,48,106** Routine Name: MAGGTU4C Before: B4891026 After: B5091959 **93,94,106** Routine Name: MAGGTU4D Before: B4896831 After: B5097764 **93,94,106** Routine Name: MAGGTU4L Before: B4891107 After: B5092040 **93,94,106** Routine Name: MAGGTU4T Before: B4891179 After: B5092112 **93,94,106** Routine Name: MAGIP106 Before: n/a After: B7756257 **106** Routine Name: MAGNDCMC Before: n/a After: B11551246 **106** Routine Name: MAGNGMR Before: n/a After: B70338961 **106** Routine Name: MAGNTLR3 Before: n/a After: B4232767 **106** Routine Name: MAGNUID1 Before: n/a After: B17116046 **106** Routine Name: MAGNUID2 Before: n/a After: B4027276 **106** Routine Name: MAGUXRF Before: B41195502 After: B31728772 **51,93,106** ============================================================================= User Information: Entered By : TROMBETTA,KATHY Date Entered : AUG 19, 2009 Completed By: CASUGAY,ELSIE G Date Completed: APR 22, 2011 Released By : FUGETT,BRENT Date Released : APR 25, 2011 ============================================================================= Packman Mail Message: ===================== No routines included