Acuo VNA for Administrators - Hyland Software · DICOM Images • PACS ... Identifies asset for future retrieval from storage ... OFFLINE –Archive Acuo Store: Digital Image Storage

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Acuo VNA for Administrators

Lenexa, Kansas

Ryan D. Haug, CNMT

LEXMARK CONFIDENTIAL 2

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Introductions:


Agenda


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Section 1 – Introduction

Section 2 – DICOM Review

Section 3 – HL7 and AcuoSemantix

Section 4 – AcuoStore and AcuoMed

Section 5 – Installation and Configuration Exercises

Section 6 – Moving Patient Data

Section 7 – Batch Move and Store Managers

Day One


Section 8 – Patient Management

Section 9 – Propagation and IOCM

Section 10 – Batch Update Manager

Section 11 – Patient Management Exercises

Section 12 – IHE Audit Log Manager and Recycle Bin

Section 13 – Tag Rule Routing

Section 14 – Federation

Section 15 – Pre/Post Fetching

Section 16 – Soundex/Name Normalization

Day Two


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Section 17 – Reconciliation / Batch Reprocessing Manager

Section 18 – Reconciliation Tag Rules

Section 19 – Reconciliation Exercises

Section 20 – Stat Routes

Section 21 – External SCU Authorization

Section 22 – Storage Commit / Batch Commit Manager

Section 23 – Custom Tag Mapper

Section 24 – Instructor Guided Exercises

Day Three


Section 25 – Image Manager Server Properties

Section 26 – PIX Manager / Acuo eMPI

Section 27 - Replication

Section 28 – Cross Enterprise Document Sharing (XDS)

Section 29 - AcuoInsight

Section 30 - WADO

Section 31 – Acuo DICOM Assisted Migration (ADAM)

Section 32 – Upgrade Process

Day Four


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Section 33 – Troubleshooting / Acuo Monitor

Section 34 – SQL Database Backups / Disk Management

Section 35 – Contacting Support

Section 36 – Final Review

Day Five


Customer Web Portal

Access to …

Submit Support tickets

Register for courses

Education Services Email

[email protected]

Trainer Email

[email protected]

VNA Videos

https://education.perceptivesoftware.com/production/acuo_vna_tutorials/

Training Resources


mailto:[email protected]

mailto:[email protected]

https://education.perceptivesoftware.com/production/acuo_vna_tutorials/

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Introduction to Lexmark VNA

• Section 1


A general purpose, digital asset management

service that allows you to store, track, and retrieve

virtually any type of digital asset routed to it.

A Vendor Neutral Archive is…


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Neutrality

Able to store data regardless of the data source.

DICOM Images

• PACS

• Modality

Non-DICOM data (XDS)

• Images

• PDFs

• Video

What does that mean?


Universal Clinical Platform (UCP)


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Reduced Management Complexity and

Interoperability

Centralized database for DICOM and Non-DICOM data

Improved Access to Images

Data sharing

Sophisticated Image Lifecycle Management (ILM)

capabilities

Image retention

Eliminates future PACS migration cost

Gives the enterprise ownership of their clinical data

Vendor Neutral Archive


DICOM Review

• Section 2


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DICOM – Digital Imaging and COmmunications in Medicine

National Electric Manufacturers Association (NEMA)

The standard in medical imaging interoperability

Virtually all imaging modalities (CT, MRI, NM, US, etc…) are supported by this standard

“…all-encompassing data transfer, storage, and display protocol built and

designed to cover all functional aspects of digital medical imaging.”

O.S. Pianykh – Digital Imaging and Communications in Medicine (DICOM)

Terms

DICOM

Modalities

PACS

VNA

What is DICOM?


Images

(1 to 100s)

Series SeriesModality

Date

TimeSeriesSeries

Date

Requestor

Etc.

StudyStudyStudy

Name

DOB

Etc.Patient

DICOM: Hierarchy

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Data elements > Modules > Information Entities > Information Object Definitions

Defined for each Image Modality

IODs specific to each modality

Carry modality-specific metadata and images

DICOM: Information Object Definitions


C-Find

Queries a remote database

C-Move

Requests a retrieve

C-Store

A “push” of DICOM images

C-Echo

Checks DICOM Associations

DICOM Ping

DICOM: Composite Commands


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SOP Class

Defined as a combination of a DICOM Service

Element (DIMSE) and an Information Object

Definition (IOD)

Commands

• DIMSE – DICOM Service Elements

- C-Move

- C-Store

Objects

• IOD – Information Object Definitions

- Template

- Patient Demographics

- Modality Images

DICOM: Service Object Pair


Transfer Syntax

A list of possible ways DICOM data can be

encoded

UIDs

Abstract Syntax

A specific SOP class

Ex. “Store an Ultrasound image”

SOP Class UID

DICOM: Abstract and Transfer Syntax


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Lossless

There is no difference between the

compressed/decompressed image

Full fidelity

1001,1001,1003,1002,1001,1005,1110

a,a,1003,1002,a,1005,1110

Lossy

There is a difference between the initial and final

image

Can only convert back to lossless once and

there is data loss

1001,1001,1003,1002,1001,1005,1110

a,a,1003,a,a1005,1110

Compression is used for:

Storage size reduction

Reduced transmission times

Defined by Transfer Syntax, negotiated during

the DICOM Association

DICOM: Compression


DICOM follows a client-server protocol

Service Class User (SCU)

Client

Service Class Provider (SCP)

Server

Some devices, such as PACS or VNA can be

both SCU and SCP depending on the

scenario

DICOM: SCU and SCP


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Parameters for an association

AE Title/Name

Port #

IP Address or Host Name

Associations bind two AEs into an associated

pair

AE1 requests an association

AE2 either accepts or rejects the association

If accepted, AE1 can transmit data

When completed, the AEs close the

association

DICOM: Associations


All devices that support DICOM must have a

Conformance Statement.

Specifies the types of SOP Classes (abstract

syntaxes)

Encodings (Transfer Syntaxes)

Document can determine whether or not a

specific device is compatible with other

devices within your organization

DICOM: Conformance Statements


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Workstation queries for studies using

C-FIND service

VNA Server responds with matching

list of studies and displays on viewer

User selects study and C-MOVE

request is sent

VNA Server locates the

image/record

VNA Server sends C-MOVE

response

VNA Sever sends C-STORE request

Work Station send C-STORE

response

Q/R

SCU

Q/R

SCP

DICOM: Query/Retrieve Workflow

SMITH 16/05JONES 02/04SMEDLEY 26/11HEDGES 22/11 LOVEJOY 02/08DAVENPOR 26/09 DAY 11/11DINGLE03/04BEALE 25/01COTTON 29/04 FOWLER 26/11FOWLER 19/11

VNA

SeverWorkstation

SMITH 16/05

C-MOVE

SCP

C-MOVE

SCU

C-STORE

SCP

C-STORE

SCU

Advantages of a MWL

Reduces operator time

Reduces data entry errors

Improves data consistency

A MWL allows a Modality to receive exam

details from an upstream system – usually

HIS/RIS

The modality queries MWL using C-Find

Searching for Patient Demographics/Study

specifics

DICOM: Modality Worklist (MWL)

MWL provider

e.g. HIS/RIS, broker

MWL

MWL

SMITH CTPELV

ORANG CTABDO

BOON CTLUNG

TRETHICK CTKUB

TRING CTPE

• Worklist of orders

displayed at modality

Order comes in from

HIS/RIS System via HL7

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Scenario

NM stores images to a PACS (via C-Store)

NM issues N-Action requesting Storage

Commitment

PACS responds with N-Action-Report with

results either on the same or separate

association

Lexmark VNA does support Storage

Commitment

Lexmark has a Storage Commit Batch

Manager to monitor this process

DICOM: Storage Commitment


SCU SCP

N-Action Rq

N-Action Rsp

N-Event Report Rq

N-Event Report Rsp

Health Level 7 / AcuoSemantix

• Section 3


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Health Level 7

Connects patient registration and ordering

systems (CPOE, HIS) with downstream

systems for procedures, studies, billing and

management systems

Triggered by events

Physician placing an order for an exam

Patient registration

Updating a patient’s demographics

Can communicate in either real-time or in

batch mode

What is Health Level 7 (HL7)?


EMR

HL7

HL7

HL7

VNA

BillingMWL

What is AcuoSemantix?

HL7/XML/DICOM solution

Designed to bridge the gap between HIS/RIS

environments and DICOM PACS

environments.

ASX receives and decodes HL7 messages

then generates DICOM workflow equivalent

messages to existing VNA systems

Trigger events can cause:

Prefetching

Patient updates / Fixit messages

Update HIS/RIS tables for Reconciliation

HL7 Messages and Lexmark VNA - AcuoSemantix


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Functionality that uses HIS/RIS events to

deliver required patient priors (images) to

destinations where patient/study events are

scheduled.

You may direct your prefetches to:

Lexmark VNA

View stations

Non-Acuo Archives (PACS)

Typical sources of these images:

Lexmark VNA

Deep level Archives attached to the VNA

Non-Acuo Archives (PACS)

HL7 Prefetching


Data Synchronization Events

Edit – A08

Merge – A40

HIS/RIS>HL7>ASX>Lexmark VNA

HL7 Patient Updates/Fixit messages


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Reconciliation – separately licensed feature

A HIS/RIS connected AcuoMed Server is able

to derive DICOM tag information from HIS/RIS

events and save this information in an XML

database

Automatic process that prevents bad data

from coming into a DICOM Database

Auto-detects differences between the incoming

data and the master patient data list

This will queue up a reconciliation event

REM

Example: A study with a missing accession

number

HL7 Updating the HIS/RIS Tables for Reconciliation


Brief overview of Reconciliation

Will cover in more detail on Day 3

Separately Licensed feature

Automatic process that prevents bad data from coming into a DICOM Database

Auto-detects differences between the incoming data and the master patient data list

This will queue up a reconciliation event

REM

Example: A study with a missing accession number

Reconciliation Process Overview

37

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HL7 Interface Engine

Filtering of HL7 messages

Mapping the HL7 data

Sending on to AcuoSemantix

ORU to SR Conversions

Study Notification within the EMR

Intelligo Enterprise Manager



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AcuoStore and AcuoMed

• Section 4


AcuoStore Digital Asset Manager (Acuo Store)

Stores, tracks, and retrieves digital assets

Assigns a Globally Unique ID (GUID)

Identifies asset for future retrieval from storage

Direct relationship to storage

SAN/NAS/CAS

1 AcuoStore per VNA (changing in 6.0.3)

AcuoMed Image Manager (Acuo Med)

Accepts data off the wire

Point-to-Point or point-to-multipoint routing and retrieval

1 instance of AcuoMed per Application Server

Can have many instances of AcuoMed depending on size of sit

Lexmark VNA is made up of two symbiotic programs:


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Identifies specific asset for future retrieval

Connects your DICOM Database entries to

actual physical storage place of Images

through AcuoStore

GUID example

0xCED2E3A5903BC946B7F304C1D7FBD400

Globally Unique ID (GUID)


Access Codes:

Tony Student 1

Jasper Student 2

Edith Student 3

Joseph Student 4

Phil Student 5

Onnie Student 6

Sarah Student 7

Elizabeth Student 8

Melissa Student 9

Navigate to:

https://lexmark.instructorled.training

Chrome/Firefox work best

Click on the Lab tab

Click on little screen in middle: Connect

Login:

User: Administrator

Password: Training

Exercises:


https://lexmark.instructorled.training/

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Installation Exercises

• 1. Disable User Account Control

• 2. Confirm UAC is off in Registry

• 3. Configure Microsoft Distributed Transaction Coordinator

• 4. Install System Prerequisites

• 5. Install Host Server

• 6. Install AcuoStore Service

• 7. Install AcuoMed Service


GUI overlay of SQL

Only one user can be logged in at any given

time (per server)

Acuo Technologies MMC

Full Version

Configuration Changes

Patient Management

Patient Management MMC

Limited

Patient Management

Snap Ins

Services

Microsoft Management Console (MMC)


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SCU Authorization

AE Title IP Address Port Number

Abstract Transfer Syntax

Post Fetching

Assign Routes

Routes

Duplicate Processing

DICOM Database Destination (MMC)

Retention Purge Policies

Storage Server Connection

DICOM Database in SQL

Application

Managed Share

CAS

Deep Level ArchiveStorage

Acuo VNA Building Blocks

Physical

Share

Enable Sharing

SecuritySAN/NAS

Image Cache

Ac

uo

Me

d

Call

ed

AE

Ac

uo

Sto

re

DIC

OM

Data

base

Image Cache

Usually SAN or NAS storage

Archive Devices

CAS – Content Addressable Storage

Tier System

Store digital assets based on when they were

generated or last accessed

Tiered image access approach:

ONLINE – Image Cache

NEARLINE – Image Cache/Archive

OFFLINE – Archive

Acuo Store: Digital Image Storage


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Creates a database in SQL from the

MMC

Contains information related to the

bulk storage of digital images

Managed Share configuration

Application configuration

One AcuoStore Database can be

shared among multiple AcuoMed

Servers

AcuoStore Database


Physical Shares

Faster retrieval than Archive Device

Typically NAS Storage

Accessed by all Application Servers

Image Cache


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Attaches at the Application level in the VNA

Archive Device Type

Bycast

Dell Cloud

Dell DX

EMC Atmos

EMC Centera

FileStore

Hitachi

Microsoft Azure

Scality

Advanced Options

AcuoStore: Archive Devices



Enable Sharing

SecuritySAN/NAS

Image Cache

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• Data only available on Local Cache

• The writer has not written this file to the

connected archive device

• Asset Location indicates the status of the

image file

AcuoStore: Online Images


Image file in a “NEARLINE” state

Written to connected archive device

Not deleted from cache.

File present in both locations

AcuoStore: Nearline Images


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• Image file in an “OFFLINE” state

• Written to the connected archive device

• Deleted/purged from cache

AcuoStore: Offline Images


Where the actual images are stored

Image Share folders can be created on any

drive or storage device accessible by the

server hosting AcuoStore

Sharing

Authenticated Users

Security

Acuo Users

Acuo Groups

Physical Image Shares – Image Cache


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Acuo Users

Acuo Service User

Acuo Groups

Acuo Administrators

Acuo Power Users

Acuo Users

Security


• A defined User

• Only User with launch permissions for

• AcuoMed, Acuo Audits, AcuoStore services, etc.

• The password never expires

• All installations must have the same password

Local User: Acuo Service User


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Access full configuration

Configuration changes

Add Destinations

Update Routes

Patient Management

Edit

Merge

Delete

Local Groups: Acuo Administrators


Denied full access to Configuration

Patient Management

Edit

Merge

Delete

View Reconciliation Event Manager

Reconcile images

Local Groups: Acuo Power Users


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Acuo Users

Read Only

Patient Management

Query

Retrieve

Local Group: Acuo User


Configuration Exercises

• 8. Prior to VNA Configuration

• 9. Install AcuoStore Database

• 10. Create Physical Image Share Folders

• 11. Configure Sharing and Security for each Folder


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AcuoStore

Two primary configurable

components

Managed Shares

Applications

Client Application

AcuoMed

Makes contact with AcuoStore

through the Application

AcuoStore Architecture


SCU Authorization



Post Fetching

Assign Routes

Routes






Application

Managed Share

CAS


• Logical mapping to a physical storage space

• Pointer to your Physical Share

• 1 Managed Share can only point 1 Physical Share


Physical

Share

Enable Sharing

SecuritySAN/NAS

Image Cache

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General

Name

Online Storage

Offline Storage

Network Share

Server Name

Share

Managed Share Properties – General/Network Share


SCU Authorization



Post Fetching

Assign Routes

Routes






Application

Managed Share

CAS



Physical

Share

Enable Sharing

SecuritySAN/NAS

Image Cache

Ac

uo

Sto

re

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Name

Archive Device Application Support

File Parameters

Application Type

High Availability Type

Application Properties - Main


Available Managed Shares

List of available Managed Shares

Allocated Managed Shares

Able to query images

Active Managed Shares

Only one Managed Share can be active at a

time

Data will only write to the Active Managed Share

Application Properties – Managed Shares


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Applications point to both:

Archive Device

Managed Shares

1 Application can point to many Managed Shares

allowing for great flexibility when adding storage

space

Active Managed Share

Can only have 1 Active Managed Share

The Active Managed Share is the only Managed

Share that can be written to

All incoming images are only written to the Active

Managed Share

Allocated Managed

Can have many Allocated Managed Shares – these

are queryable

Applications


Start

Stop

Disable

Enable

Services Snap-IN


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Start Services in the following order:

AcuoStore

AcuoMed

AcuoAudit

If applicable, start the follow services in order:

Acuo Tier Manager*

Acuo Semantix*

AcuoHA Publisher/Subscriber*

AcuoWADO*

AcuoWorkflow Services*

Acuo Patient Management REST Service*

AcuoStore Web Services*

XDS Registry*

XDS Repository*

XDS Accelerator*

XDS Information*

Stop Services in the following order:

AcuoAudit

AcuoSemantix

AcuoMed

AcuoStore

If applicable, stop these services after top four:

XDS Information*

XDS Accelerator*

XDS Repository*

XDS Registry*

AcuoStore Web Services*

Acuo Patient Management REST Service*

AcuoWorkflow Services*

AcuoWADO*

AcuoHA*

Start/Stop Services Order



• 12. Create and Configure Managed Shares

• 13. Create and Configure Applications

• 14. Start AcuoStore Services


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Database – a collection of information that

is organized so that it can easily be

accessed, managed, and updated.

AcuoStore Database – Stores AcuoStore

configurations

AcuoMed IHE Audit Database – Audit

Logs

Created upon installation of AcuoMed

AcuoMed Database – Stores AcuoMed

configurations

DICOM Database(s) – Stores pointers to

patient data

Databases within the VNA


An incoming C-Store first stops in the DILIB before routing to the intended

destination(s)

DILIB Application is responsible for writing data to the Managed Shares

DILIB acts as a holding place for images until they are able to be processed

This makes routing to multiple destination points possible

Also, allows for checks like Study UID conflicts, Exact Name mismatches, etc...

Images that are unable to make it to their intended destination(s) either through

error or availability will be “stuck” in the DILIB until the error is corrected or the

destination comes back online

Storage

Recommend the DILIB Managed Share be located on highly available and locally attached disk

DICOM Library (DILIB) Connection


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DILIB or DICOM Library


Image C-Store

VNA

DICOM Library Storage

(DILIB)

1. John Smith

2. John Doe

3. Mary Thomas

4. …

Route 1

Route 2

Route 3

Radiology

Cardiology

Hospital A

Hospital B

Image Cache Storage

Each Server/Instance

of AcuoMed will have

their own DILIB



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Required Parameters

Enable CRC Validation

Cyclic Redundancy Check-ON by default

Server Name

Server where AcuoStore application resides

Application Name

Identifies the application to connect to dilib

temporary repository



AcuoMed features packaged

individually

Allows customers to get only the

features that they need

Feature validation controls:

Storage size or study limits

Routes/IPs/Tag Rules/DICOM

Databases

Reconciliation

Compression/Encryption

HIS/RIS Connectivity

ADAM

Federation

Feature Key Validation


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• 15. Install AcuoMed Database

• 16. Configure AcuoStore Dilib Connection

• 17. Enter Feature Key


Server/Instance

SQL Login

Database Name

DB Login

Password

Database Directories

Database

Log

Creating a DICOM Database in SQL through the MMC


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MMC overlay for SQL Database you just

created

DICOM Database Destination Name

Name used within MMC – can be anything

Information that must match to SQL Database:

Server/Instance

Database Name

DB Login

Password

Test Connection

Tests connection to the SQL database

Creating a DICOM Database Destination in MMC


SCU Authorization



Post Fetching

Assign Routes

Routes






Application

Managed Share

CAS



Physical

Share

Enable Sharing

SecuritySAN/NAS

Image Cache

Ac

uo

Sto

re

DIC

OM

Data

base

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DICOM Database Destination

Local (or within VNA) database that connects

directly to the SQL database we created when

we “Installed the DICOM Database”

External DICOM Device

Outside VNA – PACS, Workstation, Modality,

etc…

Can Query/Retrieve from systems outside of the

VNA

Destinations


Located locally, within the VNA

Where you attach the MMC to the SQL

database

GUI interface that will allow you to define how

incoming C-Stores will be handled and retained



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Name that will be listed within the VNA

SQL Server Instance

Database Name

Name given to database in the previous step

This will be the database name in SQL

Database Login

Login you defined in previous step

Database Password

Password you defined in previous step

Test

Test connection to the SQL Database

DICOM Database Properties – DICOM Database Connection


When an image is routed to this destination,

this tab defines where the image will actually

go to be stored

Server Name

Application Name

This the connection point between AcuoStore

and AcuoMed

Application points to a Managed Share that

points to a physical share or folder

The physical share is where the actual

images will be stored

AcuoStore returns a GUID to AcuoMed DICOM

Database for future asset retrieval

Able to test connection to Application

DICOM Database Properties – Storage Server Connections


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Always keep higher quality asset

Always keep lossless compressed over full

fidelity

Duplicate Options

First

Last

Lockdown

Keep All Assets

Acuo Duplicate Deletion Log

ACUO_Duplicate_Deletion_Audit.LOG

Program Files\Acuo

Technologies\AcuoMed\AuditLogs

DICOM Database Properties – DICOM Database Duplicates


System Behavior of Last:

Not intended to be a comprehensive list – each site will have their own recommendations that will be

addressed by an Implementation Engineer.

All use cases below assume the DICOM UIDs are the same as the previous study stored and

compression has not changed.

DICOM Database Duplicates – Options - Last


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Current Statistics

Database Type

Permanent

Temporal

Reconciliation

Master/Permanent (Reconciled C-Stores Only)

Fix-it Propagation Route

IOCM Propagation Routes

Soundex / Match Failure Action

Batch Study Completion Detection

Ensure all images for a study have been

received

DICOM Database Properties – DICOM Database Settings


Batch Store Queue Options

Max / Min Jobs

Compression

Allows you to define compression on inbound

data being stored to this specific database

Tuning Parameters

Allows you to pre-allocate a number of database

connections for improved performance

Usually configured by Implementation Engineer

DICOM Database Properties – Options


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Criteria that can be set:

Patient Birth Data

Study Date

Insert Date

Patient Time of Death

Institution Name

Modality

Custom Policy Criteria

Can be assigned to a single or multiple

databases

Deletes performed are not Propagated

DICOM Database Properties – Retention/Purge Policies


New Policy

Name

Type

Scope

Standard Policy Criteria

Modality

SQL Query

NEW IN 6.0.3

Define ILM to Delete to Recycle Bin

Define ILM to Compress Images and send to an

‘ILM’ database specifically configured to archive

these images

Retention/Purge Policies Properties


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Routes, just simply, point to

Destinations

DICOM Databases within the VNA

External DICOM Devices outside of the

VNA

Routes can be configured to point to

any number of destinations both within

and outside of the VNA

Moves data in the following

relationships:

One destination to one destination

One destination to many destinations

Many destinations to one destination

Many destinations to many destinations

Routes


SCU Authorization



Post Fetching

Assign Routes

Routes






Application

Managed Share

CAS



Physical

Share

Enable Sharing

SecuritySAN/NAS

Image Cache

Ac

uo

Sto

re

DIC

OM

Data

base

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Route Types

Basic

Reconciliation

Propagation

Stat

Auto Change Dest

Storage Destinations

Move Options

Find Options

General Options

Federation Options

Routes Properties – Route Definition


Where you can attach one-to-many

destinations located within the VNA

Available Destinations

All unselected local DICOM Database

Destinations

Current Destinations

The route points to these specific local

destination(s)

Routes Properties – DICOM Database Destinations


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Where you can attach one-to-many

destinations located outside of the VNA

Available Destinations

All unselected External DICOM Device

Destinations

Current Destinations

The route points to these specific External

destination(s)

Routes Properties – External DICOM Device Destinations


Relevant Priors

Prefetch - HL7 ORMs messages only

Postfetch - Incoming C-Store

Relevancy Filtering

Filter studies moved when pre-fetching or post-

fetching

Accomplished by selecting only those studies

matching the selection criteria. Most relevant:

Body Part

Study Description

Synonym File

Modality

Unconstrained

• Limit studies found to certain amount with/without

additional filtering options

Routes Properties – Relevant Priors


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Move Discovery Options Tab

Most of these settings originated from data

migration

Query External Devices for specific tags

Modify how to issue C-Find requests to

include/exclude tags criteria

Changes ONLY apply to C-Finds issued to

External Devices

Routes Properties – Move Discovery Options


Storage Destination Filtering

Allows an inbound C-Store to be dynamically

sent to a subset of destinations based on the

presence of certain tag data

Configuration

Enable in the Called AE and defining the DICOM

tag used for filtering

Configure all filters and assigned destinations for

each filter inside the Properties of an existing

Route

Routes Properties – Storage Destination Filters


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Right-click in Right-hand Pane

C-Store Batch Process Settings

Expedited

Run Time

C-Find Request Content

Enforce Hierarchical Search

C-Find Response Handling

Treat Instance Available Nearline Response as

Online

Treat Instance Availability Offline Response as

Online

Routes Properties – DICOM Command Options



• 18. Install AcuoMed DICOM Database

• 19. Create Destination for Local DICOM Database

• 20. Start AcuoMed Services

• 21. Test Configuration of the Local Destination

• 22. Create a Route to Local DICOM Database


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SCU Authorization



Post Fetching

Assign Routes

Routes






Application

Managed Share

CAS



Physical

Share

Enable Sharing

SecuritySAN/NAS

Image Cache

Ac

uo

Me

d

Call

ed

AE

Ac

uo

Sto

re

DIC

OM

Data

base

Configure the Service Class Provider

Where outside systems will send images to be

stored into VNA

DICOM default Port 104

Configurable

IP Address

Static

AcuoMed to listen on specific IP/port

Any IP Address

AcuoMed to listen on all network cards

TLS Settings

Tuning Parameters

DICOM SCP


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AE Title/Name (Case sensitive)

Collaborative Routing

Default route – all incoming data will be sent

along this route

Tag Rule Routing

Route images based on DICOM Tags

Example: Institution Name, Referring

Provider, etc…

If using tag rule routing a Tag Failure Route

must be defined

Stat Route

Used to bypass the reconciliation process

Storage Destination Filtering

SCP Called AE Properties - Main


Define incoming Abstract and Transfer Syntax

Abstract Syntax – SOP Class

Transfer Syntax – How the data in encoded

Full Fidelity

Compressed

Able to change negotiation priority on Transfer

Syntax

Storage Commit

Proprietary SOP Classes

Usually 1.3…

Can be added if needed

SCP Called AE Properties – SOP Configuration


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Promiscuous vs. Non-promiscuous

Allows the VNA (SCP) to define which

systems (SCUs) can send images to a

specific Called AE

Added security

SCP Called AE Properties – External SCU Authorization


C-Move Response

C-Find Response

C-Store Response

Enable Batch Router for quicker Response

Trust IPID in received C-Store Requests

Routing

Encryption Options

Custom Tag Mapper

Name Normalization

SCP Called AE Properties - Options


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Reconciliation enabled

HIS/RIS Connection

HIS/RIS Events

Database Instance

Local

Another Instance

SCP Called AE Properties - Reconciliation


Enable Postfetch

Triggered by incoming C-stores

Batch Move Information

Job start delay

Priority

Batch Move job study description field

Only applies to configuration where Body Part

Filtering is enabled in the source route

Routing Details

Source Route

Destination AE

Move Criteria

xx Months back through xx Months back

SCP Called AE Properties – Postfetch Properties


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Issuer of Patient ID

Issuer of Accession

Allow Patient IDs from Other Domains to

Store to the DB

Enforce Patient Identity Mapping

Use Current PID value when no mapping is

provided

No Patient Identity Mapping (always use current

PID value)

SCP Called AE Properties - Domain



• 23. Configure DICOM SCP

• 24. Configure DICOM SCP Called AE Name

• 25. Create a Default External Calling AE Name


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SCP Destination Name

In this case, the VNA is the SCU and this

DICOM Device will be the SCP

External Device DICOM Parameters

AE Name/Title

IP Address/Host Name

Port #

AcuoMed

Define our Calling AE name

TLS Settings

Connection Testing

C-Echo to External DICOM Device

External DICOM Device Properties - Main


Define outgoing Abstract and Transfer Syntax

Abstract Syntax – SOP Class

Transfer Syntax – How the data in encoded

Full Fidelity

Compressed

Able to change negotiation priority on Transfer

Syntax

External DICOM Device Properties – SOP Configurations


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Batch Store Processing

Encryption

C-Store, Retry Once on Error???

Strip Private Tags

Devices that don’t support Private Tags

Tag Mapper

Browse to command file for Tag Mapper

instance

Normalization

If disabled, data will be transmitted how it was

stored

External DICOM Device Properties - Options



Issuer of Accession

Allow Patient IDs from Other Domains to

Store to the DB

Enforce Patient Identity Mapping

Use Current PID value when no mapping is

provided

No Patient Identity Mapping (always use current

PID value)

External DICOM Device Properties -


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Route View allows you to Query /

Retrieve from one-to-many

destinations that are attached to a

route

To add a Route View expand Patient

Management and right-click Route

View Management and choose the

specific route to query

Route View Management


Same as DICOM Database Properties within

Patient Management Node

Search Options

Response Limit

Batch Move Settings

Default Source Route

Default Destination AE

Route View Management Properties


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Required to move a copy of a requested

image from a Local DICOM Database within

VNA to one, or many, external destinations

Tells the VNA where to send the images

Configured by associating a Move Request

AE Name to a Route Name with the

associated destinations

Define

Destination AE Name

Route

Move/Route Mapping


Configuration Exercises• 26. Create External Destination

• 27. Create Route to Connect External Device

• 28. Create a Route View pointing to the External DICOM Device’s Route

• 29. Create a Move Route Map

• 30. Open Activity Log

• 31. Move Images from Instructor Database

• 32. Verify Images Queued in the Batch Move and Batch Store Managers

• 33. Verify Images are now located in your Local DICOM Database


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Review Exercises

• 34. Create a second External DICOM Device and “Push”

Images to it


Batch Store Manager MMC


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Provides means for administrators or

users to monitor the status of C-Stores

coming into and being retrieved from the

VNA

Each Batch Store job = 1 image

CT and MRI studies can be large

Batch Store Manager


Show Completed/Cancelled Jobs

View the last __ hours of data

0 = all available data

Batch Store Manager Properties


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Reroute store requests from one destination to another destination

Can be changed for the Destination node, Patient node, and Job node

Jobs must be in Paused or On Hold to rerun to the new destination

Completed jobs are not rerun to the new destination

To manually change a batch store destination

Right-click a destination, patient, or job under Batch Store Manager

Select Change Destination

New Route to view other destinations

Manually Changing Batch Store Destination


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Stops or Starts processing of all jobs to both

local DICOM databases and External Devices

Turning Batch Store Manager Off does not

stop incoming data from be received and

queued, it only stops it from being processed

When turning off, jobs currently in a running

state will complete

Turning Off/On the Batch Store Queue


Cancel a job

Right-click the job in the jobs summary list and select Cancel

If the job is not already paused, pause the job and use the cancel function

You can also Cancel all Paused Jobs from a destination node

Force Cancellation

Right-click the job in jobs summary > All Tasks > Force a Cancel. Ignore Errors.

Can be done at the job level and patient level

Canceling a Batch Store Job


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Expedite a Batch Store job

Right-click on destination, patient, or job level and select Expedite Job(s)

Pause/Resume jobs

Right-click on destination, patient, or job level and select

Remove Completed jobs

Hold Paused jobs

Resume On Hold jobs

Other Batch Store Manager Controls


Maximum Number of Running Jobs

Number of Days To Keep Completed Jobs on

Queue

Association Timeout for Multiple Stores per

Association

Setting Properties for Batch Store Manager


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Batch Store Processing

Multiple Stores per Association

One Store per Association

Group By Study UID

Default

Some devices this may not be the best

choice, but it is the best overall combination

of interoperability and performance

Group By Series UID

External DICOM Device - Options


Batch Store Manager GUI

• Demo


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Batch Mode v. Direct Mode


Route Configuration

Batch Modes

Low

Medium

High

Expedited

Direct Mode

Bypasses Batch queues

Batch Mode Priorities


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Direct Mode

Any implementation where a non-Acuo system performs a Query/Retrieve from Acuo

Batch Mode

When Acuo acts as a router (data simply passes through)

When configuring Routes, the general recommendation is to NOT mix Batch mode

and Direct mode devices. The route should have either all Batch mode or all

Direct mode.

General Recommendations


Batch Move Manager


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Provides means for administrators

or users to monitor the status of C-

Moves coming into and being

retrieved from the VNA

Each Batch Move job = 1 study

Batch Move jobs are created by:

Manual moves from Patient

Management

Integrated with the HIS/RIS for auto-

Prefetching

Migrations

Batch Move Manager


Right-click Batch Move Manager

New Batch Move Request

Source – Route Name

• The Route pointing to the Destination where the

image resides

Destination

• The Move/Route Map where you want the image

to go

Job Settings

• Priority and Scheduled time to run the C-Move

Move Criteria

Select OK

Scheduling a Batch Move request from Batch Move Manager


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Moves can be performed at the:

Patient

Study

Series

Image

Create a Batch Move Request

Populates Batch Move Manager

Set Source – Route Name

Set Destination – AE Name

Schedule Priority

Moves generated from Patient Management or Route View


Batch Move Manager job properties

View property data

Make changes to how job is handled

Priority

Run time

Cancel a Batch Move Job

Right-click job and select Cancel from the menu

Reschedule Batch Move Job

View and Update Batch Move Manager Job properties


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If an Inbound C-Move is received from an External SCU, a job is logged in the

Batch Move Manager with a Priority = Direct

Generally means the C-Move will be processed immediately

As opposed to Batch Moves created in Patient Management that are processed in Batch

Mode

The Patient Name and ID may indicate “None”

The following notable tags are present on an Inbound C-Move

Called AE Title – This tag will match one of the Called AE nodes configured within AcuoMed

Move Destination – This tag must match one of the Move/Route Mapping nodes configured

within AcuoMed that defines where the images are to be sent.

This Route is configured to send in either Direct Mode or Batch Mode, which determines how

the C-Stores are treated when sending outbound

Inbound C-Moves From External SCU (Query/Retrieve)


Maximum Number of Running Moves

Number of Days to Keep Completed Jobs on

Queue

Defining the Properties for Batch Move Manager


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Maximum number of running jobs to be

dynamically adjusted based on day or time

Batch Move Time Periods


Batch Move Manager GUI

• Demo


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Batch Router Manager


Images coming into the VNA must first be

stored in the DICOM Library (DILIB) before

being routed to their destinations

DILIB acts as a holding place for images until

they are able to be processed

The DILIB Application writes to the DILIB

Managed Share and from there the DILIB

subsystem moves the images to the AcuoMed

Router for further processing

Manages jobs in the queue

Reduces AcuoMed’s response time to a

DICOM C-Store



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Enable Batch Router queue

Cancel a Batch Router job

Expedite a Batch Router job

Batch Router configuration restrictions

Cannot save a Called AE name with a route that

contains a device that is Direct mode

Cannot be enabled on a Called AE where

reconciliation is enabled

Fixits bypass Batch Router queue

Other Batch Router Manager jobs

Pause/Resume/Remove Completed




How many batch router jobs can be running at

one time

Number of Days to Keep Completed Jobs in

Queue

Number of Idle Seconds Before Group

Completes

Number of seconds the queue is idle before the

next group starts

Batch Router Manager Properties


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Patient Management within MMC


Wildcards

* searches for a group characters, J* Smith (John, James, etc..)

_ searches for any single character, 25_0 (2510, 2520, etc..)

Not all devices support wildcard searches

View Patient data/metadata

Search via multiple modalities

Example: MR\CT\NM

Query for Patient within local DICOM Database


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Edit can be performed:

Patient

Study

Series

Image

Cannot edit Patient ID

Merge to fix

Edit Patient Data within local DICOM Database


Merges can be performed at each level within Patient View:

Patient to Patient Merge - merges a source patient into a destination patient.

Study to Patient Merge – merges a source patient study into a destination patient.

Series to Study Merge – merges a source series into a destination study.

Image to Series Merge - merges a source image into a destination series.

Editing Patient ID with Merge function

Only way to Edit Patient ID

Merge Patient Data within local DICOM Database


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Moves can be performed at the:

Patient

Study

Series

Image

Create a Batch Move Request

Populates Batch Move Manager

Set Source – Route Name

Set Destination – AE Name

Schedule Priority

Move Patient Data from a local DICOM Database


Deletes can be performed at:

Patient

Study

Series

Image

Deleted assets are placed in the Recycle Bin

Delete Selected

Allows you to select multiple objects for deletion

Can select any combination of patients, studies,

series, or images

Deletion and propagation

Delete Patient Data from a local DICOM Database


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Append Search Items with a *

Search View Defaults

Study View

Patient View

Allow Deletion of Multiple Items when in

Patient View

Patient Management Properties


Search Response Limit

Default 5000

Display Limit Exceeded Warnings

Batch Move Settings

Default Source Route

Default Destination AE

Move/Route Map

Patient Management DICOM Database Properties


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Patient Management within GUI

• Demo


Propagation Routes


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Propagation Route

Route Definition

External Acuo DB

destinations

Maintain data integrity

Propagation Route


The Batch Patient Update Manager

Tracks edits sent on propagation route

DB where edits are being made are immediate

To other DBs and Ext Devices can be monitored

from Batch Patient Update Manager

Propagation Route


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Image Object Change Management (IOCM)


IHE framework for keeping disparate DICOM systems images in sync

Change Management between Acuo and Non-acuo systems

Use Cases

IOCM Outbound – sending IOCM requests based on Acuo Purge/Retention policies keeping the

PACS in sync with the VNA

IOCM Inbound – processing IOCM requests from PACS/local image manager sources

Subset of Fix-It processing

Deletes are propagated throughout the network

Changes to patient data are applied by source, and resent into the VNA

Generates new UIDs for all levels of the image



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Deletion sources from VNA

Patient Management Deletes

“Rejected for Patient Safety Reasons”

HL7 Deletes

“Rejected for Patient Safety Reasons”

Retention/Purge Deletes

“Data Retention Policy Expired”

If all images are deleted for a Patient/Study/Series there will STILL be Patient

records with the corresponding IOCM Key Object(s)((KO)).

Provides history of deleted images

Little strange, since we are accustomed to seeing the Patient/Study/Series delete when the final

image is deleted



Attaches in DICOM Database Settings

Built the same as a Propagation route, just

attached on the IOCM dropdown

Vendors that support IOCM:

Fuji Synapse v. 4.3.220

AGFA Impax 6.6

EI8

Carestream (2017)

Image Object Change Management (IOCM) Configuration


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Batch Update Manager


Controls processing of jobs for Data Synchronization Events

Batch Patient Update Manager


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Properties

Job Properties

User Notes

Other Functionality

Pause/Resume

Batch Patient Update Manager job Properties


Patient Management Exercises• 35. Create a Propagation Route

• 36. Attach Propagation Route to Local Database

• 37. Edit Patient Name

• 38. Review Edit in Batch Patient Update Manager

• 39. View Update to Patient Record

• 40. Merge Patient with Patient

• 41. Review Merge in Batch Update Manager

• 42. Merge Study with Patient


• 44. Edit Patient ID with a Merge


• 46. View DICOM Dump


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IHE Audit Log Manager & Recycle Bin


Establish measures to ensure

Patient Information Confidentiality

Data Integrity

User Accountability

Installed with AcuoMed

If AcuoAudit is not running in Services, you

are not auditing anything.

IHE Audit Log Manager


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IHE Audit Log Configuration

Keep User Access Audits (6.0.2)

Keep Recycle Bin Images

Keep Acuo Audits

Keep IHE Audits

Audit Log Configuration Grid

By default will always audit Updates and Deletes

IHE Audit Log Configuration

Can configure export



IHE Audit Search

Search all criteria available by clicking the Check All

OR by filtering out the data by checking on specific criteria to be displayed in the GUI



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Images Placed in Recycle Bin

Deleted from Patient Management

Deleted from the Reconciliation Event Manager

Cancelled from Batch Store

Deleted via HL7 delete functionality on DICOM

Database and Publisher DICOM Database

Deleted via Fixit delete functionality on DICOM

Database and Publisher DICOM Database



Images Not Retained

Deleted via Retention/Purge Policies (pruner)

Deleted automatically via Duplicates Processing

Removed from the REM/Reconciliation

Database during normal reconciliation

processing

Received inbound that are not rejected or not

accepted

Deleted via HL7\Fixit delete functionality on

Subscriber DICOM Database



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Audit/Recycle Bin Configuration

Keep Recycle Bin Images

Settings

Auto Purge

Manage Manually

Deletion Verification Required



Audits in Patient Management

Local database queries

Expand of PT/ST/SE/IMG levels

Select of Study Record

Right-click: edit/merge/delete/view

Audits in Route View

Search/Select of Study Record

Move PT/ST/SE requests

Expand ST


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Expand AcuoMed Image Manager and click

IHE Audit/Recycle Bin Manager

Launches a new window

Acuo Audit/Recycle Bin Search tab

Type in a patient identifier

Under Event Types, select Delete Asset -

Search

If all images within the study must be restored,

right click the list of images and select Select

All Images

In the Restore Images window, confirm the

Server, Port, and AE Name are correct

Click Start

Restoring an Image from the Recycle Bin


Patient Management Exercises

• 47. Recycle Bin

• 48. Deleting Multiple Patients

• 49. Patient Management MMC

• 50. Modifying Patient Management MMC


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Review Exercises

• 51. Create New Physical Share on C:

• 52. Create Managed Share in AcuoStore

• 53. Create Application in AcuoStore

• 54. Install DICOM Database in AcuoMed/SQL

• 55. Create a New AcuoMed DICOM Database Destination in AcuoMed

• 56. Create a Route to Connect to the new Local DICOM Database


Tag Rule Routing


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Tag Rule Routing

Customizable DICOM tags and Tag Values to

match site’s needs

Can create tag rule definitions to control image

sources and routing to destinations

AcuoMed preset with a number of DICOM

tags that will be useful for most of your tag

building needs

Can be very simple to complex rules

Tag Rule Routing


Tag Rule dialog

Select a Tag

Select an operator (if needed)

Select a tag value from the Values list

Tag Rule Routing – Properties


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Can create Customized Tags

Create Tag Rules based on these tags

Provide high level of control over routing

Tag Rule Routing – Tag Customization


Tag Rule Route Mapping

Configure Called AE(s)

Configure Routes

If Tag Rule met, route to destination as

configured on the route

Tag Rule Routing – Assign Source & Dest


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Called AE

Default Route Name

Tag Rules

Tag Failure Route

Tag Rule Routing – Assign to Called AE


Tag Rule Routing Exercise

• 57. Tag Rule Routing


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Federated Routes / Federation


Expands AcuoMed functionality by allowing an AcuoMed Server to perform Find

and Move operations with local databases and external devices and to return a

consolidated result to the requesting system

Federation


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Federated Route

Federation


Federation Route

View where images returned came from, need to look at the traces.

Federation


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Federation Exercise

• 58. Edit Patient Name

• 59. Create a Route pointing to the Local DICOM Destination and External

DICOM Destination

• 60. Create Route View pointing to the Local and External DICOM Databases


Pre/Postfetching


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Uses HIS/RIS patient/study events to move

relevant prior images to destinations where

patient/study events are scheduled

MWL

HL7 ORM message

These events Queue up Batch Move jobs that

move prior studies from Source Destinations

(Archive Device, Legacy PACS, etc..) to Move

Routes that are connected with a Called AE

From the Called AE, Routes can be set up for

1-to-many Prefetch destinations

Prefetching


Prefetch Configuration

Station AE Title

Schedule Prefetch Jobs __ Days Prior to

Scheduled Event

Batch Queue Information

Routing Information

Source Route Name

Move Destination AE Title

Move Criteria

From 3 years to schedule procedure’s start date

HIS/RIS Connection: Prefetch Properties


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Triggered in the Called AE by incoming C-Store

Same functionality as Prefetching only it’s not completed prior to the scheduled study

Incoming C-Store initiates a Batch Move job from Source Destinations (Archive

Device, Legacy PACS, etc..) to Move Routes that are connected with a Called AE

From the Called AE, Routes can be set up for 1-to-many Prefetch destinations

The Postfetch job can be delayed for a period of time to allow the processing of

the inbound C-Store to complete.

Postfetching


Batch Move Information

Job start delay

Priority

Batch Move job study description field

Only applies to configuration where Body Part

Filtering is enabled in the source route

Routing Details

Source Route

Destination AE

Move Criteria

xx Months back through xx Months back

SCP Called AE: Postfetch Properties


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Relevant Priors

Prefetch

Postfetch

Relevancy Filtering

Filter studies moved when pre-fetching or post-

fetching

Accomplished by selecting only those studies

matching the selection criteria. Most relevant:

Body Part

Study Description

Synonym File

Modality

Unconstrained

• Limit studies found to certain amount with/without

additional filtering options

AcuoMed Routes – Relevant Priors


Relevancy Filtering Process

1. Sort all studies found during the source route discovery by Study Date, newest to oldest

2. Select all studies that meet the body part criteria up to the configured limit

3. Select all studies, not already selected, that meet the modality criteria up to the configured limit

4. Select all other studies, not already selected, up to the configured limit

Synonym File

Consists of a list or multiple lists of words that can be used as criteria when filtering prior studies

through Prefetch or Postfetch by Body Part/Study Description

When a synonym file is attached to the source route, any words identified in the list are used as

criteria for selecting relevant prior studies.

AcuoMed Routes – Relevant Priors


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199

Soundex Functionality


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Located on your DICOM Database

Destination

Phonetic algorithm for indexing names by sound

Example: “Johnson” and “Johnsen”

Exact Match

Default – Soundex disabled

Anything other than an exact match will trigger

Match Failure Action

Match Failure Action

Create a new Patient Folder

Reject the C-Store

Soundex Feature


Soundex Exact Match Example


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Soundex Soundex Example


When Create a new Patient Folder is enabled, any match failures are accepted and a New

Patient Folder is created with the same Patient ID

Match Action Failure – Create a new Patient Folder


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Name Normalization


Inbound C-Stores

Maintain image files with DICOM Patient Name

Complex formatting

On by default

Outbound C-Stores

Allow formatting of the Patient Name Complex

Off by default

DICOM Patient Name Complex Format

Last^First^Middle^Prefix^Suffix

Capitalization Settings

Truncate Text After *

Strip Trailing Delimiters

Name Normalization - Global


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• External DICOM Device

• Can override the Global settings

• Called AE

• Can override the Global settings

Normalization: Override Global Settings


Reconciliation

• Reconciliation Workflow

• Reconciliation Event Manager (REM)

• Reconciliation Route

• State Route

• Reconciliation Tag Rules


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Purpose of Reconciliation

Correct data before it reaches the

DICOM Database

Reconciliation Target

HIS/RIS

HL7 Feed

DMWL Broker Feed

Reconciliation Database

Uses DILIB temp directory

One Reconciliation Database per

AcuoMed server

Reconciliation


Located under Patient Management Node

Match all studies that fail reconciliation

with RIS events (orders) and commit

updates

Reconciliation Event Manager (REM)


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Route pointing Reconciliation Database

Reconciliation Route


Batch Reprocessing Manager


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• Part of Reconciliation functionality

• Controls queuing of jobs for reconciled

messages

Batch Reprocessing Manager


Properties

Job Properties

C-Store Reprocessing Request Info

User notes

Other Functionality

Pause/Resume

Expedite Jobs

Remove Completed Jobs

Batch Reprocessing Properties and Other Functionality


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Number of Days to Keep Completed Jobs on

Queue

Define Properties for Batch Reprocessing Manager


Reconciliation Exercises

• 61. Configure HIS/RIS Connection

• 62. Tag Rule Routing settings must be reconfigured

• 63. Reconfigure Called AE

• 64. Install and Configure Reconciliation

• 65. Create Reconciliation Database

• 66. Create Destination

• 67. Create Route to Reconciliation Database

• 68. Configure Called AE Name for Reconciliation

• 69. Review Reconciliation Event Manager (REM)


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Stat Route / Reconciliation


To bypass the reconciliation feature – we

must create a “Stat Route”

Enabling a Stat Route will ensure that

images coming into a Called AE are also

routed to a specific External DICOM

Device (Destination)

Cannot be routed to Local Destinations

Emergency/Unknown patients

Stat Route


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Stat Routes, like Reconciliation are

configured on the Called AE

Can only have one Stat Route per

Called AE

May have several External Destinations

tied to the Route.

Stat Route


Reconciliation Exercises

• 70. Create a Stat Route


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External SCU Authorization


Allows you to define systems sending images into the

VNA

Optional but you may for these reasons

Added security

Base a tag rule to control routing

Demographics (optional)

Calling AE

Implementation UID

Version Name

TCP/IP Connectivity (required)

Host Name or IP Address



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Inbound to AcuoMed Server

Provide added level of security at the

Called AE for inbound C-Stores

ONLY authorized Ext SCUs will be to

access Called AE

Authorized SCUs are added in the

SCP Called AE

Unauthorized SCUs

Rejected on the association request



SCU Authorization Exercise

• 71. Turn Reconciliation OFF

• 72. Create an External SCU Authorization


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Storage Commit

• Storage Commit

• Batch Commit Manager


Workflow

DICOM Device sends a N-Action Request to

AcuoMed

Contains SOP instance UIDs that have been

sent in a prior C-Store Request

Lexmark VNA returns a N-Action Response

Acknowledges the receipt of the request

Lexmark VNA sends a N-Event Report on a

new association

Contains the SOP instance UIDs in the

original request along with the status of each

and an AE name where they can be retrieved

Storage Commitment

Confirm images delivered and stored

Transfer ownership of SOP instance to an

archive

Storage Commitment SOP Class

SCP Called AE

External DICOM Device and Route needs to be

configured with SOP for Storage Commitment

enabled

Success/Fail report can be sent to requestor

Storage Commit


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Configuration

Configure in Image Manager Server Properties –

Storage Commit

Configure SCP Called AE

Either on same AE/port as Image Storage or

different

Add External DICOM Device and Route to send

the Storage Commit report back to sender

Storage Commit Configuration


Batch Commit Manager


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Gives visibility to the Storage Commit system

Allows you to quickly analyze any jobs that

are in a retry state

Analyze the following:

Entire Storage Commit table

Called AE

Calling AE

Acuo Commit Viewer

Color coded rows





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Study Content Notification


Acuo will send an outbound HL7 message to the EMR indicating when a study image has populate

the VNA

Study Content Notification (HL7)


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Use Case Example: Study Content Notification


Use Case Example: Study Content Notification


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Custom TagMapper


Tag Morphing

Acuo’s feature to modify tag data on

INBOUND or OUTBOUND DICOM

messages

Executes while processing a DICOM

message

Enable for all DICOM commands

Instances

TagMapper


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TagMapper feature may be applied to any of the following when configuring

Global TagMapper ‐ Traditional TagMapper enabled via Registry – all inbound data is processed

Front‐end TagMapper ‐ Configured within a separate Called AE (inbound instance)

Back‐end TagMapper – Configured within a separate External SCU (outbound instance)

TagMapper Configuration


If Patient Name =

AndIf Patient ID =

AndIf Modality =

AndIf Study Date =

Then

Replace Accession # with this value

Tag Mapper – Example 1


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TagMapper - Example 2


TagMapper – Example 3


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Tag Morphing

Acuo’s feature to modify any DICOM tag data

on INBOUND or OUTBOUND images

Executes while processing a DICOM message

Enable for all DICOM commands

Custom Tag Mapper


Image Manager Server Properties


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Type

Stand Alone

Shared Resources

Shared Configuration

Primary Node Connectivity

SQL Server Database Instance

Primary AcuoMed Database Name

Database Connectivity Test

FHIR Server Connection

URL

Timeout / Error Retry Interval

Image Manager Server – Application Node Settings


Components not Shared:

Feature Validation

ADAM Manager

Batch Process Managers (All)

Trace Settings

Registry Options

Reconciliation Event Manager (REM)

Route View Management

IHE Audit/Recycle Bin Manager

Tag Mapper Command Files

Configuration Components that are Shared:

DICOM Databases

External DICOM Devices

Routes

SCPs (Ports)

Called AE Names

Tag Rules (Routing and Reconciliation)

External SCUs

Standard Dictionary

Move/Route Mapping

IPID Domain Configuration

XDS Management

Shared Configuration


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The following are general limitations (and/or assumptions) related to Shared Configuration.

There can be no local configuration resources present on a server that is part of the Server Farm.

For example, you cannot add a new SCP or AE that will only run on a single server.

Registry options need to be set on each individual server (or Farm Member).

GUI configurations that point to files (for example, Tag Mapper command files) are as they were

before (looked at locally).

Once a server creates/joins the farm, its name will forever appear in the Server Farm list of the

Application Node Settings Tab. Even if the server goes down, or is physically removed from the

Farm, its name will remain in the list.

An AcuoSemantix server cannot be part of the server farm, since it requires additional propagation

routes be configured for DICOM Databases.

Shared Configuration - Limitations and Assumptions


Configuration

Default External Calling AE Name

Delayed Image Update Processing

Fast Access Media

Medium Access Media

Slow Access Media

Time to backup metadata changes to disk

Enable / Number of copies to be kept

Tag Rules

Encryption

REM

Image Manager Server – Options


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Event Cache

Event Cache Timer

Flush Event Cache

Stop Tracing Triggers

Event IDs

Event Text

Image Manager Server – Event Logging


WADO enabled to utilize the “View Image”

option in Patient Management

Server Name

Port

Default is 9000

View an image in Patient Management

Select the Patient

Drill down to specific image

Right-click

Select “View Image”

Image Manager Server – Patient Management


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PIX Manager / Acuo eMPI


Patient ID or MRN assigned by a given

establishment, or domain

Same individual may have services in multiple

establishments, or domains

Assigned different Patient IDs or MRNs

Patient ID Management is needed for one

domain to seamlessly communicate with

another Domain

Patient ID Management interfaces with an

MPI to obtain Patient IDs or MRNs for other

domains

Patient Identity Management


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Add Domains inside the IPID Domain

Configuration node in the MMC

Domain Name


Issuing Authority

Image Manager Server – Adding IPID Domain


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IPID Domain Summary

Add

Called AEs

DICOM DBs

Ext DICOM Device



DICOM DB

HL7 Domain Names


Issuer of Accession

XDS

Called AE / Ext Device

HL7 Domain Names


Issuer of Accession

Patient Identity Management – Called AE, DICOM DB, Ext Device


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Patient Identity Management Type

None

Multiple Domains

Data Cache

MPI Type

PIX Access

DLL file

Configuration XML

Image Manager Server – Patient Identity Management Settings


Replication


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• DICOM Replication uses Batch

Store Jobs to replicate metadata and

physical image

• Needs a Propagation route between

datacenters

• GUID is different for each datacenter

DICOM Replication


Data Sources transmit to an optional load balancer (active/active or active/passive data center)

Acuo receives DICOM content, processes, and stores the data within a DICOM database

Full image data is replicated via DICOM transmission (C-Store) to the other locations/subscribers

The subscribers receive the C-Store and process exactly the same as the primary data center,

resulting in a replication data set and application environment at the subscriber location

NOTE: Requires writing of two copies of DICOM data, this will result in two transmissions of pixel

data (once within the application, and once within storage)

DICOM Replication


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Acuo is responsible for replicating

image metadata between

datacenters

No Propagation route needed

GUID does not change

The Publisher and Subscriber are

configured at the AcuoStore

application level.

Metadata Replication/High Availability


Data Sources transmit to an optional load balancer (active/active or active/passive data center)

Acuo receives DICOM content, processes, and stores the data within a DICOM database

Upon acknowledgement through AcuoStore from the Archive device a job gets queued to Acuo’s HA service

for replication

Acuo’s HA service replicates, via a publisher service, the meta-data only, no pixel data. Meta-data includes the

Clip ID returned from the Archive Device

The subscriber to Acuo’s HA service receive the meta-data and rebuild the database entries, allowing active

retrieval of content at the subscriber location

NOTE: Pixel data only moves within storage, meta-data only moves between Acuo Applications. A single

transmission of DICOM content generates a fully replicated environment within storage and application

servers

Metadata Replication


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Health Check (optional utility)

Cisco appliance (ACE or CSS)

Query tests system status

Fail TCP Port is closed

Queries will fail

Cisco redirects TCP connection to other servers

Health Checks


Sanity Test

Validates Port number and Called AE is

receiving DICOM associations

Used by Cisco

Fail notifies Cisco to redirect further connections

Configurable watermark on share space

Sanity Test


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Cross-Enterprise Document Sharing (XDS)


XDS

XDS, Cross-Enterprise Document Sharing, is a technical framework defined by IHE that

facilitates the registration, distribution and access across health enterprises of patient electronic

health records.

XDS provides a standards-based specification for managing the sharing of documents between

any healthcare enterprise.

Enterprises belong to one or more XDS Affinity Domains. An XDS Affinity Domain is a group of

healthcare enterprises that have agreed to work together using a common set of policies and

share a common infrastructure.

XDS-I

Cross-Enterprise Document Sharing for Imaging (XDS-I) extends XDS to share images,

diagnostic reports and related information across a group of care sites.

XDS for DICOM, specific to Imaging Documents.



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Acuo Document Repository

A document Repository is responsible for the storage of documents and responding to document

retrieval requests. This is the actual location of the document.

Acuo Document Registry

A document Registry is responsible for storing information (metadata) about the documents so

that the documents may be easily found, selected and retrieved from the repository.

Document Sources and Consumers

Document Sources submit documents for registration.

Document Consumers query/retrieve relevant documents.

XDS


1. Document Sources submit items to repository.

2. The Repository then registers the document’s metadata and pointer with the associated

Registry.

3. Document consumers search for documents with specific criteria.

4. The Document consumers then retrieve selected documents from the repository.

General XDS Workflow


Provide & Register

Document Set

Register

Document Set

Document Source Document

Repository

Document

Registry

Document Consumer

Retrieve Documents

Query Documents

Return Results

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XDS- Cross-Enterprise Document Sharing

Facilitates the registration, distribution and access of patient electronic health records across

healthcare enterprises

XDS provides a standards-based specification for managing the sharing of documents between

any healthcare enterprise



Hospital A

Hospital BHospital C

AcuoInsight - Video


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Web Access for DICOM Objects (WADO)


DICOM images can be viewed through Patient Management or a browser on the

web



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Patient Management

right-click ‘View Image’ option

JPEG or GIF

Via browser on the web

URL

JPEG or GIF format

DICOM Part 10



Local Users and Groups

Administrators Group

AcuoService User

AcuoService User must be in the

Administrator group for services to work.



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• AcuoMed Database Instance

• AcuoMed Database Name

• AcuoStore Node Name

• AcuoStore Application Name

• WADO Base Directory

• Max Image Cache (Days)

• Enable WADO Tracing



WADO Configuration

Add Standalone Snap-In for WADO

Configure WADO via MMC

WADO Security access



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Patient Management

View Image



WADO Exercise

• 73. Install and Configure WADO

• 74. Add AcuoService User to Administrator Group

• 75. Add WADO Snap-In to MMC

• 76. View Images using WADO


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Acuo DICOM Assisted Migration (ADAM)


Acuo DICOM Assisted Migration (ADAM)

DICOM tool used in conjunction with AcuoMed/AcuoStore to migrate DICOM Image data from a

Source DICOM Archive to a Destination DICOM Archive.

ADAM is typically run at the Study Level

Why migrate data

Consolidate image data to new PACS

Eliminates cost of maintaining legacy archive

Service Contracts Cost

Personnel efficiency

Cleansing meta-data

Based on RIS or Rules

ADAM


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AcuoMed and AcuoStore install required

Validate ADAM feature key is enabled

Migration Project – 4 Phases

Phase 1 - DISCOVERY

Phase 2 – EDIT

Phase 3 –SCHEDULE AND MOVES

Phase 4 – VERIFY

Final reconciliation of failed studies

ADAM: Overview


ADAM learns about the current archive,

gathers all of the meta-data for each patient,

including study level information for

scheduling and moving the data

Discovery Phase is also done on the new

archive in order to eliminate migrating data

that may already reside on the destination

archive

ADAM: Phase 1 – DISCOVERY


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Based upon the data found in the archive, a

schedule is established

Summary Report provided

Customer may examine the Summary Report

for entries they may not wish to migrate

During this Phase, the Customer will gain a

better understanding of the integrity of data

being moved

ADAM: Phase 2 – EDIT


Example Summary Report


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AcuoMed Batch Move queue is populated

Movement of the data begins

A move request is sent to the source archive

Automated and manual monitoring is available

during this phase

ADAM: Phase 3 – Schedule and Moves


After all Move jobs have completed will verify

studies on the source archive are now on the

destination archive

Final reconciliation of studies that failed

automatic migration

Provide detailed completion report – studies

identified, studies migrated, studies requiring

manual migration, duplicate study UID’s and

other unsuccessfully migrated studies

ADAM: Phase 4 – Verification


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Time to migrate is dependent on:

Network speed

Time of day

Device migrating from

Hardware of old archive

Other

ADAM


ADAM Migration Exercises

• 77. Configure and Run Discovery for Migration

• 78. Configure ADAM Route

• 79. Configure ADAM for Migration

• 80. Phase I – Query

• 81. Phase II – Edit Mode

• 82. Begin Phase II – Create Batch Move Jobs for Migration

• 83. Phase III - Complete


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Upgrade Process


Acuo Release Notes

New Features

Issues Resolved

Upgrade/Install steps

Release Number Schema AA.BB.CC.DD HFXX PXX (e.g. 6.0.1.86 HF1 P4)

Major Release = 6

Minor release = 0

Service Pack = 1

Build Number = 86

HF = Hotfix (represented by the build number)

P = Patch (may represent the build number)

Upgrade Process


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New features

Existing problems fixed

Installation Procedure

Uninstall existing version

Products re-installed

Major Release Numbering Scheme

5.0 to 6.0 is considered a major release upgrade

Upgrade Process – Major Release


Some new features

Existing problems fixed

Database schema changes classified and released as a minor release

Minor Release Numbering Scheme & Reference:

5.2.1 to 5.3.0 considered a “minor” release upgrade


Uninstall of existing version

Products are re-installed

Upgrade Process – Minor Release


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Combination of designated new features and problems.

Include problems where a Hotfix is not immediately needed


Uninstall of existing version

Products re-installed

Upgrade Process – Service Pack Release


One or more critical problems or enhancements

Released on an as-needed basis

Hotfixes typically required to be installed by all sites

May contain changes to the Acuo databases

Distinction between a Patch release and a Hotfix


Installed “over-the-top” of an existing install

Script backs up existing installation files and installs new ones

Upgrade Process – Hotfix Release


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Typically a customer specific issue

Needs to be addressed immediately

No temporary work-around available

Do NOT alter Acuo databases


installed “over-the-top” of an existing install

script backs up existing installation files and installs new ones

Upgrade Process – Patch Release


No longer need to uninstall version – from 6.0.3 you can install the upgrade over

the top of the existing version

Removing support 32 bit systems – 6.0.3 64 bit only

Windows 10 and SQL 2014 support

Storage Commit will automatically search the databases attached to the Called AE

AcuoStore Extensible

New ILM features

Prune from local DICOM Database into Recycle Bin

Send a compressed copy to a database with a new type called ILM

Latest Version: 6.0.3 Highlights


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Acuo Release 6.0.3

• Enhancements

• Release Date: Feb 2017


Over-the-top upgrade support for all products in 6.0.3

For upgrades from 6.0.1 or 6.0.2, products will still need to be uninstalled and removed

Moving forward from 6.0.3, products will generally not need to be uninstalled

OS and SQL Support

Added support for Windows 10 and SQL Server 2014

Dropped support for 32 bit Operating Systems, which includes:

Windows Server 2008 (all non-R2 versions)

Windows 7 (32 bit)

64 Bit Support

6.0.3 is a “64 bit only” release

6.0.3 can now fully utilize higher levels of memory space

MMCs are now generated using Start / Run and typing

Trace files now have 8 byte addresses

Enhancements in 6.0.3


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IPv6 Support (All products/Installers)

IPv6 was previously supported for some products in 6.0.2

IPv6 addresses can now be entered into Host Name fields

Activity Log may display IPv6 addresses

Storage Commitment

Storage Commit now defaults to using the DICOM databases associated with the Called AE

where the commit was received.

Added new Option of: Number of Days To Keep Completed Jobs on Queue

Default is 7 days

Can now Remove Completed Jobs from Batch Commit Manager

Analyze Commit Jobs is enhanced with more information and additional features

Right click Batch Commit Manager and select Analyze Commit Jobs



AcuoStore – Extensible AcuoStore Databases

Multiple (extensible) AcuoStore Databases can be installed

Creates a new node named “Extensible AcuoStore Configuration” in the MMC

Additional AcuoStore Databases can be installed along with corresponding Managed Shares

and Applications

This added functionality is not intended to impact currently implemented systems

Acuo XDS ILM

Acuo XDS ILM Manager executes user-defined policies that delete XDS data in Acuo XDS

Repositories and any XDS Registry that supports the IHE XDS Metadata Update delete

transaction



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ILM Options – Compression and Keep Images

in the Recycle Bin

Allows images to be compressed via ILM rules

and sent to an ILM DICOM Database

Creates a new type of DICOM Database

named ‘ILM’

Images that meet the ILM criteria are

automatically compressed and sent to this

database

The original images are deleted and only the

compressed images stored in the ILM DICOM

Database are retained

An additional option has been added that allows

images deleted by ILM to be kept in the Acuo

Recycle Bin



AcuoMed eMPI (PIX Manager)

Bulk Patient Importer allows a large number of patients to be loaded into the eMPI Database via

an import file.

Web Admin GUI with the following functionality:

Search records

Add patient record

Edit patient record

Merge patient records

Pin multiple patient records

Edit linked patient details



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Web Admin VNA – Demo

Patient Explorer

Workflow Management

XDS Explorer

Visualization

Migration Monitor

Route Management

VNA Web Site Administration

System Diagnostics

System Management



Acuo Release 6.0.4

• Enhancements

• Release Date: May 2017


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OS and SQL Support

Added support for Windows Server 2016 and SQL Server 2016

AcuoStore

Eliminated Usage of Folder Links

Backend process that result in improved database efficiencies and better performance with

archive device reading/writing.

Moved Image Level Tags to DICOM Database

This change should result in improved performance for queries when Image level tag

information is needed.

Eliminated Usage of XML Column for Image Metadata

Another backend process that has been cleaned up.



Improved Image Deletion

Performance

Can allocate a specific number of

threads for deletion to improve

performance.

An additional configuration option has

been added to the Image Manager

Server Properties

Default thread count value: 1

Allowed values range from 1 – 10

This setting applies to all sources of

deletes except those resulting from




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AcuoMed – Batch Store Correction Options

Feature can be used to resolve Patient Name Mismatch conflicts within the Batch Store Manager

(DILIB).

Previously, in order to resolve these conflicts, one had to either delete the jobs from the Batch Store

Manager and resend the data from the source or manipulate the data in the target data base.





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AcuoMed – Batch Store Enhancements

New option to perform a DICOM Dump for individual jobs within Batch Store Manager.

To run this option, right click on a job and select “View DICOM Dump”.

Option not available for jobs with a status of Completed or Cancelled as the file no longer

resides in DILIB storage.

If the file is missing or not available, the following will be listed at the top of the output window:

“The file is not accessible at this time.”

The new option in Batch Store works similarly to the “View DICOM Dump” option in Patient

Management at the Image level.

Added the following columns to the Batch Store Manager:

SOP Class UID: Displays the SOP Class UID of an inbound or outbound store.

• Example: 1.2.840.10008.5.1.4.1.1.4

Issuer of Patient ID: Displays data from the Issuer of Patient ID tag (0010, 0021).



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AcuoMed – Miscellaneous

Added the original (Source) Calling AE Title to

the DICOM Database

Visible in Patient Management from the “View

Image Metadata” option at the Image level.

New field is titled “Image Origination AE”.

Added options to the Standard Data Dictionary

node to add a tag or delete a tag previously

added in 6.0.4.

Added an option to the Standard Data Dictionary

node to sync the database and associated

Dictionary.txt file.

Removed the Override Data Dictionary Node.



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Added the ability to submit XDS documents

directly into the Repository from the Acuo

XDS Repository Manager / Source node.

New reference documentation: Acuo XDS

Repository MMC Source_6.0.4.



Acuo Release 6.0.4

• Enhancements

• Release Date: May 2017


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OS and SQL Support

Added support for Windows Server 2016 and SQL Server 2016

AcuoStore

Eliminated Usage of Folder Links

Backend process that result in improved database efficiencies and better performance with

archive device reading/writing.

Moved Image Level Tags to DICOM Database

This change should result in improved performance for queries when Image level tag

information is needed.

Eliminated Usage of XML Column for Image Metadata

Another backend process that has been cleaned up.



Improved Image Deletion

Performance

Can allocate a specific number of

threads for deletion to improve

performance.

An additional configuration option has

been added to the Image Manager

Server Properties

Default thread count value: 1

Allowed values range from 1 – 10

This setting applies to all sources of

deletes except those resulting from




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AcuoMed – Batch Store Correction Options

Feature can be used to resolve Patient Name Mismatch conflicts within the Batch Store Manager

(DILIB).

Previously, in order to resolve these conflicts, one had to either delete the jobs from the Batch Store

Manager and resend the data from the source or manipulate the data in the target data base.





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AcuoMed – Batch Store Enhancements

New option to perform a DICOM Dump for individual jobs within Batch Store Manager.

To run this option, right click on a job and select View DICOM Dump.

Option not available for jobs with a status of Completed or Cancelled as the file no longer

resides in DILIB storage.

If the file is missing or not available, the following will be listed at the top of the output window:

“The file is not accessible at this time.”

The new option in Batch Store works similarly to the “View DICOM Dump” option in Patient

Management at the Image level.

Added the following columns to the Batch Store Manager:

SOP Class UID: Displays the SOP Class UID of an inbound or outbound store.

• Example: 1.2.840.10008.5.1.4.1.1.4

Issuer of Patient ID: Displays data from the Issuer of Patient ID tag (0010, 0021).



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AcuoMed – Miscellaneous

Added the original (Source) Calling AE Title to

the DICOM Database

Visible in Patient Management from the “View

Image Metadata” option at the Image level.

New field is titled “Image Origination AE.”

Added options to the Standard Data Dictionary

node to add a tag or delete a tag previously

added in 6.0.4.

Added an option to the Standard Data Dictionary

node to sync the database and associated

Dictionary.txt file.

Removed the Override Data Dictionary Node.



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Added the ability to submit XDS documents

directly into the Repository from the Acuo

XDS Repository Manager / Source node.

New reference documentation: Acuo XDS

Repository MMC Source_6.0.4.



Acuo Release 6.0.5

• Release Date: Tentatively on schedule for December 2017


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Troubleshooting


AcuoMed Logs

Event Viewer Log

Activity Log

Common troubleshooting scenarios

Trace settings

DICOM Hex Tracing

AcuoMonitor

Troubleshooting and Tools


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AcuoMed Log Files


AcuoMed Log files are typically located C:\Program Files (x86)\Acuo

Technologies\AcuoMed\AuditLogs

Acuo_Duplicate_Deletion_Audit.LOG

Shows image deleted due to duplicates processing

Acuo_Normalization_Audit.LOG

Shows results of normalization changes to images

Acuo_Reconciliation_Audit.LOG

Displays results of images coming into Called AE Names set for Reconciliation (pass/fail)

Acuo_Route_Rule_Audit.LOG

Shows analysis and pass/fail of tag rules

Acuo_TagMapper_InstanceName_Audit.LOG

Shows tags changed by TagMapper

ADAM_Normalization_Audit.LOG

Shows any normalization completed during migration

AcuoMed Log Files


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Event Viewer Log


One of the most important and frequently accessed Logs for troubleshooting

Will often contain clues or information pointing to a specific area

Event Viewer Logs

344

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Message Types

Information

Non-critical events

Warning

Configuration error

Network problem

Administrator fix

Error

Restart Service

Contact Support

Event Viewer Messages


Event Type: Warning

Event Source: AcuoMed

Event Category: Acuo Medical Library

Event ID: 16392

Date: 06/04/2010

Time: 09:24:35

User: N/A

Computer: ZOOM-BEEP03

Description:

Warning - Probable Configuration Mismatch.

Function = GetSOPTSPriority

Line Number = 798

Message = The SOP is supported, however the Transfer Syntax (for this SOP) is NOT supported!

Context ID: 77

Abstract Syntax: 1.2.840.10008.5.1.4.1.1.9.1.2

Transfer Syntax: 1.2.840.10008.1.2.1.

Calling Address = 160.160.160.131

Called Address =

Calling AE Name = STU_ACOMSERV

Called AE Name = FDIM01-ACOM

Implementation UID = 1.3.12.2.1107.5.4.11.1.1.42

Implementation Name = ACOMNET_11B.

Probable Configuration Mismatch

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General Case Association Error

Association Rejected

Event Type: Error


Event Category: Acuo Medical Library

Event ID: 16387

Date: 06/04/2010

Time: 16:19:01

User: N/A


Description:

Error - DiLib Function returned in error.

Function = RequestAssociation

Line Number = 600

Source File Name = .\RequestAssociation.cpp

Message = GetConnection returned with Association Rejected Error! - Return Code:

0x001a0012.

Calling Address = None

Called Address = None

Calling AE Name = BEEP02

Called AE Name = AN_C24692

Implementation UID = None

Implementation Name = None.

General Case Association Error

Error on Association Request

Event Type: Error


Event Category: Acuo Dicom Upper Layer

Event ID: 16386

Date: 07/04/2010

Time: 10:24:30

User: N/A


Description:

Error - DiLib Function returned in error.

Function = AE_2_SendAssociateRQPDU

Line Number = 1231

Source File Name = ..\DUL\dulprotocol\dulfsm.cpp

Message = requestAssociationTCP Returned in Error! - Return Code: 0x000f0012.

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Activity Log


Monitors any activity in and out

of Acuo

Association

Requests

C-FIND

C-MOVE

C-STORE

Runs under Tail.exe

Activity Log


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Analyzing UID Conflicts


Analyzing Patient, Study, Series, or Image UID Conflict

Select job from Batch Store Manager

Right-click and select All Tasks

Analyze the Job for UID Conflicts against the target database

The Batch Store job information and the target destination information displays

Analyze both sets of information to identify and resolve the UID conflict

Analyzing UID Conflicts


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Exact Name Mismatch


Trace Settings


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Should only be used under the direction of Support

Many different Traces to Monitor almost all of the VNA’s functionality

Most Trace files are output to C:\Windows\tracing

Each Trace has a maximum file size

When Trace hits max file size it is backed up to a file with the .OLD

extension

Tracing continues into the current file with the extension of .LOG

Trace Settings


Recommended to bump the maximum file size

from 100MB to 250MB

Can change location of Trace directory

Trace Properties


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• Automated Error Event Notification (AEEN)

• Automates the delivery of error event trace

information to Acuo VNA Support.

• Collect and deliver error trace data

• In Acuo Technologies > AcuoMed Image

Manager folder, double-click Save Current

Trace.

• Select all files intended to be sent from AcuoMed

trace folder and add to zip file.

• Send zip to the Acuo VNA Support Team.

Trace Settings


DICOM Hex Tracing


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Should only be used under the direction of Support

Captures full “byte for byte” transfer of DICOM data coming

and going from the VNA

Image Manager Server>Modify DICOM Relay Parameters

Target Directory points where the Hex Trace will write to

IF A DIRECTORY IS LISTED, HEX TRACING IS ON

Best practice is to point the Hex Trace to a drive with a lot of

space available

Preferably not a local drive or the DILIB storage space

If no AE Names are listed, Hex Trace will run on ALL

CALLED AEs

To turn off Hex Tracing, click the Clear Directory button

Turing On Hex Tracing


Following components are generally included

in Hex Trace:

Association Request and Response

DICOM Command Data

DICOM Tag Data

Pixel Data

DICOM Command Response

Association Release

Hex Traces can be decoded using the Decode

DICOM tool

Hex should always be turned off after use as it

can fill disk space very quickly

Hex Trace Example


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Troubleshooting Exercises

• 84. SOP Class Mismatch

• 85. Transfer Syntax Mismatch

• 86. Study UID Conflict

• 87. Exact Match Name


System Backup and Recovery


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• Customers Responsibility

• Best Practices and Recommendations in the AcuoMed Manual

• Acuo Database and Maintenance Plan



Disaster Recovery Planning and Practice

Time to recover data?

Who to contact?

Where to obtain hardware?

Who will be responsible?

Test for success

Identify failure points during testing

Stress testing

Address failures

Results of testing

Is Management informed of the Plan?



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Disk Management


Monitor available space regularly

Disk Management


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SQL Backups


Refer to the Microsoft SQL Server Best

Practices guide for the VNA for full details

Check status and test backups on a regular

basis to ensure they are properly completing

Recommended backup schedule

Back up the VNA databases daily.

Weekly full backup and daily incremental

backups

Back up the transaction log more frequently

High transaction volume: 5 – 60 minutes

Low transaction volume: twice per day

Please work with the VNA team to ensure

your backups are sufficient

SQL Backups


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Support Process


Subject to contract terms

Support Schedule

Standard Business 7am- 6pm CST (Monday-Friday, no holidays)

Extended- 5am – 10 pm CST (Monday-Friday, no holidays)

24/7- (includes weekends and holidays)

Support tiers

Tier 1- Client (Acuo does not provide Tier 1)

Tier 2- Includes upgrade support, configuration change request, peripheral diagnosis and defect

resolution

Tier 3- Peripheral diagnosis and defect resolution

Global Support Services


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Web Portal/Case Notes

Product Support


Final Review


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