Fluorospot Compact Module 1 - System Settings and Tools

Welcome to the Fluorospot Compact web based training series. This series of four modules will cover examination workflow, study and image handling, basic system setup, and postprocessing functions. In this module, we will review the suggested settings for the User Settings, the Service sub tab, and all the Logs.   You should now be able to: Successfully set up the User Settings on the FLC Navigate the Service sub tab and understand remote access and Reject Analysis Log Utilize and understand the additional tools such as the EXI log, Statistics log, and the PEX Editor   By the end of this module, you will be able to: Successfully set up the User Settings on the FLC Navigate the Service sub tab and understand remote access and Reject Analysis Log Utilize and understand the additional tools such as the EXI log, Statistics log, and the PEX Editor To access the User Settings, select the Settings Sub tab within the Patient Tab. Select the button that has an image of a wrench. The User Settings box will open, select the desired tool and make any necessary changes. Note certain settings are made available depending on the system type and service set up. Note any options not specifically mentioned will be more site specific. DICOM Properties is the first icon within the User Settings. There are four tabs within the DICOM properties General Protocol codes Sending Printing Select the link below to view the Siemens recommended default settings for the DICOM Properties window. DICOM Properties - Details DICOM Properties - Details Tab TitleTextGeneral Worklist query RIS Timer set to zero mins Modalities to query are typically CR/RF Mark Order is set to Acquisition date and time  EXI value is set to Clinical Protocol Codes Protocol codes can be customized on a per site basis Sending Default for autosending is off, make changes accordingly if needed. Consider exam protocol for manual send can be selected if the site would like either the SC image (screen captured image of the dose report) or the DICOM Dose SR (structured dose report) to go to an archive destination. Default auto-sending destination should have target one set for the main archive destination. If sending the exam protocol (dose report) a Black background is the preferred choice.   Printing This setting is site specific and only needed if printing images from the system The Image Display and Print Properties is the second icon located in the User Settings. There are two tabs: Display Layout and Print Layout Select the link below to view details of the tabs within the Image Display and Print Properties window Image Display and Print Properties - Details Image Display and Print Properties - Details Tab TitleTextDisplay Layout The information that is selected (by placing a check in the box) will be displayed on the images. Image Display configuration does not affect what information is sent to PACS, only what is displayed on the system's monitor during patient exams. Select Apply and Ok if changes are made Print Layout The information that is selected (by placing a check in the box) will be displayed on images printed from the FLC. If a printer is set up in Service then a Print Layout needs to be created. The following should be populated Name (typically the name of the printer) Type (DICOM) Size (based on film in the printer) Layout (how many images per piece of film) Text size (User dependent). Select Store as New (new printer layout) Store (editing an existing layout) Set As default (to set the layout as the default) Select Apply and Ok if changes are made. The Examination Properties window has several options for functions that can be used during an exam. Most of the functions are for fluoro systems. Select the link below to view the details of the Exam Properties window Exam Properties - Details Exam Properties - Details Tab TitleTextExamination Properties Auto Shutter Delta X/Y are both set to zero. Check Enable Auto Shutter Fluoro (brings electronic shutters in during fluoro). Auto Zoom (default is checked to enable) Auto Reference is site dependent and only available if there is a Reference Monitor. CARE MField display - set the amount of time the User wishes to see the dominants display during fluoro. Collimator Display (option) – set the amount of time the User wishes the collimator lines to display (allows for fluoro free collimation) The Display Dose can be set for the actual dose level or the sensitivity, for example 400, etc. DVD Recording is an option where the User can choose what imaging will automatically record to a DVD when activated. Film Segmentation and Heat Unit test are typically not active. If changes are made select Apply and OK.   The Site Info icon houses multiple settings that are based on User Preferences Some settings with in this icon may not be used. Select the link below to view details of the Site Info window Site Info - Details Site Info - Details Tab TitleTextSite Info The Institution Name is how the name of the Facility will appear on the image when patient information is entered manually.  The Department Name can be more specific to the facility, for example the department location (ER, west wing,etc.). Screen Saver is set for the desired number of minutes without activity before displaying. Patient Demographics, represents the patient information displayed under the patient name both on the FLC and TUI display (on the tube in the room).  The default setting is the Accession number; this is helpful with multi-accession number exams. Patient list selection determines if you can perform a multi-accession exam simultaneously moving from one accession number (multi study mode) vs. doing one study at a time (single study mode).  The default settings it multi-study mode. The "Display Image receptor size in"  field denotes whether items are displayed in inches or centimeters on the FLC.  Daylight saving time should be checked (in places where observed). If changes are made select Apply and OK.   Includes the settings necessary for matching the HIS/RIS to the PEX Editor for mapping purposes.     Includes options for the exam manager, which is needed for manually entry of views. Select the link below to view the details of the Exam Manager window Exam Manager Properties - Details Exam Manager Properties - Details Tab TitleTextExam Manager Properties The “Display Exam Manager” should be set to the middle option; “When requested Procedure or Scheduled Procedure Step is not matched”.  This is necessary so that when a RIS mismatch occurs, the Exam Manager will automatically display and allow the User to manually add the desired exam or view.. Acquisition Order, the default is not selected. RIS match, to activate check the box for Preselect exams on RIS match Dicom tag selection is based on the HIS/RIS, the following options are available. Requested Procedure, Scheduled Procedure step, or Protocol codes. Activate the Do not copy data from selected study. Do not select the Default Exams option. If changes are made select Apply and OK.   The Image Delete icon has several functions that are designed to help with workflow and logging system use. ​Not all options may be used nor are the settings required. When Image Delete settings are set to default, the FLC will maintain a set number of studies on the system while still allowing retrieval of unarchived deleted images. Settings in this section are site specific. Select the link below to view details of the Image Delete window Image Delete - Details Image Delete - Details Tab TitleTextImage Delete The “Auto Delete” helps to maintain a set number of Patients exams on the system while making sure the system does not become too full for use. Check Enable Auto Delete to activate this function Hard disc fill level to 60% Deletion size level to 40% Activation time is site specific Activation Date is set to Daily Conditions should be set for “Images Sent” Note: Auto delete will only delete images/patients that have been sent to be archived. Auto delete will not occur if any of these parameters are not populated The default setting for the Recycle Bin is to enable. The Recycle Bin serves as a “catch net” for all rejected images or any manually deleted images that were not archived. Images can be restored from the Recycle Bin The recycle Bin must be manually maintained as these images take up space on the hard drive and will never auto delete. User Initials has two options, “Use user initials” and “Use as DICOM operators name”, default setting is to check both. Use user initials will initiate a pop up box for the User initials when entering a patient exam. Use as DICOM operators name, will have the user initials sent to archive via the Operators Name DICOM field. Rejected Images Analysis, default setting is to enable rejected images analysis. This will require the Users to put in the reason for rejecting/deleting an image or study along with the User name/initials. If changes are made select apply and Ok. If desired the User can choose to set up how OGP’s will be listed in the drop down during an Examination. Default is to show the OGP’s in the order set up within the PEX Editor vs using the Acquisition Order set up. When set up the OGP’s will display based on the location of the exam, (i.e., wall, table, free, etc.) Select the link below to view the details of the Acquisition Order window Acquisition Order - Details Acquisition Order - Details Tab TitleTextAcquisition Order The Mode is where the exposure will take place, use the arrows to choose which will display 1st, 2nd, etc. The View Position is where the view order is selected.  Meaning AP exams will always come first followed by Laterals.  Use the arrow to make adjustments to the order. If changes are made select apply and Ok. The User can choose to have additional fields visible and or mandatory for the Patient Registration page. Select the link below to view the details of the Patient Registration window Patient Registration - Details Patient Registration - Details Tab TitleTextPatient Registration Input Fields Grayed out fields are mandatory for Siemens Patient Registration Last name First name ID DOB Visible fields will be seen on the Registration Page and can be populated with information. Mandatory fields must be populated prior to registering a patient exam The patient name display format can be changed at the bottom of this window If changes are made select Apply and OK   The Service subtab has mostly tools for the Siemens Service and Applications Support. The three tools that are considered User tools are the Rejected Image Statistics, Remote Desktop Assistance, and the Quality control study.  The top left button that is represented with a man and a wrench is the Service log in. Reject statistics are found under the Service Subtab (bottom right button). Rejected Image Statistics tool is utilized for documenting why an image is deleted and by whom. If a password is set in the User Settings via the Image Delete Icon, enter this same password in the pop-up box. Statistics page displays the following Desired time frame Specific User or all Users The selected statistics can be exported to a thumb drive (usb). Prior to Clearing Statistics, verify all needed information is on the thumb drive. Close out to exit the Statistics box. The FLC offers a variety of additional tools to either aid the User with workflow or offer needed information. To see the status of an image after sending to a destination, select the Send Status button.  This button has three computers on it with a question mark. Once selected, there are several tabs across the top to choose which destination the images were sent. DICOM Send would be for sending images to PACs, DICOM Print is for images that are printed from the FLC, etc.  Select the correct tab and look for the desired patient.  The status column will indicate where the system currently is, in the process of sending the images. The Study Statistics tool is located under the Settings subtab.  This button has a folder with a bar graph in front of it. The study statistics tool offers the ability to sort the system for specific exams by using the drop down. The following are fields that can be sorted: Date, study description, ward, Referring Physician and Performing Physician. After making the desired selections select Run Statistics. The statistics can be viewed on the FLC or Printed.     The PEX Editor is located in the Settings subtab, middle row far left button. When the box opens, select the radio button for Siemens. The default password is based off the software and will be given to the Users during onsite applications. In the Pex Editor there are five tabs Exam Organ Program Fluoro Program Param. Module ​Configuration Select the link below to view details of the PEX Editor window.   PEX Editor - Details PEX Editor - Details Tab TitleTextExam Tab The Exam tab houses the individual X-Ray views per location (OGP View, left side) and the Exams (Examination View, right side).  The exam tab is where the Exam names are mapped to match the hospital worklist. Additionally, the specific set up of views, the order of views, etc. are also set up in the Exam tab. Organ Program Tab The Organ Program tab is where individual OGP views can be viewed or modified for technical and processing components.   Fluoro Program Tab The Fluoro Program tab has all the technical and processing components of all the fluoro triplets.  This tab is only for fluoro systems. Parameter Module Tab The Parameter Module tab, is where stand positions are set up (when applicable), EXI values are set, along with the processing set up for each OGP View. Configuration Tab The configuration tab is where the User can back up or export the database. To view the detector status/active detectors, open the detector overview icon. The detectors that are registered to the system will display in the top along with their status.   If a detector is not connecting leave this page open and rescan the detector in. The Recycle Bin tool is located in the Settings subtab and if enabled is represented with a trashcan. Rejected images or any manually deleted images that were not archived will be moved to the Recycle Bin. For the most efficient workflow and best system utility, enable the Recycle Bin along with Reject analysis and auto delete. This combination will help prevent image loss, maintain system function and speed, all rejected images will move to the Recycle Bin allowing Auto Delete to operate to its full potential. Additionally this combination of settings will only require manual deletion of Patient studies/images from the Recycle Bin.   Select the link below to view a demonstration of this function.   Demo - Recycle Bin Demo - Recycle Bin   For monitoring purposes, the imaging system logs exposure data including the Deviation Index and EXI values. Data can also be exported to USB memory and used for statistical evaluations. If the images are available on the FLC you can view the image corresponding to an exposure Double-click the line to view the image corresponding to it.  This tool is utilized for RAD exposures only The Remote Desktop Assistance button is used to allow a Siemens representative to view the FLC remotely with the User. This is a tool that enables the user to: Show Siemens support what is currently occurring on the FLC. Review steps for any FLC process (RIS mapping, editing, measuring, etc.). Perform trouble shooting. Select the link below to view the steps required in requesting Remote Desktop Assistance. Steps to Request Remote Desktop Assistance Steps to Request Remote Desktop Assistance Checklist TitleChecklist TypeChecklist ContentStep 1HTML Call into the Customer Care Center (if not currently working with Siemens Support) and open a ticket with either Applications or Service Support.  Let the representative know that you would like them to remote into the FLC.  ​Select the Remote desktop assistance button. Step 2HTML A pop-up box will display with a disclaimer. Select I agree. Step 3HTML The next box will request a session number, which the Siemens representation will give you.  Type the numeric number in the box and select Login. Step 4HTML A box will display stating that the system is connecting this may take some time depending on the network speed at the facility.  Once the box disappears the Siemens Representative will be able to view the Users FLC on their desktop PC. The Quality Control button is a where the User can make the exposures for the optional Image quality check or view the log of the exposures. Siemens does not require the User perform a daily/weekly/etc. check of the system, Siemens service handles this during the designated PM. If the User chooses to or the facility/state requires documentation for an Image quality check, this tool can be utilized. Select the link below to view the steps required to use the Quality Control tool. Steps to use the Quality Control tool Steps to use the Quality Control tool Checklist TitleChecklist TypeChecklist ContentStep 1HTML Select the button that is represented with a folder and a screwdriver. Step 2HTML A box will display requesting a password, if set up this is site specific, if not set up simply select ok. Step 3HTML While in the Patient tab the current log will display with any exposures made to date.  This log can be Exported or Printed.  To remove the current exposures select Clear, when finished viewing the Log select Close.                Step 4HTML To make an exposure for the Image Quality check, select the Examination tab.  The system will select the preset Image Quality exposures for the desired locations (wall/table/etc.). Prior to making the exposures make sure the technical factors, the room set up, collimation, SID, detector placement, etc. are the same from day to day.  This consistency will ensure that when reviewing the Image Quality log the outcome should always be very similar. Note: The PEX editor QC organ programs will need to be customized prior to using this function.