iSite Administration (for all iSite products and features)

Introduction to the Administrative Areas

The interfaces that allow an iSite System Administrator to interact with, configure and maintain iSite are available through a standard PC when someone logs in with administrative privileges. These interfaces allow administration of the entire iSite Suite of Products, including iSite Enterprise, iSite Radiology and iVault as well as the Modality Worklist, Exceptions Handler, iQuery and iExport features. Of course, if your institution isn't using iSite Radiology or iVault, you can ignore references to those programs below.

There are two main areas where administration is performed, the iSuite interface and the iSite System Preferences. 

iSuite: To access the iSuite interface, append "/iSuite" to the IP address of the iSite server. For example, if the address used to access iSite in your institution is "http://12.345.678.90", then you can access the iSuite login page from "http://12.345.678.90/iSuite". The login page is shown below.

Enter your normal iSite username and password into the appropriate fields, select the appropriate authentication scheme and click the "Login" button. If this is your first time logging into the Administrative area of iSite, use the username and password provided to you by your Stentor Customer Engineers and use the "IDXrad" authentication scheme, as seen above.

The iSuite interface will appear, as shown below.

This initial iSuite page will display the time and date of your last login. At left is the iSuite Navigation Bar, containing the Worklist button, Patient Record button, Patient/Exam button, System Administration button, Help button, Change Password button and the Logout button. The functions of these buttons are summarized below. Certain features, such as iSite system security, patient record merging, deleting patients, digital image management and editing patient, exam and visit information will be discussed in detail later in this chapter.

iSite System Preferences:  iSite System Preferences will be available to you when you log into iSite Enterprise or iSite Radiology with administrative permissions. To access the System Preferences, click the Preferences Button in the iSite Enterprise or iSite Radiology Control Strip and select a preference from the control tree at left, as shown below. 

Some of the configurable features available in the iSite Preferences area are listed below:

The iSite System Preferences are explained in detail in the Personalizing iSite Enterprise section of this manual. To view that section, click here.

Introduction to Administrative Functions

Administration of iSite is straightforward and involves little preparation or training, if any. The program has been designed to be easy to administrate, requiring little effort on the part of the iSite System Administrator. In fact, the vast majority of iSite Enterprise's administrative functions are performed by Stentor Customer Care, in order to alleviate as much work as possible for the customer. Stentor Customer Care performs all aspects of iSite's installation and initial configuration.

This section of the manual provides information on the administrative functions that you will be responsible for, most of which deal with the initial configuration of iSite and the program's ongoing maintenance. In addition, as the iSite System Administrator, you will be an informational resource to the general community of iSite Enterprise and iSite Radiology users at your institution, including the general users, worklist technicians.

If you haven't yet familiarized yourself with the general operation of iSite Enterprise and iSite Radiology, from worklists to image-viewing and manipulation, it is highly recommended that you do so before proceeding with these section of the manual. In order to properly administer iSite Enterprise you will need to be familiar with every aspect of the program's functionality, including usage of the worklists and exception handler as well as image viewing and manipulation.  Furthermore, there will be instances, such as the addition of a new modality or changes to your institution's HIS, where you will be required to work closely with a Stentor Technical Support Engineer.

This manual is designed to help you understand what will be expected in those instances and, in particular, what information Stentor Customer Care will ask you for. If you have questions that remain unanswered by this manual, or if there are any other aspects of iSite Enterprise Administration that you need assistance with, please don't hesitate to contact Stentor Customer Care, 24 hours a day, at 877. 328. 2808. In addition, a Stentor Technical Support Engineer can be reached via email during business hours at support@stentor.com.

 Conceptual Overview of iSite Enterprise 

iSite Enterprise is an enterprise-wide, image and information distribution suite. On the server-side, iSite Enterprise resides on its own regulated servers which can be remotely accessed by Stentor Customer Care for remote installation, configuration and maintenance. On the client-side, iSite Enterprise operates as a thin-client on standard PC's with Windows 95, 98, NT, 2000, ME or XP that are running Internet Explorer 5.0, 5.5 or 6.0. The communication between the client and the server has full support for SSL.

iSite Enterprise is able to provide image and information distribution by interfacing with your institution's imaging resources and the HIS. By accepting both DICOM and HL7 feeds, iSite Enterprise can interact with modalities and information systems, making it one of the most robust image and information distribution tools available. At the heart of iSite Enterprise is Stentor's proprietary technology, a refined set of wavelet-encoding algorithms that are the mathematically optimal method for the distribution of large images. This core technology allows iSite Enterprise to operate with a speed that is exponentially faster than the closest competitor. 

Since iSite Enterprise functions as a hub that connects, synthesizes, redirects and displays DICOM and HL7 information, it is important that you have a conceptual understanding of iSite Enterprise's relationship to the imaging resources and HL7 entities in your institution. This configuration will be different for every organization as there are numerous variables, including whether a PACS is present, the type of HIS, the types and configurations of the modalities and the scale of your enterprise.

Your understanding of iSite Enterprise's relationship to image and information systems at your institution will be key when you work in conjunction with Stentor Customer Care to perform complex administrative tasks. Among these are jobs like bringing a new modality online, setting up iSite Enterprise security, users and permissions, editing  the interface between your HIS and iSite Enterprise or when you answer questions that your institution's users may have regarding the use of iSite Enterprise.

Prior to the installation of iSite Enterprise, Stentor provided you or your institution's representative with an interface analysis. This information should be kept close at hand when you work with Stentor Technical Support Engineers and may need to be updated from time to time. In addition, your contact at Stentor Customer Care should have briefed you on iSite Enterprise's connection to your various DICOM and HL7 feeds, their configurative relationship and it's implications to iSite Enterprise Administration. Considering  the large diversity of configurations, these explanations need to be given on a site-by-site basis; unfortunately, the myriad setups encountered cannot be cataloged here. If you have yet to receive this information from Stentor Customer Care, please contact a Stentor Technical Support Engineer at your soonest convenience.

The sections on the administration of iSite Enterprise are broken down into three main topics: a conceptual overview of iSite Enterprise, the configuration of certain aspects of iSite Enterprise and the ongoing maintenance of the program. 

Should you have any questions that are not answered by this manual, please don't hesitate to contact Stentor Customer Care, 24 hours a day, at 877 328 2808 or by writing email during business hours to support@stentor.com.

 Conceptual Overview of iSite Radiology

iSite Radiology is a cutting-edge diagnostic tool for radiologists and interns which provides diagnostic images and clinical patient information on a navigational console and a pair of diagnostic monitors. This configuration of three monitors is referred to as an iSite Radiology Workstation. As all navigational and contextual information is displayed on the Navigational Console, the two diagnostic monitors are reserved for the display of diagnostic images, thereby providing the maximum amount of available image-viewing real-estate for diagnosis. 

Computed Radiography (CR), Computed Tomography (CT), Magnetic Resonance (MR), Digital X-ray (DX), X-Ray Angiography (XA), grayscale secondary capture (SC), including 8-bit grayscale, Nuclear Medicine (NM), Ultrasound Multi-frame including grayscale (US), Positron Emission Tomography (PET), X-Ray RF (XRF), Radiotheraphy Image (RT Image) and Digital Mammography X-Ray Image are all supported by iSite Radiology. Unique and detailed hanging protocols can be set up for each of these modalities.

Diagnostic images can be interrogated and manipulated in a wide variety of ways using iSite Radiology. The program allows you zoom, pan, adjust window width and level, measure, annotate, invert, flip, rotate, sort series order, display in multi-image mode, copy, save and print diagnostic images. 

iSite Radiology works in conjunction with iSite Enterprise and iVault to provide radiologists with access to all necessary prior exams as well as to provide the entire enterprise of referring physicians and specialists with access to radiologists' diagnostic reports and presentation states. Additionally, the iExport feature allows radiologists to export DICOM exams to other DICOM devices, such as a 3D-imaging device.

Like iSite Enterprise, iSite Radiology is capable of communicating with your institution's HIS/RIS (Hospital Information System/Radiology Information System). This allows iSite Radiology to receive all necessary patient information, displaying reports and other patient-related information.

 iSite Enterprise Desktop and System Requirements

As Stentor Customer Care will be providing the server on which iSite Enterprise is to reside, the requirements for that machine are of no concern to the iSite System Administrator. The system requirements for a machine where iSite Enterprise will be used are as follows:

iSite Enterprise Client Side Requirements
  OS:   Windows 95, 98, NT, 2000, ME, XP
  Browser:   Internet Explorer 5.0, 5.5, or 6.0
  Memory:   64MB RAM

For the latest system requirements for iSite Radiology, please contact Stentor Customer Care at (877) 328-2808. 

 General Setup

Listed below are the general environmental specifications for setting up iSite Enterprise. Before the iSite Enterprise Server is sent to you, however, Stentor Customer Care will send you a detailed planning specification sheet which will indicate the exact requirements for setting up.

Environmental Requirements
Dimensions:  Total Cabinet         Shipping
Height:   43 in/1,092 mm   52.25 in/1,327.15 mm 
Depth:  35.8 in/909 mm        48 in/121.92 mm   
Width:  24 in/610 mm  32 in/812.8 mm     
Weight:  176 lbs/79.89 kg 225 lbs/102.13 kg 
 
Physical space required for operation:
The server will require a minimum unrestricted working space of 72 in/1820 mm x 36 in/810 mm.
 

Physical space required for service

Same as space required for operation.
 

Weight:

See physical dimensions
 

Building structural requirements:

None
 

Raised floor requirements:

None
 

Input Requirements:

Range Line Voltage:  90 to132 VAC/180 to 265 VAC (per power supply)
Nominal Line Voltage:   100 to 120 VAC/220 to 240 VAC
Rated Input Current:  4.8A (110V) to 2.4A (220V)
Rated Input Frequency:  50 to 60 Hz
Rated Input Power:   432W
BTU Rating:  1,475 BTU/HR
 
Power conditioning requirements, including the need for UPS:
 None.  UPS will be supplied if location does not have. Provide UPS power to server location.
 

Air-conditioning requirements:

Temperature Range
  Operating:   50° to 95°F/10° to 35°C
  Shipping:   –22° to 122°F/–30° to 50°C
Relative Humidity (non-condensing)
  Operating:   8% to 90%
  Non-operating:   5% to 95%
  Maximum Wet Bulb   Temp:   101.7°F/38.7°C
 

Exhaust requirements:

None
 
Water requirements:
None
 
Waste requirements:
None
 
Chemical requirements:
None
 General Administrative Duties

The general Administrative duties of an iSite System Administrator can be broken down into four general categories.

I. Configuration: During the initial stages of iSite Enterprise installation in your institution, you will be required to make several configurations. These will include setting up iSite Enterprise security, configuring new users, user groups, permissions and authorizations. You will also be called upon to assist Stentor Customer Care in interfacing the various DICOM and HL7 feeds in your institution with iSite Enterprise.

2. Maintenance: Once iSite Enterprise has been installed and configured at your institution, there will be several ongoing tasks that you will be responsible for. These will include bringing new machines online (in conjunction with Stentor Customer Care), overseeing iQuery (iSite Enterprise's DICOM Study Retrieval), resolving and removing exceptions in the Exceptions Handler, accessing iSite Enterprise Statistics and under special circumstances deleting exams and patients from the Patient Worklist. 

3. Information Resource: As an iSite System Administrator, you will be an essential information resource for all iSite Enterprise users at your institution. Aside from general questions regarding iSite Enterprise, you will most likely be asked about iSite Enterprise permissions and authorizations, iQuery, exam protocols and exam definitions.

4. Technical Representative: During the course of Stentor Customer Care's installation, configuration and maintenance of your iSite Enterprise Server, DICOM and HL7 connections and general interfaces, you will function as a primary technical liaison for Stentor Technical Support Engineers. For the most part, you will be asked for specific information about the addresses of modalities or other hardware. In other cases, you might be asked to perform specialized tasks with iSite Enterprise. Stentor Customer Care will work hand-in-hand with you through these maintenances. 

 Overview of iSite Security

Security in iSite is present to make sure that only authorized personnel can access the program and to ensure that authorized users only access those areas to which they are entitled. When properly configured and maintained, iSite security keeps sensitive materials from being improperly disclosed to outside parties and also keeps iSite Enterprise users within the boundaries of their predefined roles in the institution. For example, unauthorized personnel (such as custodial staff) in your institution will not be able to use iSite and authorized physicians will only be able to view medical images of their own patients.

The security system is composed of several interrelated parts:

The iSite System Administrator works with these parts of the security system to perform the following tasks:

The Access Groups and Users options work together to form the framework of the iSite Enterprise security system and ensure that the security system functions correctly. The Users and Access Groups options are related in the following way :

When a user logs in to iSite , the system looks at the user ID (what the user enters when logging in to the iSite system) and determines the functionality available to that user by examining the security codes associated with the access group(s) to which the user is assigned. The security system allows operators to access only the areas of the program that are assigned to them (as appropriate to their roles) and does not display the other areas.

Individual users and passwords are inherited from your existing HIS or RIS security. However, instead of the username/user group scheme probably in use by your present security, iSite Enterprise security possesses many levels of user identification and differentiation. iSite Enterprise security will be fundamentally based on your present security but, because of these differences, will have to be manually created and upgraded. The basic security information currently stored in your HIS or RIS must be translated into iSite Enterprise and additional information about the user will have to be added. Instructions for this process are included in the Configuring iSite Enterprise Section below. However, Stentor Customer Care is available 24 hours a day to help you with the process of migrating your security information into iSite Enterprise. 

For detailed information on setting up users, please see the section below titled "Configuring iSite Enterprise", sub-section "Setting up iSite Enterprise Security."

Configuring iSite Enterprise

The iSite System Administrator's role in the configuration of iSite Enterprise is limited, as most of the program's core functionality will be configured by Stentor Customer Care at the time of installation. There are, however, some essential elements that you will have to configure before iSite Enterprise can be deployed successfully at your institution.

iSite Enterprise security is the most important component to the configurations you will be performing and it will most likely be the most time-consuming. Once security has been implemented, it's maintenance should be minimal. 

Interfacing iSite Enterprise with the imaging resources and HL7 feeds at your institution will be performed by Stentor Customer Care at the time of installation. However, you will be asked for information pertaining to this interface and it will be essential that this information (concerned mostly with the manufacturers, model numbers and characteristics of your modalities and HIS or RIS) be kept at hand while configurations are taking place. You may also be asked for information about your institution's network and its properties. During the configuration process, Stentor Customer Care may need for you to perform configurations on this network to facilitate the deployment of iSite Enterprise.

To begin any of your administrative functions in iSite Enterprise, you must log in to the iSuite interface. This web address is generally the IP address of the server on which iSite Enterprise resides with "/iSuite" appended to the end of the address. When you have logged in with your administrative username and password you will see the basic screen, shown below. Click the "SysAdmin" tab at left to begin your administrative work.

 Setting up iSite Enterprise Security

Security Codes: 

iSite Enterprise contains a set of predefined (hard coded) security codes. This enables your organization to begin using iSite Enterprise immediately after installation and user training is complete. You can view the complete list of predefined codes in the Access Groups area. A complete list is also available in the iSite Enterprise System Setup Worksheets. Security codes are used to define access groups at your organization.

Security codes are 10 characters (bytes) in length. Please note the complete list of default security codes below:

DCTBODYSIT

System Administration module, Dictionaries option: Allows access to the Anatomy dictionary (stores codes representing particular areas of the body)

DCTEXAM

System Administration module, Dictionaries option: Allows access to the Exam dictionary (define information regarding exams performed at an organization)

DCTPROVIDR

System Administration module, Dictionaries option: Allows access to the Provider dictionary (define providers who use the iSuite system)

DCTREASON

System Administration module, Dictionaries option: Allows access to the Reason dictionary (define reasons used in several iSuite activities; for example, patient delayed, radiologist canceled, and so on)

DCTSUBSPEC

System Administration module, Dictionaries option: Allows access to the Sub-Specialty dictionary (stores medical sub-specialties that apply to providers)

EXHACCESS

System Administration module, Exceptions Handler option: Allows user to view exceptions list (patient or exam information entered at a modality that does not match information in iSuite)

EXHWINACT

System Administration module, Exceptions Handler option: Allows user to remove exceptions from the Exceptions Handler list

EXHWRESEX

System Administration module, Exceptions Handler option: Allows user to resolve exceptions

IMGDIGMGMT

Image Management module: Allows access to Digital Image Management option

IMGULKSUID

Image Management module, Digital Image Management option: Allows unlinking of a study from an exam (secondary security code)

IMGUNLKFUL

Application-wide: Allows ability to unlink exams in all exam statuses (expands upon the privileges granted by IMGUNLKLIM)

IMGUNLKLIM

Application-wide: Allows ability to link and unlink exams only in S (Scheduled), I (In progress), and C (Completed) status

IMGVUEIMG

Application-wide: Ability to view images for all exams

ISTACCESS

Provides the user with baseline access to the iSite Enterprise worklist.

ISTANYPAT

Provides ability to perform an ad-hoc query from iSite Enterprise for any patient in the database.

ISTANYPHYS

Provides ability to use iSite Enterprise to select to view any other provider worklist by proxy.

ISTBYMRN

Restricts iSite Enterprise user to access patients only by MRN.

ISTBYNAME

Restricts iSite Enterprise user to access patients by supplying the patient’s last name.

ISTDICTATE

Permits access to marking exam dictated.

ISTEXCEPT

Provides ability to view exceptions within the iSite Enterprise worklist.

ISTIEXP

Permits access to iExport Functionality.

ISTNOREP

Provides ability to view exams in iSite Enterprise before diagnostic report is available.

ISTPRNT

Permits access to paper printing.

ISTPRNTFLM

Permits access to film printing.

ISTPSTATE

Permits access to creating presentation states.

ISTQUERY

Provides ability to use iSite Enterprise to perform a DICOM Query/Retrieve against third party archives.

ISTRAD

Permits access to iSite Radiology workstations.

ISTSUPPORT

Provides ability for an iSite Enterprise User to access the statistics tab.

MWLACCESS

Worklist module: Allows access to the Modality option (list of exams associated with a specific resource, resource group, or modality type)

MWLBEGIN

Worklist module, Modality option: Allows access to begin exam functionality

MWLCOMPLET

Worklist module, Modality option: Allows access to complete exam functionality

MWLEDIT

Worklist module, Modality option: Allows access to change exam code functionality

MWLRCLNOTE

Worklist module, Modality option: Allows access to the Clinical Exam Notes window

MWLWPRFRES

Worklist module, Modality option: Allows ability to change performing resource

MWLWRESEX

Ability to resolve exceptions

PTREX

Patient Record module: Allows access to the Exam option (view exam-specific information)

PTRPT

Patient Record module: Allows access to the Patient option (view a patient's demographic information)

PTRRSL

Patient Record module: Allows access to the Results option (view diagnostic report information for exams)

PTRVIS

Patient Record module: Allows access to the Visit option (view a list of visit numbers and detailed visit information for a patient)

REGDEL

Registration module: Allows access to the Delete option (delete a patient record from the iSuite database)

REGFULL

Registration module, Register option: Allows access to full registration functionality

REGLIM

Registration module, Register option: Allows access to limited registration functionality

REGMERG

Registration module: Allows access to the Merge option (merge the records of two patients selected from the iSuite database)

REGMLSTFUL

Registration module, Merge List option: Allows access to full merge functionality (user can select specific information from either patient record to be incorporated in the merge)

REGMLSTLIM

Registration module, Merge List option: Allows access to limited merge functionality (allows user to select all information for one patient to be used as the primary information for the merge)

REGMRGLIM

Registration module, Merge option: Allows limited merging functionality (user cannot select individual data items on the Merge Patients window)

RWIRCLNOTE

Worklist module, Interpretation option: Allows access to the Clinical Exam Notes window

SADDCT

System Administration module: Allows access to the Dictionaries option (store the definitions, codes, and organization-specific reference information used by iSuite at your facility)

SADDCTADSC

System Administration module, Dictionaries option: Allows user to define auditing and editing capabilities of iSuite dictionaries (ability to select/deselect dictionary check boxes on the Dictionaries List window)

SADSEC

System Administration module: Allows access to the Security option (define users and access groups)

SADSTUP

System Administration module: Allows access to the Setup option (define iSuite setup for an organization)

SADSYSCTRL

System Administration module: Allows access to the System Control option (view users currently logged into iSuite, send or edit system messages, and change the status of the iSuite system)

SCHCANCEX

Scheduling module, Cancel/Delete option: Allows access to cancel exam functionality (cancel exams in S (Scheduled), I (In progress), or O (Ordered) exam (report) status)

SCHDELEX

Scheduling module, Cancel/Delete option: Allows access to delete exam functionality (delete exams in C (Completed), X (Canceled), N (Non-reportable), D (Dictated), P (Preliminary), F (Final), A (Addended), and R (Revised) exam (report) status)

SCHEDITEX

Scheduling module, Enter/Edit Exam option: Allows limited editing of exam data for exams in S (Scheduled) and I (In progress) status

SCHEDITEX1

Scheduling module, Enter/Edit Exam option: Allows limited editing of exam data for exams in C (Completed), D (Dictated), P (Preliminary), R (Revised), and A (Addended) status (secondary security code)

SCHEDITEX2

Scheduling module, Enter/Edit Exam option: Allows full editing of exam data for exams in C (Completed), D (Dictated), P (Preliminary), R (Revised), and A (Addended) status (secondary security code)

SCHEDITEX3

Scheduling module, Enter/Edit Exam option: Allows full editing of exams in F (Finalized) and N (Non-reportable) status (secondary security code)

SCHEDITEX4

Scheduling module, Enter/Edit Exam option: Allows full editing of exams in S (Scheduled) and I (In progress) status (secondary security code)

SCHEDITEX5

Allows editing Complete Exam info for exams in C, D, P, R or A status, except for exam codes or modifier. For use with SCHEDITEX1.

VISEDTADM

Visit Management module: Allow access to the Edit Visit option (enter new visit information for a patient or edit existing visit information)

VISTRK

Visit Management module: Allows access to the Visit Tracking option (view visit information and exams associated with a particular patient visit)

One security code in particular, ISTACCESS, merits special attention. If your institution has integrated the iSite System with the RIS, you can configure users' profiles with ISTACCESS such that only their patients will be listed in the Patient Worklist. Exams for which the physician is listed as the requesting, attending, or report to provider are included in the worklist. The initial display of the  worklist includes exams that have been assigned the following exam (report) statuses in the previous 14 days: P (Preliminary) and F (Finalized).

Note: If your organization does not have RIS integration, you should not assign the ISTACCESS security code by itself to a user and/or access group as the worklist will not display exams for which the physician is listed as the requesting, attending, or report to provider. Instead all exams will appear on the worklist.

Access to User and System Filters:

In order to have access to the User Filters the user must have the ISTUSRFLTR Security Code. Access to the System Filters is provided with the ISTSYSFLTR Security Code.

There are three exceptions to this security code naming rule: report codes, VIP type codes, and dictionary codes. For more information, please speak with your Stentor Customer Care representative.

Dictionary codes: There is a group of security codes that begin with the letters DCT. These codes represent each iSite Enterprise dictionary. These codes allow users to work in these dictionaries.

For more information about iSite Enterprise dictionaries, refer to the iSite Enterprise Dictionary Worksheets.

Report and VIP type codes: You will also notice the following codes and descriptions:

  • RPTxxxxxxx–Report codes generated from Report dictionary entries
  • VIPxxxxxxx–VIP codes generated from VIP Type dictionary entries

Report and VIP security codes are automatically generated by iSite Enterprise when a report or VIP type is defined in the Report or VIP Type dictionaries. Each code begins with RPT or VIP as appropriate, and the last seven letters are the actual report or VIP type code entered in the dictionary.

Example

  1. You define two VIP types in the VIP Type dictionary using the codes, CELEB (for celebrities), and EMP (for employees). iSite Enterprise automatically creates the following security codes: VIPCELEB and VIPEMP.
  2. You define a report code in the Report dictionary called REMIND for reminder letters. iSite Enterprise automatically creates the RPTREMIND security code.

For more information about the Report and VIP Type dictionaries, refer to the iSite Enterprise Dictionary Worksheets.

Access Groups:

Access groups are defined at the organization, organization group, and enterprise level. Refer to the following definitions:

Organization—an individual hospital or ambulatory facility that performs patient care services. Abbreviated as "org".

Organization group—a collection of organizations such as multiple hospitals and/or ambulatory facilities that are affiliated. Abbreviated as "org group".

Enterprise—a unique entity within the database which represents all of the organizations and organization groups. Assigning an access group to an organization or organization group enables access to the specified functionality (based on security codes) for that organization or all organizations within their organization group. Therefore, users who belong to the access group can only access the specified functionality within the organization or organization groups.

For example, the Modality Worklist access group is assigned to organizations A and B. Jane Doe is a technologist assigned to the Modality Worklist access group. When Jane logs in to iSite Enterprise to view the worklist, she can only view the worklist for organization A and B, but not organization C and D.

When the enterprise is assigned to an access group, users who belong to the same access group can access the specified functionality across the enterprise.

As such, the Modality Worklist access group is assigned to the enterprise. Jane Doe is a technologist assigned to the Modality Worklist access group. When Jane logs in to iSite Enterprise to view the worklist, she can view exams across the enterprise.

When defining an individual access group, you can only assign one organization, organization group, or the enterprise to that particular access group. However, you can define multiple access groups with the same security codes, and assign each to a different organization, organization group, or the enterprise. To assign the same security to several organizations (but not the enterprise), you can do one of the following:

  1. Define an organization group containing all of the organizations that will have the same security access, create an access group, and then assign the organization group to the access group.
  2. Define several access groups with the same security codes and assign each to an organization (all the organizations have the same security access).

An access group is a classification assigned to users who perform the same group of tasks in the iSite Enterprise  system.

For example:

  • A new technologist is assigned to an access group called "Tech". The Tech access group has privileges to access the modality worklist, the Exceptions Handler, and other appropriate functions.
  • A new scheduling clerk is assigned to an access group called "Sched". The Sched access group is designed for people who schedule imaging examinations and, therefore need access to the scheduling options in the Scheduling module.

When creating an access group, a set of security codes (which allow access to iSite Enterprise options) is grouped together, thereby enabling access to the modules and options in which users (who are subsequently assigned to this access group) can work. Assignment of an access group to a user enables that person to access the iSite Enterprise options (within specified organizations) with which the access group is associated. 

Notes:

  • Access groups can be assigned to the entire enterprise, a single organization, or a group of organizations.
  • Users assigned to groups with enterprise access can use the specified functionality across the entire enterprise, regardless of the users' designated primary organization.
  • When changes are made to an access group concerning associated security codes, this change affects all users assigned to the access group and could affect users in an organization(s) or users across the entire enterprise.
  • If a user is logged into iSite Enterprise when you edit access group information, changes to user privileges do not take affect until the user logs out of iSite Enterprise and then logs back into the system.
Defining an access group

To create a new access group, log in to the iSuite interface with your administrative username and password. Click the "SysAdmin" tab at left. Click the "Security" tab at top. Select "Access Groups" from the pull-down menu and click the "continue" button, as shown below.

Once in the Access Groups window, click the "add new" button. In the next window, shown below, enter in all pertinent information to define and describe the new access group. When you're done, click the "add" button.

Having clicked the "add" button your information will be saved and the access group you have just created will be presented as an editable entry, as shown below. From this window you can change the entry or add security codes.

To add security codes that will provide access to this access group, click the "+-security codes" button. The security codes window will appear, shown below, wherein you can select the security codes that you wish to grant access to the access group you've just created.

Below is a list of all security codes that come hard-coded within iSite Enterprise accompanied by their respective descriptions.

DCTBODYSIT

System Administration module, Dictionaries option: Allows access to the Anatomy dictionary (stores codes representing particular areas of the body)

DCTEXAM

System Administration module, Dictionaries option: Allows access to the Exam dictionary (define information regarding exams performed at an organization)

DCTPROVIDR

System Administration module, Dictionaries option: Allows access to the Provider dictionary (define providers who use the iSuite system)

DCTREASON

System Administration module, Dictionaries option: Allows access to the Reason dictionary (define reasons used in several iSuite activities; for example, patient delayed, radiologist canceled, and so on)

DCTSUBSPEC

System Administration module, Dictionaries option: Allows access to the Sub-Specialty dictionary (stores medical sub-specialties that apply to providers)

EXHACCESS

System Administration module, Exceptions Handler option: Allows user to view exceptions list (patient or exam information entered at a modality that does not match information in iSuite)

EXHWINACT

System Administration module, Exceptions Handler option: Allows user to remove exceptions from the Exceptions Handler list

EXHWRESEX

System Administration module, Exceptions Handler option: Allows user to resolve exceptions

IMGDIGMGMT

Image Management module: Allows access to Digital Image Management option

IMGULKSUID

Image Management module, Digital Image Management option: Allows unlinking of a study from an exam (secondary security code)

IMGUNLKFUL

Application-wide: Allows ability to unlink exams in all exam statuses (expands upon the privileges granted by IMGUNLKLIM)

IMGUNLKLIM

Application-wide: Allows ability to link and unlink exams only in S (Scheduled), I (In progress), and C (Completed) status

IMGVUEIMG

Application-wide: Ability to view images for all exams

ISTACCESS

Provides the user with baseline access to the iSite Enterprise worklist.

ISTANYPAT

Provides ability to perform an ad-hoc query from iSite Enterprise for any patient in the database.

ISTANYPHYS

Provides ability to use iSite Enterprise to select to view any other provider worklist by proxy.

ISTBYMRN

Restricts iSite Enterprise user to access patients only by MRN.

ISTBYNAME

Restricts iSite Enterprise user to access patients by supplying the patient’s last name.

ISTDICTATE

Permits access to marking exam dictated.

ISTEXCEPT

Provides ability to view exceptions within the iSite Enterprise worklist.

ISTIEXP

Permits access to iExport Functionality.

ISTNOREP

Provides ability to view exams in iSite Enterprise before diagnostic report is available.

ISTPRNT

Permits access to paper printing.

ISTPRNTFLM

Permits access to film printing.

ISTPSTATE

Permits access to creating presentation states.

ISTQUERY

Provides ability to use iSite Enterprise to perform a DICOM Query/Retrieve against third party archives.

ISTRAD

Permits access to iSite Radiology workstations.

ISTSUPPORT

Provides ability for an iSite Enterprise User to access the statistics tab.

MWLACCESS

Worklist module: Allows access to the Modality option (list of exams associated with a specific resource, resource group, or modality type)

MWLBEGIN

Worklist module, Modality option: Allows access to begin exam functionality

MWLCOMPLET

Worklist module, Modality option: Allows access to complete exam functionality

MWLEDIT

Worklist module, Modality option: Allows access to change exam code functionality

MWLRCLNOTE

Worklist module, Modality option: Allows access to the Clinical Exam Notes window

MWLWPRFRES

Worklist module, Modality option: Allows ability to change performing resource

MWLWRESEX

Ability to resolve exceptions

PTREX

Patient Record module: Allows access to the Exam option (view exam-specific information)

PTRPT

Patient Record module: Allows access to the Patient option (view a patient's demographic information)

PTRRSL

Patient Record module: Allows access to the Results option (view diagnostic report information for exams)

PTRVIS

Patient Record module: Allows access to the Visit option (view a list of visit numbers and detailed visit information for a patient)

REGDEL

Registration module: Allows access to the Delete option (delete a patient record from the iSuite database)

REGFULL

Registration module, Register option: Allows access to full registration functionality

REGLIM

Registration module, Register option: Allows access to limited registration functionality

REGMERG

Registration module: Allows access to the Merge option (merge the records of two patients selected from the iSuite database)

REGMLSTFUL

Registration module, Merge List option: Allows access to full merge functionality (user can select specific information from either patient record to be incorporated in the merge)

REGMLSTLIM

Registration module, Merge List option: Allows access to limited merge functionality (allows user to select all information for one patient to be used as the primary information for the merge)

REGMRGLIM

Registration module, Merge option: Allows limited merging functionality (user cannot select individual data items on the Merge Patients window)

RWIRCLNOTE

Worklist module, Interpretation option: Allows access to the Clinical Exam Notes window

SADDCT

System Administration module: Allows access to the Dictionaries option (store the definitions, codes, and organization-specific reference information used by iSuite at your facility)

SADDCTADSC

System Administration module, Dictionaries option: Allows user to define auditing and editing capabilities of iSuite dictionaries (ability to select/deselect dictionary check boxes on the Dictionaries List window)

SADSEC

System Administration module: Allows access to the Security option (define users and access groups)

SADSTUP

System Administration module: Allows access to the Setup option (define iSuite setup for an organization)

SADSYSCTRL

System Administration module: Allows access to the System Control option (view users currently logged into iSuite, send or edit system messages, and change the status of the iSuite system)

SCHCANCEX

Scheduling module, Cancel/Delete option: Allows access to cancel exam functionality (cancel exams in S (Scheduled), I (In progress), or O (Ordered) exam (report) status)

SCHDELEX

Scheduling module, Cancel/Delete option: Allows access to delete exam functionality (delete exams in C (Completed), X (Canceled), N (Non-reportable), D (Dictated), P (Preliminary), F (Final), A (Addended), and R (Revised) exam (report) status)

SCHEDITEX

Scheduling module, Enter/Edit Exam option: Allows limited editing of exam data for exams in S (Scheduled) and I (In progress) status

SCHEDITEX1

Scheduling module, Enter/Edit Exam option: Allows limited editing of exam data for exams in C (Completed), D (Dictated), P (Preliminary), R (Revised), and A (Addended) status (secondary security code)

SCHEDITEX2

Scheduling module, Enter/Edit Exam option: Allows full editing of exam data for exams in C (Completed), D (Dictated), P (Preliminary), R (Revised), and A (Addended) status (secondary security code)

SCHEDITEX3

Scheduling module, Enter/Edit Exam option: Allows full editing of exams in F (Finalized) and N (Non-reportable) status (secondary security code)

SCHEDITEX4

Scheduling module, Enter/Edit Exam option: Allows full editing of exams in S (Scheduled) and I (In progress) status (secondary security code)

SCHEDITEX5

Allows editing Complete Exam info for exams in C, D, P, R or A status, except for exam codes or modifier. For use with SCHEDITEX1.

VISEDTADM

Visit Management module: Allow access to the Edit Visit option (enter new visit information for a patient or edit existing visit information)

VISTRK

Visit Management module: Allows access to the Visit Tracking option (view visit information and exams associated with a particular patient visit)

When you've finished, click the "ok" button. You will be returned to the Access Group entry window where you will see the security codes with access to the new access group listed, as seen below.

Click the "update" button to finalize your changes.

Deactivating an access group

When you deactivate an access group, users who are assigned to the access group cannot access the modules and options associated with that group.

Notes:

  • If a user is assigned to only one access group, and that access group is deactivated, then the next time the user logs into iSite Enterprise, he or she is denied access to the system, and the following message appears: You have not been granted access to this system - Contact the Application Administrator.
  • If a user is assigned to more than one access group and one of the groups to which the user is assigned is deactivated, the user can still log into iSite Enterprise and access the modules and options associated with the active access group(s). However, the user cannot access the modules and options associated with the deactivated access group.
  1. On the vertical toolbar, click Sys Admin.
  2. On the horizontal toolbar, click Security.
  3. In the Option box, click and click Access Groups.
  4. Click continue.
  5. On the Select Access Group window, click the name of an access group. 
    Note: You can sort the list of access codes by code name, organization, description, and active status.
  6. On the Access Group window, click Active .
    Note:   indicates that the access group is no longer available for use in iSite Enterprise. 
  7. Click update.

Editing Existing Access Groups

To edit an existing access group, login to the iSuite interface with your administrative username and password. Click the "SysAdmin" tab at left and then the "Security" tab at top. Select "Access Groups" from the pull-down menu and click the "continue" button. In the "Select Access Group" window, shown below, double-click the name of the access group you wish to edit. Make necessary changes and click the "update" button.

User IDs: Adding and Editing User Profiles 

Note: You must be assigned application manager level access to view and work in the security system options.

When a new user joins an organization, you must define that individual in the security system in order for that user to access iSite Enterprise.

The iSite Enterprise Users option allows you to create and edit user records. This option also allows you to activate a user, deactivate a user, or reset a user’s password in the iSite Enterprise system.

In iSite Enterprise, security is based on each individual’s user identification (user ID). A user ID is the string of characters individuals enter when logging into the iSite Enterprise system. You define user IDs in the Users option. This user ID determines which iSite Enterprise modules and options are available to a user on the vertical and horizontal toolbars. Depending on the user privileges you assign, parts of the toolbars may or may not be visible.

Note: An organization must define access groups before defining users of the iSite Enterprise system. 

User records

When a new user is defined in iSite Enterprise, a user record is created. Each user record contains the following information:

  • User’s name
  • Organization with which the user is primarily associated
  • Active flag indicating whether the user currently has access to the iSite Enterprise system (active users can log into iSite Enterprise and perform tasks permitted by their access groups and associated security codes; inactive users cannot log into iSite Enterprise)
  • User’s job title (for example, M.D. or R.N.)
  • Number of days after which the user must change their password to access the iSite Enterprise system
  • Provider setting indicating whether this user is a care provider
  • User's ID (the name individuals enter when logging into the iSite Enterprise system)
  • User's employee number
  • Change password setting indicating whether the user must change their password(s) the next time he or she logs in to iSite Enterprise
  • Discount approval setting indicating whether the user can approve discounts in iSite Enterprise
  • List of access groups to which the user is assigned (determines the modules and options available to the user)

Once you create a user record in iSite Enterprise, you can perform the following tasks:

  • Assign the user to an access group
  • Deactivate the user
  • Define the user as a provider
  • Edit user information
  • Reset the user’s password

To create a user in iSite Enterprise, follow the steps listed below:

Using your administrative username and password, login to iSite Enterprise's iSuite interface. The http:// address of the interface is generally the IP address of your iSite Enterprise host plus "/iSuite", though this may be different in your case

Click the "SysAdmin" button on the left navigation bar then click the "Security" tab at top

Select the option "Users" from the pull-down menu and click the "continue" button, as seen below.

Click the "add new" button at left. An empty User Information page, shown below, will be displayed.

Fill in information as appropriate. Note that the default option for the "Care Provider" field is "No." This can be changed later in the user-setup process. The "Active" field is also selected by default. If you would like to have a user remain inactive until a future time, unclick this option. You need not worry about the "Discount Approval" feature as this pertains to a billing module that is not installed with iSite Enterprise. When you have finished, click the "add" button to continue.

Upon clicking the "add" button, the options you have specified will be displayed as iSite User Information.

Integrating with NT authentication

As of version 3.01, iSite can provide integration with your NT authentication system to aid in the migration of users to the iSite system, the maintenance and continuity of usernames and passwords. While the user must have a user profile in the iSite system, their NT username and password can be used to authenticate them and allow them to enter the iSite system. 

Once a user has been defined in the system, click the  "+ - user mappings" button, as seen in the image above. The following screen will appear:

In the “External User Name” field,  enter the DOMAINNAME\NEWUSERNAME, of the user. Enter "IDXNTLM" in the “Authentication Source” field. When you are done, click the "OK" button. 

You will be returned to the user's profile page. The user will now be able to use their NT username and password to gain access to iSite.

Assigning users to access groups

Once a user is defined in iSite Enterprise, that user must be assigned to an access group before they can use iSite Enterprise. Access groups determine the modules and options available to the user.

Note: When changes are made to an access group concerning associated security codes, this change affects all users assigned to the access group and could affect users in one or more organization(s) or users across the entire enterprise depending on the access group.

Click the "+- access groups" button to add the user you have just created to an access group.

Select the access group or groups to which you want the user to belong. Be sure that you are familiar with the definitions of the access groups before assigning users. Assigning users to inappropriate access groups could compromise sensitive data. When you have finished, click the "ok" button. You will be returned to the User Information screen and the Access Groups you have added will be displayed, as seen below.

Defining users as providers

iSite Enterprise allows you to define a user as a provider in the Users option. When you define a user as a provider you access the Provider dictionary and enter information as appropriate. The Provider dictionary stores information about all providers (nurses, technologists, physicians, radiologists, and so forth) who use the iSite Enterprise system to submit exam requests, sign diagnostic reports, borrow image records, perform exams, and perform other iSite Enterprise tasks. 

If the user is a care provider, click the "provider" button. You will be sent to a provider information window, as seen below. 

Enter the required information including the user's SSN. Assign the user to a location or locations and to a organizational group or groups. If the location that you wish to assign the user isn't present in the pop-up window of locations, you can add a new location by clicking the "add new" button and filling in the appropriate information. When you have finished, click the "save" button to make your entries permanent. 

Click the "security" button to return to the User Information screen.

When you are finished, click either the "setup" tab at top to enter or edit another user or any other tab to perform additional functions.

Deactivating users

You can deactivate a user in the iSite Enterprise system. Doing so indicates that the user can no longer log into iSite Enterprise. An active user, however, has access to the iSite Enterprise system (active users can log in to iSite Enterprise and perform tasks permitted by their access groups).

To deactivate a user, deselect the "active" selection in the users User Information window.

Editing user information

Once a user is defined in iSite Enterprise, you can edit that user's record. 

You can also perform the following tasks:

  • Add or edit access groups to which the user is assigned
  • Deactivate the user
  • Define the user as a provider
  • Reset the user’s password or force the user to change their password

Note: If a user is logged into iSite Enterprise when you edit access group information, changes to user privileges do not take affect until the user logs out of iSite Enterprise and then logs back into the system.

Resetting user passwords

iSite Enterprise allows you to force a user to change their password. You can do the following:

  • Reset the login and signing (if applicable) passwords to match their user ID, and force the user to change their password(s) the next time he or she logs into iSite Enterprise.
  • Simply force the user to change their password(s) the next time he or she logs into iSite Enterprise. 

To reset a user's password, click the "reset pw" button in the user's User Information window. A message, shown below, confirming that the user's password has been reset will be displayed.

Click the "close" button to return to the user's User Information window. The next time the user logs in, they will have to use their username as a password and then will be forced to create a new password, as shown below.

Notes

  • When you create a user record, you can also define a number of days that must pass before the system prompts the user to change their password(s). 
  • A user can reset their password(s) at any time using the Change Password option on the vertical toolbar.
  Assigning a Computer to a Performing Resource

iSite System Administrators can assign a specific imaging resource to a computer. The designated performing resource specifies the modality or modalities at which the user can begin and complete exams.

MWL (Modality Worklist) cookie

iSite Enterprise uses information stored in cookies to determine if a computer has been linked to a performing resource. The cookie that specifies the Modality Worklist performing resource is kept with all of the other cookies stored on the local machine. It is called "username@MWL[x].txt."

A cookie is a text file given to a web browser by a web server. The browser stores the text file and sends it back to the server each time the browser requests a page from the server. The main purpose of cookies is to identify users to the server in order to prepare customized content or settings without reentering them each time the user accesses iSite Enterprise. 

The following instructions outline the procedure for linking a performing resource to a computer.

  1. Open the Modality Worklist on the computer to which you would like to link the resource.
  2. If the Modality Worklist cookie is not found on a computer that accesses the Modality Worklist, the Change Performing Resource Location window appears automatically and displays the following message: 

    "Is this location associated with a resource where exams may be begun?"

    Note: If you are changing, adding, or removing a performing resource from a computer which has already been assigned to a resource, click the select button ( ) next to the Performing Resource(s) box on the Modality Worklist window.

  3. Click the "yes" button and then click the "next" button.
  4. In the Organization Filter box, click the drop-down menu button ( ) and select the appropriate organization.
  5. In the Resource Lookup box, enter the resource code or click the select button ( ) and select the performing resource.
    Note: To select multiple resources, click the select button (     ) and select each performing resource.
  6. Click the "ok" button when you are finished selecting resources.
    Note: The next time the user accesses the Modality Worklist from the same computer, he or she will not be prompted     for this information again.

Configuring PowerScribe™ Integration

Please note that this section of the manual applies only to administration of iSite Radiology. If your institution utilizes PowerScribe dictation, you can integrate the functionalities of PowerScribe and iSite Radiology to work together. For more details on the features that can be provided to your iSite Radiology users through this integration, please see the iSite Radiology User Manual chapter titled iSite Radiology Integrated Dictation.

Configuring this integration for your users is very simple. Most importantly, users who will be using iSite Radiology integrated with PowerScribe must belong to an access group that has the ISTDICTATE security code. For more information on access groups and security codes, please see the corresponding section above, or click here.

Once the user has been added to an access group with the ISTDICTATE security code, his or her User Preferences will include a section titled "Dictation." The user will have to enter his or her PowerScribe username and password in order for iSite Radiology to access PowerScribe at login. For information regarding the configuration of PowerScribe usernames and passwords, please see PowerScribe's user documentation.

With regard to technical support for the iSite Radiology PowerScribe integration, calls should be made to the appropriate party (Stentor or Dictaphone™). As a general rule, if the problem concerns connectivity between iSite Radiology and PowerScribe (ex: the user doesn't see the Dictation sub-section in the User Preferences screen), call Stentor's Customer Care at 877. 328. 2808. For all other issues regarding PowerScribe, please call Dictaphone's technical support. For more information, visit http://www.dictaphone.com/support/.

iSite Enterprise Maintenance

iSite Enterprise was designed to be maintained with as little work for the iSite System Administrator as possible. Stentor Customer Care will be performing the vast majority of iSite Enterprise maintenance remotely, from our offices in San Francisco. There are some maintenance duties that will fall to you, however, as we cannot access them remotely. These functions are partly ongoing, such as monitoring your institution's DICOM and HL7 feeds, administrating iQuery and dealing with exceptions. The other component of iSite Enterprise maintenance is sporadic and will vary greatly from institution to institution. These tasks will center around the introduction of a new modality at your facility or infrequent changes in your network that may necessitate changes in iSite Enterprise.

Bringing New Machines Online

When a new modality, other imaging resource, RIS or HIS is brought online at your institution, it is imperative that you contact Stentor Customer Care prior to its installation as these changes in the configuration of your network can affect the performance of iSite Enterprise or cause it to shut down entirely.  Please give Stentor Customer Care as much advance notice as possible before the planned installation of the new resource. Stentor Customer Care will work with you to install the new machine without it interfering in the performance of iSite Enterprise. 

Administrating iQuery

As the iSite System Administrator, you have authorization to alter the iQuery Retrieval Queue, shown below.  The alterations include removing exams from the queue, retrying failed exams and submitting exams for immediate retrieval. 

Be advised that the standard iQuery user may call upon you to perform these administrative functions. To carry out these requests, click the "View Queue" button from the iQuery main screen, highlight the exam in question and click the appropriate button to the right of the queue. Note that you must have logged in with your administrative login to perform these functions.

Click here to view the corresponding section on iQuery.

Resolving and Removing Exceptions

For detailed information on resolving and removing exceptions, please see the chapter titled "Using the Exceptions Handler," available from the table of contents at left.

Merging Patients and Exams

WARNING: Hazard Area! 
The patient record merge functionality (Merge option) has been identified as a hazard area in iSite that could result in one of the following situations:

Stentor strongly recommends that you visually verify the patient records you want to merge before performing the merge function.

At times, a single person is entered into your institution's HIS/RIS with two different Medical Record Numbers (MRNs). One example would be entries for "John Smith, MRN: 123456, M, DOB: 12/31/00..." and "John Smith, MRN: 12345, M, DOB: 12/31/00...." In reality, both of these entries belong to the same individual even though, because of their differing MRNs, the system sees them as two unique individuals. 

In theory, this scenario can pose a risk to patient care. In this case, the two John Smith's, both having identical demographic information, should be merged into one record. Be aware that there are significant implications to merging two patient records. Should a pair be mistakenly merged, patient care could be delayed or impeded, as mentioned above in the Hazard warning. Furthermore, the merge process is nearly impossible to reverse. PATIENT MERGING SHOULD ONLY BE PERFORMED BY PEOPLE WHO ARE IMPLICITLY AWARE OF THE POSSIBLE REPERCUSSIONS OF ERROR AND WHO HAVE EXCELLENT KNOWLEDGE OF THIS PROCEDURE. 

There are two ways to merge a patient, via the Merge List and the Merge Patient areas:
Merge List: The Merge List is a list, automatically created by iSite, of all likely candidates for a patient merge. iSite will identify patients who share demographic data but whose MRN is different and will recommend them for merging if they meet certain complex criteria. The Merge List makes recommendations for merge candidates basic on a highly-complex algorithm which weighs various similarities and discrepancies between two individual patient listings. Of course, each recommendation should be carefully scrutinized before being accepted.

Access the Merge List by clicking the Patient Exam button in the navigation area at left, as seen below.

Then click the Merge List button, as seen below.

The Merge List, seen below, will appear.

As is visible in the image above, iSite presents a list of likely merge-candidate pairs. Each listing contains the patients' names, Social Security Numbers, Dates of Birth, Sex and, finally, a Weight that iSite assigns each listing and which reflects iSite's confidence in the merge pair.

To select a merge-pair, check the box next to the pair's listing and then click the continue button. A detailed merge profile will be displayed, as shown below.

Check the boxes of the information that you wish to include in the newly merged patient profile. In the above example, the MRN and the correct spelling of the last name are taken from Patient 2, while the rest of the information is taken from Patient 1. When you have indicated all the correct information, click the "merge" button, as seen above. If information is missing (ie. one of the fields haven't been checked for either Patient listing), iSite will notify you, as seen below.

If all the information is in place, you will be presented with a confirmation message, as seen below.

When you click the "OK" button, you will be returned to the Merge List.

Merge Patient: The second way to merge patients within iSite is the manual method. This method is required in instances when the two patient records that need to be merged are so different that iSite won't recognize them as merge candidates and thus, they won't appear in the Merge List. 

One possible scenario when this could occur is if an unconscious patient is brought into the Emergency Room. The patient is given the name "Jon Doe" and is assigned a fictitious MRN and other information when the technician enters him into the HIS and images him. Later, when the patient regains consciousness, the technician is informed of his true name, date of birth, etc., and enters this into the HIS.

Now, two patient records exist for the same patient. However, iSite won't be able to recognize these two records as merge candidates. In order to merge these patient-records you must access the Merge Patient feature and perform a manual merge. To access the Merge Patient feature, click the "Merge Patient" button in the Patient/Exam area, as seen below.

Upon clicking the "Merge Patient" button, you will be presented with a search dialog. Select a search criteria from the pull down menu, as shown below. 

Enter enough information to locate the patient in question and click the "Search" button. The patient will be displayed beneath, as shown below. 

If more than one patient appears, as is the case here, select the correct patient, as seen below, and then click the "Search" button again. 

Upon clicking the search button again, you will be presented with another search dialog, this time for the second patient record. The information of the first patient will be listed in the green information space at top. Enter in the necessary information, as demonstrated above, and click the search button. If more than one record comes up, select the correct listing. Once this is done you will be presented with the Merge Patient Dialog, as seen below. 

Select the fields that you wish to keep, which in this case come entirely from the second patient record, and then click the "merge" button, as seen above. If information is missing (ie. one of the fields haven't been checked for either Patient listing), iSite will notify you, as seen below.

If all the information is in place, you will be presented with a confirmation message, as seen below.

When you click the "OK" button, you will be returned to the Merge Patient search screen.

Deleting Patients and Exams

WARNING: Hazard Area! 
The delete patient record and patient exam functionalities (Delete Patient and Delete Exam) have been identified as a hazard area in iSite that could result in one of the following situations:

Stentor strongly recommends that you take the following precautions when using the delete patient record or delete patient exam functionality:

Delete Patient:

This feature is used to remove patient records from the iSite database. All exam information for the patient in question will be permanently lost. As described above, if done incorrectly, this procedure poses clear threats to patient diagnosis and patient care. As such, only qualified and thoroughly training professionals should be given access to this feature. These professionals should be completely aware of the ramifications of deleting a patient record before undertaking this operation.

Use the delete patients feature to remove duplicate records, records that have been corrupted and records for patients who never arrived for their exams (provided the patient record doesn't contain information for another exam you wish to preserve.

To delete a patient record, click the "Delete Patient" button from the Patient/Exam area.

You will be presented with a search dialog. Choose a search criteria from the pull down menu and then add information as necessary to retrieve the patient in question. To continue, click the radio button next to the patient's listing, as seen below.

Upon clicking the radio button, you will see the delete patient information page, shown below.

Enter the reason for deleting the record and fill in the "Authorized by" field. When you have thoroughly reviewed the record, making sure that it is fit for deletion, click the "Delete" button in the upper right-hand corner. The record will be deleted and a confirmation message will be displayed. PLEASE NOTE, THERE IS NO CONFIRMATION PAGE. WHEN YOU CLICK THE DELETE RECORD BUTTON, THE RECORD WILL BE IMMEDIATELY, IRREVERSIBLY DELETED.

Delete Exam: This feature is used to delete a specific exam. As with deleting a patient record, the incorrect use of this feature poses serious threats to patient diagnosis and patient care. As such, only qualified and thoroughly training professionals should be given access to this feature. These professionals should be completely aware of the ramifications of deleting an exam before undertaking this operation.

Exams with the following statuses can be deleted:

When you delete an exam, iSite erases all record of the exam from the system. For example, the diagnostic report associated with the exam is deleted when you delete the exam record. 

Delete an exam only in the rare instance that the exam should never have been scheduled. For example, if two separate patients have the same name, and an exam is performed on the correct patient but recorded under the wrong name, you would need to delete the exam from iSite and re-enter the information under the correct name.

To delete an exam, click the "Delete Exam" button from the Patient/Exam area of iSuite, as shown below.

You will be presented with a Search dialog. Enter the name of the patient whose exam you wish to delete. Identify the patient by clicking the radio button next to their name, as shown below.

Upon clicking the radio button, you will be taken to a Cancel/Delete Exam page, as seen below.

Click the button to view a list of the patient's exams. Select an exam from the list and the following Cancel/Delete Exam screen will be displayed.

Carefully review the exam to make sure you wish to delete it. If you are sure, click the "Delete Exam" button. iSite will display the following confirmation message.

If you wish to proceed, click the "OK" button. In the following screen indicate the reason for deleting the exam and enter the name of the authorizing party. To complete the deletion, click the "OK" button. The exam  will be deleted and a confirmation message will be displayed. PLEASE NOTE, THERE IS NO CONFIRMATION PAGE. WHEN YOU CLICK THE "OK" BUTTON, THE EXAM WILL BE IMMEDIATELY, IRREVERSIBLY DELETED.

Digital Image Management

At times, it is necessary to detach a study from a patient's exam record. For example, if images belonging to one patient's exam are accidentally assigned to another patient's exam, you will have to detach those images from that exam and reassign them to the correct patient's exam. 

The basic procedure for this involves detaching a study or studies from a patient's exam  record, thereby creating  an exception, and then resolving the resulting exception by assigning it to the correct patient's exam. 

To access the digital image management area, click the "Digital Img Mgt" button from the Sys Admin area of the iSuite interface, as shown below.

Upon entering the Digital Image Management area you will be presented with a search dialog. Enter the appropriate criteria to identify the patient who's study will be detached and click the "Search" button. The patient will be listed, as seen below.



Click the radio button next to the patient name and you will be shown an Exam Search page. Click the button, check the radio buttons at left to select a study or studies, and then click the "Continue" button, as seen below.

Upon clicking the "Continue" button you will be returned to the main page. The study that the exam you've selected contains will be displayed, as seen below.

Any linked exams will be displayed above the Digital Study Information. In the instance above, there are no linked exams. Uncheck the box next to the Study Instance UID listing and click the "detach" button, which will have become active. The study will be detached from the exam in question.

When the study is detached from the exam, that exam will become an exception. This exception can then be resolved and reassigned to the correct patient.

iSite Statistics and Auditing

iSite provides iSite System Administrators with access to a wealth of statistical information about the volume of users and general usage of the program. Statistics can be viewed based on date, modality, patient MRN, or iSite user. To access the iSite Statistics page, click the "Statistics" listing in the iSite Folder, as seen below.

The following screen will appear.

The four main statistics models are listed in the upper bar. They provide the following information:

iVault

Stentor’s iVault is a long-term storage device that works in conjunction with iSite Enterprise and iSite Radiology to provide round-the-clock access to archived patient exams (iVault is not a stand-alone product). iVault™ uses a unique, perpetual on-line medical imaging data storage model that stores all image data in active Storage Modules, a Cache Storage Module which stores three months of data and Persistent Storage Modules which are designed for the multi-year storage of medical exams to meet the industry’s legal requirements for long-term image storage. iVault™ enables immediate data accessibility to all iSite™ clients across the enterprise. Utilizing the underlying iSyntax™ and Imaging Suite™ infrastructure, iVault™ assures system-wide worklist & workflow management.  iVault™ data is on-line, all-the-time, eliminating the need for complicated pre-fetching and routing schema as in traditional PACS architectures. The Storage Modules are based on an expandable array of low-cost, network-attached devices. The architecture can scale to support millions of exams or hundreds of Terabytes of on-line data, which is simultaneous accessible by hundreds of users across the enterprise.

Leveraging the reduced cost of disk storage, which is now comparable to the cost of off line storage media, (optical disk/digital tape), the SIMA model employs an “all-on-line all-the-time” philosophy. Data will be stored on line for the minimum seven-year legal requirement.

This approach has a number of benefits:

Two types of Storage Modules are utilized: a Cache Module with the most recent three months image data to which the primary diagnostic sub-systems are directed first, and the Persistent Storage Modules that have all of the current and prior data for the facility.

Storage Modules are configured with RAID 5 hot-swap disks, redundant power supplies and redundant NICs.  Storage Modules deliver the image coefficients directly to the requesting clients without routing through the worklist server or any other performance or reliability bottleneck.

The most critical short-term data (one week) is stored on three sets of mirrored RAID 5 devices. The near-term data (three months) is stored on two sets of mirrored RAID 5 disks and the long-term (greater than three months) data is stored on RAID 5 NAS devices, which are continuously backed up to the Stentor Disaster Recovery Data Center.

All hardware chosen for iVault™ is required to meet minimum MTBF, MTBR and total reliability performance. Components meet Data Center specifications and critical subsystems are designed with automatic fail over to a redundant, clustered or parallel resource. Individual components themselves have built in redundancy such as RAID disks, redundant power supplies, network cards, etc. The hardware platforms are rigorously tested and shipped with a 24X7 – 4 hour on site warranty.

At present (), it is not expected that there will be more than a couple administrative functions to perform with iVault. At most, these may include occasionally rebooting the iVault server or assisting Stentor Customer Care as they engage in the administrative functions of iVault. In short, this product is meant to require no administration from the iSite System Administrator. However, these requirements may change by the time iSite 3.0 is feature complete and ready for release. This documentation will be amended at such time. If you have questions regarding iVault, please don't hesitate to contact Stentor Customer Care at 877 328. 2808.