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WebWorks Clinician`s Guide

1. Study List All Updated Today Name ID Sex Birth Date status JOHNSON JOHNNIE PIDOOO00130 M DELIWI CTCR ABD PIDOOOOO17 M 10 1 81 ASSIG The user can customize which columns are displayed and what information displays for the selected study in the detail area at the bottom of the screen There are also some additional tabs that they user can select See the Customization section for details BRIT WebWorks Clinician s Guide UM WW_0012 21 Section Ill Image Viewing Tools Searching for Patients The physician may find their patient in their default search that appears under any of their worklist applications The most useful applications are Search and My Studies Selecting Queries from the Search Panel The user can adjust their default query and select a different query at any time from the Search panel s Select Query tool in the Actions Bar Note that many of the other worklist applications come with built in queries The last query selected will be sticky The queries available from the Select Query tool are as follows p gt My Patents 2 All Updated Today pa All Updated in Last Week 2 Action Needed p gt Has Urgent Finding 2 Has ER Diagnosis 2 Signed Reports 2 sentBy Me 2 Public Studies p gt Accessed by me 2 All Quizes The user can also select patients from other application tabs that they have selected Ad Hoc Queries Ad hoc queries support an extensive list of search
2. ROI Tool The ROI tool is selected from either the side of the image lil or under the right mouse click menu After selecting the main tool the shape of the ROI region is selected from the list displayed Freehand Rectangle Ellipse or Polygon Once selected a small pencil appears on the image Use it to draw a perimeter around the area of interest by depressing the left mouse key dragging and releasing After releasing the ROI calculation displays on the bottom right of the screen and then displays in the image Multiple a different images Click on the specific ROI tool again to turn it off BRIT WebWorks Clinician s Guide UM WW_0012 w Hide Study Actions Window Level Orientation Bo Patient Discov E Invert E Sigmoid Abdomen Brain Lung Mediastinum Spine Bone Default 2 Study Actions D Window Level Oriental Mean 393 Std_dev 404 54 Area 52 67 mmSq Perimeter 27 61 mn Mean 43 Std dev 651 14 ea 77 69 mmSq Perimeter 33 1 mm dl ROI has been calculated Mean 43 Std dev 651 14 Area 77 69 mmSq Perimeter 33 mm 37 ViEV Ee p be a BRIT Section lll Image Viewing Tools Systems Angle Measurements The Angle tool is selected from either the tools on the side of the image S or under the right mouse click menu After selecting the main tool there are two selections Angle and Cobb Select the Angle and a small pencil appea
3. Roentgen Works Login _ Roentgen Works Login Y ao EEn dl is Mn Q D worksdemo britpacs com t f f tmi sit 4 tge A Y a8 lf the multiple facility screen is presented select the facility This displays the facility s logon page Bookmark it Then enter the User ID and Password and click on the button on the facility s login screen Next time go right to the facility login screen using the bookmark Capital X Ray Logon Screen for Single Site Note screen will be customized for every server and every site BRIT WebWorks Clinician s Guide UM WW_0012 5 Section Il Customization BRIT Systems B Search Screen The first screen shown is the Search Tab By default it lists all patients to which the user has access privileges who have had updates to their file within the last 24 hours a Welcome Shelly Physician yo Se 5 Roentgen WorKS sern sy name aon Patients My Studies 7 Search 5 Messages 0 Action Needed 4 Study List All Updated Today n f o f S n o Name Da Sex Birth Date Status Acc Mod Body Part Description Date Physician Radiologist Comment images Faxes COOK SAM PIDOOO000 M 06 16 19 SCHEDULED OID000000 CR SPINE THORACOLUMBAR SPINE 06 15 2011 3 Dave Thomas 0 0 MRICHEST MARC PID0000011 M 02 05 19 REPORTED OID000459 CT CHEST Thorax 1CHEST WITHOU 02 21 2005 1 dave thomas Radiologist 2 0 ARNETTE PIDO000011 M READ OID000463 CT ABDO
4. The Reply to Message window closes and the reply is available under the recipient s message tab on To close the window without sending a message click on the button BRIT WebWorks Clinician s Guide UM WW_0012 43 Section Ill Image Viewing Tools Acknowledging a Message Users can acknowledge a message that is in their inbox without opening up the Reply tool To acknowledge a message 1 Click on the message on which to acknowledge 2 Click on the Acknowledge button Acknowledge Message n the Action Bar 3 The message is listed as ACKNOWLEDGED in the State column in the message list Deleting a Message Users can delete a message that is in their inbox To delete a message 1 Clicking on the message that needs to be removed 2 Click on the Delete Message button of Delete Message from the Action Bar 3 The selected message is immediately deleted 44 BRIT WebWorks Clinician s Guide UM WW_0012
5. IN WEBWORKS RELEASE 1 2 siii 1 CLINK EAI SS OUVUCK USESHEE ostras 2 PRODUCTINTRODUCTIO NN irssssessescconrcesescsscccaceercnssvesescscsendeseeceueccucvesevancesvectsaseneccusveuectecwenceassascsusscoonsesesssiesdeceesestcswese 3 A STARTING THE ROENTGEN WORKS APPLICATION cccccsccssccssccuccsccucccuccescescceuccscescsescescenseesseucsencsessessenssusceseesceuss 5 IP Aa CEN e a E no o E A 6 Ce E TAB ap E E A E A 6 DS ARCL C OSTOMZEARND LOC OUT eean a aE ania 7 EAN A 0 II E 8 E PATEN TIA acc cnsras 10 PATENTE OLI E eo ecasuaS 11 TL IVI TUDE DA E E EA E E E ca aueewssbacuaceotasucbenceseaneccausens 12 E VMESSACIN TAD e E E E A E A A E 13 SECTION T CUSTOM PA TON ai A e 14 A CUSTOMIZING GENERAL INFORMATION ccccccscccsccssccscccuscsceuccesccusceuccessesseuccessessesccesseesseucsesseuscenccesseuseenccusseusss 14 B CUSTOMIZING CONTACT INFORMATION ccccscccscccsccssccucccsccsceuccesscsceucseuscssencsesscussescsesseuscenceesseussesceessescenccusceusss 15 AAA e PPP O E o PE OA 15 C CUSTOMIZING DETAILS AREA cccccccceccscccsccsccusccuccesccscenccescescenccesseescesccesseuscecsesscussessesscussecsesscussenssesccuseeuceusceuss 16 D CUSTOMIZING COLUMNS IN WORKLISTS cccccssccsccesccucccsccsceusccuccsceusceuccscencsessescescsesseusseuscesseucsenseesceuscenscusceuccs 17 E CUSTOMIZING APPLICATIONS THAT DISPLAY IN TABS ssccccccssssssesecccccscessssseccceseeessessscccssecasseessceesseaussssssceeseqenss 18 F C
6. OT OTHER 11 17 2002 4 AAPM Luminance 1K Unassigned NA AAPM TEST PAT PIDO00000 07 04 2 NEWSTUDY 20022002 OT CHEST 11 17 2002 1 AAPM Resolution 1K Unassigned NA AAPM TEST PAT PID000000 07 04 2 NEWSTUDY 20022002 OT OTHER 11 17 2002 5 AAPM Glare 1K Unassigned NA AAPM TEST PAT PIDO00000 07 04 2 NEWSTUDY 20022002 OT OTHER 11 17 2002 7 AAPM Multi Purpose 1K Unassigned NA AAPM TEST PAT PID000000 07 04 2 NEWSTUDY 20022002 OT OTHER 11 17 2002 1 AAPM Noise 1K Unassigned NA AAPM TEST PAT PID000000 07 04 2 NEWSTUDY 20022002 OT CHEST 11 17 2002 6 AAPM Resolution 2K Unassigned NA W SWISS CR CHEST 19990408 M 01 08 1 NEWSTUDY OID000123 CR CHEST 04 08 1999 1 Shelly Fisher Emergency Unassigned Status ORDERED FISHER TOOTIE PID000089 F 09 07 14 ORDERED 1D000126 CT HEAD Shelly Sales CT HEAD BRAIN W O CON Y Status SCHEDULED El BARTON ROBERT PID000086 M 11 04 14 SCHEDULED 01D000125 CR HEAD 06 13 2011 8 Shelly Sales NASAL BONES FISHER TOOTIE PID000089 F 09 07 14 SCHEDULED 01D000124 CR CHEST 06 13 2011 5 Shelly Sales CHEST 4 VIEWS E Customizing Applications that Display in Tabs The user can select which applications or tabs appear on their Roentgen Works screen and they can arrange the order of the tabs From the initial customizations screen select the application icon CA This displays the following screen CMA Setup Tabs Visible Tab
7. click the x at the top right of POM the window To return to the worklist and leave the study open click on the square next to the x This displays the tabs again and you can select the Search or any other tab 8 10 Studies requiring your attention will be color coded in the worklist Urgent Findings will be orange ER Discordances will be red if the rad disagrees or green if it just requires acknowledgement These can be placed in a separate Actions Needed tab Answer them with tools available under Study Actions or available from the Actins Bar on the Actions Needed tab Also see the WebWorks Quick Tip Sheet o BRIT WebWorks Clinician s Guide UM WW_0012 Section Introduction Product Introduction BRIT Roentgen Works supports many different modules a specific implementation may have any subset of these for support of clinicians The modules are gt WebWorks for the viewing of medical images on a zero foot print browser or an iPad The studies may be from multiple attached 8 AR ee PACS i NHIN Gateway for finding patients with different IDs on different PACS and presenting the studies for downloading within WebWorks UrgentWorks for the communications of urgent findings Emergency Contacting for the delivery of more general emergency messages this is included as a subset of UrgentWorks ER Discordance for the tracking of physician calls made in the emergency room with those made later by t
8. it must be turned off on the selected item clicking ON 4 Previous Image the item does not turn it off Any of the icons will act as a cursor as well as support its own function Window Level Cine Soro Pan Image Measure Tool ROI Tools To clear annotations utilize the Clear Annotations tool under the right mouse click tools menu If the image window size is too small only a subset of these icons will be dake aaa displayed These tools and more are also available by right clicking anywhere in the image viewing area This displays the right mouse click menu Menu items with blue arrows to their right have additional tools under them 36 BRIT WebWorks Clinician s Guide UM WW_0012 BRIT a oe Section lll Image Viewing Tools Window and Leveling Window and Leveling is controlled via the window and level on screen tools available on the side of the image under the right mouse click or at the bottom of the screen The first two are manually changes with the mouse the bottom of the screen supports a selection of choices depending on the type of study For plain radiographs this includes Invert Sigmoid and Default Default resets it to the original W L used upon opening the study For CIs the selection includes CT presets established by the system administrator for the following tissue types Abdomen Brain Lung Mediastinum Spine Bone VVVVV WV Click on the desired present to set that W L
9. need to type the entire name As you type 3 letters a list of names starts to appear and then filters as you continue typing Double click on the name in the patient list to display the specific patient in its own tab BRIT WebWorks Clinician s Guide UM WW_0012 10 Section Il Customization G Patient Folder Detailed information on a given patient is available from within their folder which is accessed from the Patients Tab Double click on any patient name in the Patients Tab and that patient s folder opens into a tab with the patients name This can be done multiple times opening separate tabs for each of the selected patients Roentgen Y Se Se POP oh Patient s Tab Update patient BONEY BARRY Moet Patients BONEY BARRY Patient BARRY BONEY range 1818 Patient ID First Name Middle Name Last Name Problems Acute tonsillitis Tonsillitis Stress fracture of tibia or fi BARRY Allergies BONEY fire ants penicillin codeine Suffix Birth Date 06 19 1986 9 Gender MALE v Phone Home 821 442 1818 Name Prefix m Medications Orders Studies orders count 4 pne Business E mail Home boney disney com Diagnostic results 195 Walters Way Drop In 75882 Insurance Companies Blue Cross Blue Shield Immunizations LICENSE Ethnic Group ms Family History Fathers Mothers g gt hg Close Y E
10. that are used in the application So some functions may not work at all Please see the Quick Tip Sheet for the abridged way to use WebWorks Logging On and Gaining Access to Patients All users must have a user ID and password assigned to them They must also have viewing permissions for the patients they need to see The user will have permission to view patients if 1 the Site Coordinator or System Manager selects their name as part of Completing the study or editing the study 2 their name comes across in the DICOM header of the study and it has been matched to their user ID 3 their name come across in the order for the study and it is the name used in their user ID 4 they are ina physician group where one member has access 5 they are in another type of access group that has been granted access by nature of some information in the order or DICOM header such as patient location BRIT WebWorks Clinician s Guide UM WW_0012 20 BRIT a oe Section lll Image Viewing Tools Once a user has an ID and access permission they can open their browser and point it to the URL of the server They will see a log in screen similar to the one shown below these are customizable by site a ye ber n Baesegen Werks Loge trenger Aum supe an a de Sams Mo Capital X Ray BRIT can also provide API information to integrate with EMRs below My Studies 2 Search 2 Messages 0 Action Needed 4
11. used This is set from the Tools Application A a as shown above In the bottom right hand corner there is a pull down menu named Choose theme Select from BRIT default Gray Slate or Amber themes The changes to not take effect until after the user logs off and back on Any user can select their own color theme PS AG Setup Tabs Visible Tabs Available Tabs Patient List e User List Use this panel to setup which Applications appear Studies for My Patients e Modality List int your Tab Bar Just drag the Available Tabs into Study Search e Location List the Visible Tabs area to the right and re arrange as Message List e Site List needed Action Needed e Studies with Urgent Findings e Discordance Studies Studies Sent By Me e Studies with Quizzes e Public Studies e Remc BRIT Default BRIT Default Gray Theme Slate Theme Amber Theme Choose theme BRIT Default BRIT Default Gray Theme Slate Theme Amber Theme BRIT WebWorks Clinician s Guide UM WW_0012 19 BRIT Section Ill Image Viewing Tools Systems Section lil Image Viewing Tools This section provides basic information on how a referring physician will use WebWorks the browser based viewer that comes with Roentgen Works This application is a pure browser based application however it works much better with Safari Fire Fox or Chrome It does not perform very well with IE Also IE does not provide some of the standard browser tools
12. 8 BRIT WebWorks Clinician s Guide UM WW_0012 BRIT Systems Section Ill Image Viewing Tools Image Magnification Images can be magnified and zoomed out by via the slider bar on the upper right hand side of the _ screen or via the Zoom In and Zoom Out tools on the right mouse click menu AMPLE TEST M TESTSAMPLE To zoom in magnify smoothly magnify on an image drag the green ball on the slider bar up To zoom out drag it down An alternative method is to select Zoom In or Zoom Out from the right mouse click tools Images in different series are not zoomed together Images in the same series are all zoomed together Images that are larger than the window can be moved around by panning the image The panning tool can be selected from the tool bar or under the right mouse click While in Pan mode the cursor is the four headed arrow that looks like its icon on the toolbar The tool remains active until it is released by clicking on it from either selection location Add Snapshots gt Next Image lt Previous Image Window Level Cine Scroll Pan Image Measure Tool ROI Tools b Angle Tools f MH Show Hide b Orientation p D Window Level b E Add Snapshot oF Clear Annotations DICOM Dump Info In this release the Snapshots are limited to radiologist s placing snapshots of the current screen into reports BRIT WebWorks Clinician s Guide UM WW_0012 39 S
13. Add Order di PO EL Wla PA Patient ent Demographics The following subset if information is available under from the Patient Tab gt Patient Demographics displayed under its own tab and also displayed on the bottom part of the screen that does not change as different subsets are selected This area is adjustable in size Problems Lists patient problems and allows for allows for problems to be entered Allergies Provides a list of allergies and allows for allergies to be added Medications Provides a list of medications and allows medications to be added Radiology Orders Provides a list of radiology orders allows them to be edited and images to be viewed Diagnostic results provides a list of diagnostic results and allows more to be added Insurance Companies displays a list of insurance companies associated with the patient and allows for editing and adding of additional insurance company information Immunizations supports entering and editing of immunizations Family History Supports entry and editing of family history information VV VV VVV WV Section Il Customization H My Studies Tab My Studies provides a list of all orders studies and or reports available on the system for studies ordered by that user with recent changes Roentgen Works sa ara a da Pat rams sous stein lt TT My Studies Tab Study List My Patients pr Birth Da
14. BRIT Systems WebWorks Clinician s Guide September 2011 Release 1 2 BRIT Systems UM WW_0012 Notices Copyrights and Revision Records BRIT Systems This document is subject to change without notice and does not represent a commitment by BRIT Systems Inc The information set forth in this document and all rights in and inventions disclosed herein and the patents that might be granted thereon disclosing or employing the materials methods techniques or apparatus described herein are the exclusive property of BRIT Systems Inc Copyright Copyright 2011 BRIT Systems Inc All rights reserved Printed in the United States of America BRIT Beyond Roentgen Imaging Technology BRIT Systems Inc BRIT Viewer and the Pincher Man logo icon are trademarks of BRIT Systems Inc Microsoft and MS Windows are registered trademarks of Microsoft Corporation All other product names or trademarks mentioned herein are the property of their respective owners ii BRIT WebWorks Clinician s Guide UM WW_0012 Notices Copyrights and Revision Records Revision Records Revision Record for User Manual for BRIT WeWorks Clinician s Guide E z z z z Revision Date q section Pages Affected 4 Reason for Author Release Number 4 Change Number September All i 2011 A A A aE LABEL AL BBL ERY 0 200 REBEL A 1 1380 1 NERY 0 28 EERE E AO 1 100 1 NERY 0 2 E 1 380 2 NERY 0 20 80 AL A ce a ee eee
15. Barak0 at root Send Canca robert OES at public ies cara aia Guest User guest at public Neil Rosenbarger neilr at root Jim Hunt hunt at public Palazzolo Liz lizp brit com at public PenRad penrad at public Send Cancel Send Cancel BRIT WebWorks Clinician s Guide UM WW_0012 41 Section Ill Image Viewing Tools Note after a user has been selected from the list they are available from the blue arrow button to the right of the Send To entry field 2 Type the message in the window 3 Click on the Send button to save and send the message The New Message window closes and the message is placed in that user s message tab To close the window without sending a message click on the button The user to whom the message was sent will see the message in their messages tab Replying to a Message Users can reply to a message that is in their inbox To reply to a message 1 Click on the message on which to reply in the Message List 2 l the message is associated with the study it is listed in the study list area in the middle of the screen To read the message select Reply Message R Reply Message on the Actions Bar The Reply to Message box appears with the message in it To see the related study before answering the message Cancel the Reply to Message box then open the study by double clicking on the study description or on any of the exam s thumbnails which appear in the Study Detail area W
16. HANGING THE COLOR PALLETTE cccccsccssscssccsccesccsseuccesscsseuccessessenscesseessenccesseessenccesseussenccussesseeccesseuseunccussensss 19 SECTION III IMAGE VIEWING TOOLS wessccessicscasesccacsendesscassavecseenssaccebesecdssenantecesesessseensiacdsbeseeacnqnsstecetiseeccsenseonsuss 20 LOGGING ON AND GAINING ACCESS TO PATIENTS eesssseececccsssecceccccssecccccccsseccecccccseececccccsecccccccsseeccecccsssecceecese 20 SEARCHING FOR PATIENTS aero i 22 Selecting Queries from the Search Panel ooonononnnnnnnccnnnnnnnnnonnnnnononnnnnnnnnnnnnnnnnnnnnnn nono nn nnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnss 22 Ad LOC OIE A Aia 22 WORKING WITH THE RESULTS FROM THE SEARCH PANEL ccccccccssssseeeeeeeeeaeeeseececeeeaueeeeeceeeessaaeseeceeeeeaaeeseeeeeeeeeaaaees 23 TS CVE EIN are E OP to PORO E rs ese gape E EA ea net A E E A O E E 23 D COTA ICS a as cea Sete re eth encase da tee tis ave secession ee ad a sett ean ea masta 2 A A A E E E aad 23 DONNA A Ni 23 SA MESS E ios 24 AAA o En O E E 24 WORKING WITH REMOTE SERVERS STUDY LIST ocnocnnncnnocnnccnoconoconccnoconoconocnnronoconocnnronoconocnnronoronocnnconoconocnnronoconocnnccnoss 24 OPENING A STUDY SCREEN LAYOUT AND TOOLS csscccccccccsssscscccccccssssscsccccccccsssssccccccceesssscscccceceeseees 25 TIME LINES REPORTS AND LABS scssosicccdssse oncogene sandaacncaowansesabasacegacasesssdbeonceeemiaansabaencegesmedadsdbbosesaonsenasabdiocadensnsadsaboaentens 26 HID
17. ING SHOWING THE TIME LINE AND REPORT cccccseccecccsccsccusccsccscesscesccusceuscessesseuccesceusceussesseussenccussescenceusseusss 26 BRIT WebWorks Clinician s Guide UM WW_0012 Notices Copyrights and Revision Records PCM MOINS DAR Serio it sere S 27 COMPARING IMACES WIN STUDY sia 28 RS RU AULA AAA og PEE Eo E 28 AAA ECO e Io ooo 29 A e e qe o PP T T 30 Selecting Series to View SIMUltaneousIV iia titi 30 COMPARINO SIDE Srta tae ods atera 31 INCREASING IMACE VIEWING PAGE roo sa 32 A E oschaneeiaces comassueads 32 VENNA DPPN I I REPOR T aa E E 33 PANTNRS OF SOVING he Report 10 VOUr COMPULET sorer oae ene E A NA EA EEA EE E 34 MAE NIANPULA TON ie iata 35 Di O oa eee 35 E I es AE a E OAIE EN A EIEE a 37 POTTO yaris ee 37 ANDIE MOOSUT EMEIS srira i Erina ni EE EEEE EEIE iia 38 CTI AONO uate A iia 38 IMAGE MAGNIFICATION tarima 39 ADO SINS Oe diles 39 WORKING WITH REMOTE SERVERS IMAGE VIEWER ccccccccseccscccuccsccucccuccesceusceuccuscesccesscessesceuscessescenseusseuscencsusceuscs 40 CLOSING THE IMAGE VIEWER csccssscsscccsccssccssccscecscccsccscecsccvscevsecscessceusecscesscencecseeesceusecscesscevsesceesceesesssesscesscesceeseees 40 SECTION IV USING THE MESSAGING UTILITY ccscccscsccscsccccccccsccccsccccscccccsccccsccccccccsccccsccccsscccsoccess 41 TAKING ACTIONS IN THE MESSAGES TAB siesncsiccucesacoicnesciennoas 5svitacsioindeondSideunaodenduceddadieansededooatdiidinsd salves iuddeves
18. M WW_0012 Section IV Using the Messaging Utility Section IV Using the Messaging Utility Taking Actions in the Messages Tab The Action Bar on the messages screen includes the following tools gt Refresh Send Message Reply Message Acknowledge Message Delete Message and Y VV V WV Study Actions This section provides the steps to perform each of these tasks in the Messages tab and other ways to send a message Send Message A message can be attached to a study by selecting the study from any worklist and then selecting the Send Message Taf Send Message utility from directly on the Action Bar from under the Study Actions pull down menu or from under the right click menu It is also available in the image viewing screen from under the Study Actions pull down menu A general message not attached to the study can be sent from the messages tab by selecting the Send message utility from the Action Bar of the Messages tab After selecting the utility the Send a Message window opens as shown below Send a Message ie f i t pee To enter a user in the Send To field start typing the name and a list of all entries matching the typed letters will appear in the list dynamically refined as more letters are typed Send a Message Send To b O Subject admin alex adminalex at AlexSabo ES radalex radalex at AlexSabo Send To b a ee aes Subject Barton robert barton pbrit com at public A a Barak Obama
19. MEN Body Soft tissue 06 13 2001 1 New England Baptist Radiologist you can go in and type y 80 0 3 0 DUDE SPEN 2288593 M 03 05 19 REPORTED OIDOO00002C CR ANKLE RT ANKLE 05 04 2008 4 gene suburban Radiologist i Paget of1 bi 12 2 Study Actions JO Select Query Displaying 1 5 of 5 Ue a Ds Scanogram Attachment Attachment 06 13 2001 11 31 AM PID00000119 The columns displayed their size and order can all be adjusted using customization tools The detailed area at the bottom of the screen can also be customized For a full explanation of the Search Screen click here C The Tabs The tabs across the top of the browser represent different applications which are functions or worklists The default tabs for clinicians are shown below Patients Search 5 Messages 0 Action Needed 4 Study List All Updated Today Patients provides detailed information on patients and allows the physician to enter radiology orders if that module is being used My Studies provides list of studies ordered by the user Search is the default entry tab and was described above Messages is a list of messages that have been sent to the doctor These messages can be from any user of the system and are related to specific studies 6 BRIT WebWorks Clinician s Guide UM WW_0012 Section Il Customization Action Needed lists studies where some action needs to be take or will need to be taken by the u
20. Select Close when finished The Detailed Area resulting from the above settings is shown below 16 BRIT WebWorks Clinician s Guide UM WW_0012 Section Il Customization D Customizing Columns in Worklists The columns that are displayed their order and the sorting of the list can be customized for each if worklist by user To customize the list select the list icon from the initial customization screen The following page is displayed e lh a Setup Columns for Study List Visible Columns Available Colunms Name e Study UID Use this panel to setup the columns that appear in the List Just drag the ID e Arrival Date Available Columns into the Visible Columns area to the right and re arrange Sex Last Updated as needed Drag columns into the areas below to specify Grouping and Sort Birth Date e Patient History Order Status Study Reason Acc e Study Priority Group By Sort By Modality e Procedure Code Status Name Body Part e Phys Primary Modality Study Date e Phys Secondary Physician e Contact Description e Sending AE Ordering Location e Contact Primary Radiologist e Contact Secondary Study Comment e Image Count Fax Count e Contact 2 e Cont 2 Primary e Cont 2 Secondary e Ord Loc Primary e Ord Loc Secondary e Urgent Reason e Urgent Note e Action Needed e Hold Reason e Site e Contact Location e Cont Loc Primary Cont oar Secondary Close First select drag t
21. W99 F 3 7 03 10 55 AM L Spine WWWDAVIS SAMMY ZT123WW22 F 12 15 04 10 57 AM Pelvis 1 WWDEAN JAMES ZT66WW789 F 6 14 03 5 42 PM MRSHOL 112 WWDEAN JAMES ZT66WW789 F 10 6 02 7 56 AM MRLSPS 141 WWJACKSON MICHAEL ZT123WW88 M 2 4 05 8 43 AM 99 WWJOHNSON JOHNNIE ZT11WW123 M 10 11 02 11 33 AM XR SHOULDER LEFT 3 OR 4 VIEW 4 WWJOHNSON JOHNNIE ZT11WW123 M 11 12 02 2 43 PM XR ELBOW RIGHT 3V 3 WWJOHNSON JOHNNIE ZT11WW123 M 9 16 01 2 02 PM CH2 2 WWIMICHAEL SMITH ZT123WW66 F 1 31 05 2 56 PM FULL SINUS 74 WWBALL LUCY E K 1 CR 2 16 04 1 37 PM F A 92 WWWBALL LUCY ZT33WW456 F 8 18 30 010000073 OT OTHER 11 16 06 11 29 AM TEST 1 WWBALL LUCY ZT33WW456 F 8 18 30 J305 us BREAST 2 28 07 11 35 AM US_BREAST_BREAST 1 WWWPITT BRAD ZTSSWWE7S M 10000072 CT ABDOMEN 2 1 05 10 36 AM ABD 136 WWPITT BRAD ZTSSWW678 M 1 CR CSPINE 11 12 00 11 45 AM C SPINE PENTET 7 Y 7 ay DE Ps Aen LL tay Y As f Fa APRA 171 e APR EQ IIA gt i g P ty Actons P Sveci Query gt xetrresn Actions ana TCannec Jue Tes Displaying 1 35 of 35 ES A gt i 4 The Quick Search area and additional tools advance search and logout icons to the right of the Quick Search are visible from all tabs Entry of items into the Quick Search field from any tab results in a worklist displayed in the Search application The components displayed on the Search tab and all worklist tabs are gt Application Tabs allows user to quickly navigate between the different Roentgen W
22. an be shown on the PER Allimages screen using the layout tools iS This Series Double clicking on any image in any of the multiple image layouts changes the layout to 1 x 1 with the selected image displayed ER Layout Format 44 Page DD Page lt 4 Series DD Serie H Show Selected ER Initial Layout S Stack Layout BRIT WebWorks Clinician s Guide UM WW_0012 25 Section Ill Image Viewing Tools Time Lines Reports and Tabs lf there is a report it displays on the right hand side of the screen MCCUROY DAVID Study 6 16 05 10 16 AM 797499 LIVER for MCCUROY DAVID 78965412 M MCCUROY Namo IDO 70905412 DAVIO BRIT Systems vito aa 1909 Hi Line Dr Description LIVER Accession 797499 Performed 8 16 05 10 16 am Dallas TX 75207 6 26 00 9 10 AM 214 630 0636 The Radiologist SIGNED Administrator History heavy drinker Reason FO Lung Cancer abdominal pain Reported Techniques e MR of Chest REPORT e No comparison was available Findings e No pneumothorax e No cancer impressions f A Retesh Layout Format gt a mage formats DU Pace DO Page D Series DD Senos gt row Layout Hate Scouts Hate Report amp Moo Trreine A Study Actions gt The timeline of other studies for that patient displays on the top of the screen Hiding Showing the Time Line and Report The time line and report can be hidden and redisplayed via selecting deselecting the Time
23. atients Roentgen WOrkKS seansynam r ss aa Schedule Patients BONEY BARRY Unscheduled 4 Search 317 Users Sites Messages 0 Name AMYLOID FRED FLINT M 09 09 1920 S DOB Search Clear Search Area Name ld ex 51602 1015868187 Yassin s Site List of Patients with Recent Changes OR Result of Search from Search Area 51602 1015868187 ed brit com 4 4 Page1 oft bi Sa Add Patient Bo Edit Patient Sy Delete Patient Bo Export CCR E Add Order EX Access Report GE Action Bar Displaying 1 1 of A Y E Selected Patient Information When first entering this screen a list of patients with recent studies appears Tools within the Search Area support searching by ID Name and Date of Birth The results display in the middle of the screen Once a patient has been selected the detailed information about that patient displays in the bottom of the screen in the Selected Patient Information area The Action Bar also lists other actions that can be initiated from this screen including Add Patient Edit Patient Delete Patient Export CCR Continuity of Care Record Add Order and Access Report list of who has access this patient s record YYYYVY The columns in the Results area can be resized but can t be rearranged To find a specific patient start typing their last name followed by a comma and then their first name in the Name field You don t
24. criteria The Quick Search field is always available from the top of any screen It can be used to perform a search for a patient s study based on name ID or accession number To perform an Advanced Search using more parameters click on the magnifying glass on the right hand upper corner of the screen Once this has been done a pop up box appears as shown pent ee The Advanced Search box provides various criteria ga J ci J end by which to search for the patient s study Criteria pa includes study date ranges modality body part E A e e study status assigned radiologist CPT code and me an Emenocasss rice Poema physician contact If there are multiple sites then mos Pure Smo q i ore the user can search by site as well Searching by mme Essen ERED E wy Rado ert Saes the patient s birthdate is supported from the Search E sc a sore z m Date pull down menu Ok Cancel Clear 29 BRIT WebWorks Clinician s Guide UM WW_0012 BRIT Eins Section lll Image Viewing Tools After selecting the criteria select OK To clear all settings in the query select Clear To close without running the query select Close Once the query completes the list of all studies meeting that criteria are displayed Click on the patient to select it and the Details Area fills Working with Remote Servers the user will also have a Remote tab The user can select the Remote Tab and perform the same
25. cted patient information opens Patient Folder Administrative Tools Patient Access Report Displays list with selectable date of who has viewed the selected patient s folder Administrative Tools Study Event Displays history of selected study Vv VVVVVVV WV 12 BRIT WebWorks Clinician s Guide UM WW_0012 Section Il Customization Messaging Tab Roentgen Works has its own built in messaging tool that allows users of the system to send messages to each that can be related to studies such as a message between a radiologist and a referring physician The system also can send messages to users that are alerts such as studies taking too long to be read or a failure in a requested action such as a user trying to send a study to another user or another system This can be considered an informal communication mechanism i e these messages are not archived but it is a secure mechanism so it may be considered preferable to email when messages relate to patient data Message List To From Subject Text Studies Spencer William The Administrator Missing comp We don t see any comparison study for th E Meeting on pertin Can we have a meeting to discuss pe M Li t Spencer William The System HELDTOOLONG The attached Study has been HELD essage IS Spencer William The Administrator Vacation don t see anyone on the schedule for this Y Spencer William The System UNREADTOOLONG Studies are taking too lon
26. e Priority Main Contact Call Mobile Phone Priority Backup Dont me Priority Backup Contact No Alert second method that Report Delivery Method Don t Send will be used if the first fails after a system manager Save Changes Click Here established period of time All of these contacts are mainly used with the Change Password Urgent Findings module The Report Delivery Method is used to determine how reports will be sent to the user when they are listed as the ordering physician on a study Only select methods where the fields have been filled out When finished select Save Changes Changing Password This is also the screen used by a user to change their password To change a password Select Change Password Fill in the New Password and Confirm Password fields following the rules described in the box which have been established by the system administrator When finished select Submit BRIT WebWorks Clinician s Guide UM WW_0012 15 Section Il Customization C Customizing Details Area The bottom of the screen is called the Details Area The size of this area can be changed on each application by dragging the line between it and the action bar up or down It is used to display additional information about the selected item in the list above including thumbnails of objects medical images key images other pictures reports recordings etc and to display warning messages The information on each
27. ebedeaedeotetenes 41 SEND MESSAGE sita niciaes 41 REPEYING TONES ACE iio caca onicie 42 ACRNOWESDO NOA MESSAGE traia 44 D EEIN A MISS AE ant sa 44 BRIT WebWorks Clinician s Guide UM WW_0012 V Section Introduction Section Getting Started What s New in WebWorks Release 1 2 for Clinicians This manual covers the Roentgen Works WebWorks features only See Roentgen Works Clinician s Guide for information about the related products such as Urgent Works and ER Discordance The new features for WebWorks include the following DICOM image uploading utilities upload the images and they create a study on WebWorks this feature requires special user permissions More controls for the Web viewing space allows for more image viewing area Additional Imaging tools Cobb Angles Cine Loops ROI Tool Support for accessing studies on a different server for patients with the same patient ID Optional NHIN Gateway for accessing studies on a different server with different patient IDs BRIT WebWorks Clinician s Guide UM WW_0012 1 Section Introduction Roentgen Works Clinician s Quick Use Sheet 1 Open up your browser Fire Fox Chrome or Safari preferred and point to the URL provided by your system administrator book mark this for future use 2 You are opened into the Search tab If the patient you want is not on the list use the Search field at the top of the screen to enter a patient name ID
28. ection Ill Image Viewing Tools Working with Remote Servers Image Viewer When working with Remote Servers studies in the timeline from remote studies display with a blue border around them and an R in the corner of the thumbnail This helps indicate that it may take longer to retrieve the study but not necessarily Note that the current study is highlighted in green DORM AREA AR p am T E mt 2 ee p y Pu p E PJ i R 2 2003 2004 2005 2006 2007 2008 2002 Y CR CHEST at 12 09 2002 11 39 AM OI1D000002131 for MURRY RSNA RSNA200910 i Any of the thumbnails can be doubled clicked to open or dragged and dropped onto the image viewer same as with local studies Double clicking opens the study in its own window Dragging and dropping it on the screen splits the screen and displays both studies on the same screen Before downloading the study the user must respond to the following confirmation message Do you want to download the following study US ABDOMEN at 03 23 2007 12 26 PM 000555 for MURRY RSNA RSNA200910 Size 6 Mb Download Cancel Note that the message includes information as to the size of the study Closing the Image Viewer To close the image viewer select the x in the upper right hand corner of the viewing screen or select the x on the study tab on the Applications bar Note this only closes the one study other studies remain open under their own tabs 40 BRIT WebWorks Clinician s Guide U
29. ed or stored to a local system using browser tools Close the PDF by selecting the X in the upper right hand corner of the browser page Printing or Saving the Report to your computer While viewing the report from either the worklist or the image viewer select Show PDF This displays the report in a PDF viewer in a separate browser window tab Note the PDF viewer must be installed on the computer Use the browser s tools to print the study or to save the report to your system When finished close the browser s tab by selecting the x on the tab different browser may utilize different methods of closing windows tabs 34 BRIT WebWorks Clinician s Guide UM WW_0012 BRIE Section Ill Image Viewing Tools Leader of the PACS Image Manipulation On Screen Controls The web viewer includes on screen controls for magnification scrolling through images and various other tools that work when selected with the mouse The layout is shown below Magnification Slider 4 VEVD p Scroll Cine Bar All of these tools are grayed out until the mouse goes over them The magnification slider bar adjusts the size of the image The zoom factor is listed directly to the left of the magnification slider bar The Scroll bar advances the study through the images in the series The mouse tool bar is used to select the function to be performed by the mouse Click on the function and the cursor bar takes the shape of the icon The fu
30. eens i iii TE EAE I Initial M Fisher 1 2 WNERNERNG A SOOO LOE LOE LEE LEE LE ELBE ELE E RAN E E 4 4 AL idad gf ce amar ar ABBE A AR LAL A AB LA LAE i EEE RE AS BELEE ES ELE ES fr am CALL CALLER AE EE EE LEELA EE EEL LE AEA WA AE AE A AL A E AA BRE OA CER EERE L AE REL AREA E AOL AEE L A E AN E ARO ER A EERE d ABBE LARC BUY E ADO ER A E ABV BBE L EE AO E ARO LARA EEL PLETE SEL EBL BE ILE EL BR BE ERE P yL MB AR LALALA LULA 0100000000000 4000000000 LEON LAR LEON L AE LEO LAE SERLO LAL AE SERIAN TOR A A LEO LP OLE ELE BEL i A A a a SSRN o 5 A A Gi EERE EERE REE ay py T 0 18 EASED RY 0 A E E ESE E U E E E E E E BREE ERY E U E E E U E E E a a E2 E E 2 00 0 200 E LA OEE BRET ERES EL LEE BEL EERE LEE LEE BOLE EAE EE AE AE AES AENA LLL LL CIN PE AIR AET LIOOS EEE LE EEE EEE TOO TINE RCA A PEREIRA ERASE LINDO TY EMILE T IE SOTA EMR 4 4 i 4 4 E 4 4 pra iaw iaeaea iaw iaeiaiai LALA 2 O O On O O O O LALLA O O 0001001001000 a UALL ANL EL ANE TLE NET ELELE P 07 0310000810800 0000000001007 iii iii LAE EAT AR i i YA Y A 4 SRO O LOO LEE LEE LEE LEE ELE ELBE E YA Copyright 2011 Technical Publications Department BRIT Systems Inc BRIT Systems Inc Printed in U S A 1909 Hi Line Drive All rights reserved Dallas TX 75207 BRIT WebWorks Clinician s Guide UM WW_0012 jii Table of Contents Table of Contents Contents SECTION E GETTENG STATED iia 1 WHAT S NEW
31. format so it creates the number of series to view on the screen For example if 4 series are to be viewed simultaneously select a 2 x 2 format to create 4 windows on the screen e Drag and drop left mouse button depress the thumbnail of the desired series to any of the on screen windows This opens the series in that window 30 BRIT WebWorks Clinician s Guide UM WW_0012 Section Ill Image Viewing Tools Comparing Studies To compare studies open the first study into the viewer Drag left mouse depress and drag the additional studies from the timeline into the any of the windows and release This splits the screen and displays the studies side by side The thumbnails for the second study are listed on the right hand side of the screen The currently active study is highlighted in a bolder brighter green on the timeline 2003 2004 2005 2006 2007 2008 2009 2010 2011 R CHEST at 08 30 2002 2 01 PM OID000433 for BONEY BARRY PIDOO000EECR SHOULDER at 09 21 2002 1 16 PM OID000432 for BONEY BARRY PIDO fe Refresh FR Layout Format a image Format lt q Page DD Page lt q Series DD Series Stack Layout Show Hide 2 Study Actions D Window Level Orientation B Patient Discovery Only two studies can be opened in the viewer simultaneously A different study and be dragged and dropped from the timeline to either the left or the right image viewing window If the timeline is not shown select Show Timeline
32. from the patient buttons To open the study into a separate window double click on the thumbnail from the timeline To view a single study again close the second study by clicking on the x in the upper right hand corner if the image viewing screen for that study BRIT WebWorks Clinician s Guide UM WW_0012 31 Section Ill Image Viewing Tools Increasing Image Viewing Space To obtain the largest viewing space the following actions can be taken 1 Hide the Timeline using the toggle switch on the Actions Bar 2 Hide the Roentgen Files tabs and header by clicking on the box next to the x on the upper right hand side of the viewing screen Note to get it back click on the double box 3 Hide the Thumbnails on the right hand side of the screen by deselecting the thumbnails from the Show Hide pull down menu x Note it toggles between the box and the double box Timeline Thumbnails J System Markups User Markups Full Screen Pi A Study Actions The same Study Actions available from the worklist screens are available from within the viewer by selecting Study Actions from the Actions Bar urgent Findings Ea Discordance E Study Events E Download Study Eau Send Message Call Contacts 39 BRIT WebWorks Clinician s Guide UM WW_0012 BRIT Epes Section lll Image Viewing Tools Viewing and Printing Reports Reports will be shown as an icon in the timeli
33. g to READ 2011 07 07 14 29 NEW Spencer William The System HELDTOOLONG The attached Study has been HELD 2011 07 07 14 20 NEW Name ID Sex Birth Date Status Acc Mod Body Part Date Physician Sending AE Description Radiologist Comment images Faxe AGFALGDOGTI AGFA_LGD M NEWSTUD 20080723 CR Study Details Area The Action Bar on the messages screen includes the following tools gt Refresh Send Message Reply Message Acknowledge Message Delete Message and V VV V WV Study Actions where study actions are the same set of actions that can be taken from any worklist screen See Using The Messaging Utility for information on how to use this tool BRIT WebWorks Clinician s Guide UM WW_0012 13 Section Il Customization Section Il Customization A Customizing General Information All users can customize their screens They will only be allowed to add tabs for which they have permissions For example a referring physician would not have access to the HL7 Queue or the System tab as these are only relevant to system managers To access all customization tools select the tab to be customized Search for example then select the tools icon es in the upper right hand corner of the screen This will display the customization utility for that tab P ihm Setup Tabs Visible Tabs Available Tabs Schedule e Studies with Urgent Findings Use this panel to setup which Applications appear Patien
34. he column names you want displayed from the Available Columns to the Visible Columns Rearrange the column names in the list the top of the list will be the leftmost column Next the list can be grouped by any of the fields This will be the top level sort and it produces a named line in the worklist and all items in its category are listed under that line For example if the user wants all patients from the same location listed together then the Site would be listed in the Group By Ifthe user wants to group it by study status then Work Status would in that box The Sort By indicates how the list is to be sorted under the Group heading This supports a multilevel sort Changes occur immediately there is not a separate save step Select Close when finished From the worklist the widths of the columns can be adjusted by moving the cursor over the line between the column headings depressing the left mouse and dragging in either direction The worklist resulting from the above settings is shown below BRIT WebWorks Clinician s Guide UM WW_0012 17 Section Il Customization Study List Quick Search Name ID Sex Birth Date Status Acct Mod Body Part Date Physician Description Ordering Location Radiologist Comment J Status NEWSTUDY AAPM TEST PAT PID000000 07 04 2 NEWSTUDY 20022002 OT OTHER 11 17 2002 6 AAPM Multi Purpose 2K Unassigned NA AAPM TEST PAT PID000000 07 04 2 NEWSTUDY 20022002
35. he radiologist and Order Entry the on line medical imaging procedure reservation system This manual will only discuss WebWorks See Roentgen Works Clinician s Guide for information on the other components The system works best with the latest Chrome Safari or FireFox browsers IE will not have all the functionality of these other browsers particularly within the WebWorks image viewing module and will not perform as well within any module IE 6 will not perform well BRIT WebWorks Clinician s Guide UM WW_0012 3 Section Il Customization A Starting the Roentgen Works Application This application is started from Firefox Safari or Internet Explorer 7 or later web browser by entering the URL Address of the application Each user must have an ID and a password assigned to them One of two screens can appear depending on the URL assigned If there are multiple sites on the server you may be directed to a screen that shows multiple facilities and requires that you select a site Roentgen Works Please select your facility to log into Screen with multiple facilities oe O O O ABC CLINIC CA Capital X Ray Clean Data er gt er Dogs and Cats FireDrill site My Site Suburban Cl nic e T VAPACS ed parker site ao a a g GG Or a screen that is for a single facility that appears something similar to the picture below _ ersus E AA g Public Vi Privete Cio E www nevwbelgiurn beer st
36. hen done with the study close it it can t be answered from within the image viewing area 49 BRIT WebWorks Clinician s Guide UM WW_0012 BRIT Eee Section lll Image Viewing Tools To From Subject Text Missing comp We don t see any compari Spencer William The Administrator Meeting on pertineni Can we have a meeting to discuss Spencer William The System HELDTOOLONG The attached Study has been HE Spencer William The Administrator Vacation don t see anyone on the schedu Spencer William The System UNREADTOOLONG Studies are taking too long to READ Spencer William The System HELDTOOLONG The attached Study has been HELD Message with Related Study 011 07 07 14 29 NEW 2011 07 07 14 20 NEW 1 Name iD Sex BirthDate Status Acc Mod Body Part Date Physician Sending AE Radiologist Comment image Faxe WATSON WW_N 456DD9017 M 06 18 19 TRANSCRII 3 Click on the Reply Message button S Reply Message in the Actions Bar The message from another user on the system appears o Reply to Message o Send To The Administrator admin at root O Subject Meeting on pertinent history gt From The Administrator at 2011 07 07 16 33 gt Can we have a meeting to discuss pertinent histories and how to communicate them Let us know your schedule Send Cancel 4 Type the message in the window Click on the Send button to save and send the reply 6
37. left on the left hand side of the screen as a thumbnail The images are sized in a fit mode i e the entire image is displayed within its window The scout image displays the scout line registering the location of the axial images All on screen series are automatically synchronized Refresh H Layout Format image Format lt q Page DD Page lt q Series DI gt Series RA Flow Layout H Show Hide Study Actions Window Level Orientation Scrolling through Images in a Series To scroll through the images depress the left or middle mouse button on the scroll bar on the bottom on any of the image windows and slide it to the left or right All images stay in synch and the position is displayed on the scout in the thumbnail area For finer control select the arrow head from the tools palette on the right E hand side of the window Alternatively Next Image and Previous Image can be selected from the right mouse click menu iil Go to the next image Another option is to select the Cine Scroll tool from under the right mouse click menu When selected move the mouse horizontally across any part of the image screen while depressing the left mouse button to gt Next Image scroll through the series Alternatively a scroll wheel can be used ane Note that the scroll widget on the bottom of the screen moves to lt Previous Image indicate the position in the stack and the scout image also continues to regi
38. line and Report boxes 2 respectively from the Show Hide Action Bar pull down Y Thumbnails menu System Markups V User Markups Full Screen A Stack Layout le Show Hide PP Study Actions The time line can also be hidden by selecting the pin icon in the upper right hand ys da by corner of the window above the timeline It can then be visualized by moving the mouse over the bar at the top of the window labeled Time Line The timeline can be replaced by selecting the horizontal pin in the upper right hand corner it toggles between being upright and being horizontal The Report can be also be hidden by selecting the x in the upper right hand corner of the report window a x 26 BRIT WebWorks Clinician s Guide UM WW_0012 BRIT Systems section Ill Image Viewing Tools Actions Bar Shown below the image screen are the buttons that allow the user to manipulate the images studies and reports efres ayout Format mage Format age age eries eries Y Stack Layo ow ev u tions indow Level Orientation v atient Discovery Refresh P Layout Format image Format lt q Page D gt Page QK Series DD Series Stack Layout Show Hid Study Acti Window Level Orientation 8g Patient Di They are as follows gt gt Y VV V WV Refresh reload the webpage Layout format changes the image format within a series The selection ranges from 1x1 to 4x4 per page including all images ju
39. nctions are as follows Depressing the left button and moving it over the image allows the user to adjust window level settings for that image Clicking in an areas with either the left or middle mouse produces an optimized W L setting for that region Note that the Window and Level settings are listed in the upper right hand corner along with the zoom factor Also see Window Level on toolbar below images BRIT WebWorks Clinician s Guide UM WW_0012 35 Section Ill Image Viewing Tools A Left clicking this button allows the user to view or hide annotations associated with the image i Left clicking this button allows the user to make measurements on the image After selecting it move the cursor into the image area and drag and drop the ruler To make multiple measurements drag and drop it again It works with both the left and middle mouse buttons Left clicking this button allows the user to pan the image by depressing the left mouse key and dragging the image around It will only work when the image is larger than the screen Ch Rotates the image as per the selection under the button gt Advances one image in the series or the study lil ROI tools selectable by freehand rectangle ellipse or polygon S Angle measurement tool includes a regular angle and a Cobb measurement tool To turn off any of these tools you can click on it again Note to turn off a tool gt Next image with multiple selections
40. ne if there is not study associated with them If there is a study then it will be displayed when the study opens on the right hand side of the screen lt can be hidden and redisplayed using the Show Hide pull down menu on the Actions Bar The report can be viewed as a PDF by selecting Show PDF in the lower left hand corner of the report screen lt can also be displayed by double clicking on the icon from the Details Area of worklists This opens the study into its own tab Roentgen WHOS search Ey Name I alaaieietnenbcisainiateate G Se System Urgent Findings 1 Action Needed 6 On Hold 2 Unassigned 111 Jl Search 57 Report for LUMBARO1 MR 3 Report for Study 08 10 2007 12 11 PM 2618321 SL2V for LUMBARO Name LUMBARO1 MR ORTH Birth Date 03 08 1956 M Description SL2V Report Header 2618321 Procedure Code e 08 10 2007 12 11 PM Radiologist Smith Ben e 03 15 2011 2 01 PM technique impression conclusion Re po rt Body E Urgent Finding Internal Bleeding Please admit Report Created by Radiologist 1 PE SE Image 2 image 3 Detail Area Select Show PDF from the bar directly below the report and it displays the report in its own browser tab including the icon for the site This requires that the computer has a PDF viewer BRIT WebWorks Clinician s Guide UM WW_0012 33 Section Ill Image Viewing Tools lt can then be print
41. or select from the other precanned queries under the pull down menu 3 Select the patient study of interest from the list 4 lf there are images in the study thumbnail s will appear at the bottom of the screen If there is a report there will be a report icon You can double click on the worklist or the thumbnail to view the images You can double click on the report icon to view the report 5 When opening the study a time line of additional studies displays at the top of the screen Double clicking on it opens the study into a separate tab Dragging and dropping into the image area opens it side by side with the current study studies The timeline can be hidden with the Show Hide button on the bottom of the screen 6 Thumbnails on the left side of the screen can be dragged and dropped into the viewing area The format of the viewing area can be changed with the Layout Format tool on the bottom of the screen on the Actions Bar 7 Manipulation and measurement tools are available under the right mouse click Some tools are also available via icons on the right of each image A slider bar to mag the image is available in the top right of the image An image scroll bar is available at the bottom of the image window 8 Some of the same tools and additional tools are available on the Action Bar Also Study Actions tools available from the worklist are also available from the Action Bar 9 To return to the worklist and close the study
42. orks utilities Users can customize the tabs visible to them and their location The tabs include a number indicating the number of items in that list If the number is red then something new has popped into that list since last viewed or originally displayed In the picture above there are 3 items in Action Needed 36 in the Search tab and 11 Messages gt Worklist displays the list of patients meeting the query The columns displayed are customizable by user gt Refresh refreshes the page gt Study Action contains a selection of actions which allow the user to perform specific additional functions on the study These are different for each individual tab gt Detail Area provides the details for the selected study and can be customized by each user Some of the details that can be included are amp Reason for Study amp Location BRIT WebWorks Clinician s Guide UM WW_0012 8 Section Il Customization amp History amp Physician 24 Tech Comments 4 Backup Contact amp Study Status amp Misc Contact amp Final Read amp DICOM Doc YA Patient Name Some worklist screens also have the Select Query option It provides a set of canned queries that the user can select BRIT WebWorks Clinician s Guide UM WW_0012 9 Section Il Customization F Patient Tab The Patient Tab is used to see a list of Patients with recent changes and to search for patient information about specific p
43. ote Servers have been defined a special information box displays indicating how many remote studies have been found for that patient as shown below AAPM TEST PATTERNS PIDOO0000 0 7 4 02 20022002 oT OTHER 11 17 02 6 55 PM Multi Purpose 2K 1 MURRY RSNA RSNA2_61 M 2 16 33 OIDO00552 CR CHEST 5 30 08 7 19 AM CHEST X RAY 1 MURRY RSNA RSNA200910 M 2 16 33 01D000002131 CR CHEST 12 9 02 11 39 AM CHEST X RAY 1 16 Remote Studies for MURRY RSNA click here to download Zoom of the information box 16 Remote Studies for MURRY RSNA ASN4200910 click here to download The user can select to download all studies They will appear on the timeline from the image viewer and can be selected from there 24 BRIT WebWorks Clinician s Guide UM WW_0012 BRIT Bens Section lll Image Viewing Tools Opening a Study Screen Layout and Tools To open a study double click on the worklist This will display the entire study in stack mode with scout lines to the left of the screen To display a single series in stack mode double click on the E na thumbnail or double click on an PER ix2 image on the screen E 2 To return to the entire study mode 22 double click on the Stack Layout EE 2x3 on the Action Bar or select Initial Pa s2 Layout from under the Layout Format pull down menu on the Bs ac Action Bar ES 3x4 i 4x3 After a single series is being En axa displayed multiple images from that series c
44. queries as the Search tab Working with the Results from the Search Panel After selecting the patient the user can take the following actions by selecting Study Actions drop down menu from the Actions Bar Urgent Findings En Discordance 2 Study Events E Download Study Urgent Findings Selecting Urgent Findings will display any Urgent Finding History and allow the referring physician to acknowledge any Urgent Findings Discordance This selection will only be available on system with the optional ER Discordance tools Selecting Discordance will display any Discordance History and also allow the referring physician to enter initial diagnosis and acknowledge the radiologist s response Study Events Selecting Study Events displays the study history Download Study Selecting Download Study allows the user to DICOM Store a study to the DICOM device defined in their user profile under Tools network BRIT WebWorks Clinician s Guide UM WW_0012 23 Section Ill Image Viewing Tools Send Message Selecting Send Message allows a user to send a message to another user on the system that will be attached to the study The message will display in the other user s Messages tab Call Contacts Selecting Call Contacts displays a name of users associated with the study lf the workstation has been integrated with Skype then selecting a user s name can initiate the call Working with Remote Servers Study List When Rem
45. rs Move it to the start of the xi first line depress the left mouse button the line draws as the mouse moves then release Next depress the left mouse button again draw the second line and release The inner angle displays Multiple angles can be measured Move the pencil to the next place and repeat The tool also acts as a cursor so a different image can be selected for measurement When finished deselect the tool by clicking on the Angle Tool that has the blue dot in front of it on the second level menu Note this can be from either the right menu or the toolbar but it must be deselected from the second level selection where it was originally selected If not deselected it remain active even if a different patient is selected Pj A Show Hide Cobb Angle The Cobb angle is used to measure the curvature of the spine To use the Cobb Angle Select the Cobb angle tool from either the angle measurement tool on the tool ban or under the right mouse button A small pencil appears Draw a line through the first vertebrae moving mouse to one side and dragging and dropping it on the other side moving parallel along the bone Repeat on the second vertebrae The Cobb angle appears Note the tool actually measures the angle of the intersection of the lines Multiple measurements can be taken on multiple images When finished deselect the tool by clicking on the Angle Tool and the underlying Cobb Angle Tool 3
46. s Available Tabs Schedule e Studies with Urgent Findings Use this panel to setup which Applications appear Patient List e Discordance Studies int your Tab Bar Just drag the Available Tabs into Unscheduled Orders e Action Needed the Visible Tabs area to the right and re arrange as Study Search e Studies with Quizzes needed User List e Public Studies Site List e Scheduled Orders Message List Modality List Location List Remote Choose theme BRIT Default close Only applications for which the user is authorized will be visible on the list Drag the applications desired from the Available Tabs list to the Visible Tabs box Rearrange the applications within the visible box as desired The top application is listed on the far left of the screen Hint for workflows it is useful to list the tabs representing the next step in the process from left to right Changes occur immediately there is not a separate save step Select Close when finished 18 BRIT WebWorks Clinician s Guide UM WW_0012 Section Il Customization F Changing the Color Pallette Study lists are color coded in The Roentgen Works Basically different categories of studies use different colors ER discordances use blues Urgent Finding use orange Patients who have not arrived on the calendar On Holds use yellow normal studies user white or light coloring The brighter the hue the more important the status There is also the ability to change the color pallette
47. screen can be customized by the users From the initial ec customization screen select the detail icon The following screen appears if Setup Details for Study List Available Fields Use this panel to setup the data that appears in the Detail area at the bottom of the screen Just drag the e Sex available fields on the right into the columns below and re arrange as needed e Study UID Column 2 Column 3 e Body Part Patient History Study Date Status Study Reason e Last Updated Action Needed Urgent Reason Study Comment Physician Contact Location Study Priority Show Icons for Selected Study Show Popups Warning Boxes a e 8 Close The Details Area displays information in 3 columns as listed above Drag left mouse depress and move the desired informational item from the Available Fields list on the right hand side of the screen to the desired column The items within a column can be rearranged by dragging them up and down the list as well Selecting the Show Icons for Selected Study creates a space at the top of the Details Area where the thumbnails will appear once an object in the worklist has been selected Selecting the Show Popups Warning Boxes displays the warnings in the bottom right hand side of the Details Area Warnings may include information such as faxes that have not been assigned to a study or new images arriving for a study Changes occur immediately there is not a separate save step
48. ser or another person associated with the study This lists the On Holds Urgent Findings and ER Discordances Additional tabs are available via using the Customization Tools D Search Customize and Log Out In the upper right hand corner of the screen are three icons gt advanced search y gt Users settings customize ya DJ gt Log out When the user needs to log out click on the door with the red arrow at the top right portion of the window The system logs the user out and returns to the login window Note a user can log on to the server multiple times from different computers but the screen from one user can be exported at indeterminate intervals to all the other screens where that user is logged on BRIT WebWorks Clinician s Guide UM WW_0012 Section Il Customization E Search Tab The Search Tab provides access to all patients in the system for which a user has access It displays a list of all patients with recently changed information as the default list ED Case Studies BRIT Systems x Roentgen Works Study List Advan BRIT Ticket Login Roentgen Works Study List Acc x Untitled ld Roentgen Works ci Quick Search Name o Sex Beth Date Accs Wod Body Part Date Descrpton WWWBOND JAMES ZT123WW11 F 11 13 98 MR TEA MRI Knee WWCAPTAIN KIRK ZT123WW99 E Applications T SPINE X RAY WWCAPTAIN KIRK ZT123WW99 F TTO rer L Spine WWCAPTAIN KIRK ZT123W
49. st this series and the initial image on the page Page gt page forward Page lt page backward Series gt series forward Series lt series backward Stack Layout images can either be viewed as they flow from one to the next on a page or they can be stacked on one another This toggles between Stack Layout and Flow Layout Clicking on Stack Layout displays every series in a window on the screen Clicking on Flow Layout puts a single series on the screen and then the Layout Format tools can adjust the number of images within a single series to display simultaneously it sets the montage Show Hide Provides toggles for displaying and hiding features on the screen It is used to help utilize more of the window for viewing images Study Actions Drop down list on actions that can be taken Window Level provides default Window and level settings Sigmoid Invert and Default settings Default resets the window level setting to the one originally displayed Orientation Flips and rotate functions Patient Discovery This is only available on systems with this optional feature that searches other PACS for patients with a matching set of criteria that may not include patient ID BRIT WebWorks Clinician s Guide UM WW_0012 27 Section Ill Image Viewing Tools Comparing Images within a Study The default layout when opening a study is to open each study in the series on the screen except in CTs the scout line is
50. ster the location Deselect the Cine Scroll tool to release the alen aii tool Cine Scroll Pan Image Measure Tool ROI Tools p Angle Tools 28 BRIT WebWorks Clinician s Guide UM WW_0012 BRIT AS Section lll Image Viewing Tools Play Cine Images can be automatically scrolled at a selected rate via the Play Cine function under the right mouse click menu If the acquisition rate is provided by the modality as it sometimes is with ultrasounds then the default rate will be the actual acquisition rate Note this viewer supporst multiframe ultrasound images To play the cine select Play Cine from the right mouse click menu The images can be in any format on the screen however only one set of images can run in cine mode at a time The Play Cine Box appears The box can be moved around the screen by dragging it with the left mouse depressed The 4 headed arrow appears when the box is in the move mode Play Cine US at 03 11 2002 1 36 F Start FPS 30 tao Start Frame 1 End Frame 11 PlayMode Forward Forward cycle Reverse cycle E Reverse SS UNA e a Dor Tr A A A ee E O SE Select Start to begin playing The cine can run just select frames by entering the Start Frame and the End Frame must be done while stopped or paused When it first opens the number in End Frame also indicates the number of images in the series Adjust the speed with the FPS frame per second pull down men
51. t List e Discordance Studies int your Tab Bar Just drag the Available Tabs into Unscheduled Orders e Action Needed the Visible Tabs area to the right and re arrange as Study Search e Studies with Quizzes needed User List e Public Studies Site List e Scheduled Orders Message List Modality List Location List Remote Choose theme BRIT Default Close All information entered into the customization areas are immediately available throughout the application BRIT WebWorks Clinician s Guide UM WW_0012 14 Section Il Customization B Customizing Contact Information The Roentgen Works utilizes contact information to display to other users and also in some applications such as Urgent Works the system will utilize this information to automate calls placed to users This is also where the users indicate their preference for receipt of reports select the telephone icon a from the initial customization screen shown above Enter the information and select Save Changes then Close Selecting Close without selecting Save Changes first is the same as cancelling the actions Most of the entry fields are self a LA explanatory Mobile 214 755 3594 The Backup Office 214 630 0636 Contact is a user E on the system who eee will contacted if you Page can t be reached for an emergency The Priority Main Email Address shelly brit com Contact is the first Fax method used when A attempting to reach the user Th
52. te se 0 3 Mod Body Part Description BONEY BARRY 06 19 1986 M 08 30 2002 2 01 PM REPORTED CR CHEST CHEST PORTABLE BUNNY EASTER 04 24 1950 M 06 24 2011 9 30 AM SCHEDULED CT HEAD CT HEAD BRAIN W O CONTRAST BUNNY EASTER 04 24 1950 M 04 27 2011 9 45 AM SCHEDULED MR LOWER EXTREMITY MRI KNEE WO W CONTRAST CLAUSE SANTA 12 25 1920 M 04 22 2011 5 30 PM SCHEDULED CT LOWER EXTREMITY CT LOWER UNI EXT WO CONTRAST BUNNY EASTER 04 24 1950 M 04 22 20 CHEST CHEST SINGLE VIEW L SP SD 12 03 1937 F 11 0 LSPINE LSP CHIARDO CHRISTOPH 09 25 1967 M SPINE 72070 THORACIC SPINE 2 VIEWS Worklist Area Action Bar Displaying 1 7 of 4 4 Page 1 btt gt i gt EHDiscordance Urgent Findings Q Call Contacts gt Study Actions SAR A FA Details Area The following actions can be taken from the Action Bar or from under the right mouse click gt Discordance The user can enter an initial diagnosis for a radiology study and then follow the radiologist s final diagnosis with the Discordance tool Urgent Finding View and acknowledge Urgent Findings Call Contacts View a list of contacts and if integrated with Skype place the call View Study View images in WebWorks Download Study Download the study to DICOM server defined under the user s profile Take a Quiz Answer a quiz if one has been set up for the study Edit or Add Order Edit or Add an order for a radiology exam opens Order window Edit Patient edit sele
53. u or via the slider bar to its right The cine runs forward in a continuous loop when in its default Forward cycle PlayMode The other modes are Reverse cycle Forward which plays once and stops and Reverse which plays once in reverse and stops Select Stop to stop playing and Start to start playing at the first frame Select Pause to stop playing and Start to start playing at the next frame Select Close to stop the cine and exit the cine mode BRIT WebWorks Clinician s Guide UM WW_0012 29 Section Ill Image Viewing Tools Viewing a Single Series To view a single series double click on the image in the desired series This displays a single window on the monitor with the selected image Then adjust the format montage of the images using the Layout Format tools from the Action Bar This display multiple images from the same series on the monitor Use the Page forward and backward arrows on the action bar to move through the series a set of images at a time To view the next series double click on the series thumbnail or select the forward and backwards Series buttons from the Action Bar Note that the border around the active series is green The series will display in the same format as the previous series Selecting Series to View Simultaneously To view select series simultaneously on the screen e Open the study e Double click on one of series to be viewed This displays a single viewing window e Select the layout

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