Wills Eye Telemedicine: CDC Platform - User`s Manual V
Contents
1. Technician Medical Info Link back Add Patient Upload Technician Figure 5 Image upload process Wills Eye Telemedicine CDC Platform User s Manual V 1 0 Reading Physician of Record Reading Technician Wills Eye CDC Patient Info Patient images 2 6 Uploading Images Browser Upload Once images have been taken using the Nidek camera and the Navis Lite software resulting DICOM images will be exported to a designated desktop folder Go back to the upload page Figure 5 above and press the Upload Images button You will now see the browser based Upload interface in your browser Figure 6 DI Wills Eye Institute MA ERA A Upload Images Patient Browse MRN Date Of Service First Name Last Name DOB mm dd yyyy Reading Center Gender Race Ethnicity Patient Search 48 03 09 2011 Jonathan Doe 05 02 1962 WE2 Male Puerto Rican RIGHT EYE drop a file or click to here drop a file or click to here drop a file or click to here October 2011 SIMITIWI HIF S LEFT EYE drop a file or click to nere drop a file or click to nere drop a file or click to here Figure 6 Upload images by dragging them into this browser interface Wills Eye Telemedicine CDC Platform User s Manual V 1 0 2 7 Uploading Images Drag and Drop Drag images from desktop folder to the browser Images will upload placement will be determined by DICOM data such as MRN and time stamp for2. Zip Country Phone Fax Cell Phone Mobile Carrier Cell phone information is for SMS notifications Wills Eye Telemedicine CDC Platform User s Manual V 1 0 2 Uploading Accounts The CDC diagnostic platform can manage different functions for Telemedicine An important position in the ROP Telemedicine workflow is the upload technician Upload technicians are directly associated with individual Reading Centers and this acts as a filter in that each upload account can only view patients uploaded to their corresponding clinic 2 1 Uploading Images Default Page Logging in with an Upload account will bring the user to the default page with the patient list designated as either Read or Unread On this template see Figure 1 the user can search for patients view status edit information on existing patients or Add a new patient The most common activity on this screen will be adding new patients for the Reading Technician to read 3 Email support Support type Welcome Reading Tech Clinic WE2 Wi Wills Eye Institute Patient Browse Show patients Unread Actions 146 03 09 2011 Jonathan Doe 05 02 1962 Dr Federman F 4 23 October 2011 S M TWH F S Figure 1 Default Upload template Wills Eye Telemedicine CDC Platform User s Manual V 1 0 2 2 Uploading Images Add New Patient On the left hand menu click on the Add link to go to the Patient demographic and medical inf
3. in the Navis Lite interface Ethnicity Hispanic Latino or Spanish origin Capture images in the Navis Lite software and drag and drop into the Medical Information browser When you are ready to upload images press the Upload Date of Service Images button below mm dd yyyy E A AAA UPLOAD IMAGES E Visual A Snelle Or use the back up up osc aft Pra Viciial Amity Figure 4 Add images through the Upload Interface Wills Eye Telemedicine CDC Platform User s Manual V 1 0 2 5 Uploading Images Process overview The upload process is outlined below Figure 5 The Nidek camera software settings should be changed in order to output DICOM images The images will be dragged and dropped into the browser interface where the will transfer and appear A Verify button simply confirms that the images uploaded correctly visual check and takes the Tech back to the Patient Browse page NOTE the DICOM upload will ONLY work with DICOM images generated by the Navis Lite Nidek camera and software WET PH2 5 CDC Upload Process drags images folder into the browser as instructed O The Nidek software exports DICOM images mn to a folder on the PC The Upload thech then A En gt Can MRN Softare generates patient 4 9 9 gt gt Login ENTER Clinic Upload Patient Info NEXT PATIENT
4. Browse LastName CDC First Name test2 Patient ID 00001 DOB mm dd yyyy 10 01 2001 Location WE1 Tech 1D 023 Clinic Code Gender Male Race Ethnicity Hispanic Latino or Spanish origin October 2011 Principal Investigator Jay Federman M D S IMI TIWIHIF S Date of Service mm dd yyyy 10 19 2011 RE Visual acuity 20 50 Lens Status OD No known cataract LE Visual acuity 20 100 Lens Status OS No known cataract Wears Contact Lens OD Soft Lens Present Present Diagnosis Wears Contact Lens OS Soft Lens Present Medications Labs FBSmg dL Labs HbA1C Comments Right Ext Nas Left Ext Nas Showing image field Right Ext Significant Cataract Significant Corneal Anomaly Significant Iris Findings Cummulative findings Ext No apparent abnormalities Figure 10 Reading Technician Reading Field Wills Eye Telemedicine CDC Platform User s Manual V 1 0 3 3 Reading Technician Interpretation The Interpretation Chart Figure 11 is the last check and opportunity for editing before saving the report Images on the left can be replaced with an image from any of the small thumbnails that are visible underneath the larger image Comments or recommendation fields can be edited and the changes will carry through to the final report When the reader has finalized the report click on the Save button you can now view the final report as a PDF and it has been saved in the database Email support Support type
5. Welcome Reading Tech Clinic WE2 My Profile M Log Off Wi Wills Eye Institute ROP Browse patients View All Photo Sessions MRN 48 Eg Patient Browse Add Patient Information Patient Search Demographic Information LastName CDC First Name test2 Patient ID 00001 DOB mm dd yyyy 10 01 2001 Location WE1 Tech ID 023 Clinic Code Gender Male Race Ethnicity Hispanic Latino or Spanish origin e OE RSEN ES Principal Investigator Jay Federman M D S M TW HF S 1 Medical Information 2 3 4 5 6 7 8 Date of Service mm dd yyyy 10 19 2011 9 10 11 1213 14 15 RE Visual acuity 20 50 Lens Status OD No known cataract PA Ald LE Visual acuity 20 100 Lens Status OS No known cataract mcd id hic Wears Contact Lens OD Soft Lens Present Present Diagnosis Wears Contact Lens OS Soft Lens Present Medications Labs FBSmg dL Labs HbA1C Comments IIS II II Cataract pre pem a TO be present Diabetic Diabetic Retinopathy Findings are Suggestive of Findings are Suggestive of No Apparent Diabetic Retinopathy No apparent diabetes related ce present Other Retinal Other Retinal Findings are Suggestive of are Suggestive of LJ ld Hypertensive Changes present kefe Temp Photographie Imaging Report Left Eye Cataract AAA be present Diabetic Diabetic Retinopathy Findings are Suggestive of Findings are Suggestive of No Apparent Diabetic Retin
6. cataract may be present Diabetic Retinopathy Findings are Suggestive of Unreadable No apparent DR No apparent diabetes related maculopathy is present A AE 07 Hypertensive Changes are present a Re evaluate in twelve months Read and certified on 08 24 2011 06 34 10 by Jay L Federman MD Cari H Park MD Wills Eye Institute Reading Center WillsEyeTelemedicine com Ocular Imaging Assessment by Photographic Documentation is not a Substitute for a Comprehensive Ophthalmic Evaluation by an Eye Care Provider Figure 12 Final Report Wills Eye Telemedicine CDC Platform User s Manual V 1 0 3 5 Reading Technician Read Patients By using the Show patients toggle and setting it to Read the patient list can be filtered by patients that have already been examined Figure 13 146 145 131 66 64 62 57 Show patients Read MRN Date Of Photograph First Name Last Name DOB mm dd yyyy Status Readings Photo sess Actions 03 07 2011 ut test 2 march eight 03 02 2011 PR 1 2 E 03 05 2011 ut test march eight 03 02 2011 PR 1 1 02 03 2011 recedit test 02 01 2011 1 1 10 21 2009 Noah Porter 10 21 2009 PR 3 1 10 20 2009 Gabriel Gray 10 20 2009 PR 1 1 _ 10 13 2009 Nate Drake 10 13 2009 PR 3 1 _ 08 13 2009 Roy Test 08 11 2009 PR 3 1 _ Figure 13 Reading Technician Read Patients 3 6 Reading Technician Read Patients Details When a patient has been read t
7. Eye Telemedicine CDC Platform User s Manual V 1 0 2 3 Uploading Images Designate Reading Technician and Principal Investigating Physician PIP After the demographic and medical information has been entered a Reading Tech and PIP must be selected Pay close attention to this part since the correct Reading Technician assignment is important To select the Reading Tech and PIP use the pull down menu Figure 3 Pd Physician Information Reading Technician Smith Bob Reading Physician of Record Federman Jay Figure 3 Add Physician Information 2 4 Uploading Images Patient Images Once the correct Patient Demographic information Medical Information and Physician information has been added press the save button You will now see a Read Only version of the Demographic and Medical Information AND an MRN Patient ID plus further instructions The MRN is used to initiate image capture on the Navis Lite software and camera Figure 4 Demographic Information m Patient Images MRN 48 Status First Name Patient Information Uploaded Successfully Last Name CDC Please review the Patient Information and edit if necesary DOB mm dd yyyy 10 01 2001 Internal MRN 48 Hosp MR fdsfds Clinic JNICU Image Upload PENDING Clinic Code Please Open the Navis Lite Software in order to capture field images eee Male Enter the Internal MRN number above in order to create a new patient
8. RPR Actions 147 03 09 2011 Brian Jones 05 02 1962 ma WE2 Dr Federman E cc 20H 146 03 09 2011 Jonathan Doe 05 02 1962 WE2 Dr Federman SMTWHEFS 66 10 21 2009 Jane Smith 02 21 1958 WE4 Federman 145 10 21 2009 Joan Blue 02 21 1958 WE2 Dr Federman 144 03 09 2011 Cindy Brown 03 12 1962 poo WE2 Dr Federman 65 10 21 2009 Roger Smith 02 21 1970 PR WE4 Dr Federman 64 03 09 2011 Samantha Doe 12 02 1969 ul WE4 Dr Federman 2 143 10 21 2009 Robert Smith 02 21 1975 R WE4 Dr Federman E 61 03 09 2011 Jonathan Smith 05 02 1960 PR WE4 Dr Federman 142 10 21 2009 Jane Doe 02 21 1958 ul WE4 Federman 141 03 09 2011 Jonathan Doe 05 02 1962 R WE2 Dr Federman 63 10 21 2009 Jane Smith 02 21 1958 WE4 Dr Federman Figure 14 PIP Wills Eye Telemedicine CDC Platform User s Manual V 1 0 4 CDC Technician Data Mining Wills Eye Telemedicine CDC Platform User s Manual V 1 0
9. Wills Eye Telemedicine CDC Platform User s Manual v 1 0 Wills Eye Telemedicine CDC Platform User s Manual V 1 0 1 ADMINISTRATIVE AREA 1 1 CLINIC ADMINISTRATION 1 2 GLOBAL ADMINISTRATION 1 3 REGION ADMINISTRATION 1 4 SETUP 2 UPLOADING ACCOUNTS 2 1 UPLOADING IMAGES DEFAULT PAGE 2 2 UPLOADING IMAGES ADD NEW PATIENT 2 3 UPLOADING IMAGES DESIGNATE READING TECHNICIAN AND PRINCIPAL INVESTIGATING PHYSICIAN PIP 2 4 UPLOADING IMAGES PATIENT IMAGES 2 5 UPLOADING IMAGES PROCESS OVERVIEW 2 6 UPLOADING IMAGES BROWSER UPLOAD 2 7 UPLOADING IMAGES DRAG AND DROP 2 8 UPLOADING IMAGES EDIT REVIEW 3 READING ACCOUNTS 3 1 READING TECHNICIAN UNREAD PATIENTS 3 2 READING TECHNICIAN READING FIELDS 3 3 READING TECHNICIAN INTERPRETATION 3 4 READING TECHNICIAN REPORT 3 5 READING TECHNICIAN READ PATIENTS 3 6 READING TECHNICIAN READ PATIENTS DETAILS 3 7 READING ACCOUNT PIP 4 CDCTECHNICIAN DATA MINING Wills Eye Telemedicine CDC Platform User s Manual V 1 0 WWW WwW W gt OO ON A O 10 10 11 12 13 14 14 15 16 1 Administrative Area The most important section for managing every aspect of the CDC diagnostic platform is the Administrative Area The Administrative area is the control center of the entire platform making this section the most important in terms of management and security For this reason Administrative accounts and access will be limited to IT special
10. his section contains many more options The bottom examination was read and the Reading Physician is presented with a number of different options at this stage Actions Re read Exam Takes user to the Reading Chart The exam is read again as a new session View Chart Shows the reading charts but they are read only and may not be edited View Interpretation View Read Only Version of the interpretation View PDF Report View PDF copy of the final report Wills Eye Telemedicine CDC Platform User s Manual V 1 0 3 7 Reading Account PIP The Principal investigating Physician account is similar to the Reading technician with some important differences PIP accounts function at the Regional level This means that they can view patient lists from any of the CDC Reading centers within the region they are assigned to PIP accounts can switch to other reading centers in their region by using the CDC reading center pull down that is found at the top of the page This feature IS ONLY available for PIP accounts Figure 14 PIP accounts will only have Read Only accounts and will not be able to edit patients or examinations Email support Support type Welcome Dr Federman Change clinic wez My Profile MLog Off JI Wills Eye Institute w S Browse patients i se gt Brow Show patients All MRN Date Of Service First Name Last Name DOB mm dd yyyy Status CDC Clinic
11. ists and high level stakeholders In this module Administrators can perform any of the following functions 1 1 Clinic Administration e Add Browse Roles Roles are the definitions referring to each account Reading Technician Upload Technician Printing Technician etc This section is technical in nature and it is where the developers enter the code defining each role This section should only by edited by technical developers 1 2 Global Administration e Add Browse Regions Regions are the geographical or organizational divisions under which clinics or reading centers can be organized e Add Browse Users This is the area where individual user accounts can be added Users will be associated to a specific region reading center and will be assigned one or more roles 1 3 Region Administration e Add Browse Clinics Reading Centers The actual name and contact information to the individual clinic or reading center in a particular Region 1 4 Setup To set up a new Region or Reading Center and subsequent users please provide the Account managers with the following information Region Name Description Reading Center Name Website State Zip Code Main Phone Main Address City Region from above Clinic setup CDC Diabetic etc Clinic Design upload logo upload CSS file for new design User Username Email First Name Last Name Account Setup User Profile User Role Contact Information Address City State
12. le Reading accounts are set up by the administrators and managed by the Upload workflow 3 1 Reading Technician Unread Patients The Reading Tech accounts default to the Unread patient list Figure 9 There is a single action button View All Photo Sessions eye The template uses the same toggle as the Uploading accounts to filter the patient list Unread Read All Email support Support type Welcome Dr Federman JI Wills Eye Institute Show patients Unread Actions 146 03 09 2011 Jonathan Doe 05 02 1962 WE2 Dr Federman 66 10 21 2009 Jane Smith 02 21 1958 WE4 Federman October 2011 S M T W H F S Figure 9 Reading Technician home page Wills Eye Telemedicine CDC Platform User s Manual V 1 0 3 2 Reading Technician Reading Fields The reading chart below the Patient Demographic information defaults to the Right gt External field After completing a field either click on the field name in Or you can roll over either end right or left of the image and an arrow will hover Clicking on this arrow will move you to either the next or previous image depending on the direction of the arrow Figure 10 Advancing to the next field automatically saves your findings All findings may be changed as many times as desired BEFORE saving the exam in Interpretation Email support Support type Welcome Reading Tech Clinic WE2 1 m MI Wills Eye Institute Patient
13. opathy No AREA diabetes related maculopathy present Other Retinal Other Retinal Findings Suggestive of are Suggestive of LJ lud LJ ind Hypertensive Changes present Diabetic Retinopathy Recommendations Re evaluate in twelve months Other Recommendations Figure 11 Reading Technician Interpretation Wills Eye Telemedicine CDC Platform User s Manual V 1 0 3 4 Reading Technician Report Final Report is saved as a PDF Figure 12 Wills Eye Institute Diabetic Retinopathy Report Patient Information Last Name Rasthabanh First Name Rasthabanh Patient ID WE1 000001 DOB mm dd yyyy 07 05 2011 Gender Female Race Ethnicity African American Location of Service WE1 Technician ID 22234 Date of Service mm dd yyyy 08 23 2011 RE Visual acuity 20 25 Principal Investigator Jay Federman M D LE Visual acuity 20 25 Right Eye Nasal Field Photographic Imaging Report Right Eye External Anterior Segment Findings are Suggestive of Right Eye Temporal Field Significant cataract may be present Diabetic Retinopathy Findings are Suggestive of Unreadable No apparent DR No apparent diabetes related maculopathy is present Hypertensive Changes are present Left Eye Nasal Field Left Eye Temporal Field Photographic Imaging Report Left Eye External Anterior Segment Findings are Suggestive of Significant
14. ormation upload module Figure 2 Enter all required in red demographic and medical Information Email support Support type Welcome Reading Tech Clinic WE2 My Profile Log Off JI Wills Eye Institute EAS Browes patients Ej Patient Browse Patients Browse Add Asterisk denotes a required field Demographic Information First Name Patient Images Status October 2011 gt gt S M T W H F S 1 Waiting for Patient Information Last Name 234 56 78 9 1011 1213 14 15 1617 18 1920 21 22 DOB mm dd yyyy 2324 25 26 27 28 29 30 31 Patient ID THIS 15 THE MRN Tech ID INTERNAL Clinic Clinic Code Gender Female Race Ethnicity White non Hispanic Medical Information Date of Service mm dd yyyy Visual Acuity Snellen Left Eye Visual Acuity 20 10 Right Eye Visual Acuity 1 5 20 10 Lens Status C No known cataract OD C No known cataract OS Cataract present OD Cataract present OS Cataract removed OD Cataract removed OS Wears Contact Lens O Soft Lens Present OD C Soft Lens Present OS Soft Lens Removed OD Soft Lens Removed OS C Hard Lens Present OD C Hard Lens Present OS Hard Lens Removed OD C Hard Lens Removed OS Present Diagnosis Diabetes Figure 2 Add Patient Wills
15. sequence Review uploaded images and click on the Verify button to confirm This lets the system know that the images are correct Figure 7 and returns you to the Browse page NOTE This feature is only supported in FireFox Chrome and Safari Browsers LEFT EYE Figure 7 Review images and Verify 2 8 Uploading Images Edit Review On the main Browse page the right hand column of the patient list contains a fixed set of identical actions for each patient Figure 8 Actions Figure 8 Actions Actions e Modify pad pencil Edit Information fields for each patient e Upload New Exam window arrow Allows Tech to re read the exam This generates a NEW report different MRN e Disable flag This essentially turns the patient off Disabled patients can be enabled at the administrative level Wills Eye Telemedicine CDC Platform User s Manual V 1 0 3 Reading Accounts There are two types of Reading accounts Reading Technicians and Principal Investigating Physicians PIP Reading Technicians are specific to CDC Reading centers and they are responsible for the primary reading of the patient images Principal Investigating Physicians PIP are the overseeing Physicians responsible for all data and report generation within regions multiple CDC reading centers These accounts are limited to Read Only privileges These accounts allow the user to view images and see the final report as a PDF fi
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