OTN Telestethoscope User Manual
Contents
1. E Delet mm lli Administrative Took Mail recipient kis Rename Jo Catalyst Control ig DVD RW Drive D d Cisco Properties jlawson mrkmecfps02 Home H a cisco AnyConne temp Vumrkmecfps02 X i Ec AIT Pe Talt pai s nni t Ico UNITE Ersond ommuni ator public PAmrkme cfp D 2 Zz Jj Games Help and Support a Google Chrome Run 4 Back Shut down iss 14 Telemedicine s Leader 6 Verify that Cisco AnyConnect VPN Client icon is on your Desktop Cico AnyLonnect VPN Client e Installing OTN s Telesteth Shortcut 1 Create a new folder in your My Documents directory and name it OTN Copy the Telesteth icon graphic file attached to the OTN Installation email and save it in your OTN folder If you do not have the Telesteth icon you may skip this step 2 Right click on your desktop screen and create a new Shortcut Arrange Icons By Refresh D he Paste ri Ch mule iF Paste SMorecue Undo Delete Chrlt 2 NVIDIA Control Panel 5 Shared Folder Synchronization E Eolder nview Properties d m Shortcut Properties mE Microsoft Access Database E Briefcase EM Bitmap Image Wh Microsoft Word Document EE Microsoft Project Document E CMADesktap Document mE Microsoft PowerPoint Presentation IP Microsoft Publisher Document E Text Document ER Microsoft Visio Drawing A WAVE Audio File EF Micro2. 4 Click on Se lecteActiveX prompt Installation _ Click Here This website wants to install the Following add on Cisco Secure Desktop From Cisco Systems Inc IF you trust the website and Efe add on and want to install it click here cisco Cisco Secure Desktop amp WebLaunch Using ActiveX for Installation Please look at the top of your browser for the Platform information bar Detection 3 This site might require the Following ActiveX control ActiveX Install ActiveX Control What s the Risk Information Bar Help To proceed with set up select Install Activex Control If you are an administrator of this device please accept the UAC prompt if you see it otherwise please select Cancel Continuing in 20 seconds skip 5 Click on nstall This Add On for All Users on this Computer installation e This website wants to install the Following add on Cisco Secure Desktop From Cisco Systems Inc If you trust the website and the add on and wa amp 2 Click Here Install This Add on For All Users on This Computer What s the Risk Information Bar Help Cisco Secure Desktop CISCO amp WebLaunch Using ActiveX for Installation Please look at the top of your browser for the Platform information bar Detection ActiveX Senu What s the Risk Information Bar Help To proceed w
3. Enter your User Name and Password Follow the instructions to connect your stethoscope with your computer Click on the My Stethoscope down arrow pick your stethoscope from the list and follow the instructions on the pop up window You will see a green checkmark when connected My Stethoscope BA ses Te E Hi M rl PatentID Posture Supine 7 The Patient site will always Host a Session a random session ID number will be generated Share the Session ID number with the Consultant site 8 Once successfully connected the computer icons will turn green Follow the direction of the consultant regarding requested placement Filter Indicator PE Battery Life Indicator Amplification Indicator E inor use Ampbhioatinn M Button Filter Button Decrease Amplification Power 9 When patient assessment is complete click on End Session and log out of the software 1O Disconnect the SSLVPN by right clicking on the icon in the taskbar 59 Telemedicine s Leader
4. vpn access okn ca v d Group OTM Store Forward Access w Username telehealthimanish_ sf SRE connect N Please enter your username and password 20 Accept on the Welcome screen Cisco AnyConnect VPN Client Welcome to Store and Forward DT Click Here EN 21 Upon successful connection you will see icons at the bottom on the taskbar for connection e gap 84M 12 10 2011 15 Telemedicine s Leader ad SSLVPN Shortcut Placing the VPN client icon on your Desktop 1 Click the Windows Start button 2 Click on All Programs Cisco Cisco AnyConnect VPN Client Uk 3CDaemon d i Accessories d Administrative Tools dO Catalyst Control Center jJ Cisco M Cisco AnyConnect VPN Client d Cisco AnyConnect VPN Client y Cisco Unified Personal Communicator Uk Games bad Control Panel Devices and Printers Default Programs Help and Support Run 4 Back 5 Right click on Cisco AnyConnect VPN Client icon 4 Select Send to from the pop up menu 5 Select Desktop create shortcut from the next pop up menu eM RES Seen eee I Windows Media Play e Windows Update C3 Winzip Send to F l Wireshark 3 XPS Viewer Cut uk 3CDaemon Copy UR Accessories Scan for Viruses Include in library E Compressed zipped folder Desktop create shortcut Documents Fax recipient
5. Click Here change destination Folder 4 6 Once installed click Close amp Java Setup Complete You have successfully installed Java Java updates will automatically be downloaded to provide you with the latest features and security improvements To change this see http java com autoupdate Telemedicine s Leader b Enable Java script Click on nternet Explorer IE click on Tools gt Internet options gt Security gt Internet gt Custom level gt click Enable on Active Scripting gt Scripting Setting Tai Aganadl General Secuntv Privacy File Edit Vie Help Delete Browsing History Ctrl Shift Del Select a zone to view or change security settings InPrivate Browsing Ctrl Shift P a yeg E A I Diagnose Connection Problem a t 8 a Reopen Last Browsing Session Internet Localintranet Trusted sites Restited InPrivate Filtering Ctrl Shift F Ment j vxo This zone is for Internet websites InPrivate Filtering Settings except those listed in trusted and restricted zones Pop up Blocker Security level for this zone alowed levels for this zone Madum to High Hedium high Appropriate for most websites Prompts before downloading potentially unsafe con Unsigned ActiveX controls wil not be downloaded IJ Enable Protected Mode restartng Internet Explorer Windows Update ice dh Gua t delaidtl feat 28 zones to dekat lev
6. X86 based PC gt All Programs Cisco a ames Open 0 msinfo3d b Intel R Atom TM CPU N270 J E Cam T APANI TOR This task will be created with administrative privileges BIOS Version Date American Megatrends Inc 3401 Search programs and files SMBIOS Version 25 c Windows Directory CAWindows a Cancel J Browsew Systern Directory CAWindows systern32 Boot Device Device HarddiskVolurnel Locale United States Hardware Abstraction Layer Version 76 1 7600 16385 User Name Not Available Time Zone US Eastern Daylight Time Installed Physical Memory RAM 1 00 GB Total Physical Memory 0 99 GB Available Physical Memory 514 MB Tatal Virtual Memory 1 99 GB Available Virtual Memory 135 GB Page File Space 1 00 GB For helo with the technical requirements for Telesteth contact your Regional Manager If you need assistance call us at 1 866 454 6861 54 Telemedicine s Leader How to Tell If Your PC Has USB2 Click on Start Settings Control Panel System Device Manager USB Expand on sign ES Device Manage File Action view Help H PE A ER InteltR wireless WiFi Link 496566 y PCMCIA adapters Processors Smart card readers um 7e Sound video and game controllers Hi i E System devices Universal Serial Bus controllers EE Intel R ICHS Family USE Universal Host Controller 2830 Intel R ICHS Family USB Univer
7. abruptly Can t login to the Telesteth session server 32 Open Internet Explorer browser and key in URL https ta otn ca telmedweb launch Open Internet Explorer browser and key in URL https ta otn ca telmedweb launch Make sure the Stethoscope device is within the range of the Bluetooth dongle installed on the PC The available bandwidth on the internet connection may not be sufficient to support a Telesteth session This may be due to other local applications demanding internet bandwidth at the same time If using SSL VPN make sure that your secure session is running by looking at the icon on the bottom right of your screen Host site needs to restart the session by clicking Host a Session and communicating the new Session ID to the consultant side The stethoscope device has an AutoOff function that will switch off power to the device after a few minutes of inactivity You could disable the Auto Off feature however this will drain your battery quickly To disable Auto Off press the M button on your stethoscope use the keys to scroll to Set Up press M again then use the keys to scroll to Auto Off press M then scroll to Disable and oress M a final time Make sure that you are correctly keying in the username and password provided by OTN Please note that the username and password are case sensitive Contact OTN Service desk at 1 866 454 6861 Telemedicine s Leader Telesteth
8. file Java will load before you see the Telesteth Welcome Window Enter your User Name and Password Follow the instructions to connect your stethoscope with your computer Click on the My Stethoscope down arrow pick your stethoscope from the list and follow the instructions on the pop up window You will see a green checkmark when connected Real Time Streaming Session i Upload Download My Account 4 Session ID 569233 N pst Host Name vv Patient 1 posre im m M Hl The Patient site will always Host the Session a random session ID number will be generated Share the Session ID number with the Consultant site Once successfully connected the computer icons will turn green follow the direction of the consultant regarding requested placement Filter Indicator Battery Life Indicator Amplification Indicator incre Ampiticutinn M Button Filter Button Decrease Amplification Power 8 When patient assessment is complete click on End Session amp log out of the software Telemedicine s Leader Quick Reference Guide SSLVPN PC Consultant site 1 Plug the Bluetooth dongle into the USB port on the computer When running properly a green light on the USB dongle will flash 2 Connect to the network a Click on the VPN icon on your desktop b Enter your User Name and Password NET e Always Select OTN Store Forward Access Lal Hy Cisco AnyConnect VP
9. in this field Click the Pair Now button below Once you have paired your stethoscope you will only need to connect when using the same computer for future stethoscope sessions Please note if you are using the SSL VPN and using the same stethoscope on different PCs you will need to pair the stethoscope for each device prior to use Real Time Streaming Session Upload Download My Account Connecting your Stethoscope Now that your stethoscope is ZARGIS x paired select the name of the Em 25 stethoscope at the site to which you want to connect from the drop down list Note some sites may have more than one stethoscope Press M on the stethoscope to select Power ON the Stethoscope CONNECT and then press the M button again Press M select Connect and press M again to establish connection between Computer and Stethoscope On successful connection you will see a Green checkmark next to the name of the stethoscope Creati ng a Real ti me Session Real Time Streaming Session Upload Download My Account If you are the Patient site click ZARGIS wy Ble renee dii on the Host a Session button ER FSR ma v If you are the Consultant site click on the Join a Session button Note the Patient Site is the site transmitting the patient s heart and lung sounds therefore they must Host a Session A random Session ID nu
10. A compatibile with Zags Cardescon amp Zags Sxesh amp sast Username I Pairing your stethoscope The first time you connect to the Telesteth software you will need to pair your stethoscope To do this click on the Add Scope option in the My Stethoscope field Real Time Streaming Session Dawnlosd My Account EEEN a ZARGIS S My Stethoscops4 sz MEDICAL x D ME d Dx T pem H Session ID paula Host Pa srir dt a The following window will automatically open Please follow the steps exactly To connect a Model 3200 stethoscope to Zargis TeleSteth for the first time follow the steps below to pair the stethoscope with TeleSteth Step 1 The PIN will be displayed Make sure the stethoscope is not currently on the stethoscope connected to any other open Zargis program window Type the such as Zargis StethAssist or Zargis Cardiascan An easy way to ensure this is simply to turn the number onto the software stethoscope off and then back on screen in this field Step 2 Press M on the stethoscope Use and to select PAIR Then press the M button again A 4 digit PIN number wil appear on the stethoscope LCD screen S Select a name for your Step 3 stethoscope this name Enter the PIN number here PIN will be displayed in the Step 4 software Type the name Create an ID for the stethoscope and enter it here Stethoscope ID onto the software screen Step 5 Dj opa
11. ELEMEDICINE T L M DECINE Information Bar Help NETWORK ONTARIO OTN RIO Cisco AnyConnect VPN Client CISCO ga WebLaunch Using ActiveX for Installation Please look at the top of your browser for the _ Platform information bar Detection P This site might require the Following ActiveX control Install Activex Control Activex What s the Risk Information Bar Help To proceed with set up select Install ActiveX Control If you are prompted to Retry or Cancel select Cancel Continuing in 12 seconds skip 11 You will be prompted again to install ActiveX Controller e https vpn access1 otn ca CSCOE portal html Click Here 2 This website wants to install the following add on Any Connect VPN Client From Cisco Systems Inc IF you trust the website and the add on and want to install it click here V Sioa This Add on For All Users on This Computer X ONTARIO hat s the Risk i TELEMEDICINE TELEMEDECINE Information Bar Help NETWORK ONTARIO OTN alea Ci A 7l cisco isco AnyConnect VPN C ga WebLaunch Using ActiveX for Installation Please look at the top of your browser for the information bar Platform Detection This site might require the Ins ActiveX What s the Risk Information Bar Help To proceed with set up select Install Activex Control If you are prompted to Retry or Cancel select Ca
12. Inc 080002 8 14 20 Wi M 3 pidis Vesno gy Set Program Access and PRED mss vj SMBIOS Version 23 Defaults Windows D irectory CAWINDOWS D Tour Windows XP t A Printers and System Directory C WINDOWS system32 ge Printers and Faxes Browse Boot Device DeviceNHarddiskVolumel Cancel PE ENE eer J Help and Support Fis ie Absit Layer Veron 512800 5512 psp 080413 2111 i azar User Name DTN Manishr wil ig Time Zone Eastern Standard Time W Microsoft Word 2010 gt Search Total Physical Memory 64 00 MB g mi gt HE M Find what ind Close Find C Search selected category only Search category names only All Programs b EJ Log Off o Shut Down Windows 7 Users System Properties Click on Start gt All programs gt Accessories gt Run and type msinfo32 into the popup box field that is displayed A System Information File Edit View Help Systen 3 il hem value m OS Name Microsoft Windows 7 Professions 2n Version 6 1 7600 Build 7600 FEE BER re ES ses J LE re other OS Description Not Available 205 Windows Run OS Manufacturer Microsoft Corporation e System Name TORSEVDL Ta Magnifier di Type the name of a program folder document or Intemet System Manufacturer ASUSTek Computer INC D de t uj Kemote Desktop vonni resource and Windows will open it For you System Model 1005HA ET System Type
13. N Client Enter User Name ex telehealthNssmith Enter Password Click Connect upon successful connection the VPN icon will appear in the lower right tray Turn on the Telesteth Littman 3200 stethoscope by pressing the Power button Double click on the Telesteth Icon to launch Telesteth software Note software will be blocked right click on the message header and click Download file Java will load before you see the Telesteth Welcome Window Enter your User Name and Password Follow the instructions to connect your stethoscope with your computer Click on the My Stethoscope down arrow pick your stethoscope from the list and follow the instructions on the pop up window You will see a green checkmark when connected zarcis Join Session Please enter the session ID to join the host must provide the ID Session ID Enter Session ID 7 The Patient site will always Host a Session the Consultant site clicks on Join a Session amp enters in the Session ID provided by the Patient site 8 Once successfully connected the computer icons will turn green and you are ready to provide placement direction to the patient site as required adjusting the filter settings and amplification using the button on the stethoscope Digital Filter Settings Filter Indicator PE Battery Life Indicator Press the Filter Button until desired mode appears or screen i Diaphragm mode A
14. Technical Support and Advanced Exchange Hardware Warranty Replacement Process Along with the Telesteth pricing OTN has also negotiated an Advanced Exchange Hardware Replacement process through Cardinal Health and 3M Canada Through the Advanced Exchange program your Littmann 5200 or Bluetooth dongle would qualify for warranty replacement within 24 hours of the approval of the claim should there be a defect Only Telesteths or Littmann 5200s with a Telesteth license purchased through Cardinal Health qualify for the Advanced Exchange Warranty replacement Unless otherwise required all Members are asked to contact OTN Service Desk if any technical problems with Telesteth arise OTN Service Desk is the first line support for Telesteth technical issues Before you contact OTN please ensure you have the following 1 Your Littmann 3200 with serial and access to the Telesteth pc you are using 2 Your bill of sale or any documentation that indicates when the Telesteth was purchased Process 1 Call OTN Service Desk at 1 866 454 6861 to request technical assistance with Telesteth 2 OTN Service Desk will complete a Telesteth Warranty Replacement Checklist with you 5 f your Littmann 3200 has a hardware problem that requires a warranty replacement OTN will forward your Telesteth Warranty Replacement Checklist to Cardinal Health to request an Advanced Exchange Warranty replacement 4 Cardinal Health will review the checkl
15. Y QJ D lt in ect June 2012 Table of Contents Welcome to the OTN Telesteth Service eene 2 Getting Started Checklist eene nnne h tres saa aiia aa nasa a aaa aaa aaa kerner d OTN Telesteth PC System Requirements eeeeee eee 4 SOitware VES Cet lO Meare ricateatyre cea rncarenisan i Feafin eu Ra GARE o Fata Sari N revet 5 rs MEO ofc ORNE RS s 5 EE S R fe Zs R legio RRRRE 7 S SM a LS ee ee E E E E ee ee eee eee 7 d Installing OTN S Telesteth S AOF PETE ccm iia inn aaia nin ERE rendt 14 Running a Real Time Telesteth Session seeee eene 20 Getting to Know the Littmann 3200 ssssssssee mH mme nnn nennen nnne nnn nnns 26 SS CHV OTN Pelestebb sensen iertndEdas qupd uc MN n Fee US EDAM INE 29 Troubleshooting eene nnnnnnen nnne nn rr hne r renda nate e arena 31 Telesteth Technical Support and Advanced Exchange Hardware Warranty Replacement PEOGOSS osea b re E Ea aaar ian 33 Appendices How to View Your PC System Properties ssssesee meer 54 How to Tell Your PC Has USB2 un mosuridisad iens mesi dua i rai Flair ra rou aiii 55 Quick Reference Guide OTN dedicated PC Consultant site 36 Quick Reference Guide OTN dedicated PC Patient site sssee 57 Quick Reference Guide SSLVPN PC Consultant site sseeee 58 Quic
16. d with other non certified Bluetooth dongles Please have your IT resource assist with disabling any other Bluetooth functionality that may conflict with the operation of the supplied Bluetooth dongle b If the only USB port is at the rear of your computer please use an USB extender to elevate the dongle to be visible from the front Connecting to the OTN Network If you are using your SmartSteth PC you will automatically be connected to the OTN network and may proceed to Step 3 Connect to OTN s Network using a secure SSL VPN by following these quick steps a Click on the VPN icon on your desktop oe Cisco Any Conneck VPN Client If the VPN icon is not on your desktop it may be accessed through the Start button Click on Start gt Programs gt Cisco gt Cisco Anyconnect VPN Client gt Cisco Anyconnect VPN Client b Enter your Login information i Always Select OTN Store Forward Access i Enter User Name and Password click on Connect 22 Cisco AnyConnect VPN Client FEE Connection 9 Statistics amp About TEFEN ET CISCO J Connect En vpn access otn ca wij e OTM Stare Foreward Access v telehealthimanisk sf Telemedicine s Leader Connect ji C Click Accept on the Welcome Screen Cisco AnyConnect VPN Client Welcome to Store and Forward OTN d Upon successful connection you will see the VPN
17. e SmartScreen Filter Manage Add ons Compatibility View Compatibility View Settings i Subscribe to this Feed Feed Discovery Developer Tools F12 C Cisco VPN Anytime Connect SSLVPN In order to access OTN s network and the Telesteth server you SSL VPN secure remote access software 1 Open nternet Explorer https n access otn ca in the address bar Type the URL V J Enable 9 Prompt E Alow status bar updates vis scrot d Osable Enable X Aiow websites to prompt for information using scripted wind e Dues i E m l Takes effect after you restart Internet Explorer Reset custom settings Reset to Medum high default must install OTN s Customize Your settings Windows Internet Explorer Gm A T Ro 4 jie a A certificate warning may be displayed Accept it to continue with the installation we d e Certificate Error Navigation Blocked 9 There is a problem with this website s security certificate The security certificate presented by this website was not issued by a trusted certificate authority Security certificate problems may indicate an attempt to fool you or intercept any data you send to the Server We recommend that you close this webpage and do not continue to this website Click here to close this webpage i Continue to this website not recommended 9 More information Telemedicine s Leader
18. ecialist You are now ready to start the real time transmission of heart s Leader Patient ID Posture lung sounds If desired you may demonstrate your stethoscope placement by selecting the appropriate mannequin icon in the software and indicate the position on the patient s body by clicking on the corresponding location on the mannequin A white dot will appear where you have clicked ZARGIS e My Stethoscope 10 Ending the Session ears l When the patient assessment is oot TM complete click on the End Session button log out of the Zargis software by clicking on log out at the bottom of the screen inl mi ih lil Patient ID Listening Site Mariually Selected Patient Name Fir st 5 rt wwWw zargis com 11 If applicable disconnect your SSL VPN by right clicking on Open the icon in the taskbar and selecting Disconnect i AnyConnect Disconnect Quit 25 Telemedicine s Leader Getting to Know the Littmann 3200 Littman 3200 Digital Stethoscope 26 Battery Powered stethoscope takes one AA battery and will provide approximately 50 60 hours of continuous use Changing the battery Hold chest piece in one hand while slightly twisting the battery cap approximately 25 counter clockwise Remove battery cap Insert new battery with positive end out sign will be visible in the battery compartment Remount battery cap t
19. elp swith this section System 1 Patients Contact Email Tel Number De 1 L TNO p Eventlog 0000000000 r help with this section yi ites confirmed and patient notified will arrive 20 minutes early Mo letter necessary July 26 11 JH Cs please have your AMD SmartSteth available for this appointment Schedule Event Save Draft 50 Telemedicine s Leader Troubleshooting The following chart is designed to help troubleshoot issues with the Littman 3200 Stethoscope Problem Trouble hearing anything when using the stethoscope Consultant site only is unable to hear anything when using the stethoscope Littman won t pair with Telesteth software Internet connection keeps dropping 31 Possible Cause Ear pieces in backwards Sound amplification is set too low Software at consultant site has option of Play to PC checked Bluetooth dongle not plugged into USB port before initiating the Telesteth software USB port is obstructed or behind the computer Built in laptop Bluetooth is not functioning SS VPN has timed out due to inactivity Inconsistent service from the internet service provider Wireless internet connection signal strength is weak Possible Solution Littman stethoscopes have headsets that are angled and designed to fit properly within your ear canals When holding the stethoscope be sure that the headset is pointed towards the ceiling and then
20. ent 5 Received your Littmann 5200 Digital Stethoscope Received a Welcome email from OTN that contains your username If you have not received a Welcome email please contact your Regional Manager Note information on accessing the e training course for Telesteth will be included in the Welcome package 5 Received a password from OTN via secure email or registered mail If all of the above are complete then you may proceed with installation Telemedicine s Leader OTN Telesteth PC System Requirements The Telesteth requires the use of a Windows PC Laptop at both the Consultant and Patient site in order to transmit heart and lung sounds in a real time Telemedicine event This PC Laptop may be used to support other OTN services such as Ncompass and Otn teledermSF in addition to Telesteth Should you decide to purchase a new PC through your organization or use an existing PC provided by your organization it must be connected to OTN s network via the internet and an SSL VPN connection provided by OTN Please see the requirements listed below before choosing a new PC Minimum PC Hardware Software and Network requirements for a new Telesteth PC 1 5GHz or higher recommended amp 512K minimum 1 GB recommended Hard disk 1Gbor higher Transmission station uses 3M Littmann Stethoscope Sound card Receiving station uses high fidelity headphones including integrated USB sound card or 3M Littmann Stetho
21. icon at the right lower corner of your screen on the taskbar Beil i5 no 20x 5 Launching the Telesteth Software Double click on the Telesteth icon on your desktop If a download warning appears click on it and select Download File If a run prompt appears click on run to start program C https ta otn ca telemedweb launch Windows Internet Explorer BEl xl v Ys 1 ig https ta otn ca telemedweb launch x lt A Google n M File Edit View Favorites Tools Help Yr 37 Favorites I E Suggested Sites iM Free Hotmail amp Upgrade Your Browser m All Doctors Search Doctor 5 launch Eg otri caftelemedwebilaunch Ey RES Page Safety Tools amp i mum Download File What s the Risk Information Bar Help 4 Login to the Telesteth Software Enter your private Username and Password Note The Telesteth software requires each user to have his her own username and password Your password is the one you use to access all OTN services and must not be shared 21 Telemedicine s Leader 22 Zatgis Tele t ultation Made E Welcome to Zargis TeleSteth Online Auscultation Made Easy r int Li Shere auscuitatory recordings 8 analysis results with colleagues across town cr across the globe e Use Ce interet to See ancutetorns qm retina to c lesgue located anywhere qs the world See recorded auctore v itre anid forward e Ley acess Joye Tekst fom your PC e A
22. information that you received in your New Site Welcome package farpis TeleSteth Online Auscultation Made Easy 07 02 0006 testta Welcome to Zargis TeleSteth Online Auscultation Made Easy Share auscultatory recordings amp analysis results with colleagues across town or across the globe Lee the Interet b steam auscultations in pegl tie to colleagues located armmwhere in the world Share recorded auscultations via store anchforwand 4 Eai acess Zange TeteSteth from your PC Fully compatible with Zange Cardiescan amp Tangs Stethassiet Username Password Ergat Barre fe Rartambar m tecum To establish a Sage Teiesteth account call amp a 4pg a amp na qn U S y GIS Leann about Zargi Medicai s other computer aided suscultation products at we zahrfis corri Macit amp At 19 Telemedicine s Leader Running a Real Time Telesteth Session 1 20 Setting up for wireless stethoscope connection a Plug the Bluetooth dongle into the USB port on the computer supplied with the Littman 3200 Stethoscope When running properly a green light on the USB dongle will flash Note OTN and 3M do not support the use of Bluetooth devices other than the dongle provided with the Telestethoscope The orovided dongle has been certified by 3M to work correctly with the Littman stethoscope Your telestethoscope should not be paired with Bluetooth transmitters that are built into laptops nor should it be paire
23. ist and determine if your Littmann 3200 is under warranty 5 f your Littmann 3200 is covered by warranty a replacement scope will be mailed to you within 24 hours 6 Once you receive your replacement scope use its packaging along with the pre printed waybill to send your defective scope back to Cardinal Healthcare 7 Contact OTN Service Desk to certify your replacement stethoscope 55 Telemedicine s Leader Appendices How to View Your PC System Properties Windows XP Users System Properties Click on Start gt Run and type msinfo32 into the popup box field that is displayed Manish Rughani admin 2 System Information Windows File Edit View Tools Help Internet E My Documents internet Explorer 4 My Recent Documents gt n E mail Item Value i Microsoft Outlook e My Pictures OS Name Microsoft Windows XP Professional EJ amp Components Version 5 1 2600 Service Pack 3 Build 2600 i Software Environment OS Manufacturer Microsoft Corporation xI MSN 3 MY MUSE E Intemet Settings System Name MANISHTEST 4 Pr Computer System Manufacturer Microsoft Corporation i ja P Type the name of a program Folder document or System Model Virtual Machine eee Des Pe f Internet resource and Windows will open it for you System Type ABE based PC Je control Panel Processor 486 Family 6 Model 15 Stepping 6 Genuinelnt BIOS Version Date American Megatrends
24. ith set up select Install Activex Control If you are an administrator of this device please accept the UAC prompt if you see it otherwise please select Cancel Continuing in 11 seconds skip 6 Install the required software from Cisco Internet Explorer Security Warning Do you want to install this software Name Cisco Secure Desktop Publisher Cisco Systems In x More options While Files From the Internet can be useful this file type can potentially harm your computer Only install software From publishers you trust What s the risk Telemedicine s Leader 7 Select the Group OTN Store Forward and enter your Username and Password Click on Login Note your log in information was sent with the Welcome Letter Please enter your username and password Select GROUP OTN Store Forward Access onour OTN Store Forward Access v Enter USERNAME telehealth manish_sf USERNAME Click on Login If you are logging in for the first time you will be asked to enter a new password Enter a new password and click Continue New Password Required Password expiring you must enter a new password to continue Mew Password laseseses 8 Click Continue on the Welcome screen Welcome ta Store and Forward OTN 9 Install AnyConnect Click on Start AnyConnect N an 3 bttps vpn access1 otn ca CSCOE
25. k Reference Guide SSLVPN PC Patient site sseeeeeeeeenen 59 Telemedicine s Leader Welcome to the OTN Telesteth Service OTN is pleased to provide the Telesteth Service for OTN Members to use in conjunction with a real time clinical videoconferencing event Key service features The Telesteth utilizes a 3200 Digital Stethoscope which provides superior sound quality making it easier to hear S3 gallop murmurs and abnormal lung sounds versus analog stethoscopes The Littmann 5200 connects wirelessly via USB2 Bluetooth technology to a Windows XP or newer PC and is easy to use in real time telemedicine amp The new service accesses OTN s Network via the internet through an SSL VPN Secure Sockets Layer Virtual Private Network The purpose of this training manual is to provide you with all the information you need to set up install and use the Telesteth application in real time telemedicine Please follow each step in order to get started with the new Telesteth service Telemedicine s Leader Getting Started Checklist Before you begin installing your Telesteth service please ensure you have all the necessary permissions and equipment You must have 1 Contacted your OTN Regional Manager to arrange purchasing and to complete the required forms to set up your Telesteth 2 Verified that your PC meets the required specifications See Telesteth PC System Requirements in this docum
26. ling a clinical encounter that requires a stethoscope 1 Review the Consultant protocol and or the OTN referral form considering past practices of the consultant to determine if a stethoscope is required for the telemedicine appointment 2 When you confirm the appointment with the patient and consultant sites a Check that they will be using Telesteth b Ensure that Telesteth is available If the Telesteth is installed on a laptop and is portable ensure the laptop is available at the system being used Ifa Telesteth is not available at the system you are booking search for a system that has one available If there is no Telesteth available ask the consultant if Telesteth is required 5 Once the event is confirmed please include the following reminder in your usual notifications to the consultant and patient sites You will be using your Telesteth Please have available at the appointment Examples Scheduling a stethoscope using the TSM log Clinical Request Maintenance Complatad Approval Consultant Site Site Verification Patient Verification Confirmation Sites confirmed and patient notified Letter sent July 25 11 JH Both sites please ensure your Telesteths are available and on site for this appointment Schedule Request ID 8557504 View Fax Confirmation 29 Telemedicine s Leader Scheduling a stethoscope using the Ncompass Event Log Patient System s Click here for h
27. mber will be automatically generated ZARGIS 9j and your login name will be ave y ety s 1 ession ID 5692 displayed as the Host name ost Host Name Patient ID S Rastures lsupine E Otmn Telemedicine s Leader 8 9 24 Share the Session ID number with the consultant site and ask them to click Join a Session they will be prompted to enter the session ID number provided in the Do p U p WI n d OW Zargis leleSteth Online Auscultation Made Easy 02 03 0001 otn1 Real Time Streaming Session Upload Download My Account ZARGIS My Stethoscope Session ID Host Guest Please enter the session ID to join the ost must provide the ID High ee Mid Liaw Logout Support www zargis com Once the Consultant site successfully joins the session the 5eme streaming Session glos invente Wy he computer icons should turn My Stethoscope 9 e Green and the remote ME 2 tion ID 569233 TES TR a TN participant s login name will A appear as Guest The Consultant site must also select the option of how they will listen to the assessment by either choosing Play to PC when using Headphones or Play to Stethoscope when using Littman 5200 stethoscope in the Guest Audio Box MEDICAL Real Time Streaming Session Upload Download My Account FF Steth A v y Session ID 569233 Host Anish Shah Guest Ta Sp
28. mplifies sounds from 20 2000Hz but emphasizes the x sounda between 100 500Hz Amplification Indicator s Increase Amplification BHellmocde Amplifies soumda from 20 1000Hz but emphasizes lower frequency sounds between 20 200Hz A M Button Filter Button Extended Range Amples sounds from 20 2000H but provides more low frequency response between 50 500He z i aos Decrease Amplification Power 9 When patient assessment is complete click on End Session and log out of the software 10 Disconnect the SSLVPN by right clicking on the icon in the taskbar 58 Telemedicine s Leader Quick Reference Guide SSLVPN PC Patient site 1 Plug the Bluetooth dongle into the USB port on the computer When running properly a green light on the USB dongle will flash 2 Connect to the network a Click on the VPN icon on your desktop b Enter your User Name and Password Always Select OTN Store Forward Access Enter User Name ex telehealthNssmith Enter Password Click Connect upon successful connection occurs you will see the VPN icon in the lower right tray L Cisco AnyvConnect YPN Client Turn on the Telesteth Littman3200 stethoscope by pressing the power button Double click on the Telesteth Icon to launch Telesteth software Note software will be blocked right click on the message header click Download file Java will load before you see the Telesteth Welcome Window
29. n 50 5OOHz Adjust Sound Amplification Levels the and can be used to amplify the sound levels in 8 increments up to 24x amplification of a non electronic stethoscope Custom Configuration the stethoscope has several operational settings that can be changed to suit your needs Press the M button to access the main menu the and buttons for scrolling and the M button for selecting options The Filter button acts as an escape key Telemedicine s Leader Best Practices Recommendations Optimize use of your wireless digital stethoscope It is important that the stethoscope chest piece and wireless dongle are in close proximity and that the path between them is free of any obstructions Walls furniture and bodies may degrade the wireless signal Positioning of the stethoscope and wireless adapter is important to good wireless performance In some cases when the USB port is located at the rear of your computer use of a USB extension cable can improve signal strength by elevating the adapter and reorienting it to face the front It may help for the computer to be located in front of or next to the patient rather than behind them so that the patient s body does not block the signal path Minimize the distance between stethoscope and PC Under typical conditions a distance of 1O feet should be readily achievable Hold the chest piece firmly with fingertips rather than a cupped hand to allow the wirele
30. ncel Continuing in 20 seconds skip 12 Install Anyconnect Internet Explorer Security Warning Do you want Eo install this software Mame Anvconnectk YPN Client Publisher Cisco ems I More options While Files From the Internet can be useful this File type can potentially harm your computer Only install software from publishers vou trust What s the risk 10 Telemedicine s Leader 15 Click on Next i Cisco AnyConnect VPN Client Setup Welcome to Cisco AnyConnect VPN Client Setup Wizard The Setup Wizard will install Cisco 4nyConnect vPIN Client on your computer Click Next to continue or Cancel to exit the Setup Wizard O gllekHere ll m i5 Cisco AnyConnect VPN Client Setup End User License Agreement P 4 Please read the Following license agreement carefully M Client Software License Agreement of Cisco Systema nm THE SOFTWARE TO WHICH YOU ARE REQUESTING ACCESS IS THE PROPERTY OF CISCO SYSTEMS THE USE OF THIS SOFTWARE IS GOVERNED BY THE TERMS AND CONDITIONS OF THE AGREEMENT SET FORTH BELOW YOU ON BEHALF OF YOURSELF ND THE BUSINESS ENTITY YOU REPRESENT MUST AGREE TO THE FOLLOWING TERMS AND CONDITIONS IN ORDER TO USE THE SOFTWARE IF YOU DO NOT AGREE TO THE FOLTOWTNG TERMS ANT CONDTTTONZS THEN VOM ARE NOT T accept the terms in the License Agreement CT do not accept the terms in the License Agreement Ad
31. ng Systems Recommended Version 6 Update 22 Select the file according to your operating system from the list below to get the latest Java for your computer Remove Older Versions gt Whatis Java By downloading Java you acknowledge that you have read and accepted the terms ofthe end user license agreement AU Windows Verify Now After installing Java restart your browser and verify Java has been installed correctly Information about the 64 bit Java plug in Typical download size is 10 MB which is the minimum download The size may increase if additional features are selected 4 Download Java and install click Run Internet Explorer 5ecurity Warmng Do you want to run this software More options e Mame Javal THISE Runtime Environment amp 0 Update zz Publisher Sun Microsyste while Files From the Internet can be useful this File type can potentially harm vaur computer Only run software From publishers you trust What s the risk Telemedicine s Leader 5 Click nstall Welcome to Java Java provides safe and secure access to the world of amazing Java content From Business solutions to helpful utilities and entertainment Java makes your internet experience come to life Mao personal information is gathered as part of our install process For more information on what we do collect see http java com data Click Install to begin installing Java now
32. on the Consultant site clicks on Join a Session amp enters in the Session ID provided by the Patient site 7 Once successfully connected the computer icons will turn green and you are ready to provide placement direction to the patient site as required adjusting the filter settings and amplification using the button on the stethoscope Digital Filter Settings Filter Indicator PE Battery Life Indicator Press the Filter Eutton until desired mode appears or screen Diaphragm mode Amples sounds from 20 2000Hz but emphasizes the i Y sounds between 100 500Hz Amplification Indicator 2 Increase Amplification Bellmode Amplifies sounds from 20 1000Hz but emphasizes blower frequency sounds between 20 200Hz Filter Button Extended Range Aamplifies sounds from 20 2000Hz but provides more low frequency response between 50 500Hz 1 3 s Decrease Amplification Power 8 When patient assessment is complete click on End Session amp log out of the software 56 Telemedicine s Leader Quick Reference Guide OTN dedicated PC Patient site Plug the Bluetooth dongle into the USB port on the computer amp When running properly a green light on the USB dongle will flash Turn on the Telesteth Littman 3200 stethoscope by pressing the Power bu Double click on the Telesteth Icon to launch Telesteth software Note software will be blocked right click on the message header and click Download
33. portal html e E gen Page Safety Tools W ONTARIO R SEAU TELEMEDICINE TELEMEDECINE ONTARIO OTN 2 Lama Logout Initiate an AnyConnect client session to provide client applications on your desktop with network access through your VPN depending on your company s VPN configuration and your own network access rights For example an AnyConnect session might be necessary to use K Microsoft Outlook or Microsoft Outlook Express to send or receive e mail The following instructions describe how you can use your browser to get remote access to Microsoft Terminal Services running on computers in your network e Requirements e Before you Connect Add to Trusted Sites e How to Connect e Always Log Out Requirements To access remote services over an AnyConnect client session your system must have the following setup e Your VPN site must be in the list of trusted sites as described below Required for w Internet Telemedicine s Leader 10 Click on ActiveX Control and select nstall This Add on e https vpn access1 otn caj CSCOE F portal html Click Here m This website wants to install the Following add on AnyConnect VPN Client From Cisco Systems Inc IF you trust the website and the add on and want to install it click here Click Here Install This Add on for All Users on This Comp ONTARIO R SEAU What s the Risk T
34. sal Host Controller 2831 f Intel R ICHS Family USB Universal Host Controller 2832 Intel R ICHS Family USB Biers Host Controller 2634 f Intel R ICHS Family f Intel R ICHS F f Intel R ICHS F f USE Root Hub f USE Root Hub f USE Root Hub f USE Root Hub f USE Root Hub USE Root Hub USB Root Hub il LISBz Enhanced Host Controller 2836 il LISBz Enhanced Host Controller 2834 ET 35 Telemedicine s Leader cj Quick Reference Guide OTN dedicated PC Consultant site 1 Plug the Bluetooth dongle into the USB port on the computer When running properly a green light on the USB dongle will flash Turn on the Telesteth Littman 3200 stethoscope by pressing the power button 5 Double click on the Telesteth Icon to launch Telesteth software Note software will be blocked right click on the message header and click Download file Java will load before you see the Telesteth Welcome Window Enter your User Name and Password Follow the instructions to connect your stethoscope with your computer Click on the My Stethoscope down arrow pick your stethoscope from the list and follow the instructions on the pop up window You will see a green checkmark when connected MEDICAL i Join Session Please enter thre sessioni ID to joir Uwe host must provide the ID Enter Session ID Session ID 6 The Patient site will always Host the Sessi
35. scope Operating Systems Windows XP sp2 Windows 7 Internet Explorer 7 or higher Web browser Direct connection not through proxy server Plug ins Java 6 or higher does Java 7 work uu Internet bandwidth 128Kbps or better Connectivity o amp SSL VPN secure connectivity to OTN s network Allow web browsing Outbound TCP ports 80 and 443 Outbound TCP ports 1100 to 1300 Version 2 0 support USB Ports amp USB extender required if USB port is situated on the rear side of the PC Network Firewall Port Settings Telemedicine s Leader Software Installation The software installation instructions provided are to guide you through the software installation process Due to variances in Windows versions PC software and updates to the service there may be small changes in the way the software installs Ask your IT department to assist you if you encounter any messages that do not align with these installation instructions a Java 6 Plug in Please do not install Java 7 at this time as they are not compatible with Telesteth 1 Open Internet Explorer 2 Type the URL http www java com en download manual jsp in the address bar gt Java Downloads for All Operating Systems Windows Internet Explorer Available Operating Systems Windows Solaris Linux Apple Search ex Java in Action Downloads Help Center Java Downloads for All Operati
36. soft Excel worksheet ET winzip File 5 Type https ta otn ca telemedweb launch into the Type the location of the item field and then click on Next Create Shortcut This wizard helps you to create shortcuts to local or network programs Files Folders computers or Interna addresses Type the location of the item https Nta aln caJEelemedweb launch Click Next Ea continue 15 Telemedicine s Leader 4 Type Telesteth in the Type a name for this shortcut field and the click on Finish Select a Title for the Program Type a name Far this shortcut TeleSteth Click Finish to create Ehe shortcut xm ap ces 5 A shortcut named Telesteth will be created on your desktop screen 6 Create Shortcut Delete Rename Properties 16 Telemedicine s Leader 8 C 17 The properties window will expand as shown below Click on Change icon TeleSteth Properties General W eb Document Security URL thps ka otm caftelemedweb launch Shortcut key None Visits Unknown Change Icon The following screen will appear hange Icon Look For icons iri this File 2 Select an icon From the list below Click on Browse Click on My Documents then click on the OTN folder you created in Step 1 Telemedicine s Leader 8 he screen as shown in Step 7
37. ss antenna to be unobstructed for optimum performance Optimize sound quality 27 Environment Ensure there are no background conversations during assessment Minimize background sounds as much as possible Patient Preparation Properly prepare the patient so that stethoscope assessments can be conducted against bare skin Instruct the patient to breathe in a normal and quiet manner Remind the patient not to speak during the assessment Stethoscope Placement The sound sensor is quite small and is located in center of the chest piece so it is important to focus on the point of contact with the patient with the very centre of the chest piece Firm contact is necessary excessive pressure on the patient may result in artifact sounds Contact with the patient must remain steady and consistent for optimal sound quality Movement with the chest piece will induce frictional noise Itis best to start your exam at a lower amplification level and increase as required Telemedicine s Leader Cleaning Cleaning of the stethoscope should be done between each patient use Ear tips ear tubes plastic tubing and chest piece can be wiped clean with alcohol Ear tips may be removed for a more thorough cleaning Note Do not immerse the stethoscope in any liquid or subject it to any sterilization process 28 Telemedicine s Leader Scheduling OTN Telesteth Here is a checklist to consider when schedu
38. vanced Installer Cancel 15 Click on nstall iz Cisco AnyConnect VPN Client Setup Ready to Install The Setup Wizard is ready to begin the Typical installation Click Install to begin the installation IF you want to review ar change any oF your installation settings click Back Click Cancel to exit the wizard Advanced Installer 1 Telemedicine s Leader 16 Once the install is complete click on Finish ig Cisco AnyConnect VPN Client Setup Ej Completing the Cisco AnyConnect VPN Client Setup Wizard Click Ehe Finish button to exit the Setup wizard Cancel 18 To start OTN SSL VPN click on Start gt Programs gt Cisco gt Cisco Anyconnect VPN Client gt Cisco Anyconnect VPN Client Note helpful for TMC to have this as an ICON on their desktops Set Program Access and Defaults i Windows Catalog b windows Update Cisco AnyConnecE YPN Client ie Symantec Endpoint Protection gt E Symantec pecAnywhere Documents k j OTM VPM Programs Settings Search Help and Support Run Windows Terminal Server Log OFF XPMLlser 12 Telemedicine s Leader 19 Enter Group Name Always select O7N Store Forward Access with username as telehealth yourusernameand password click on Connect 2 Cisco AnyConnect VPN Client Seed Connection Statistics 24 About TIT IT CISCO Connect En
39. when placing it in your ears be sure that the headset is pointed towards your nose Adjust the sound amplification by pressing the and buttons on the keypad It is important that the very center of the chest piece is making good contact with the patient as this is the location of the sound sensor Select the option of play to stethoscope Exit the Telesteth software and ensure that the Bluetooth dongle is in the USB port and flashing Restart the session and attempt to pair If your USB port is at the back of the PC use a USB extender to re position it and create a clean line of site between the Bluetooth dongle and the Littman OTN does not support the use of Bluetooth devices other than the dongle provided with the Telesteth The OTN SSL VPN is set to time out after approximately 50 minutes verify please of inactivity If you plan to use the Telesteth for a clinic ensure that you reactivate it between patients by tapping the diaphragm Talk to your IT department or call your internet service provider to ensure connectivity is consistent OTN does not recommend the use of wireless internet for real time clinical telemedicine Plug your PC into a land Telemedicine s Leader Telesteth icon missing on desktop screen Unable to initiate Telesteth application software On clicking The Telesteth icon does not connect to the server Error displayed Communication error ended
40. will be displayed Click OK 18 f l My Documents File Edit View Favorites Tools Help Back pa Search lie Folders Ez 51 Folder Sync Address a My Documents File and Folder Tasks My Albums My Business Card i m Rename this folder Ly Move Ehis Folder t3 E mail this Folder s Files X Delete this folder My Shapes Other Places My Videos OTN D Copy this Folder My Music My Pictures EZ Share this Folder Gg Desktop 4j My Computer amp 4 My Network Places TeleSteth PB Animate otn f 22x32 Icon Details rdi UpdaterS PEng File Folder Date Modified Monday May 09 Visual Slideshow Web Page Maker 2011 3 14 PM Default Remote Desktop Connection 2 KB TUTTI Change Icon Look for icons in this File C Documents and SettingsashahiC Browse i Select an icon From the list below TeleSteth Properties General W eb Document Security Otn TeleSteth URL https ta otn cajtelemedweb launch Shortcut key None Visits Unknown Change Icon Select Telesteth icon file which you saved in Step 1 Click on Open Telemedicine s Leader 9 The following icon will be displayed on your computer desktop 10 Double click on the Telesteth icon created in Step 11 It will automatically launch the Telesteth internet site and prompt you to login this will be the login
41. wisting cap approximately 25 clockwise until locked Make sure the two marks are aligned Position the Headset Ear tips should point in a forward direction as you insert them into your ear canals When ear tips are properly positioned diaphragm will face towards your body Turn On Off This stethoscope has an advanced power management system Manual Turn On Depress and release power button LCD display will activate indicating stethoscope is on Manual Turn Off Depress and hold power button for two seconds LCD display will shut off indicating stethoscope is off Auto Off with Standby Feature After manual turn on stethoscope will stay on during use but switch to a power saving standby mode after 20 seconds of inactivity LCD display will display the Littmann logo during standby mode When stethoscope diaphragm or any button is pressed LCD display settings will reappear and stethoscope will be ready to use After two hours of non use the stethoscope will leave standby mode and fully power off Select Filter This electronic stethoscope allows the user to select between three Bell mode amplifies sounds from 20 100OHz but emphasizes lower frequency sounds between 20 200Hz o Diaphragm mode amplifies sounds from 20 2000Hz but emphasizes the sounds between 100 500Hz Extended Range mode amplifies sounds from 20 2000Hz similar to the Diaphragm mode but provides more low frequency response betwee
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