Vista Imaging Network Router Vista Routing User Manual

Routing User Guide-DRAFT  
VistA Imaging  
V. 3.0, Patch 18ꢀ  
April 2006 ꢀ  
VistA Imaging Software Design & Development  
Veterans Health Administration ꢀ  
Department of Veterans Affairsꢀ  
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Contents  
Introduction........................................................................................................ v  
Terms of Use....................................................................................................................v  
About this Manual............................................................................................................viꢀ  
Related Documents.........................................................................................................viiꢀ  
Routing Overview ...............................................................................................1ꢀ  
Routing Explained............................................................................................................ 1ꢀ  
Routing Prerequisites ....................................................................................................... 2ꢀ  
How Autorouting Works.................................................................................................... 4ꢀ  
How On-Demand Routing Works....................................................................................... 7ꢀ  
How Routing Priority Works .............................................................................................. 8ꢀ  
Defining Routing Rules.......................................................................................9ꢀ  
Routing Rules Explained ................................................................................................... 9ꢀ  
Rule Destinations............................................................................................................12ꢀ  
Rule Conditions...............................................................................................................14ꢀ  
Routing Rule Priority .......................................................................................................22ꢀ  
Routing Images from Prior Exams ....................................................................................22ꢀ  
Routing Rule Tips............................................................................................................23ꢀ  
Configuring Routing .........................................................................................25ꢀ  
Defining Imaging Destinations .........................................................................................26ꢀ  
Defining DICOM Destinations...........................................................................................37ꢀ  
Defining “Route Priors” Logic ...........................................................................................40ꢀ  
DICOM Gateway Configuration.........................................................................................42ꢀ  
Importing Routing Rules (Route.dic).................................................................................44ꢀ  
VistARad Configuration—Sending Sites..............................................................................47ꢀ  
VistARad Configuration—Receiving Sites ...........................................................................48ꢀ  
Changes Affecting Routing System Configuration...............................................................50ꢀ  
Using the Routing Gateway..............................................................................51ꢀ  
Activating Routing...........................................................................................................51ꢀ  
Maintaining Routing ........................................................................................................53ꢀ  
Disabling Routing............................................................................................................54ꢀ  
Routing Gateway Menu Options .......................................................................................55ꢀ  
Using VistARad in a Routing System ................................................................59ꢀ  
Displaying Routed Exams.................................................................................................59ꢀ  
VistARad & On-Demand Routing.......................................................................................61ꢀ  
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Routing User Guide  
Contents  
Troubleshooting Routing..................................................................................65ꢀ  
Basic Troubleshooting .....................................................................................................65ꢀ  
Getting Help...................................................................................................................65ꢀ  
Additional Routing Considerations.....................................................................................66ꢀ  
Appendix A........................................................................................................69ꢀ  
Imaging Destination Worksheet........................................................................................71ꢀ  
DICOM Destination Worksheet .........................................................................................73ꢀ  
Routing Rule Definition Worksheet ...................................................................................74ꢀ  
Routing Setup Checklist...................................................................................................78ꢀ  
Appendix B: Using MAG_Decompressor ...........................................................79ꢀ  
Licensing........................................................................................................................79ꢀ  
MAG_Decompressor Setup...............................................................................................79ꢀ  
MAG_Decompressor Logging............................................................................................81ꢀ  
Glossary ............................................................................................................83ꢀ  
Index ................................................................................................................87ꢀ  
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Introductionꢀ  
This manual explains how to configure and use the routing capability of the VistA  
DICOM Gateway. This manual also explains how to use the on-demand routing  
capability of the VistARad diagnostic workstation software.  
This manual is intended for:  
ƒStaff at VA Medical Centers who are responsible for setting up and maintaining  
Routing Gateways.  
ƒClinical staff who need to use VistARad for on-demand routing.  
For technical staff, this manual assumes familiarity with the VistA system, MUMPS, and  
Windows networking. For clinical staff, this manual assumes familiarity with the  
Windows environment and the VistARad diagnostic workstation software.  
Terms of Use  
In compliance with FDA and VA policies, authorization to use the software described in  
this document is contingent on the execution of a Site Agreement between the VistA  
Imaging HSD&D group and the site where this software is installed.  
Once a routing system is enabled at a site, an updated Site Agreement must be filed  
before significantly altering the configuration of a routing system.  
In addition to any restrictions noted in the Site Agreement, the following restrictions  
apply:  
Caution: Federal law restricts this device to use by or on the order of either a  
licensed practitioner or persons lawfully engaged in the manufacture or  
distribution of the product.  
!
No modifications may be made to this software without the express written  
consent of the VistA Imaging National Project Manager.  
!
The Food and Drug Administration classifies this software as a medical device.  
!
Modifications to the computer where this software is installed, such as the  
installation of unapproved hardware or software, will adulterate the medical  
device. The use of an adulterated medical device violates US Federal Law  
(21CFR820).  
US Federal regulations and VA internal policy prohibit unencrypted transmission  
of patient information outside the VA's intranet.  
!
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Introductionꢀ  
Routing User Guide  
About this Manual  
Using this Manual  
This document contains material of interest to different types of users.  
User  
Please read…  
All users  
The Routing Overview and the Glossary. The Index can  
also be used to find information about specific topics in  
this document.  
Clinical users  
Users responsible for  
DICOM Gateway  
operation and  
The Using the Routing Gateway chapter. You may also  
find useful information in the Troubleshooting Routing  
and Defining Routing Rules chapters.  
maintenance  
Users responsible for  
installing or configuring chapters.  
a routing system  
Installation worksheets are available in Appendix A.  
Conventions  
This manual uses the following conventions:  
ƒExamples are shown in Courier.  
ƒUseful or supplementary information is indicated by a  icon  
ƒVA File Manager file names are shown in SMALL CAPS. The first time a FileMan file  
is referenced in a topic, the file number is indicated in parentheses.  
ƒMenu options, buttons and other controls found in a graphical user interface are  
indicated by title case. Menu sequences are indicated by vertical bars ( | ).  
ƒCross-references are underlined. If this document is being used online,  
cross-references are shown in blue and are active links.  
ƒSidebars shown in margins indicate new or revised content.  
Acknowledgements  
This document is based on the “Autorouting Tutorial” authored by Ed de Moel.  
Special thanks to Brian Belleau, Craig W. Hunter, Cheryl Marland, Arnold Pfenninger,  
and Hedy Towan, who provided valuable background information and feedback for  
initial drafts of this document.  
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Routing User Guide  
Introduction  
Revision Table  
Date  
Rev.  
Notes  
25 Jun 2002  
.9  
Draft. Based on 23 Sep 1999 “Autorouting Tutorial.” Updated for  
Patch 9, test 2 distribution.  
20 Mar 2003  
22 Sep 2003  
1.0  
1.1  
Final version for p9 release. A. McFarren, E. deMoel  
Minor p22 updates in VistARad chapter. Added info about  
routing rules and priority that was not included in original rev.  
Minor clarifications and corrections throughout. A. McFarren, J.  
Christensen.  
30 Jul 2005  
03 Apr 2006  
1.2  
1.3  
Updates for patches 11 and 51. Change bars in margins indicate  
updated content. A. McFarren, E. deMoel  
Updates minor updates for patch 18. Change bars in margins  
indicate updated content. A. McFarren, J. Christensen  
Related Documents  
The following documents contain additional information about routing:  
ƒPatch Descriptions for patches 9, 11, and 51.  
ƒRouting Guidance Document  
The following documents contain additional information about components in the routing  
system:  
ƒDICOM Gateway User Guide  
ƒDICOM Gateway Installation Guide  
ƒVistARad User Guide  
The following documents contain information about the VistA Imaging system in  
general:  
ƒVistA Imaging System Installation Guide  
ƒVistA Imaging System Technical Manual  
ƒVistA Imaging System Planning Document & Approved Equipment List  
Copies of these documents are available at http://vaww.va.gov.imaging.  
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Introduction  
Routing User Guide  
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Routing Overviewꢀ  
This chapter explains how routing functions within the VistA Imaging system. It covers  
the following topics:  
Routing Explained  
In VistA Imaging, routing is the combination of methods and software used to identify  
and transmit exams produced at one site to a storage location at another site.  
Routing takes two forms: autorouting, and on-demand routing.  
ƒIn autorouting, automatically selected images are transmitted to one or more  
destinations. Images are selected based on a predefined set of routing rules.  
Autorouting functions are managed using the Routing Gateway.  
ƒIn on-demand routing, manually selected exams are transmitted to one or more  
destinations. Exams are selected using the VistARad diagnostic workstation and are  
transmitted by the Routing Gateway.  
Destinations of routed images fall into two broad groups. Imaging destinations are  
defined to support remote reading using a VistARad workstation. Images sent to these  
destinations are in VistA Imaging’s internal file format. DICOM destinations are defined  
to support transmission of DICOM images to a Storage SCP (Service Class Provider),  
such as a film printer or an external PACS.  
A properly implemented routing system can streamline a site’s imaging workflow.  
Scenarios where routing can be used include:  
ƒWorkload sharing between institutions or service providers  
ƒRapid access of exams at remote clinics or other facilities  
ƒRemote specialist interpretation or consultation  
ƒOff-hours, holiday, or emergency services  
ƒOff-site contract radiology services for primary interpretation  
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Routing Overviewꢀ  
Routing User Guide  
What is a Routing Gateway?  
A Routing Gateway locates routable images, determines where the images are to be  
routed to, and sends copies of those images to other locations. Routing is a function of the  
DICOM Gateway software. When properly configured, any DICOM Gateway can  
function as a Routing Gateway.  
Typically, a Routing Gateway runs on a dedicated computer. At sites where only a small  
volume of images are produced, a Routing Gateway can coexist on the same computer as  
an Image Gateway or a Text Gateway.  
Routing Prerequisites  
For a site to be authorized to use a routing system:  
ƒAn executed Site Agreement must be filed with the VistA Imaging HSD&D group.  
Note: An updated site agreement must be filed if the routing system is altered (for  
example: if site information changes, if a new destination is added, or if routing  
volume increases by 50% or more).  
ƒA contingency plan must be implemented at all sites in the routing system and filed  
with the VistA Imaging HSD&D group. The contingency plan must contain  
procedures to be followed should the routing system be unavailable.  
General hardware and operational requirements for routing are summarized below. For  
detailed information, contact your VistA Imaging Implementation Manager.  
Infrastructure Requirements  
Routing relies on the following infrastructure:  
ƒIf remote interpretation is being performed, one or more VistARad diagnostic  
workstations for the display of routed exams.  
ƒAn operational VistA Hospital Information System, an operational Image Gateway,  
and an operational Routing Gateway, configured as described in this document.  
ƒAn operational Local Area Network (LAN).  
ƒAn operational Wide Area Network (WAN) with sufficient bandwidth to manage the  
anticipated volume of routed exams.  
ƒWindows-based servers to provide exam storage at each routing destination,  
configured as described in this document.  
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Routing User Guide  
Routing Overview  
Operational Requirements  
The medical and IT management at a site implementing the routing system will need to  
develop policies establishing:  
ƒLocations to which the exams may and may not be routed  
ƒReporting / transcription requirements for routed exams  
ƒBandwidth utilization guidelines and priorities  
ƒStorage of routed exams at receiving sites  
ƒManagement of patient confidentiality and privacy issues related to routed exams  
ƒMethods for addressing performance issues and/or misuse of the routing system  
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Routing Overview  
Routing User Guide  
How Autorouting Works  
The following figure illustrates the transfer of automatically routed images to a  
VistARad workstation for remote reading. The processes outlined in this figure are  
explained in more detail below. (Apart from the destination, the same processes are used  
when autorouting images to a DICOM Storage SCP).  
Image G/W  
processes  
images, then  
archives images  
Routing G/W  
compares  
image data  
Routing G/W  
copies  
routable images  
to destination (2)  
Images  
reviewed  
at destination  
Images  
acquired  
to routing rules (1)  
Patient  
VistA  
data  
Images  
VistARad login  
Destination Site  
HIS  
Sending Site  
Modality  
Image links  
1
VistARad  
2
Image Gateway  
2
Routing Gateway  
1) Eval. Processor  
2) Trans. Processor  
Local image copies  
Images  
Remote Storage  
Destination  
Image Archive  
Identifying Images to be Autorouted  
Autorouting begins with an Image Gateway. As it is processing newly acquired images, a  
properly configured Image Gateway will add routing-specific entries to the rule  
evaluation queue.1 This queue is continually checked by the evaluation processor (which  
resides on the VistA Host and is started from the Routing Gateway).  
ÂIf the Image Gateway is not configured to add entries to the rule evaluation queue, the  
images being processed by the gateway cannot be autorouted. For more information,  
see page 44.  
Each image referenced in the rule evaluation queue is checked against a set of  
site-specific routing rules. If the rules indicate that the image should be routed, the  
evaluation processor creates an entry in the transmission queue.2 Entries in the rule  
evaluation queue are deleted after they are checked.  
1
The rule evaluation queue is a subset of the IMAGE BACKGROUND QUEUE file (#2006.03).  
The transmission queue is stored in the SEND QUEUE file (#2006.035).  
2
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Routing User Guide  
Routing Overview  
Autorouting Images from Prior Exams  
Autorouting offers the option to include images from prior exams. When this option is  
used in a routing rule, the Routing software will use the VistARad prefetch logic defined  
at acquisition site to create a list of prior exams. Images from the prior exams will be  
routed using same priority as the newly acquired image and, when appropriate, will be  
purged based on the same retention period as the newly acquired image. For more details  
about autorouting priors, see page 22.  
Sending Images to Destinations  
The transmission of routed images is based on entries in the transmission queue. Each  
entry in the transmission queue identifies the image to be routed and the destination of  
the image.  
The transmission queue is continually checked by the Routing Gateway transmission  
processor. For each entry in the queue, the transmission processor locates the image, and  
identifies the destination.  
For Imaging destinations, the transmission processor is responsible for copying the image  
to the destination. For DICOM destinations, the transmission processor passes the image  
and destination information to the ‘Transmit DICOM Images to a DICOM SCP’ function  
of the DICOM Gateway, and waits for the function to report the status of the transfer  
back to the routing software.  
After the image is copied, the appropriate entry in the transmission queue is updated with  
the status of the image transfer. Transmission queue entries are retained for tracking and  
troubleshooting purposes. Entries can be deleted as described on page 57.  
Remote Reading with VistARad  
A properly-configured VistARad workstation can be used to display and interpret exams  
routed from another site. Radiologists performing remote reading can use VistARad to  
log into the site that sent the routed exams, and then use the contents of the RC (Remote  
Cache) exam list column to determine which exams have been routed to them. For  
additional information about working with routed exams, refer to page 59.  
Exporting DICOM Images  
In general terms, any DICOM Storage SCP (Service Class Provider) can serve as a  
DICOM destination. Apart from transmission logs, images routed to a DICOM  
destination are not tracked by the Imaging system. Retention, management, and deletion  
of routed images is the responsibility of the destination.  
Deletion of Routed Images  
For Imaging destinations, the amount of time routed images are retained is based on the  
value of the RETENTIONPERIODfield in the NETWORK LOCATION File (#2005.2). When  
connecting to a destination for the first time on a given day, the transmission processor  
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Routing Overview  
Routing User Guide  
determines if images at the destination are older than the number of days specified in  
RETENTIONPERIOD. Images older than the specified number of days1 are deleted from  
the destination’s storage location.  
For DICOM destinations, routed images are retained until they are deleted locally. The  
routing software will not delete images sent to DICOM destinations.  
ÂRouted images are copies. The original image files are retained at the site where they  
were acquired.  
1
The age of a routed image is based on the transmission queue entry for that image, not on the  
date of the image file itself. Changes made to the date of the image file (such as those made by  
some anti-virus packages) will not affect when the image is deleted.  
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Routing User Guide  
Routing Overview  
How On-Demand Routing Works  
On-demand routing uses the same infrastructure as autorouting. However, in on-demand  
routing, exams to be routed are manually selected by a VistARad user, rather than being  
identified automatically by a Routing Gateway. With the proper security keys,  
on-demand routing is available to any VistARad user in the routing system.  
The following figure illustrates the transfer of images between a local and remote  
VistARad workstation using on-demand routing.1 On-demand routing can also be used to  
transfer images to a DICOM destination such as a film printer or an external PACS.  
Exams available  
in VistARad  
exam lists  
VistARad used to  
queue exams for  
on-demand routing  
Routing G/W  
copies images  
to destination  
Images  
reviewed  
at destination  
VistARad login  
Remote VistARad login  
VistA  
HIS  
Sending Site  
Destination Site  
Route  
Request  
VistARad (sending site)  
VistARad (destination site)  
Routing Gateway  
(Trans. Processor)  
Images  
Local image copies  
Image Archive  
Remote Storage  
Destination  
Selecting Images for On-Demand Routing  
VistARad’s Route Request dialog is used to select the exams to be routed on-demand and  
to indicate where exams are to be sent. When a user accepts the settings in the Route  
Request dialog, the exams are checked by VistARad to see if they can be routed (images  
present, available in short-term storage, etc.). Then entries for each image in the selected  
exams are added to the transmission queue.  
Once an exam has been added to the transmission queue, on-demand routing functions in  
the same way as autorouting.  
1
This figure illustrates on-demand routing being initiated from the site with a local Routing  
Gateway. On-demand routing can also be initiated from a destination site, as long as the  
destination site is logged into the location (division) where the exams to be routed were acquired.  
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Routing Overview  
Routing User Guide  
How Routing Priority Works  
The following factors are used to determine the priority of a routed exam:  
ƒAssigned priority  
ƒClinical urgency (autorouting only)  
ƒTime in transmission queue  
Priority and Autorouting  
For automatically routed exams, the routing software uses the priority assigned in a  
routing rule and the clinical urgency of the exam to calculate a numeric value. Images  
with the highest priority value are transmitted first.  
Factor  
Values  
Notes  
Assigned priority  
Low:  
+250 Priority is set in routing rules as described  
on page 9.  
Medium: +500  
If not explicitly set, a default value of  
Medium is used.  
High:  
+750  
Clinical urgency  
Routine:  
Urgent:  
STAT:  
+0 Values are based on the clinical urgency  
defined for the exam in the VistA system.  
+10  
+20  
Priority and On-demand Routing  
When an exam is routed on-demand, VistARad’s Route Request dialog can be used to  
assign a priority of Low, Medium or High. (The clinical urgency of the exam is not  
used). The Route Request dialog is described on page 61.  
If a user selects an exam to be routed on-demand that is already in the transmission  
queue, the higher priority of the two instances will be used.  
Other Priority Factors  
If two or more entries in the transmission queue have the same priority value, entries are  
processed on a First In, First Out (FIFO) basis.  
Because the transmission processor works on an image-by-image basis, it is possible for  
the images in a lower-priority exam to be interrupted ‘mid-stream’ by the images in a  
higher-priority exam. If this happens, transmission of all lower priority images will  
resume after transmission of all higher-priority images is complete.  
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Defining Routing Rules ꢀ  
This chapter explains how to define the rules used for autorouting. This chapter covers  
the following topics:  
ÂRouting rules can be defined before the configuration of the routing system is  
complete, but cannot be tested until the setup of the routing system is finished.  
Routing Rules Explained  
The Routing Gateway uses routing rules to determine which images are to be  
automatically routed and where the images are to be sent. Routing rules need to be  
established as a part of configuring the routing software, and will need to be adjusted if  
there is a change of staff availability or workflow.  
The definition of routing rules involves: ꢀ  
1 Determining the needs of the staff at the sending and receiving sites. ꢀ  
2 Determining what resources will be used at the receiving site. ꢀ  
3 Translating the resulting information into a rule that can be executed by the routingꢀ  
software. ꢀ  
ÂA rules definition worksheet is located in Appendix A.ꢀ  
How Routing Rules Work  
Routing rules are defined in a text file and are implemented when the text file is imported  
into a local table on the Routing Gateway.  
A basic routing rule looks like:  
send(“destination”)ꢀ  
when [condition Aꢀ  
condition B...] ꢀ  
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Defining Routing Rulesꢀ  
Routing User Guide  
Each routing rule must contain at least one destination and one condition. When the  
conditions in a rule are met, the image is sent to the specified destination.  
ƒThe destination specified in a rule must match an entry in either the NETWORK  
LOCATION File (#2005.2) or the DICOM TRANSMIT DESTINATION File (#2006.587).  
Routing rule destinations are described in detail on page 12.  
ƒA condition is a comparison between a general image property and the specific value  
associated with a particular image. Conditions are described in detail on page 14.  
Sample Routing Rules  
The following pages contain examples of routing rules as they would be entered into the  
Route.dicfile. For more information about the Route.dicfile, see page 44.  
A Simple Routing Rule  
A common routing scenario is the transmission of images from a particular modality for  
remote interpretation.  
Send CR images to Kansas City  
send("KANSASCITY")  
when MODALITY = "CR"  
Rules using Multiple Conditions  
If a rule contains more than one condition, all of the conditions must be met for an image  
to be routed.  
Send CR images produced in Wichita to Kansas City  
send("KANSASCITY")  
when MODALITY = "CR"  
SOURCE = "WICHITA"  
Tip: When defining multiple conditions for a rule, list the most restrictive condition first.  
Listing the most restrictive condition first will minimize the amount of time needed by  
the routing software to process the rule.  
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Routing User Guide  
Defining Routing Rules  
Rules using Wildcards  
Wildcards can be used when you want a condition to be valid for more than one value. In  
the example below, all images, regardless of modality, will be routed.  
Send all images to Kansas City  
send("KANSASCITY")  
when MODALITY="*"  
Wildcards are described in detail on page 20.  
Rules using the “does not match” Operator  
A condition can use different types of operators. The previous examples used “=” as an  
operator, indicating that the specified image property must match a particular value for a  
condition to be met.  
The following example uses “!=” as an operator, indicating the image property in  
question can be any value except the listed value.  
Send non-CR images to Kansas City  
send("KANSASCITY")  
when MODALITY != "CR"  
Operators are described in detail on page 20.  
Rules using Date/Time Conditions  
A rule using date/time conditions can be used to route images based on date, time of day,  
or “type” of day (such as weekday, holiday, and so on).  
A rule to send all CR images to a destination on certain days would look like:  
Send CR images to Kansas City on Mon/Wed/Fri  
send("KANSASCITY")  
when MODALITY="CR"  
NOW={MON 00:01AM to 11:59PM;  
WED 00:01AM to 11:59PM;  
FRI 00:01AM to 11:59PM}  
The NOWcondition is described, along with other date/time conditions, on page 21.  
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Defining Routing Rules  
Routing User Guide  
Rule Destinations  
The first parameter in a routing rule contains either the sendcommand or the balance  
command, and contains one or more destination names.  
The sendand balancecommands are described in detail below. Destination names are  
described on pages 26 and 37.  
The SEND Command  
Typically, the sendcommand is used to specify a single destination, as in the example  
below:  
send("KANSASCITY")  
when MODALITY="CR"  
NOW={MON 00:01AM to 11:59PM;  
WED 00:01AM to 11:59PM;  
FRI 00:01AM to 11:59PM}  
To send similar exams to multiple destinations, multiple rules would be used, as shown  
below:  
send("KANSASCITY")  
when MODALITY="CR"  
send("BACKUP")  
when MODALITY="CR"  
The BALANCE Command  
Use the balancecommand when you want to divide a pool of exams between multiple  
destinations. When using the balancecommand, you must specify what percentage of  
exams should be sent to each destination.  
In the sample rule below, 25% of the exams are sent to KANSASCITY, and 35% of the  
exams are sent to KANSASCITY2. The remaining exams are not routed at all (as indicated  
by the <local>=40%portion of the command).  
balance("KANSASCITY"=25%,"KANSASCITY2"=35%,<local>=40%)  
when MODALITY="CR"  
ÂThe total value of the percentages specified in the command must equal 100%.  
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Routing User Guideꢀ  
Defining Routing Rules  
How Load Balancing Works  
When a rule incorporates the balancecommand, the routing software uses two things to  
determine which destination receives a given exam: the percentages specified in the rule  
and internal counters set by the routing software.  
When a rule including a balancecommand is first applied, the routing software begins  
distributing exams the same way a deck of cards is dealt: the first destination receives one  
exam, the second destination receives the next exam, and so on. Exams are evenly  
distributed until the destination with the lowest value specified in the balancecommand  
has received its allotted percentage of exams. Then that destination is skipped until the  
counter resets. Since load balancing is based on percentages, the counter is reset each  
time 100 exams have been sent.  
For example, if a rule specifies…  
balance("DEST1"=10%,"DEST2"=40%,"DEST3"=50%)  
when MODALITY="CR"  
ƒThe first 30 CR exams will be distributed evenly, with each destination receiving 10  
exams. Once DEST1has received 10% of the exams, the routing software will skip  
DEST1until the counter resets.  
ƒThe next 60 CR exams are split evenly between DEST2and DEST3. After this point,  
DEST2and DEST3each have a total of 40 exams. DEST2now has its allotment of 40  
exams, and will be skipped until the counter resets.  
ƒThe remaining 10 CR exams are sent to DEST3, giving that destination a total of 50  
exams.  
ƒOnce 100 CR exams have been sent, the routing software resets its counters to zero,  
and starts distributing exams to all three destinations again.  
Note that a destination receiving a comparatively smaller percentage of exams will  
become idle more often than destinations that receive a greater percentage of exams.  
Resetting the Load Balancing Counter  
When routing rules are imported, the counters used for load balancing are all reset to  
zero. You can take advantage of this trait if you need to fine-tune or troubleshoot  
situations where load balancing is used. Note that it is not necessary to change routing  
rules to achieve this; you only need to re-import them.  
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Defining Routing Rules  
Routing User Guide  
Rule Conditions  
In routing rules, a condition is a comparison between a particular property of an image  
and a user-supplied value. The results of the comparison determine if the rule will be  
applied to an image or not.  
A routing rule can contain multiple conditions. A single whenstatement precedes all  
conditions in a rule.  
send("KANSASCITY")  
when MODALITY = "CR"  
SOURCE = "WICHITA"  
The parts of a condition are:  
property operator value  
A property is one of the known attributes of an image. Properties that can be used in a  
condition are listed the following section.  
An operator is a code for a type of comparison. Operators are described on page 20.  
A value is a text or date string supplied by the user. A value specifies what is being tested  
in the condition. Values are described on page 21.  
Properties  
The properties listed in this section can be used in routing rule conditions.  
ÂProperty names are not case-sensitive. However, properties are typically rendered  
in uppercase.  
Frequently Used Properties  
MODALITY  
Abbreviation for the type of modality. Possible values are listed below. Retired  
values are indicated by (ret.).  
AS:Angioscopy  
AU:Audio  
MA:Magnetic Resonance Angiography  
MG:Mammography  
BI:Biomagnetic Imaging  
CD:Color Flow Doppler  
CF:Cinefluorography  
CP:Colposcopy  
CR:Computed Radiography  
CS:Cystoscopy  
MR:Magnetic Resonance  
MS:Magnetic Resonance Spectroscopy  
NM:Nuclear Medicine  
OP:Ophthalmic Photography  
OT:Other  
PR:Presentation State  
CT:Computed Tomography  
PT:Positron Emission Tomography (PET)  
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Routing User Guide  
Defining Routing Rules  
(continued)  
DD:Duplex Doppler  
PX: Panoramic X-Ray  
DF:Digital Fluoroscopy (ret)  
DG:Diaphanography  
DM:Digital Microscopy  
RF:Radio Fluoroscopy  
RG:Radiographic Imaging (conventional)  
RTDOSE:Radiotherapy Dose  
DS:Digital Subtraction Angiography (ret) RTIMAXGE:Radiotherapy Image  
DX:Digital Radiography  
EC:Echocardiography  
ECG:Electrocardiography  
EPS: Cardiac Electrophysiology  
ES:Endoscopy  
FA:Fluorescein Angiography  
FS:Fundoscopy  
GM: General Microscopy  
HC: Hard Copy  
RTPLAN:Radiotherapy Plan  
RTRECORD:RT Treatment Record  
RTSTRUCT:Radiotherapy Structure Set  
SM:Slide Microscopy  
SMR:Stereometric Relationship  
SR:SR Document  
ST:Single-Photon Emission Computed  
Tomography (SPECT)  
TG:Thermography  
HD: Hemodynamic Waveform  
IO:Intra-oral Radiography  
IVUS: Intravascular Ultrasound  
LP:Laparoscopy  
US:Ultrasound  
VF:Videofluorography  
VL:Visible Light (VA extension)  
XA:X-Ray Angiography  
LS:Laser Surface Scan  
XC:External-camera Photography  
NOW  
Date and time that the rule is being processed. For more information, see page 21.  
SOURCE  
Name of the site that originally acquired the image. The value for this field is  
determined as follows:  
If the ACQUISITION SITE field (#2005, .05) has a non-empty value, the value of  
this field is used, otherwise;  
If the end-user credentials have a non-empty value for the current division (i.e. the  
location code for the DICOM Gateway from which the evaluation processor was  
started), the number of this division will be used, otherwise;  
As a last resort, the KERNEL SITE PARAMETER field for the number of the  
institution will be used.  
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Defining Routing Rules  
Routing User Guide  
Other Properties  
ABSTRACT_REF  
The network storage location of the image abstract.  
ACQUISITION_DEVICE  
The name of the device that generated the image as defined in the ACQUISITION  
DEVICE File (#2006.04).  
BIG_JUKEBOX_PATH  
Full file path on jukebox for .BIG images. This field indicates whether this file is  
located on the jukebox.  
BIG_MAGNETIC_PATH  
Full file path for .BIG images. This field indicates on which magnetic server this file  
resides.  
CLASS  
The class of the image, as stored in the CLASS INDEX field (#2005, 41). Typical values  
are CLIN, ADMIN, CLIN/ADMIN, and ADMIN/CLIN.  
CLINIC  
If an image is associated with a patient encounter (visit), the value of this parameter is  
the name of the clinic where the appointment occurred.  
DESCRIPTIVE_CATEGORY  
This is mainly for Document Imaging; it further describes the type of document  
image.  
EXAM_TIME  
The date/time of the procedure or the examination. For more information, see page 21.  
EXAM_TIMEcan be used to compare the exam date/time of the “image at hand” to the  
provided value.  
EXAM_TIME_FIRSTcan be used to compare the exam date/time of the earliest (oldest)  
image in the exam to the provided value.  
EXAM_TIME_LASTcan be used to compare the exam date/time of the latest (newest)  
image in the exam to the provided value.  
EXPORT_REQUEST_STATUS  
The value of this field, if defined, indicates if MailMan will send or has sent the image  
to another site. Possible values are:  
1 = EXPORT REQUESTEDꢀ  
0 = EXPORTED ꢀ  
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Routing User Guide  
Defining Routing Rules  
FILE_REF  
The unique image filename of the image, as stored on the magnetic server (and/or  
jukebox).  
IMAGE_SAVED  
The date and time the image was captured (as opposed to the date and time of the  
procedure or exam). For more information, see page 21.  
IMAGE_SAVEDcan be used to compare the save date/time of the “image at hand” to  
the provided value.  
IMAGE_SAVED_FIRSTcan be used to compare the save date/time of the earliest  
(oldest) image in the exam to the provided value.  
IMAGE_SAVED_LASTcan be used to compare the save date/time of the latest (newest)  
image in the exam to the provided value.  
IQ  
A flag that indicates whether or not an image has questionable integrity, as specified  
in the IQ field (#2005, 13). This field is either empty or equal to YES. Note that  
images with questionable integrity will be transmitted, but may not be displayed by  
the software on the receiving system. (On VistARad workstations, a warning is  
displayed if a user opens an image with questionable integrity, and only a user with  
the proper security key can actually display the image.)  
LAST_ACCESS  
The date and time the image was last viewed or accessed. For more information, see  
page 21.  
LAST_ACCESScan be used to compare the last access date of the “image at hand” to  
the provided value.  
LAST_ACCESS_FIRSTcan be used to compare the last access date of the earliest  
(oldest) image in the exam to the provided value.  
LAST_ACCESS_LAST can be used to compare the last access date of the latestꢀ  
(newest) image in the exam to the provided value. ꢀ  
MAGNETIC_REF  
The path for the network location of the stored image.  
MICROSCOPIC_OBJECTIVE  
Free text description of the Microscopic Objective selected by the pathologist. It  
identifies the power of the microscope objective used when capturing an image of a  
slide.  
OBJECT_NAME  
The natural language name for the image, usually consisting of the patient name,  
social security number, and image description.  
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Defining Routing Rules  
Routing User Guide  
OBJECT_TYPE  
The object type (such as still image, black & white image, x-ray) as described in the  
OBJECT TYPE File (#2005.02).  
PACKAGE  
An abbreviation for the name of the package that the image is attached to, as defined  
in the PACKAGE INDEX field (#2005, 40). Possible values are: RAD, LAB, MED,  
NOTE, CP, SUR, PHOTOID, NONE, or CONS.  
PACS_PROCEDURE  
The name in the radiology reports file that identifies the procedure.  
PACS_UID  
The unique 26-character image identifier of the PACS image.  
PARENT_DATA  
The name of the file that contains the “Parent Data.” See also  
PARENT_DATA_FILE_IMAGE_POINTER, PARENT_GLOBAL_ROOT_D0and  
PARENT_GLOBAL_ROOT_D1.  
PARENT_DATA_FILE_IMAGE_POINTER  
In the file identified by “Parent Data,” a multiple valued field may exist that identifies  
groups of images. When there is such a “multiple,” the value of this parameter is the  
entry number in this multiple that points back to the parent image of the current  
image.  
PARENT_GLOBAL_ROOT_D0  
The internal entry number in the file identified by PARENT_DATA.  
PARENT_GLOBAL_ROOT_D1  
The value of this parameter is defined only for laboratory images to record the third  
subscript of ^LR(D0,"SP",D1) as a backward pointer for use in report display and  
image deletion.  
PATH_ACCESSION_NUMBER  
The Anatomic Pathology accession number - the identifying number for the slide.  
PATIENT  
The name of the patient.  
PROCEDURE  
An abbreviation for the procedure as stored in the PROCEDURE field (#2005, 6).  
This field is set automatically by Imaging. Typical values are COL for colonoscopy,  
SUR for surgery, SP for surgical pathology, or XRAY for radiology.  
PROCEDURE_OR_EVENT  
The name of the procedure or event for which the image was created, as stored in the  
PROC/EVENT INDEX field (#2005, 43).  
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Routing User Guide  
Defining Routing Rules  
PROCEDURE_TIME  
The date/time of the procedure or the examination. For more information, see page 21.  
PROCEDURE_TIMEcan be used to compare the procedure date/time of the “image at  
hand” to the provided value.  
PROCEDURE_TIME_FIRSTcan be used to compare the procedure date/time of the  
earliest (oldest) image in the exam to the provided value.  
PROCEDURE_TIME_LASTcan be used to compare the procedure date/time of the latest  
(newest) image in the exam to the provided value.  
RADIOLOGY_REPORT  
The name of the Radiology Report associated with the image.  
SAVED_BY  
The name of the person who logged in to capture the image.  
SHORT_DESCRIPTION  
A one-line description of the image or object record.  
SPECIALTY  
The specialty (or sub-specialty) for which the image was acquired, as stored in the  
SPEC/SUBSPEC INDEX field (#2005, 44).  
SPECIMEN  
The specimen number of the slide given in the LAB DATA File (#63).  
SPECIMEN_DESCRIPTION  
The description given to the specimen in the LAB DATA File (#63).  
STAIN  
Free text description of the Histological Stain.  
SUMMARY  
A flag that indicates whether or not the image functions as a summary for a group.  
The value of this property is either empty, or equal to 0 (NO) or 1 (YES).  
TRACKING_ID  
An identifier for the package that performed the Import (value looks like package  
name, semi-colon, ID-code).  
TYPE  
The type of image, as stored in the TYPE INDEX field (#2005, 42). Typical types are  
IMAGE, DIAGRAM, CONSENT, etc...  
URGENCY  
A code that indicates the clinical urgency of the exam for which the image was  
produced. Possible values are: ROUTINE, URGENT and STAT. The value for this  
field is determined by the Radiology Package.  
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Defining Routing Rules  
Routing User Guide  
WORM_REF  
The network location of the jukebox platter where the image is stored (provided there  
is a jukebox in the Imaging system).  
Operators  
The following operators can be used in routing rule conditions:  
Operator Image property must…  
=
!=  
<
Match value in rule.  
Not match value in rule.  
Be less than a numeric value in rule. For date/time values, this  
operator can be used for “earlier than.”  
>
Be greater than a numeric value in rule. For date/time values, this  
operator can be used for “later than.”  
<=  
>=  
Be less than or equal to a numeric or date/time value in rule.  
Be greater than or equal to a numeric or date/time value in rule.  
Values  
Values are the user-supplied part of a routing rule condition. Most values are text strings.  
Values are typically enclosed in quotation marks ("). If a value contains both upper and  
lowercase characters, or if it contains punctuation marks or spaces, quotation marks are  
required.  
Two types of wildcard characters can be used in routing rules: the asterisk (*) and the  
question mark (?). The question mark allows one single character in a value to be “any  
character.” The asterisk allows one or more characters to be “any character.”  
The following examples demonstrate how wildcards can be used in text-based values:  
PATIENT=“*CRAY*”  
To meet this condition, the patient name for an image must contain the characters  
CRAY. Any characters may precede or trail these characters. Names like CRAY,  
MCCRAY, and CRAYNEwill meet this condition, but CREYwill not.  
PATIENT=“SMIT?”  
To meet this condition, the patient name for an image must start with the characters  
SMIT, after which exactly one character may follow. Names like SMITHand SMITT  
will meet this condition, but SMITHSONwill not.  
PATIENT=“PETERS?N”  
To meet this condition, the patient name for an image must start with the characters  
PETERS, then contain one arbitrary character, then end with N. Names like  
PETERSON and PETERSEN will match this comparison, but PETERSSEN will not.  
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Routing User Guide  
Defining Routing Rules  
Values for Date/Time Properties  
When condition based on date and time is used, the supplied value must adhere to  
VA-FileMan conventions. Values for date/time conditions are presented as a range  
enclosed in braces { }.  
The most frequently used date/time property is NOW. NOWcan be used to select the times  
that a staff member will be present by specifying certain workdays and times of day.1  
Send CR images to Kansas on Mon/Wed/Fri  
send("KANSAS")  
when MODALITY="CR"  
NOW={MON 08:00AM to 17:00PM;  
WED 08:00AM to 15:30PM;  
FRI 08:00AM to 17:00PM}  
Date/time properties can also be used to specify holidays. In this context, holidays are  
those days that are marked as such in the sending site’s HOLIDAY File (#40.5). A rule to  
send images on holidays only could be specified as:  
Send CR images to Kansas on Holidays  
send("KANSAS")  
when MODALITY="CR"  
NOW={HOL 00:01AM to 23:59PM}  
Date/time ranges use a 24-hour clock. While the use of AM or PM indicators is not  
required they can be useful when the hours specified are 0:00 AM (midnight) and  
12:00 PM (noon). Date/time ranges can be used to express date values from any century  
as well as time values for any second in the day.  
When the routing software compares a date/time property in an image entry to a specified  
value, the date/time value is broken into components:  
Day of week  
Day of month  
Month  
Hour  
Minute  
Second  
Year  
Which of these components will be used in the actual comparison will depend on the  
specified value.  
1
The actual value of NOW is the moment when the rule is evaluated.  
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Defining Routing Rules  
Routing User Guide  
Routing Rule Priority  
Automatically routed exams are assigned a default priority of ‘Medium.’ This priority  
can be changed by adding a prioritystatement after the conditions for the rule.  
Prioritize images based on destination  
send("KANSAS")  
when MODALITY="CT"  
priority HIGH  
send("BACKUP")  
when MODALITY="CT"  
priority LOW  
In addition to the priority that is derived from routing rules, the routing software takes the  
clinical urgency of an exam into account. For more information, see page 8.  
Routing Images from Prior Exams  
Images from prior exams can be automatically routed by adding a priorstudy  
statement after the conditions for the rule.  
Do or Do Not include Prior Studies  
send("KANSAS")  
when MODALITY="CT"  
priorstudy YES  
send("BACKUP")  
when MODALITY="CT"  
priorstudy NO  
When priorstudyis set to YES, images from prior exams will be included based on  
routing-specific settings in the MAG RAD PRIOR EXAMS LOGIC File (#2006.65).  
(Settings in this file are described in detail on page 40).  
When priorstudyis set to NO, or if the priorstudystatement is absent, images from  
prior exams will not be included.  
Using priorstudyin a routing rule can significantly increase network traffic. If  
a rule of this sort is implemented, be sure to monitor the network to ensure no  
problems arise.  
!
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Routing User Guideꢀ  
Defining Routing Rules  
Routing Rule Tips  
The following tips may be useful while creating or editing routing rules:  
ƒWhen defining multiple conditions for a rule, list the most restrictive condition first.  
This will reduce the amount of time needed to process the rule.  
ƒThe number symbol # can be used for comments, or to disable a rule. When disabling  
a rule, precede each line in the rule with #.  
ƒSpaces and line breaks can be used as needed for legibility.  
ƒRoute.dic must end with a line-feed. To ensure proper termination of the last  
meaningful line, add a comment-line after the last routing rule, such as:  
# last update on 1 April 2003ꢀ  
# end of file ꢀ  
When rules are imported as described on page 44, the routing software will check the  
syntax used and will report on any problems detected.  
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Defining Routing Rules  
Routing User Guide  
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Configuring Routing ꢀ  
This chapter assumes that routing software has been installed, and that an initial set  
of routing rules have been defined.  
This chapter explains how to configure a routing system. The following table lists the  
configuration tasks described in this chapter.  
See  
Page…  
Configuration Task  
Performed By  
Set up Imaging destinations  
Set up DICOM destinations  
Review/edit route priors logic  
Image Gateway configuration  
Routing Gateway configuration  
Import routing rules  
All sites involved  
All sites involved  
Sending site  
Sending site  
Sending site  
Sending site  
VistARad site parameter setup  
VistARad workstation setup  
Sending site  
Receiving site  
Alter configuration in response to  
changes in routing system  
All sites involved  
A configuration checklist is also available in Appendix A.  
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Configuring Routing ꢀ  
Routing User Guide  
Defining Imaging Destinations  
The following sections explain how to define an Imaging (non-DICOM) destination for  
routing. In general terms, defining an Imaging destination breaks down into the  
following steps:  
1 Establish naming conventions that are agreed on by the sending and receiving sites.  
2 Define storage folders for routed images at the receiving site and verify that the  
sending site can access those folders.  
3 Create routing-specific entries in the NETWORK LOCATION File (#2005.2) at the  
sending site.  
A destination definition worksheet is located on page 71.  
Note: Imaging destinations are defined to support remote reading using VistARad. For  
information about defining a DICOM destination, see page 37.  
Naming Conventions for Imaging Destinations  
Before an Imaging destination is established, the sending and receiving sites should  
decide how to identify themselves to routing users.  
The values that identify an Imaging destination are stored in the NETWORK LOCATION  
File (#2005.2) at the site where the Routing Gateway is installed. The values defined for  
the following should be related in some way.  
Field  
Description  
Notes  
Network  
Location  
(.01)  
The “official”  
destination name.  
Used by routing rules and the Routing  
Gateway at the sending site. Referenced  
in VistARad CacheLocationID at  
appropriate receiving site.  
Cannot match any other name in the  
NETWORK LOCATION File or in the DICOM  
TRANSMIT DESTINATION File (#2006.587).  
30 max, no spaces or punctuation.  
The value used should contain the  
nationally assigned 3-character site code  
and should indicate that the entry in  
question is used for routing.  
Physical  
The computer and  
The name used should be meaningful to  
both the sending and receiving sites.  
Cannot exceed 63 characters in length  
Reference (1) share name at the  
receiving site.  
Site (25)  
Destination as  
reported to  
Used in the RC column of VistARad’s  
exam lists.  
VistARad users.  
The value used should contain the  
nationally assigned 3-character site code.  
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Routing User Guide  
Configuring Routing  
When an Imaging destination is established, all the above values should be related in  
some way. The following example illustrates destination names for a fictional routing  
system.  
In this system, the sending site uses autorouting to meet two sets of needs. MRI images  
are routed to an off-site specialist for interpretation. Urgent exams acquired in the  
evening are routed to an affiliated hospital for after-hours interpretation.  
Jonesville  
Offsite location (MRI Interp.)  
Routing Gateway  
Remote Storage  
Destination  
\\JONESVILLE_MRI_RC  
VistARad  
Maryvale (off-hours coverage)  
Image Archive  
VistA  
HIS  
Remote Storage  
Destination  
\\MRV\JONESVILLE_RC  
VistARad  
(Network location file  
entries for destinations)  
NETWORK LOCATION File Entries at “Jonesville”  
Name field for Destination 1: OFFSITE_MRI_READ  
Phys. Ref. field for Destination 1: \\JONESVILLE_MRI_RC  
Site field for Destination 1: JVL_MRI  
Name field for Destination 2: MARYVALE_RC  
Phys. Ref. field for Destination 1: \\MRV_RC1\JONESVILLE_RC  
Site field for Destination 2: MRV  
Storage Location Names for offsite MRI specialist  
Folder name: Exams_from_Jonesville  
Computer and share name: \\JONESVILLE__MRI_RC  
VistARad CacheLocationID: JVL_MRI_RC  
Storage Location Names at for after-hours coverage at Maryvale  
Folder name: Exams_from_Jonesville  
Computer and share name: \\MRV_RC1\JONESVILLE_RC  
VistARad CacheLocationID: MARYVALE_RC  
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Configuring Routing ꢀ  
Routing User Guide  
Storage Folders for Imaging Destinations  
This section explains how to create and verify a folder for an Imaging destination on a  
Windows-based server. The folder will be used as the storage location for routed images  
at a receiving site.  
The resulting folder will be referenced in the NETWORK LOCATION File (#2005.2).  
Folder Prerequisites  
Before creating the folder:  
ƒA username and password, to be used by the routing software to copy images to the  
folder, will need to be established by the receiving site. The username/password must  
be provided to the sending site.  
Note: Unannounced password changes are a major cause of routing problems. To  
avoid future problems, the sending and receiving sites need to establish a  
procedure by which username/password changes can be implemented without  
adversely affecting routing.  
ƒThe sending site and the receiving site must establish naming conventions to use for  
the various elements that describe an Imaging destination. For more information, refer  
to the previous section.  
ƒThe sending site should work with the receiving site to estimate the amount of storage  
space needed based on the anticipated volume of transmitted images and the planned  
retention period.  
Folder Creation  
When the folder to be used as an Imaging destination is established by the receiving site,  
the receiving site will need to choose a logical folder name and share name. The share  
name will ultimately be referenced in the sending site’s NETWORK LOCATION File.  
Creating & sharing a folder to be used in an Imaging destination  
1 Log in as an Administrator to the computer where you will be creating the folder, and  
start Windows Explorer (choose Start | Run, then type Explorer).  
2 Select the drive (or folder) that you want to create the new folder in.  
3 Click File | New | Folder. After the new folder appears in the right side of the Explorer  
window, type the name of the new folder and press Enter.  
4 Right click the new folder, then click Sharing.  
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Configuring Routing  
5 In the Sharing tab, click the option that allows for sharing the folder, then enter the  
share name you want used for the folder.1  
ÂThe share name cannot contain punctuation marks or spaces, and the combined  
string identifying the computer and the shared folder cannot be more than 63  
characters long.  
ÂThe share name you enter must match the PHYSICAL REFERENCEfield value  
(#2005.2,1) defined at the site that will be sending images to this folder.  
ÂIt is recommended that you make the folder a hidden share by adding a dollar sign  
($) to the end of the share name. A hidden share will be accessible by the routing  
software, but will not be visible to users browsing your network.  
6 After typing the share name, click Permissions.  
7 In the Permissions dialog, click Add, then select the user group / user name that the  
routing software will use to access this folder.  
ÂThe username and password for the user you choose will need to be included in the  
NETWORK LOCATION File entry that references this folder.  
ÂUse the domain name as well as the username. Example: VHAIS\VHAKANIU(note  
the absence of leading backslashes).  
8 After adding the “routing user,” set the access type for the routing user to Full.  
9 In the list of users allowed to access the folder, click the “Everyone” user group, then  
click Remove.  
10 When you are finished, click OK to apply your changes and to close the Properties  
dialog.  
Folder Verification  
After the receiving site has created the folder, the sending site will need to verify that the  
folder can be remotely accessed and that files can be copied to and deleted from the  
folder.  
ÂTo complete the following steps, you will need the username and password that the  
routing software will use to access the folder.  
Testing folders from the sending site (Explorer)  
1 On the computer you will be using to test the folder, log in as an Administrator.  
1 Under Windows NT, the option name is ‘Share As’. Under Windows 2000, it is ‘Sharing’.  
Under Windows XP and 2003, it is ‘Sharing and Security’.  
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2 Start Windows Explorer (choose Start | Run, then type Explorer), then click Tools |  
Map Network drive.  
3 In the Map Network Drive dialog, enter the drive letter, path, and username (including  
domain name) that the routing software will be using. Then click OK.  
ÂIf desired, you can map a drive to the folder to make troubleshooting easier.  
However, be aware that the transmission processor will map certain drives as it  
sends exams to Imaging destinations. For more information, see page 66.  
4 When prompted, enter the password that will be used by the routing software, then  
click OK.  
ÂIf you cannot map the folder, use the next set of steps below (Testing folders from  
the sending site (Command Line)) to provide more detailed information about the  
problem you are encountering.  
5 Select the folder you just mapped to, copy a test file into the folder, and then delete  
the file. If the file is successfully copied and deleted, the routing software should be  
able to use the folder.  
6 Disconnect the mapped drive.  
Testing folders from the sending site (Command Line)  
1 Log in as an Administrator to the computer you will be using to test the folder on.  
2 Open a command prompt window (choose Start | Run, then enter CMD).  
3 Enter the following command to map the folder to a local drive. Parameters shown in  
bold will need to be replaced with valid values established by the receiving site  
> net use x: \\VHAxxxxxx\sharename\ password /u:username  
4 After mapping the drive, copy a test file to the folder, and then delete the file. If the  
file is successfully copied and deleted, the routing software should be able to use the  
folder.  
> copy any.file x:\<path>ꢀ  
> delete x:\<path>\any.file ꢀ  
5 When you are satisfied that the above parameters can be used to successfully access  
the folder, delete the test file, then terminate the test connection.  
> net use x: /delete  
ÂBe sure to terminate the test connection. Letting a connection linger may prevent  
the routing software from establishing its own connection to the folder.  
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Routing User Guideꢀ  
Configuring Routing  
Imaging Destination Definition  
Imaging Destination Definition using FileMan  
The following steps explain how to create an Imaging destination using FileMan. For  
information about values for specific fields, refer to page 32. A destination definition  
worksheet is also located on page 71.  
Editing the Network Location File at the sending site  
1 Log into the VistA Hospital Information System.  
2 Use FileMan to select the NETWORK LOCATION File (#2005.2) for editing.  
Select OPTION: E ENTER OR EDIT FILE ENTRIES  
INPUT TO WHAT FILE: 2005.2 NETWORK LOCATION (7 entries)  
EDIT WHICH FIELD: ALL// <Enter>  
3 When you are prompted to select a network location, enter the name that you want  
used for the destination.  
Select NETWORK LOCATION: TESTDEST  
Are you adding 'TESTDEST' as a new NETWORK LOCATION (the 11TH)? No// YES  
ÂThe name must be entered in upper case, cannot contain punctuation or spaces, and  
cannot match the name of a DICOM destination.  
4 At the next prompt, enter the computer name and share name of the storage location  
you want used for this destination. This name references a folder defined as described  
on page 28.  
PHYSICAL REFERENCE: \\VHAxxxxxx\images$\  
5 At each new prompt, enter the desired values for each field. Be sure to enter Yat the  
ROUTERprompt.  
ÂTypical values for a routing destination are shown below. For more detailed  
information about a particular field, enter "?" at the prompt, or refer to the next  
section.  
ꢀ  
STORAGE TYPE: MAG  
MAGNETICꢀ  
TOTAL SPACE: <blank>ꢀ  
SPACE USED: <blank>ꢀ  
FREE SPACE: <blank>ꢀ  
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Routing User Guide  
OPERATIONAL STATUS: 1 On-Line ꢀ  
HASH SUBDIRECTORY: <set as appropriate for your site>ꢀ  
ABSTRACT: N No ꢀ  
Yes ꢀ  
Yes ꢀ  
FULL: Y  
BIG: Y  
TEXT: Y  
DICOM: N  
Yes ꢀ  
Noꢀ  
COMPRESSION: <blank or J2K>ꢀ  
USER NAME: <Use the “routing username” here>ꢀ  
PASSWORD: <Use the “routing password” here>ꢀ  
MAINTAINCONNECTION: <blank>ꢀ  
MAX # RETRY ON CONNECT: 3 ꢀ  
MAX # RETRY ON TRANSMIT: 5ꢀ  
SYNTAX: U UNCꢀ  
SUBDIRECTORY: <blank>ꢀ  
Select USER  
<blank>ꢀ  
RETENTION PERIOD: 5 ꢀ  
LAST PURGE DATE: <set by routing software>ꢀ  
SITE: <set as appropriate for your site>ꢀ  
ROUTER: Y YESꢀ  
TIME OFFLINE: <blank>ꢀ  
MUSE SITE #: <blank>ꢀ  
MUSE VERSION #: <blank> ꢀ  
Imaging Destination Definition using the Background Processor  
The Background Processor software can also be used to define an Imaging destination in  
the NETWORK LOCATION File (#2005.2). (In the Background Processor, choose Edit |  
Network Location Manager). A destination definition worksheet is also located on  
page 71.  
Imaging Destination Values  
Fields used in the NETWORK LOCATION File are described below. These fields are listed  
in the order that they are defined in the file, and their descriptions assume that a routing  
destination is being defined.  
NETWORK LOCATION  
The value of this field will serve as the destination name for the location where image  
files will be sent. The routing software will accept uppercase alphanumeric characters  
and dashes ( – ), but will not accept values that use lowercase characters or other  
punctuation marks.  
ƒThe value for this field is used in the routing rules file (described on page 44).  
ƒThe value for this field can be different from the actual directory name or “share”  
name used for physical network location being referenced.  
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Routing User Guide  
Configuring Routing  
PHYSICAL REFERENCE  
The value of this field identifies the physical network location where routed images  
will be stored. This value must contain the computer name and the share name of the  
directory where routed images will be stored.  
\\ISWIMG01\IMAGE1$\ ꢀ  
\\TeleRad\Wichita$\ ꢀ  
This value must be entered using UNC (Universal Naming Convention) standards.  
This field is limited to 63 characters in length, must end in a backslash ( \ ), and the  
part of the name that identifies the computer cannot contain punctuation.  
TOTAL SPACE  
SPACE USED  
FREE SPACE  
These fields are not used for routing. The Background Processor uses these fields and  
will set values as needed.  
OPERATIONAL STATUS  
The value for this field can be 0(off-line) or 1(on-line). The routing software will set  
this value appropriately as it is operating. When no connection can be established, the  
routing software will set this field to 0(off-line). Once this field is set to 0, the routing  
software will not attempt to reach the storage location referenced in this entry for 15  
minutes. After 15 minutes have passed, the routing software will reset this field to 1  
and then try to connect again.  
STORAGE TYPE  
The value of this field describes the media type for the storage location identified  
above. For routing destinations, the value will be MAGNETIC.  
HASH SUBDIRECTORY  
The value of this field determines if routed image files are stored in one single  
directory (value is Noor empty), or in a hierarchy of directories (value is Yes). This  
value should be set based on the needs of your site.  
ABSTRACT  
The value of this field indicates whether or not “abstract” files should be transmitted  
to this destination. Abstract files (also known as thumbnail or icon files) are used by  
Clinical Display workstations.  
FULL  
The value of this field indicates whether or not “full” files should be transmitted to  
this destination. Full files contain the complete image, potentially at a reduced  
resolution. For routing, this field should be set to Yes.  
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Configuring Routing  
Routing User Guide  
BIG  
The value of this field indicates whether or not “big” files should be transmitted to this  
destination. Big files contain the complete image, always at the original resolution.  
For routing, this field should be set to Yes.  
TEXT  
The value of this field indicates whether or not text files should be transmitted to this  
destination. Text files contain the header information from the original DICOM file.  
For routing, this field should be set to Yes.  
DICOM  
Do not use.  
COMPRESSION  
The value of this field is a code that indicates which type of compression will be used  
for routed images. When the value of this field is equal to “J2K”, JPEG 2000  
compression will be applied before the file is transmitted. When the value of this field  
is empty or equal to “None”, no compression will take place. All images that are sent  
to the destination will be treated in the same fashion, that is: either compressed or  
uncompressed.  
Note: If compressed images are to be sent to a VistARad workstation, the  
MAG_Decompressor software will need to be installed on the workstation. See  
Appendix B for more information.  
Note: A toolkit license is needed for each system that is sending or receiving  
compressed images. For more information, contact VistA Imaging Customer  
Support.  
If some images need to be sent compressed and some not compressed, set up two  
destinations that are almost the same, one with a name like "WhereEver", with this  
field set to <blank>, and one with a name like "WhereEver_Compressed", with this  
field set to the appropriate type of compression.  
All other fields in the two records could have the same value, most specifically the  
field named "Physical Location".  
Then, the following routing rules could be set up:  
Send("WhereEver")ꢀ  
when MODALITY="MR" ꢀ  
and  
Send("WhereEver_Compressed")ꢀ  
when MODALITY="MR" ꢀ  
This will allow both compressed and uncompressed images to be sent to the same  
destination.  
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Configuring Routing  
USER NAME  
The value of this field is the username that the routing software will use to log into the  
shared folder defined in the PHYSICAL REFERENCEfield. This username must  
include permission to read, write, and delete on the physical storage space for this  
destination.  
PASSWORD  
The value of this field is the password that is used with the username above to log into  
the destination. The password is case-sensitive and is stored in an encrypted format.  
MAINTAINCONNECTION  
This field is not used for routing, and should be left blank.  
MAX # RETRY ON CONNECT  
Indicates the maximum number of successive attempts that will be made by the  
routing software to connect to this destination. A typical value is three attempts.  
If a successful connection cannot be made, the destination will be marked “off-line.”  
After 15 minutes, the destination will be marked “on-line,” and the routing software  
will begin trying to connect to this destination again.  
MAX # RETRY ON TRANSMIT  
Indicates the maximum number of successive attempts the routing software will make  
to transmit a file to this destination. A typical value is five attempts.  
When it is not possible to make a successful copy of an image within the number of  
attempts, the entry for the image in the transmission queue will be marked as failed  
(There is a Routing Gateway menu option to re-transmit failed queue entries.)  
SYNTAX  
The value of this field is a code that indicates the format for the name of the physical  
location. Currently, only UNC(Universal Naming Convention) is accepted.  
SUBDIRECTORY  
Typically, this field is left blank. The value of this field determines if a subdirectory  
(under the directory specified in PHYSICAL REFERENCE) should be used to store files  
for this destination. If hashing is turned off, all transmitted files will be stored in the  
subdirectory specified in this field; if hashing is turned on, all transmitted files will be  
stored in subdirectories of this subdirectory.  
Select USER  
<Future use> The values that may be entered for this (multiple-valued) field are  
e-mail addresses that will be used by a future version of the routing software to notify  
people about significant events related to routing activities.  
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Configuring Routing  
Routing User Guide  
RETENTION PERIOD  
The value of this field determines the number of days routed image files are stored at  
this destination. A typical value is five days.  
Whenever a transmission processor connects to a destination, it checks whether or not  
it has executed a purge for that destination on that day. If the connection in question is  
the first of the day and no purge has been executed yet, a purge will be initiated.  
During a purge, any image files older than the number of days specified by  
RETENTION PERIODare deleted (note that files are always retained at the sending  
site).  
LAST PURGE DATE  
The value of this field is set by the transmission processor when it executes a purge.  
SITE  
The value of this field is a code used by VistARad to identify the source of routed  
exams. The value of this field can be any text string. In the VistARad software, the  
value for this field will be shown in the RC (Remote Cache) exam list column.  
ROUTER  
The value of this field indicates whether or not the shared folder defined in the  
PHYSICAL REFERENCEfield is being used as a routing destination. For routing, the  
value of this field must be Yes.  
TIME OFFLINE  
The value of this field will be filled in by the transmission processor if it marks a  
destination as off-line. For more information, see MAX # RETRY ON CONNECT.  
MUSE SITE #  
This field is not used for routing. For MUSE EKG network locations, this field  
contains the MUSE site number assigned by a GE Marquette field engineer during  
MUSE server installation.  
MUSE VERSION #  
This field is not used for routing. For MUSE EKG network locations, this field  
contains the MUSE software version number.  
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Routing User Guideꢀ  
Configuring Routing  
Defining DICOM Destinations  
In general terms, defining a DICOM destination breaks down into the following steps:  
1 Determine the names that will be used to identify the destination and gather  
information about the receiving application.  
2 Edit the SCU_List.dic file, a dictionary file used by the DICOM Gateway(s).  
3 Use the DICOM Gateway to load the contents of SCU_List.dic into the MUMPS  
databases on the DICOM Gateway and on the VistA Host.  
The three following sections explain in detail how each general step is performed. A  
destination definition worksheet is located on page 73.  
Note: A DICOM destination must be a DICOM Storage SCP (Service Class Provider).  
For information about defining Imaging (VistARad) destinations, see page 26.  
Naming Conventions for DICOM Destinations  
The first step in defining a DICOM destination is determining what to name the  
destination and how to identify the sender of DICOM images.  
ƒWhen selecting a destination name (entered as the Application in SCU_List.dic), be  
sure that the name is 31 characters or less in length (case insensitive, punctuation is  
allowed), and that the name does not match any name defined for an Imaging  
destination.  
ƒThe sender of DICOM images (Calling AE in SCU_List.dic) is the ‘Transmit DICOM  
Images to a DICOM SCP’ function of the DICOM Gateway. The name used to  
identify this function needs to be agreed on by the sender and receiver of the DICOM  
transmission.  
The remaining information needed to define a DICOM destination is determined by the  
system that will be receiving the routed images. This information is described in detail  
on page 39.  
DICOM Destination Definitions in SCU_List.dic  
This section explains how to update SCU_List.dic specifically for the purposes of  
routing, and how to load the contents of SCU_List.dic into the DICOM and VistA system  
databases. The steps below assume that a single instance of SCU_List.dic is used by all  
DICOM Gateways at a site.  
Adding DICOM Destinations to SCU_List.dic  
1 Stop all active DICOM processes by waiting until they reach an idle state, and then  
terminating them.  
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Routing User Guide  
2 On the DICOM Gateway, use a text editor to open  
x:\DICOM\Dict\SCU_List.dic, where xis the name of the drive used by the  
DICOM Gateway to store dictionary files.  
3 Add the information for each DICOM destination as shown below (comment lines are  
preceded by #). Specific fields are defined in the next section.  
# User Application List  
# Format:  
# line 1:App Name|Called AE|Calling AE|Destination IP Address|Socket  
# line 2:|Presentation Context Name|Transfer Syntax Name  
# line 3:||Transfer Syntax Name (if there are more than one)  
#
MERGE EFILM|VistA_Storage|VistA_Send_Image|111.222.33.44|4006  
|Modality Worklist Information Model - FIND|Implicit VR Little Endian  
|Verification SOP Class|Implicit VR Little Endian  
4 Save the file into the directory noted in Step 1.  
ÂWhen using programs such as Microsoft Word, make sure that the file is saved in  
“text only” mode.  
ÂConfirm that the file extension is not changed by the text editor. The file will only  
be imported if it is named SCU_List.dicand if it is stored in the proper  
directory.  
5 Open a terminal window and log into the DICOM Gateway software.  
6 Enter 4to select “System Maintenance” from the DICOM Gateway Menu  
[MAGDMENU].  
7 Enter 2to select “Gateway Configuration and DICOM Master Files”.  
8 Enter 5to select “Update SCU_List.dic”  
9 When you are prompted to update the file, enter Y.  
Ready to read dictionary file “<x>:\DICOM\Dict\SCU_List.dic”? y// y  
<Enter>  
10 The file will be updated. If the operation is successful, you will be prompted to return  
to the menu.  
ÂIf you encounter any errors, record the information and then press Enter. You will  
need to correct the offending information and repeat the ten steps above.  
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Configuring Routing  
Field Definitions  
Fields defined in SCU_List.dic and used in the DICOM TRANSMIT DESTINATION File  
(#2006.587) are described below. These fields are listed in the order that they are defined  
in SCU_List.dic.  
Application  
The name that will be used to identify the receiving application and to identify the  
destination in a routing rule. The value for this field may be up to 31 characters in  
length, is case-insensitive, and punctuation can be used.  
Called AE  
The Application Entity Title of the application that is being called. The value of this  
field is dictated by the system that will be receiving the DICOM transmission.  
Calling AE  
The Application Entity Title of the application that initiates the call (i.e., the Transmit  
DICOM Images to a DICOM SCP function of the DICOM Gateway). The value for  
this field may be up to 16 characters in length, is case-insensitive, and punctuation can  
be used.  
Destination IP  
The TCP/IP address of the machine that will be receiving the DICOM transmission.  
The IP address can be numeric (123.46.57.89), symbolic (xxx.yyy.med.va.gov), or a  
name stored in the local “hosts” file.  
Socket  
The TCP/IP port number on which the system that will be receiving the DICOM  
transmission expects to be called.  
Presentation Context  
The name of a presentation context expected by the system that will be receiving the  
DICOM transmission. Refer to the current DICOM standard for a complete list of  
possible values.  
Transfer Syntax  
The name of a transfer syntax expected by the system that will be receiving the  
DICOM transmission. There are four possible transfer syntaxes  
Implicit VR Little Endian ꢀ  
Implicit VR Big Endianꢀ  
Explicit VR Little Endian ꢀ  
Explicit VR Big Endianꢀ  
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Configuring Routing ꢀ  
Routing User Guide  
Defining “Route Priors” Logic  
Verifying that Prefetch is Enabled  
The capability to route priors assumes that ‘prefetch’ is enabled. Prefetch is generally  
enabled at sites using VistARad.  
You can verify that prefetch is enabled by checking the following settings.  
ƒIn the Protocol File (#101), use FileMan to verify that MAGJ PREFETCH/SEND  
ORM is defined as a Subscriber to the RA REG protocol.  
ƒIn the APPLICATION PARAMETER File (#771), verify that MAGJ CLIENT is set  
to “Active.”  
Note: The PREFETCH ACTIVE? setting in the VistARad Site Parameters File  
(#2006.69) does not affect the automatic routing of priors.  
For more information, refer to chapter 3 in the Imaging System Installation Guide.  
How Prior Exam Routing Works  
The logic for automatically routing prior exams is triggered when a prior study  
statement is used in a routing rule. The baseline logic for routing priors is:  
For each exam being automatically routed, also route up to one matching prior exam  
up to 1800 days (about five years) old.  
This logic is stored in the MAG RAD PRIOR EXAMS LOGIC File (#2006.65). In a  
nutshell, this file is used for three things:  
1 It is used to identify, based on procedure name/CPT code, what qualifies as a ‘prior  
exam’.  
2 It is used to determine the maximum number and age of exams to automatically route  
as priors.  
3 It is used to determine the maximum number and age of exams to retrieve from the  
jukebox for VistARad prefetch.  
Note: Numbers 1 and 3 above are pre-existing functions. Number 2 is a new function  
introduced in Patch 51.  
Altering “Route Priors” Logic  
To alter the logic used for automatic routing of prior exams, you will first need to identify  
the procedure name/CPT code of the current exams in question. Then you will need to  
edit the MAG RAD PRIOR EXAMS LOGIC File (#2006.65) as described below.  
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Routing User Guideꢀ  
Configuring Routing  
Note: Altering the settings used to identify a prior will affect both VistARad’s prefetch  
function as well as the auto-route priors capability. However, the settings that determine  
the number and age of priors to be auto-routed can be set independently from the similar  
settings used for prefetch.  
To change “route priors” logic  
1 Log into the VistA Hospital Information System.  
2 Use FileMan to select the MAG RAD PRIOR EXAMS LOGIC File (#2006.65) for editing.  
Select OPTION: E ENTER OR EDIT FILE ENTRIES ꢀ  
INPUT TO WHAT FILE: 2006.65 MAG RAD PRIOR EXAMS LOGIC (288 entries) ꢀ  
3 Select the following fields for editing.  
EDIT WHICH FIELD: ALL// .01 <Enter> CURRENT CASE CPT GROUP  
THEN EDIT FIELD: 1 <Enter> PRIOR CASE MATCHING CPT GROUP (multiple)  
EDIT WHICH PRIOR CASE MATCHING CPT GROUP SUB-FIELD: ALL// .01 <Enter>  
MATCHING CPT GROUP  
THEN EDIT PRIOR CASE MATCHING CPT GROUP SUB-FIELD: 1 <Enter> AUTO-DISPLAY?  
THEN EDIT PRIOR CASE MATCHING CPT GROUP SUB-FIELD: 2 <Enter> DAYS  
LIMIT/AUTO-DISPLAY  
THEN EDIT PRIOR CASE MATCHING CPT GROUP SUB-FIELD: 3 <Enter> VERSION  
LIMIT/AUTO-DISPLAY  
THEN EDIT PRIOR CASE MATCHING CPT GROUP SUB-FIELD: <Enter>  
THEN EDIT FIELD: <Enter>  
STORE THESE FIELDS IN TEMPLATE: <Enter>  
4 At the following prompt, enter the CPT code or description for the types current  
exams you want to alter the route priors logic for. (Enter ? to see a list of CPT codes  
and descriptions).  
Select MAG RAD PRIOR EXAMS LOGIC CURRENT CASE CPT GROUP:  
5 At the ‘Select MATCHING CPT GROUP’ prompt, enter a CPT code that has been  
previously entered as being a match for the current exam, or enter a new CPT code to  
match to the current exam.  
Note: Altering the settings for this prompt will affect both VistARad’s prefetch  
function as well as the auto-route priors capability.  
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Configuring Routing ꢀ  
Routing User Guide  
6 Set the following three prompts as desired for autorouting priors. Details follow.  
AUTO-DISPLAY: YES//ꢀ  
VERSION LIMIT/AUTO-DISPLAY: 1//ꢀ  
DAYS LIMIT/AUTO-DISPLAY: 1800// ꢀ  
AUTO-DISPLAY?  
The value of this field should be set to “YES” for entries that should cause  
autorouting of prior studies  
DAYS LIMIT/AUTO-DISPLAY  
The value of this field should be set to an integer number. Studies that precede the  
current image by more than this number of days will not be candidates for auto-  
routed transmission. Only studies that are less than the number of specified days  
will be included.  
VERSION LIMIT/AUTO-DISPLAY  
The value of this field should be set to an integer number. This number indicates  
the maximum number of prior studies that will be auto-routed for the current  
image.  
Note: The names of fields will be changed in a future patch.  
7 Select additional fields to edit, or exit FileMan.  
DICOM Gateway Configuration  
A site that is the source of auto-routed images will need to set the configuration file for  
all Image and Routing Gateways as described in the following sections.  
ÂNo configuration changes are needed for Text Gateways in a routing system.  
Image Gateway Configuration  
Image Gateways at a site using autorouting will need to have their configuration file set  
as described below.  
ÂThe following steps cover only routing-related configuration parameters. For  
information about other configuration parameters, refer to the DICOM Gateway  
Installation Guide.  
To configure Image Gateways  
1 Open a terminal window and log into the DICOM Gateway software.  
2 Enter 4to select “System Maintenance” from the DICOM Gateway Menu  
[MAGDMENU].  
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Routing User Guide  
Configuring Routing  
3 Enter 2to select “Gateway Configuration and DICOM Master Files.”  
4 Enter 1to select “Update Gateway Configuration files.”  
5 Set the prompts indicated in bold below to Yes.  
ꢀ  
Will this computer be a DICOM Image Gateway? YES// YES ꢀ  
Will this computer be a DICOM Text Gateway? NO// NO  
Will this computer be a Routing Gateway? NO// NO  
ÂWill this computer be part of a system where autorouting is active? NO// Yes  
Send text to a commercial PACS, Mitra Broker, et cetera? NO// NO ꢀ  
ꢀ  
6 Press <Enter> to cycle though the rest of the prompts and to exit the program.  
Routing Gateway Configuration  
The workstation serving as a Routing Gateway will need to have its configuration file set  
as described below. Completing these steps will make the Routing Gateway menu option  
and its submenus available in the main DICOM Gateway Menu [MAGDMENU].  
ÂThe following steps cover only routing-related configuration parameters. For  
information about other configuration parameters, refer to the DICOM Gateway  
Installation Guide.  
To configure the Routing Gateway  
1 Open a terminal window and log into the DICOM Gateway software.  
2 Enter 4to select “System Maintenance” from the DICOM Gateway Menu.  
3 Enter 2to select “Gateway Configuration and DICOM Master Files.”  
4 Enter 1to select “Update Gateway Configuration files.”  
5 Set the prompts indicated in bold below to Yes.  
ꢀ  
Will this computer be a DICOM Image Gateway? YES// NO ꢀ  
Will this computer be a DICOM Text Gateway? NO// NO  
Will this computer be a Routing Gateway? NO// Yes  
Âꢀ  
Will this computer be part of a system where autorouting is active? NO// Yes  
Âꢀ  
Send text to a commercial PACS, Mitra Broker, et cetera? NO// NO ꢀ  
ꢀ  
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Configuring Routing ꢀ  
Routing User Guide  
6 Press <Enter> to cycle though the rest of the prompts and to exit the program.  
Importing Routing Rules (Route.dic)  
This section covers the following topics:  
This section assumes that you have prepared your routing rules as described in the  
previous chapter.  
Creating and Importing a Routing Rules File  
Routing rules are initially defined in the \DICOM\Dict\Route.dicfile, which is stored  
on the Routing Gateway. This file can be created and modified using any text editing  
program.  
Routing rules take effect after Route.dichas been imported into a local MUMPS table  
used by the Routing Gateway.  
To create and import routing rules  
1 On the Routing Gateway, use a text editor to open x:\DICOM\Dict\Route.dic,  
where xis the name of the drive used by the Routing Gateway to store dictionary  
files.  
ÂThe first time routing rules are defined; this file will need to be created. If you are  
modifying an existing file, it is recommended that you create a backup copy of the  
file.  
2 Enter your rules.  
ÂRoute.dic must end with a line-feed. To ensure proper termination of the last  
meaningful line, add a comment-line after the last routing rule, such as:  
# last update on 1 April 2003ꢀ  
# end of file ꢀ  
3 Save the file into the directory noted in Step 1.  
ÂWhen using programs such as Microsoft Word, make sure that the file is saved in  
“text only” mode.  
ÂConfirm that the file extension is not changed by the text editor. The file will only  
be imported if it is named Route.dicand if it is stored in the proper directory.  
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Routing User Guide  
Configuring Routing  
4 Open a terminal window and log into the Routing Gateway software. ꢀ  
5 Enter 3to select “Routing Gateway” from the DICOM Gateway Menu [MAGDMENU]. ꢀ  
6 Enter 5to select “Import Routing Rules.” ꢀ  
7 When you are prompted to build the Routing Table, enter Y. ꢀ  
Ready to build the Routing Table? y// y <Enter>  
8 The file will be imported. If the import is successful, the following will be displayed.  
You will be prompted to return to the menu.  
nnn rules stored in the database  
Press <Enter> to continue:  
ÂIf you encounter any errors, record the information and then press Enter. You will  
need to correct the offending rules and repeat these steps.  
Verifying Imported Rules  
When new routing rules are imported it is important to double-check that the new set of  
rules corresponds to the intent of the end-user.  
To verify imported rules  
Open a terminal window and log into the Routing Gateway software. ꢀ  
1 Enter 3to select “Routing Gateway” from the DICOM Gateway Menu [MAGDMENU]. ꢀ  
2 Enter 10to select “Display Routing Rules”. ꢀ  
3 The current set of Routing Rules will be displayed:ꢀ  
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Configuring Routing ꢀ  
Routing User Guide  
Routing rules:  
SEND(IMAGPROVIDER1)  
If: MODALITY=CT  
SEND(IMAGPROVIDER2)  
If: MODALITY=CR  
SEND(BAL2)  
If: MODALITY=XA  
Priority: HIGH  
Press <Enter> to continue...  
4 After the rules are displayed and double-checked, press Enter to return to the menu.  
Re-Importing Routing Rules  
To be change routing rules, Route.dicwill need to be modified, and then re-imported.  
When routing rules are re-imported:  
ƒThe existing routing table will be replaced. Retaining the original set of rules in a  
backup file allows you to restore the routing table, if necessary.  
ƒIf you are using load balancing, importing routing rules will cause internal counters  
that control load balancing to be reset. For more information, see page 13.  
ƒIf multiple Routing Gateways are present, the steps for importing the modified rules  
file must be performed for all Routing Gateways, so that Gateways will all use the  
same set of rules.  
Routing Rules & Multiple Routing Gateways  
If multiple evaluation processors need to be active (as could be the case at a consolidated  
site) each Routing Gateway can use its own local set of rules.  
However, it is usually better for all Routing Gateways to use a single set of rules stored in  
a shared directory. Using the same set of rules will make maintenance easier (changes to  
rules need to be made in only one Route.dicfile, rather than several), and allows each  
gateway in the pool to function as a backup for any other gateway.  
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Routing User Guideꢀ  
Configuring Routing  
VistARad Configuration—Sending Sites  
For sites that will be sending autorouted images:  
ƒThe MAG VISTARAD SITE PARAMETERS File (#2006.69) needs to be edited.  
ƒA site’s SITE CODE(IMAGING SITE PARAMETERS File (#2006.1)) must be set to a  
non-null value that will identify the sending site.  
To set routing-related VistARad site parameters  
1 Open a terminal window and log into the VistA Hospital Information System.  
2 Access the VistARad System Options menu [MAGJ MAIN] and run the “E/E  
VistARad Site Parameters” option [MAGJ VISTARAD SITE PARAMETERS].  
3 Set the routing-related fields (shown in bold below) to YES.  
Select MAG VISTARAD SITE PARAMETERS VISTARAD SITE NAME: DEMO ꢀ  
VISTARAD SITE NAME: DEMO//ꢀ  
ENABLE STATUS UPDATE?: YES//ꢀ  
RECENT EXAMS DAYS LIMIT: 9999//ꢀ  
UNREAD EXAMS DAYS LIMIT: 9999//ꢀ  
PREFETCH ACTIVE?: YES//ꢀ  
LIST ONLY EXAMS HAVING IMAGES?: NO//ꢀ  
ENABLE SERIES DISPLAY?: YES//ꢀ  
BACKGROUND COMPILE EXAM LISTS?: NO//ꢀ  
UNREAD BKGND COMPILE INTERVAL: 2//ꢀ  
RECENT BKGND COMPILE INTERVAL: 30//ꢀ  
REMOTE LIST ONLY REMOTE CACHE?: NO// YES <obsolete>1  
SITE SENDS TO REMOTE CACHE: NO// YES  
PATIENT LIST LIMIT # YEARS: 10//  
PATIENT LIST LIMIT # EXAMS: 15//  
UNREAD LIST PRIORITY SEQ: S,U,P,R//  
<required>2  
ÂThese steps assume that other fields in MAG VISTARAD SITE PARAMETERS are  
already set as desired. For information about other site parameters, refer to chapter  
3 in the VistA Imaging Installation Guide.  
4 Use FileMan to check the value of your site’s SITECODEfield (#2006.1,.09). The  
value entered must not match any of the CacheLocationIDvalues defined at  
1
REMOTE LIST ONLY REMOTE CACHE? This field is retained for backward compatibility. For  
sites using the patch 32 VistARad client, this field, when set to YES, will show only the exams  
that have been routed to their site. For sites using the patch 18 client, this setting is a filter that  
can be set as desired by each user. For more information, refer to the VistARad Quick Start  
Guide.  
2
SITE SENDS TO REMOTE CACHE? Setting this field to YES turns on extra processing that  
is needed to manage routed exams properly. One of the results of setting this field to YES is the  
addition of the RC column to VistARad’s exam lists. The RC column is described on page 59.  
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Configuring Routing ꢀ  
Routing User Guide  
receiving sites (see the next section for details). It is recommended that the SITE  
CODEbe set to your standard 3-digit site code.  
Select OPTION: E ENTER OR EDIT FILE ENTRIES ꢀ  
INPUT TO WHAT FILE: 2006.1 IMAGING SITE PARAMETERS (1 entry)ꢀ  
EDIT WHICH FIELD: ALL// .09 SITE CODE ꢀ  
THEN EDIT FIELD: <enter> ꢀ  
Select IMAGING SITE PARAMETERS NAME: `1 TEST SITE ꢀ  
SITE CODE: TSTꢀ  
VistARad Configuration—Receiving Sites  
VistARad workstations at receiving sites will need to be configured to check the  
appropriate local storage location for the presence of routed exams. This is done by  
setting the CacheLocationIDin the MAGJ.INIfile for each VistARad workstation.  
Setting the CacheLocationIDaffects VistARad in the following ways:  
ƒWhen a user logs into VistARad, the locally-defined CacheLocationIDis compared  
to the SITE CODE(IMAGING SITE PARAMETERS File (#2006.1)) of the site being  
logged into. If the two values are different, the VistARad software assumes that it will  
be used to display routed images.  
ƒWhen a routed exam is selected for display, VistARad will check the local storage  
location for routed images. The storage location checked is specified in the applicable  
NETWORK LOCATION File (#2005.2) entry at the sending site.  
The following steps must be performed for each VistARad workstation that will be used  
to display routed images.  
To set the CacheLocationID in MAGJ.INI  
1 Log into the VistARad workstation as an administrator.  
2 Use Explorer or the Start | Run menu option to open  
C:\Programs\Vista\Imaging|MAG_VistaRad\MAGJ.INI.  
3 Locate the CacheLocationIDline under [Workstation Settings], near the beginning  
of the file.  
4 For CacheLocationID, enter the destination name that contains local copies of  
routed images.  
ÂThe value you enter must match a routing destination name as defined in the ꢀ  
sending site’s NETWORK LOCATION File. ꢀ  
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Routing User Guide  
Configuring Routing  
ÂPartial matching can be used to allow VistARad to access images from multiple  
destinations. For more information, see the next section.  
[Workstation Settings]  
WorkStation TimeOut minutes=0  
ID=UNKnown  
Location=UNKnown  
VistaRad test mode=FALSE  
CacheLocationID=DEMO  
5 Save and close the file.  
Making Multiple Destinations Accessible to VistARad  
A VistARad workstation can be used to display images from multiple (local)  
destinations. This is possible because partial matching is used when the  
CacheLocationIDis compared to the names of routing destinations defined in the  
NETWORK LOCATION File (#2005.2).  
For example, if a site is sending images to the destinations shown below, a VistARad  
workstation with its CacheLocationIDset to Teleradwould be able to access both  
destinations.  
TeleradMain ꢀ  
TeleradBackup ꢀ  
Note that the partial matching used is based on leading characters. Continuing the above  
example, a destination named NewTeleradwould not be treated as a match for  
workstations using Teleradas their CacheLocationID.  
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Configuring Routing  
Routing User Guide  
Changes Affecting Routing System Configuration  
The following table lists situations that will require a change in routing configuration, and  
outlines the changes that will need to be made.  
Routing System Change  
Related Configuration Change  
Alteration of location, permissions, Update NETWORK LOCATION File (#2005.2) entry for the  
etc., of a Imaging destination  
folder  
applicable destination  
New destination, or name change  
of existing destination  
ƒ
Update NETWORK LOCATION File entry for the  
applicable destination  
ƒUpdate routing rules  
ƒStop and restart transmission processor (if one  
processor serves all destinations), or start a new  
instance of the transmission processor for the new  
destination  
ƒUpdate VistARad workstation MAGJ.INI at  
receiving site  
New Image Gateway / imaging  
modality  
ƒConfigure Image Gateway  
ƒReview and update routing rules if needed  
Change of radiology staff at  
sending or receiving site  
ƒReview and update routing rules if needed  
ƒ
Review NETWORK LOCATION File entry for  
destination and adjust if needed.  
ƒDetermine if new staff members need on-demand  
routing privileges  
Addition of new VistARad  
workstation  
Update VistARad workstation MAGJ.INI  
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Using the Routing Gateway ꢀ  
This chapter explains how to use the Routing Gateway. This chapter covers the following  
topics:  
This chapter assumes that the Routing Gateway has been properly installed and  
configured.  
US Federal regulations and VA internal policy prohibit unencrypted transmission  
of patient information outside the VA's intranet.  
!
Routing can have a significant impact on network traffic. It is the responsibility of  
!
sites using routing to properly manage network demands related to routing. Before  
activating the routing software, notify your network administrator that there will  
be an increase (often a significant one) in network traffic to routing destinations.  
Activating Routing  
The steps below explain how to start the Routing Gateway’s evaluation processor and  
transmission processor.  
ÂBefore performing the following steps, verify that Image Gateways in the routing  
system are processing images. If images are not being processed, no new entries will  
be added to the rule evaluation queue.  
Starting the Evaluation Processor  
1 Verify that the MSM server is running on the Routing Gateway. If it is not,  
double-click the MSM Console icon to start the MSM server.  
2 Open a terminal window and log into the DICOM Gateway software.  
3 Enter 3to select “Routing Gateway” from the DICOM Gateway Menu [MAGDMENU].  
4 Enter 3to select “Start Evaluation Processor” from the Routing Gateway Menu.  
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Using the Routing Gateway ꢀ  
Routing User Guide  
5 Position and size the terminal window for subsequent monitoring. (Note that no new  
information will be shown in the terminal window until the evaluation processor  
encounters entries in the rule evaluation queue.)  
Starting the Transmission Processor  
1 Open a new terminal window and log into the DICOM Gateway software. ꢀ  
2 Enter 3to select “Routing Gateway” from the DICOM Gateway Menu [MAGDMENU]. ꢀ  
3 Enter 1to select “Start the Transmission Processor.” ꢀ  
4 A list of destinations will be displayed. To select all possible destinations, enter anꢀ  
asterisk (*). To enter a partial list, follow the instructions at the prompt.  
Possible destinations are:  
125: KANSAS at \\TELERAD3\wichita  
152: ST LOUIS CR at \\vhastlvistarad  
164: IMAGPROVIDER1 at C:\REMOTE\IMAG1\  
166: LEAVENWORTH, KS at C:\REMOTE\LVW\  
167: IMAGPROVIDER2 HOME at C:\REMOTE\IMAG2\  
168: ST. LOUIS, MO at C:\REMOTE\STL\  
Select destinations by:  
==> Enter their number(s), separated by commas  
==> Enter an asterisk (*) to select all possible destinations  
Prefixing an entry with a dash deselects the listed  
destinations  
Enter a period when the selection is complete.  
---> *  
5 The destinations you selected will be displayed. Enter a period when you are finished.  
6 Position and size the terminal window for subsequent monitoring.  
ÂAs the transmission processor sends exams to Imaging destinations, it will map  
and un-map certain drives. For more information, see page 66.  
7 To start additional transmission processors, repeat steps 1 – 6 in a new terminal  
window.  
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Routing User Guide  
Using the Routing Gateway  
Maintaining Routing  
This section provides a summary of maintenance tasks for a routing system and explains  
how to access Routing Gateway log files.  
Periodic Maintenance  
The following tasks should be performed periodically to control the size of the  
transmission queue and to detect potential routing problems.  
Task  
Interval  
Menu Seq.  
Check terminal windows for evaluation  
and transmission processors  
2-3 times daily  
N/A  
Review log files for error messages  
Daily  
4, 1, 2  
3, 8  
Re-queue all failed entries in the  
transmission queue  
As needed  
based on  
routing volume  
Purge completed and expired entries in  
the transmission queue  
Monthly  
3, 7  
3, 9  
N/A  
Remove obsolete entries from  
transmission queue  
Monthly  
Monitor available free space in Imaging  
destinations (this can be done using the  
Background Processor’s Network  
Location Manager)  
As Needed  
Confirm access to routing destinations  
As Needed  
N/A  
Using Routing Log Files  
A log file is created for each evaluation and transmission processor session. These log  
files can be used to review routing processes and to ensure that no errors have occurred.  
ÂA DICOM Gateway retains the 20 most recently generated log files. Additional files  
will be retained if they are still open. Older log files are deleted.  
Displaying log files  
1 Open a terminal window and log into the Routing Gateway.  
2 Enter 4at the prompt to select “System Maintenance” from the DICOM Gateway  
Menu [MAGDMENU].  
3 Enter 1to select “System Operation.”  
4 Enter 2to select “Display DICOM Message Log.” The most recent log files will be  
displayed.  
5 Enter the number of the log file you wish to display.  
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Using the Routing Gateway ꢀ  
Routing User Guide  
Disabling Routing  
Short-Term Routing Shutdown  
If routing needs to be disabled for a short period of time, the easiest thing to do is to stop  
the transmission processor(s). When this is done, images will still be evaluated and  
queued, but they will not be transmitted until the transmission processor is restarted.  
Before restarting the transmission processor, use option 9: Remove Obsolete Entries from  
Transmission Queue to remove any entries that may have been created while the routing  
system was disabled. For more information, see page 57.  
Long-Term Routing Shutdown  
If routing needs to be disabled for an extended period of time, perform the following:  
ƒStop the evaluation processor  
ƒStop all transmission processors  
ƒAlter the configuration files for all Image Gateways to indicate that they are NOT part  
of a routing system (see page 37 for more information).  
All images processed when routing is disabled as described above cannot be  
autorouted, even after routing has been restarted. Such images will need to be  
routed on-demand using VistARad.  
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Routing User Guide  
Using the Routing Gateway  
Routing Gateway Menu Options  
This section describes the menu options associated with the Routing Gateway. Routing  
Gateway menu options are accessed by entering 3: Routing Gateway from the DICOM  
Gateway main menu.  
1 Start the Transmission Processor  
2 Stop the Transmission Processor  
3 Start the Evaluation Processor  
4 Stop the Evaluation Processor  
5 Import Routing Rules  
6 Purge all completed entries in the Transmission Queue  
7 Purge completed and expired entries in Transmission Queue  
8 Re-Queue all Failed Entries in the Transmission Queue  
9 Remove Obsolete Entries from Transmission Queue  
10 Display Routing Rules  
1 Start the Transmission Processor  
Use this option to start the transmission processor. Once started, the transmission  
processor will begin processing entries in the transmission queue.  
ÂAs the transmission processor sends exams to Imaging destinations, it will map  
and un-map certain drives. For more information, see page 66.  
If a single transmission processor cannot manage a site’s routing workload, additional  
transmission processors, each sending images to a subset of destinations, can be started  
using this option. For detailed steps, see page 51.  
2 Stop the Transmission Processor  
Use this option to stop all running instances of the transmission processor. When this  
option is executed, a flag is set that the transmission processor will recognize as “stop  
processing.” The transmission processor checks this flag after transmitting each image  
file.  
ÂStopping the transmission processor can result in an incomplete exam being sent to  
a destination. If this occurs, the remainder of the exam will be transmitted when  
the transmission processor is re-started, provided that the applicable entries in the  
transmission queue are still present.  
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Using the Routing Gateway  
Routing User Guide  
3 Start the Evaluation Processor  
When this option is executed, the evaluation processor will begin examining  
routing-specific entries in the rule evaluation queue. This file is populated by Image  
Gateways (provided that Image Gateways are configured as part of a routing system).  
The evaluation processor uses the rule evaluation queue and site-specific routing rules to  
determine which images are to be routed and where they are to be routed. Entries for  
images to be autorouted are added to the transmission queue.  
Typically, a single instance of the evaluation processor can manage all images produced  
at the sending site. For consolidated sites, an instance of the evaluation processor should  
be started for each location. (In this situation, a “location” equates to an entry in the  
IMAGING SITE PARAMETERS File (#2006.1).)  
4 Stop the Evaluation Processor  
Use this option to stop the evaluation processor. When this option is executed, a flag is  
set that the evaluation processor will recognize as “stop evaluating.” The evaluation  
processor checks this flag after analyzing each image file against the routing rules.  
5 Import Routing Rules  
When this option is executed, the rules in \DICOM\Dict\Route.dicwill be loaded into  
the Routing Gateway’s local MUMPS environment. For detailed steps about importing  
routing rules, see page 44.  
6 Purge all completed entries in the Transmission Queue  
Use this option to reduce the size of the transmission queue in test installations.  
Executing this option will remove entries for files that have been transmitted  
successfully.  
ÂThis option is intended for use at test sites. If this option is used, routed images  
will be “orphaned” at a destination—rather than being deleted automatically (after  
the defined retention period); the images will remain until deleted manually.  
To purge completed entries without orphaning routed images, use the option described in  
the next section.  
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Routing User Guideꢀ  
Using the Routing Gateway  
7 Purge completed and expired entries in the Transmission Queue  
Use this option to control the size of the transmission queue. Executing this option will  
remove entries if both of the following conditions are met:  
ƒThe status of the entry indicates that an image file has been transmitted successfully.  
ƒThe entry is older than the RETENTION PERIOD(number of days) for the applicable  
destination.  
This option should be run once a month as part of a Routing Gateway’s periodic  
maintenance cycle.  
8Re-Queue all failed entries in the Transmission Queue  
Use this option to try to re-send routed images that could not be sent within the number  
of attempts specified for that destination.  
This option should be run periodically as part of a Routing Gateway’s maintenance cycle.  
Sites that route a large number of exams, or that route high priority exams, should run  
this option daily. Sites that route a lower volume of exams may only need to run this  
option once a week.  
9 Remove obsolete entries from Transmission Queue  
Use this option when there is a large backlog of outdated entries in the transmission  
queue. When this option is executed, you will be prompted to enter a cutoff date (the date  
can be entered using FileMan conventions). After the date is entered, all unprocessed  
queue entries older than the specified date will be removed.  
This option should be run once a month as part of a Routing Gateway’s periodic  
maintenance cycle.  
10 Display Current Set of Routing Rules  
Use this option to display the current set of routing rules. This option is especially useful  
immediately after using option 5 to import a new set of rules.  
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Using the Routing Gateway  
Routing User Guide  
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Using VistARad in a Routing System ꢀ  
This chapter explains how to use the VistARad diagnostic workstation software at sites  
that are part of a routing system. This chapter covers the following topics:  
Displaying Routed Exams  
In VistA Imaging, the VistARad diagnostic workstation is used to display routed exams.  
A routed exam is available for display when the RC (Remote Cache) column in a  
VistARad exam list contains the destination name established for your site.  
Values in the RC column are based on the SITEfield in the sending site’s NETWORK  
LOCATION File (#2005.2).  
ƒWhen VistARad is used at a site that is the source of routed exams, the RC column  
can be used to determine which exams have been routed, and where they have been  
routed to.  
ƒWhen VistARad is used at a site that is the destination of routed exams, users will  
need to log into the sending site’s VistA system. After logging in, VistARad will  
automatically filter exam lists to include only routed exams (this filter can be removed  
if desired; see the next page for details).  
Detailed steps for displaying routed exams are on the next page.  
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Using VistARad in a Routing System ꢀ  
Routing User Guide  
To display a routed exam  
1 Log into the site or division that the routed exam was sent from.  
2 Use an exam list to locate the routed exam you want to open. By default, exam lists  
are filtered to show only exams that have been routed from the site or division you are  
performing remote reading for.  
ÂYou can view all exams (routed and non-routed) by clearing the checkbox in the  
Remote Read Filter area near the top of the Manager window.  
3 Double-click the exam, or select the exam and click Open.  
ÂIf a non-routed exam (an exam without a value in the RC column) is selected for  
display, there will be a delay while the images are retrieved.  
ÂA routed exam can be locked and marked as interpreted in the same manner as any  
other exam. For more information, refer to VistARad User Guide.  
ÂYou can use ReadList to successively display all routed exams in an exam list. For  
more information, refer to VistARad User Guide.  
ÂLocal copies of routed exams are stored for a certain period of time (typically  
several days) and then deleted automatically by a process initiated from the  
sending site. The “original” exam remains available at the sending site after routed  
copies are deleted.  
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Routing User Guideꢀ  
Using VistARad in a Routing System  
VistARad & On-Demand Routing  
This section describes on-demand routing prerequisites and explains how to use  
VistARad’s on-demand routing capability.  
US Federal regulations and VA internal policy prohibit unencrypted transmission  
of patient information outside the VA's intranet.  
!
Like autorouting, on-demand routing can have a significant impact on network  
traffic. It is the responsibility of sites using routing to properly manage network  
demands related to routing.  
!
On-Demand Routing Requirements  
For on-demand routing to function:  
ƒA VistARad user must be logged into an Imaging system that includes a Routing  
Gateway.  
ƒAt the site being logged into, the VistA Imaging host, the Routing Gateway, and  
storage folders must be set up as described in this manual. The Routing Gateway’s  
transmission processor must be running.  
ƒTo route images to other non-DICOM destinations within the VistA system (such as  
VistARad at a remote site) a VistARad user must have the MAGJ DEMAND ROUTE  
security key assigned to their account. To route images to a DICOM Storage SCP  
destination, the MAGJ DEMAND ROUTE DICOM key must be assigned to their  
account.  
Using On-Demand Routing  
On-demand routing lets you use VistARad to manually select exams and transmit them to  
existing routing destinations. On-demand routing is intended for situations where you  
need to route exams that do not satisfy existing routing rules, or where autorouting is not  
used.  
ÂIf you are frequently using on-demand routing for the same sorts of exams, contact  
your Imaging Coordinator and request that a change or addition be made to the rules  
used for autorouting.  
Any exam that appears in a VistARad exam list can be routed on-demand. Newly  
acquired exams should not be routed until they have been case edited by a technologist  
using the Radiology package. Such exams have a status of “examined” in VistARad’s  
exam lists.  
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Using VistARad in a Routing System ꢀ  
Routing User Guide  
To use on-demand routing  
1 Log into VistARad. The VistARad workstation used for on-demand routing must be  
logged into a VistA system that includes a Routing Gateway.  
ÂIf you have access to more than one division, log into the division where the exams  
to be routed originate from.  
2 Use the exam lists in the VistARad Manager to select the exams you want to send.  
3 Click the Route Exams button, located in the upper right corner of the exam list.  
ÂIf the Route Exams button is not present, your user account does not have any of  
the security keys for on-demand routing assigned.  
4 When the Route Request dialog opens, make sure all the exams you selected are  
shown.  
ÂIf a selected exam is not “online” (not available in short-term storage), a message  
will appear at the bottom of the Route Request window indicating that exam has  
been requested from the jukebox (long-term storage). Once the exam is available  
in short-term storage, you can select it for on-demand routing.  
5 For each exam, click the ‘Route To’ field to select where you want to send the exam.  
ÂIn the ‘Route To’ field, the first destinations listed are Imaging destinations, such  
as remote VistARad workstations. If there are any DICOM destinations (such as  
film printers) defined, they will appear at the bottom of the ‘Route To’ field and  
will be preceded by “dcm”.  
ÂUse the Default Route To box near the bottom of the Route Request window to  
choose a single destination for all listed exams.  
6 For each exam, use the Priority field to select the priority used to send the exam.  
ÂUse the Default Priority box near the bottom of the dialog to choose a single  
priority for all listed exams.  
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Routing User Guideꢀ  
Using VistARad in a Routing System  
ÂThe priority assigned to exams for on-demand routing is not related to the exam  
priority indicated in VistARad’s exam lists.  
7 Confirm that the settings in the Route Request dialog are correct.  
ÂYou can choose not to route a listed exam by selecting the Route To box for that  
exam and choosing the [Do Not Route] option.  
ÂYou can click Cancel to close the Route Request dialog without routing anyꢀ  
exams. ꢀ  
8 Click OK to route the exams. When the exam is received by the receiving site, the RC  
column entry for that exam will show the name of the receiving site.  
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Using VistARad in a Routing System  
Routing User Guide  
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Troubleshooting Routing ꢀ  
This chapter covers the following topics:  
Basic Troubleshooting  
If images are not arriving as expected at a routing destination, perform the following  
steps:  
If…  
Then…  
This is the first time that routing  
software is being used  
Verify that all configuration steps described in this document  
have been completed. Configuration checklists are available  
in Appendix A.  
Exams are not being routed or  
are being routed incorrectly  
1
Check the Image Gateways and verify that they are  
processing images.  
2
Attempt to re-send images by running the “Re-Queue all  
failed entries in the Transmission Queue” option (Routing  
Gateway menu shortcut: 3, 8).  
3
4
Review the routing log files to determine if the images  
were transmitted successfully (if you have just used the  
re-queue failed entries option, wait 15-20 minutes before  
opening the log files).  
Review the contents of the routing rules file (Route.dic).  
The routing software cannot  
connect to the destination  
Verify that the network connection being used is available  
and set up properly. If the destination is an Imaging  
destination, refer to the steps for testing folders on page 29.  
The log files indicate an invalid  
username or password.  
Contact the receiving site and verify that the correct user  
name and password is being used by the routing software.  
Getting Help  
If additional assistance is needed, contact your Imaging Coordinator or local support  
staff.  
If the problem cannot be resolved locally, open a help desk ticket, or contact the National  
Help Desk between 8:00AM and 6:00PM Eastern time, Monday through Friday, at  
1-888-596-4357.  
Urgent after-hours service requests can be directed to the Expertise Center at  
1-800-299-7282.  
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Troubleshooting Routingꢀ  
Routing User Guide  
Additional Routing Considerations  
Transmission Processors and Drive Mapping  
For each Imaging destination that it sends exams to, the transmission processor will map  
a drive using the following progression of drive letters: Q – Z, then G – P. If a drive  
letter (Q, for example) is not available, it will move to the next letter (R, for example) and  
so on. When all entries for a particular destination have been processed, the applicable  
drive is unmapped. This logic is not used for DICOM destinations.  
Factors Affecting Routing Speed  
Given a T1 connection and a light to moderate amount of network traffic, the first images  
in a routed exam will typically begin arriving at a destination within minutes. However,  
any of the following can impact the delivery of routed exams:  
ƒA backlog of images at the Image Gateway, which is responsible for adding entries to  
the rule evaluation queue.  
ƒA backlog of entries in the transmission queue. If numerous large exams are flagged  
for routing in a brief period of time, there will be a delay while all the images in the  
exam are transmitted. In situations where multiple destinations are being used,  
additional transmission processors may be used to alleviate delays. For more  
information, see page 51.  
ƒProblems connecting to destinations. For Imaging destinations, the routing software  
will attempt to re-connect or retransmit the number of times specified for each  
destination in the NETWORK LOCATION File (#2005.2). For DICOM destinations, retry  
attempts are part of the DICOM transmission protocol. Failed connection or  
transmission attempts are logged by the Routing Gateway.  
ƒThe routing priority of a particular exam. For more information, see page 67.  
Routed Images vs. Routed Exams  
The Routing Gateway evaluates and transmits data on an image-by-image basis. If the  
transmission processor is disabled when an exam is partially transmitted, the exam is  
usually treated as “unrouted” until the transmission processor is re-started, and the  
transmission of the exam is completed.  
In some situations, such as the presence of multiple Image Gateways or the use of  
on-demand routing, images from one exam will “interrupt” the transmission of images of  
an exam that is partially routed. This can occur because entries are added to the rule  
evaluation and transmission queues for each image, rather than for each exam. Usually,  
this behavior is invisible to the end user.  
If a partially routed exam is opened from VistARad, the VistARad software will first  
attempt to retrieve images from the local storage location identified in the MAGJ.INI file  
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Routing User Guide  
Troubleshooting Routing  
for that workstation. Images not found in local storage will be retrieved from their  
originating site.  
How the RC Column is Populated  
The RC (Remote Cache) column in VistARad's exam lists is populated with a  
destination-specific indicator when a routed exam is received by a destination. The same  
indicator is removed from the RC column when the routing software deletes the local  
copy of the exam.  
The addition or removal of the indicator is dependent on a specific "representative image"  
in the routed exam. A "representative image" is the last image processed by an Image  
Gateway for a given exam. Typically, the representative image is also the last image in an  
exam's clinical sequence.  
Image Gateways process images in the order that they are received from a modality.  
Some modalities may send images to Image Gateways in an order other than the expected  
clinical sequence. If this occurs, and if such an exam is routed, the RC column may be  
populated before transmission of all the exam's images has completed. A user opening  
such an exam may experience a delay while part of the exam is retrieved from the  
sending site.  
Preventing Transmission of Duplicate Exams  
For Imaging destinations, the transmission processor will check the destination to see if  
the image to be routed is already present. If a duplicate of the image is found, the  
transmission processor removes the redundant entry from the transmission queue, and  
moves on to the next entry in the queue.  
For DICOM destinations, image management and duplicate checking is the responsibility  
of the destination system.  
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Troubleshooting Routing  
Routing User Guide  
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Appendix A ꢀ  
This appendix contains worksheets that can be used while setting up a routing system.  
They can also be used for record-keeping purposes. The following worksheets are  
provided:  
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Appendix A  
Routing User Guide  
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Routing User Guide  
Appendix A  
Imaging Destination Worksheet  
Use this worksheet to record information about a specific Imaging destination. A sample Network  
Location File definition is provided on the next page.  
Destination name1  
Site served by destination  
General purpose of this destination  
Alternate/backup destination  
Storage folder name  
Destination computer/share name2  
Username/password for destination  
Associated user group (if any) 2  
File types transmitted to destination (circle those that apply) 3  
Retention period? (in days) 3  
Abstract / Full / Text / Big  
1
Specified in the .01 field in the NETWORK LOCATION file. Referenced in routing rules  
(Route.dic), and in the CacheLocationIDparameter for VistARad workstations at receiving  
sites.  
Specified by receiving sites when creating a storage folder. Referenced sending site’s NETWORK  
LOCATION file.  
2
3
Specified in sending site’s NETWORK LOCATION file.  
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Appendix A  
Routing User Guide  
NETWORK LOCATION File Sample  
For detailed information about specific fields, see page 32.  
Select NETWORK LOCATION: TESTDEST  
Are you adding 'TESTDEST' as a new NETWORK LOCATION (the 11TH)?  
No// Y  
PHYSICAL REFERENCE: \\VHAxxxxxx\images$\ꢀ  
STORAGE TYPE: MAG  
MAGNETICꢀ  
TOTAL SPACE: <blank>ꢀ  
SPACE USED: <blank>ꢀ  
FREE SPACE: <blank>ꢀ  
OPERATIONAL STATUS: 1 On-Line ꢀ  
HASH SUBDIRECTORY: <set as appropriate for your site>ꢀ  
ABSTRACT: N  
No ꢀ  
Yes ꢀ  
Yes ꢀ  
FULL: Y  
BIG: Y  
TEXT: Y  
DICOM: N  
Yes ꢀ  
Noꢀ  
COMPRESSION: <blank or J2K >ꢀ  
USER NAME: <Use the “routing username” here>ꢀ  
PASSWORD: <Use the “routing password” here>ꢀ  
MAINTAINCONNECTION: <blank> ꢀ  
MAX # RETRY ON CONNECT: 3 ꢀ  
MAX # RETRY ON TRANSMIT: 5ꢀ  
SYNTAX: U UNCꢀ  
SUBDIRECTORY: <blank>ꢀ  
Select USER  
<blank>ꢀ  
RETENTION PERIOD: 5 ꢀ  
LAST PURGE DATE: ꢀ  
SITE: <set as appropriate for your site>ꢀ  
ROUTER: Y YESꢀ  
TIME OFFLINE: <blank>ꢀ  
MUSE SITE #: <blank>ꢀ  
MUSE VERSION #: <blank>ꢀ  
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Routing User Guide  
Appendix A  
DICOM Destination Worksheet  
Use this worksheet to record information about a specific DICOM destination.  
Destination name1  
Site served by destination  
General purpose of this destination  
Alternate/backup destination  
Calling AE Title  
Called AE Title  
IP address/hostname  
Socket/port  
Presentation Context / Transfer Syntax (list all used)  
DICOM Destination Sample  
For detailed information about specific fields, see page 39.  
# User Application List  
# Format:  
# line 1:App Name|Called AE|Calling AE|Destination IP Address|Socket  
# line 2:|Presentation Context Name|Transfer Syntax Name  
# line 3:||Transfer Syntax Name (if there are more than one)  
#
MERGE EFILM|VistA_Storage|VistA_Send_Image|111.222.33.44|4006  
|Modality Worklist Information Model - FIND|Implicit VR Little Endian  
|Verification SOP Class|Implicit VR Little Endian  
1
Specified as the Application in the SCU_List.dic file, and referenced in routing rules  
(Route.dic).  
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Appendix A  
Routing User Guide  
Routing Rule Definition Worksheet  
Rule Request (to be completed by Radiology staff or supervisor)  
Identify the purpose of the rule (circle one):  
a
b
c
d
e
Routine workload sharing  
Rapid access for clinic / facility  
After-hours or holiday coverage  
Second opinions / consults  
Transfer of images to a non-local specialist / support for a new modality or imaging type  
Other  
f
List each destination that this rule will serve:  
a
d
e
b
c
Will prior exams be included with this rule? (circle one):  
Will prior exams be included with this rule? (circle one):  
Will all exams for this rule be sent to all listed destinations (circle one):  
Yes  
Yes  
Yes  
No  
No  
No  
If the answer to the above is NO, specify the % of exams each destination should receive (total  
must = 100%):  
a
b
c
%
%
%
d
%
%
%
e
local (not routed)  
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Routing User Guide  
Appendix A  
List conditions that will trigger the execution of the rule (fill any all that apply):  
a
b
Exam modality of:  
Off hours/holiday coverage (specify hours/days)  
c
Other  
Rule Impact/Review (to be completed by Imaging Coordinator)  
Estimated amount of storage needed at each destination for this rule:  
Bandwidth available between sending and receiving sites:  
Total number of exams expected to be transmitted per month:  
Rule adheres to routing policies established by sending site (circle one):  
Yes No  
Yes No  
Rule adheres to routing policies established by receiving site (circle one):  
Rule Implementation (to be completed by staff responsible for Routing G/W)  
Rule as entered into the Route.dic file: (sample rules listed below)  
Route.dic imported to Routing Gateway (circle one):  
Rule tested and found to be functional (circle one):  
Yes No  
Yes No  
Date  
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Appendix A  
Routing User Guide  
Sample Rules  
The following sample rules use the fictional destinations listed below:  
Imaging destinations (entered in the Network Location File (#2005.2))  
Archive  
Contractor1  
Contractor2  
Contractor3  
ContractingReaderꢀ  
LocalJukeBox  
LogBook  
DICOM destinations (entered in the DICOM Transmit Destination File (#2005.587)  
via SCU_List.dic):  
E-FilmApplication  
LaserShare  
Example #1:  
# auto-route all images from a specific modality to a  
# contractor who reads this type of images, using standard  
# copy for transmission  
Send("ContractingReader")ꢀ  
When MODALITY="CT" ꢀ  
Example #2:  
# auto-route all images to an archive, using standard copy  
# for transmission  
Send("Archive")ꢀ  
When MODALITY="*" ꢀ  
Example #3:  
# auto-route all images from a remote site back to local  
# storage at that site, using standard copy for  
# transmission  
Send("LocalJukeBox")ꢀ  
When MODALITY="*" ꢀ  
SOURCE="StElseWhere" ꢀ  
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Routing User Guide  
Appendix A  
Example #4:  
# auto-route all important studies to an internal  
# workstation, using standard copy for transmission  
Send("LogBook")ꢀ  
When MODALITY="*" ꢀ  
URGENCY="STAT" ꢀ  
Example #5:  
# auto-route all images from a specific modality to three  
# contractors, balancing the load, so that each contract  
# receives a pre-determined fraction of the studies and  
# leaving a pre-determined fraction for interpretation by  
# local staff, using standard copy for transmission  
Balance("Contractor1"=20%, "Contractor2"=40%,ꢀ  
"Contractor3"=20%, <LOCAL>=20%)ꢀ  
When MODALITY="XA" ꢀ  
Example #6:  
# auto-route all images from a specific modality to a  
# contractor who reads this type of images, using standard  
# copy for transmission and giving these transmissions a  
# high priority  
Send("ContractingReader")ꢀ  
When MODALITY="XA" ꢀ  
Priority High ꢀ  
Example #7:  
# auto-route all images from a specific modality to a  
# printer, using the DICOM protocol for transmission and  
# giving these transmissions a low priority  
Send("LaserShare")ꢀ  
When MODALITY="CT" ꢀ  
Priority Low ꢀ  
Example #8:  
# auto-route all images from a specific modality to a DICOM  
# repository, using the DICOM protocol for transmission and  
# including images from prior studies  
Send("E-FilmApplication")ꢀ  
When MODALITY="CT" ꢀ  
PriorStudy Yes ꢀ  
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Appendix A  
Routing User Guide  
Routing Setup Checklist  
Imaging Destination Setup  
a Username and password available for each destination?  
b Folders created and shared for each destination?  
c Ability to access and write to each storage folder verified?  
d Network location entry defined for each destination?  
e VistARad site parameters set up at sending site?  
f CacheLocationID set on workstations at receiving sites?  
DICOM Destination Setup  
a Destination information added to SCU_List.dic?  
b SCU_List.dic updated on DICOM Gateway?  
Destination application accessible?  
DICOM Gateway Setup  
a Image Gateways configured properly?  
b Routing Gateway configured properly?  
Routing Rule Setup  
a Rules defined in Route.dic?  
b Route.dic imported successfully?  
Routing Activation  
a Image Gateways processing images?  
b Routing Gateway evaluation processor activated?  
c Routing Gateway transmission processor(s) activated?  
d Images routed successfully?  
e Images at receiving site purged at end of retention period (Imaging dest. only)  
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Appendix B: Using MAG_Decompressor ꢀ  
This section explains how to install and configure the Automatic Decompression Service  
(MAG_Decompressor).  
MAG_Decompressor can be installed on a VistARad workstation or on any other system  
that is receiving compressed images via automatic or on-demand routing. Note that  
MAG_Decompressor should NOT be installed on a DICOM Gateway.  
Once it is configured, MAG_Decompressor runs in the background and will de-compress  
routed images as they are received by the destination system.  
This service does not need to be installed on systems that only receive uncompressed  
routed images.  
Licensing  
A toolkit license is needed for each system that is sending or receiving compressed  
images. For more information, contact VistA Imaging Customer Support.  
MAG_Decompressor Setup  
Distribution  
The decompression software is distributed as a part of Patch 51. The installation file,  
MAG_Decompressor_Setup.exe, is available on the Imaging FTP site under  
Software\Released Software\ Mag3_0p51\MAG_Decompressor.  
Installation  
1 Log in as an administrator on to the system that will be receiving compressed images  
via automatic or on-demand routing.  
2 Install the MAG_Decompressor_Setup.exe file as follows:  
a Locate the distribution directory for MAG_Decompressor_Setup.exe and ꢀ  
double-click the file. ꢀ  
b As the InstallShield script is executed, click on Next, OK and Finish as ꢀ  
appropriate. The software will be installed into its own folder under ꢀ  
C:\Program Files\VistA Imaging.ꢀ  
3 Set up system variables for the decompression service as follows:  
a Open the Windows Control Panel (click Start | Settings), then double-click on  
System.  
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Appendix B: Using MAG_Decompressor ꢀ  
Routing User Guide  
b In the System Properties dialog, click the Advanced tab, then click Environment  
Variables.  
c In the System Variables list at the bottom of the dialog, locate the followingꢀ  
variables and adjust the values if needed. ꢀ  
DECOMP_LOG_FSPEC: the path and file name of the decompression service logꢀ  
file. The administrative user must have write-permission for this file. The format ꢀ  
of this name must follow the usual pattern: <drive:>\<path>\<filename>.<ext>ꢀ  
(neither <filename> nor <ext> may contain a period). ꢀ  
DECOMP_LOG_FILE_MBYTES: the maximum size permitted for the decompression ꢀ  
service log-file (default is 1MB); when this limit is reached, the old log-file is ꢀ  
renamed and a new one is created. The last 10 files are retained. ꢀ  
DECOMP_WATCH_DIR: the root-directory of the directory tree that will beꢀ  
monitored by the decompression service (default is c:\). This value should be ꢀ  
changed to reflect the folder that is receiving compressed images. ꢀ  
The format of this name must follow the usual pattern: <drive:>\<path>[\]ꢀ  
DECOMP_DELAY_MS: the number of milliseconds that the service will wait after ꢀ  
detecting a compressed file before beginning the decompression process (default is ꢀ  
50ms). ꢀ  
d Click OK on the various dialogs until all dialog windows for setting up System  
parameters are closed. (Keep the Control Panel open; it will be needed for a later  
step).  
4 Activate the MAG_Decompressor program as follows:  
a Open a command line window (click Start | Run, then enter ‘cmd’).  
b Enter the following command to switch to the MAG_Decompressor installation  
folder:  
cd \Program Files\VistA\Imaging\MAG_Decompressor <Enter>  
c Enter dirat the prompt and verify that the files shown below are present.  
Directory of C:\Program Files\Vista\Imaging\MAG_Decompressor  
05/02/2005 09:37a  
05/02/2005 09:37a  
04/13/2005 07:16a  
05/02/2005 08:39a  
<DIR>  
<DIR>  
. ꢀ  
.. ꢀ  
856,064 awj2k.dllꢀ  
53,248 MAG_Decompressor.exeꢀ  
909,312 bytes  
2 File(s)  
2 Dir(s) 58,401,358,848 bytes free  
C:\ . . .>  
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Appendix B: Using MAG_Decompressor  
Note: If the DLL file is not present, contact the Imaging Group for information  
about acquiring a toolkit license. The decompression software will not work  
without the DLL file.  
d Enter the following command to activate the program (The command willꢀ  
complete without any warning or error messages). ꢀ  
Mag_Decompressor –install <Enter>  
e Close the command window.  
5 Activate the decompression service as follows:  
a In the Control Panel, double-click Administrative Tools.  
b Double-click Services. (On some versions of the Windows operating system, this  
icon is labeled Component Services.)  
c In the window that opens, locate the entry for the “MAG J2K Decompressor  
Service”.  
d Right-click on the entry and select Start. Wait until the status display shows that  
the service is started.  
e Right-click again on the entry and select Properties.  
f
In the Properties window, select Automatic as the startup type, then click OK.  
g Verify that the status display shows that the service is “Automatic”.  
h Close all remaining Control Panel windows.  
Your system is now ready to start decompressing files that were routed in compressed ꢀ  
form. ꢀ  
Note: when parameters need to be modified, the steps listed above can be used to ꢀ  
establish new values for the parameters. However, it will be necessary to reboot the ꢀ  
computer before the new values of the parameters will become effective. ꢀ  
MAG_Decompressor Logging  
The decompression software will run automatically when needed. If problems are  
encountered review, the log files generated by the MAG_Decompressor software.  
Log files are stored in the location specified in the DECOMP_LOG_FSPECsystem  
variable. The ten most recently generated log files are retained.  
Sample log entry:  
2005-04-19 16:59:01 -----------------------------------------------------------------------------------------------  
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Appendix B: Using MAG_Decompressor  
Routing User Guide  
2005-04-19 16:59:01 S T A R T E D Directory-Watch/Decompression Service overꢀ  
C:\test_img_cache\ꢀ  
2005-04-19 17:01:10 C:\test_img_cache\MAG_EyeClot.J2K Status -> SUCCESS (0)ꢀ  
2005-04-19 17:01:11 C:\test_img_cache\MAG_Skull.J2K Status -> SUCCESS (0) ꢀ  
2005-04-19 17:01:19 C:\test_img_cache\MAG_Spine.J2K Status -> SUCCESS (0) ꢀ  
2005-04-20 13:32:59 C:\test_img_cache\MAG_Spine.J2K Status -> OutFile Already Exists, InFileꢀ  
Removedꢀ  
….. ꢀ  
….. ꢀ  
2005-04-21 13:34:32 S T O P P E D Directory-Watch/Decompression Service overꢀ  
C:\test_img_cache\ (status=ok) ꢀ  
Selected log file error codes:  
1..999 Aware JPEG2000 library errors  
1000... Application errors:  
2006: EIFILEREMOVE-- input file remove error (access violation)  
3000: EOFILEEXISTS-- output file already exists  
3001: EOFILEOPEN-- error while opening the output file  
3003: EOFILEWRITE-- problem attempting to write the data to the output file  
3004: EOFILERENAME-- error while renaming output file from .tmp to .<ext>  
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Glossaryꢀ  
This manual uses the following terms:  
autorouting The automatic transmission of selected images to one or more destinations.  
Autorouting functions are managed using the Routing Gateway.  
destination An intended recipient of routed images. Destinations can be Imaging  
destinations, such as VistARad workstations, or DICOM destinations, such as a film  
printer or external PACS (or any other DICOM Storage Service Class Provider).  
DICOM TRANSMIT DESTINATION File (#2006.587) The FileMan file where information  
about DICOM destinations is stored. This file should not be edited directly; to update the  
contents of this file, use the DICOM Gateway to update the SCU_List.dic file.  
evaluation processor The process responsible for handling entries in the rule evaluation  
queue. This process is started or stopped from the Routing Gateway, and executes from  
the VistA Host.  
IMAGE BACKGROUND QUEUE File (#2006.03) The FileMan file where rule evaluation  
queue entries are stored. The IMAGE BACKGROUND QUEUE File contains entries used by  
various processes to move, copy, or delete images. The IMAGE BACKGROUND QUEUE File  
is populated by Image Gateways, and is used by both the Background Processor and the  
evaluation processor.  
locks Used on a VistARad workstation prevent more than one radiologist from  
interpreting the same exam. If a radiologist opens a locked exam, they will be notified  
that the exam is locked, and while they can display the exam, they will be unable to  
update its status.  
NETWORK LOCATION File (#2005.2) The FileMan file where routing destinations are  
defined. The NETWORK LOCATION File contains entries for all physical storage devices in  
the Imaging system.  
on-demand routing The transmission of manually selected exams to one or more  
destinations. Images are selected using the VistARad diagnostic workstation and are  
transmitted by the Routing Gateway.  
receiving site The recipient of routed images. The receiving site provides either a  
storage folder (for Imaging destinations) or a DICOM Storage SCP (for DICOM  
destinations) for images to be routed to.  
Route.dic The DICOM Gateway dictionary file used to store routing rules.  
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Glossary  
Routing User Guide  
routing In the VistA system, the process responsible for sending images across a WAN  
to one or more remote locations. Routing can be performed automatically (autorouting),  
or on-demand.  
Routing Gateway A computer running the DICOM Gateway software that is  
configured to manage the routing of images in the VistA system. A Routing Gateway is  
typically run on a dedicated computer. Also, the set of menu options in the DICOM  
Gateway software specific to routing.  
routing rules The information used by the Routing Gateway to select images for  
autorouting. Routing rules are defined in a text file and are imported into a MUMPS table  
used by the Routing Gateway.  
routing system All of the software and hardware components related (but not  
necessarily limited to) routing. Parts of the routing system include the Routing Gateway,  
Image Gateways, and VistARad workstations.  
rule evaluation queue The queue used to determine if newly acquired images will be  
autorouted or not. This queue is populated by Image Gateways. Entries in this queue are  
compared to routing rules by the evaluation processor. Entries that meet the criteria in  
routing rules are added to the transmission queue.  
SCU_List.dic A dictionary file used by the DICOM Gateway that contains information  
about each DICOM Storage SCP that can receive DICOM images from VistA Imaging.  
DICOM Storage SCPs in this file can receive DICOM images sent automatically as a  
function of routing, or sent manually using a menu option on the DICOM Gateway.  
SEND QUEUE (#2006.035) The FileMan file where transmission queue entries are stored.  
sending site The site where routed images are produced. The Routing Gateway resides  
at and is maintained by the sending site.  
storage folder The physical storage location provided by an Imaging destination. A  
storage folder must be referenced in a destination entry in the NETWORK LOCATION File.  
transmission background processor The original name of the transmission processor  
in test versions of the routing software. There is no relationship between the transmission  
background processor and the Background Processor.  
transmission processor The Routing Gateway process responsible for processing  
entries in the transmission queue, and for purging obsolete routed image files from  
routing destinations.  
transmission queue The queue used by the transmission processor to send routable  
images to their destinations. Each entry in this queue represents a single image file.  
Entries are added to this queue by the evaluation processor (for autorouting) or by  
VistARad (for on-demand routing). Processed entries can be purged from this queue  
using a Routing Gateway menu option.  
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Routing User Guide  
Glossary  
VistARad In VistA Imaging, the software used to display diagnostic-quality radiologic  
exams. VistARad is the primary tool used to display routed exams and to route exams  
on-demand.  
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Index ꢀ  
DICOM destinations (cont.)  
on-demand routing to 61 ꢀ  
worksheet 73ꢀ  
DICOM Gateway 2, see also Image Gateway;  
Routing Gateway  
DICOM SCPs, routing to 5, 37 ꢀ  
DICOM TRANSMIT DESTINATION File (#2006.587)ꢀ  
39, 83 ꢀ  
A-C  
after-hours coverage 11, 21 ꢀ  
autoroutingꢀ  
defining rules for 9–23 ꢀ  
described 1, 4–6, 83 ꢀ  
prior exams 5, 22, 40ꢀ  
see also routingꢀ  
Background Processor 32ꢀ  
balance command 12 ꢀ  
cache, remote see RC column; storage foldersꢀ  
CacheLocationID 48 ꢀ  
comments in routing rules 23ꢀ  
completed trans. queue entries, purging 57ꢀ  
compression 34, 79 ꢀ  
conditions, routing rule ꢀ  
defining 14–22 ꢀ  
displaying routed exams 5, 59 ꢀ  
displaying routing rules 57 ꢀ  
drives, transmission processor and 66ꢀ  
E
evaluation processorꢀ  
described 4, 83ꢀ  
described 14ꢀ  
examples of 10–11 ꢀ  
configuration ꢀ  
log files for 53ꢀ  
multiple instances 46ꢀ  
starting 51, 56 ꢀ  
destination 26–39 ꢀ  
stopping 54, 56ꢀ  
general information 78 ꢀ  
Image Gateway 42 ꢀ  
Routing Gateway 43 ꢀ  
routing rules 9–23 ꢀ  
VistARad 47–49 ꢀ  
exam listsꢀ  
filtering at receiving site 47ꢀ  
RC column in 36, 59, 67 ꢀ  
using for on-demand routing 62ꢀ  
exam locks 60, 83 ꢀ  
configuration filesꢀ  
exams, routed ꢀ  
MAGJ.INI 48ꢀ  
compression 34, 79 ꢀ  
deleting 5, 36, 60 ꢀ  
DICOM SCPs and 5ꢀ  
displaying 5, 59 ꢀ  
Route.dic 44–46, 56, 83 ꢀ  
SCU_List.dic 37–39, 84 ꢀ  
coverage, after-hours 11, 21 ꢀ  
customer support 65 ꢀ  
dividing between destinations 12ꢀ  
prior 5, 22, 40 ꢀ  
priority of 8, 22 ꢀ  
representative images in 67ꢀ  
expired trans. queue entries, purging 57ꢀ  
exporting exams to DICOM SCPs 5ꢀ  
D
date/time conditions 11, 21ꢀ  
deleting routed exams 5, 36, 60ꢀ  
destinationsꢀ  
described 1, 83ꢀ  
DICOM 37–39 ꢀ  
F
Imaging 26–36 ꢀ  
failed trans. queue entries, re-queuing 57 ꢀ  
filtering exam lists 47ꢀ  
folders, storageꢀ  
routing rules and 9, 12–13 ꢀ  
VistARad and 48–49 ꢀ  
DICOM destinationsꢀ  
configuring 37–39 ꢀ  
described 1, 5ꢀ  
described 84ꢀ  
for Imaging destinations 28–30ꢀ  
VistARad and 48–49 ꢀ  
in SCU_List.dic 37ꢀ  
formatting routing rules 23ꢀ  
naming conventions 37 ꢀ  
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Index  
Routing User Guide  
H-I  
O-P  
help desk 65ꢀ  
obsolete trans. queue entries, purging 57ꢀ  
on-demand routingꢀ  
hidden shares, creating 29 ꢀ  
historical exams, routing 5, 22, 40 ꢀ  
holidays, routing rules and 11, 21ꢀ  
IMAGE BACKGROUND QUEUE File (#2006.03) 4, 83 ꢀ  
Image Gateways 4, 42, 67 ꢀ  
images, representative 67ꢀ  
Imaging destinationsꢀ  
described 1, 7, 83 ꢀ  
requirements for 61ꢀ  
using 61 ꢀ  
see also routingꢀ  
operators, routing rule 11, 20 ꢀ  
passwords 28, 29ꢀ  
compression 34, 79 ꢀ  
configuring 26–36 ꢀ  
described 1, 5ꢀ  
patient information, transmission of v ꢀ  
prior exams, routing 5, 22, 40 ꢀ  
priority, routing 8, 22 ꢀ  
in NETWORK LOCATION File 31–36ꢀ  
naming conventions 26 ꢀ  
on-demand routing to 61 ꢀ  
passwords for 28, 29ꢀ  
procedures: see examsꢀ  
purging the transmission queue 56, 57ꢀ  
storage folders for 28–30 ꢀ  
user names for 28, 29 ꢀ  
R
RC (Remote Cache) column 36, 59, 67 ꢀ  
receiving sitesꢀ  
worksheet 71ꢀ  
importing routing rules 44–46, 56 ꢀ  
configuration tasks for 25ꢀ  
described 83ꢀ  
displaying routed exams at 60 ꢀ  
exam list filtering for 47ꢀ  
VistARad configuration for 48 ꢀ  
see also destinationsꢀ  
J-L  
JPEG 2000 34, 79 ꢀ  
keys, security 61ꢀ  
lists see exam listsꢀ  
load balancing 12ꢀ  
locks, exam 60, 83 ꢀ  
log files 53ꢀ  
related exams, routing 5, 22, 40ꢀ  
Remedy Help Desk 65ꢀ  
Remote Cache (RC) column 36, 59, 67 ꢀ  
remote storage see storage foldersꢀ  
representative images 67ꢀ  
retention period 5, 36, 60 ꢀ  
Route Request dialog 7, 61 ꢀ  
Route.dic 44–46, 56, 83 ꢀ  
routed exams ꢀ  
M-N  
MAG RAD PRIOR EXAMS LOGIC File 40ꢀ  
MAG VISTARAD SITE PARAMETERS File 47ꢀ  
MAG_Decompressor 79 ꢀ  
compression 34, 79 ꢀ  
deleting 5, 36, 60 ꢀ  
MAGJ DEMAND ROUTE DICOM key 61 ꢀ  
MAGJ DEMAND ROUTE key 61 ꢀ  
MAGJ.INI 48ꢀ  
displaying 5, 59 ꢀ  
dividing between destinations 12ꢀ  
priority of 8, 22 ꢀ  
maintaining routing 53ꢀ  
routingꢀ  
manual routing see on-demand routingꢀ  
mapped drives, transmission processor and 66ꢀ  
modality, routing rules and 14ꢀ  
MSM server 51 ꢀ  
activating 51 ꢀ  
configuration 25–49, 50, 78 ꢀ  
described 1–7, 66–67, 84 ꢀ  
destinations 26–39 ꢀ  
multiple conditions in routing rules 10, 23ꢀ  
multiple evaluation processors 46ꢀ  
naming conventions ꢀ  
DICOM destinations 37ꢀ  
Imaging destinations 26ꢀ  
NETWORK LOCATION FILE (#2005.2)ꢀ  
described 83ꢀ  
disabling 54ꢀ  
Image Gateway config. options 42 ꢀ  
log files 53ꢀ  
maintaining 53ꢀ  
menu options for 55–57 ꢀ  
on-demand 61–63 ꢀ  
Routing Gateway config. options 43 ꢀ  
rules 9–23, 44–46 ꢀ  
terms of use vꢀ  
troubleshooting 65ꢀ  
field descriptions 32–39ꢀ  
Imaging destinations in 31ꢀ  
sample values for 31, 72ꢀ  
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Routing User Guide  
Index  
routing (cont.)  
storage foldersꢀ  
defining 28–30 ꢀ  
described 84ꢀ  
VistARad and 48–49 ꢀ  
studies see exams  
support 65ꢀ  
VistARad configuration 47–49  
Routing Gateway 55 ꢀ  
configuring 43 ꢀ  
described 2, 84ꢀ  
importing rules for 44–46 ꢀ  
log files 53ꢀ  
menu options for 55–57 ꢀ  
using 51–54 ꢀ  
rule evaluation queue 4, 51, 84ꢀ  
rules, routingꢀ  
T
time of day, routing rules and 11, 21ꢀ  
transmission processor ꢀ  
described 5, 84ꢀ  
comments in 23 ꢀ  
conditions in 14–22 ꢀ  
date/time in 21ꢀ  
drives mapped by 66ꢀ  
log files for 53ꢀ  
starting 52, 55 ꢀ  
stopping 54, 55ꢀ  
described 9, 84ꢀ  
destinations in 12ꢀ  
displaying 45, 57 ꢀ  
examples of 10–11 ꢀ  
formatting 23 ꢀ  
importing 44–46, 56 ꢀ  
load balancing with 12ꢀ  
multiple sets of 46ꢀ  
operators 20 ꢀ  
transmission queue ꢀ  
populating 5, 55 ꢀ  
population of 7ꢀ  
purging 56, 57 ꢀ  
re-queuing failed entries in 57ꢀ  
size of 53, 56ꢀ  
troubleshooting routing 65ꢀ  
priority 8, 22 ꢀ  
wildcards 20 ꢀ  
worksheet 74ꢀ  
U-Z  
unprocessed trans. queue entries, purging 57ꢀ  
user names 28, 29 ꢀ  
S
values in rule conditions 20ꢀ  
verifying routing rules 45ꢀ  
VistARad ꢀ  
SCU_List.dic 37–39, 84 ꢀ  
security keys 61ꢀ  
send command (routing rules) 12 ꢀ  
SEND QUEUE File (#2006.035) 4, 84 ꢀ  
see also transmission queue  
sending sites ꢀ  
configuration tasks for 25ꢀ  
described 84ꢀ  
displaying routed exams at 60 ꢀ  
VistARad configuration for 47 ꢀ  
shutdown, routing 54 ꢀ  
configuring for routing 47–49 ꢀ  
described 85ꢀ  
displaying routed exams with 5, 59 ꢀ  
on-demand routing and 7, 61–63 ꢀ  
using for multiple destinations 49ꢀ  
weekend/weekdays, routing rules and 11, 21ꢀ  
wildcards 11, 20 ꢀ  
worklists see exam listsꢀ  
worksheets ꢀ  
speed, routing, factors affecting 66 ꢀ  
configuration 78ꢀ  
destination 71, 73 ꢀ  
routing rule 74 ꢀ  
April 2006  
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