EFilm RIS-PACS System Guide

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eFilm RIS/PACS 2.

0 Users Guide

eFilm RIS/PACS User Manual Version 2.0

This document has been prepared by Merge Healthcare for its customers. The
content of this document is confidential. It may be reproduced only with written
permission from Merge Healthcare. Specifications contained herein are subject to
change, and these changes will be reported in subsequent revisions or editions.
It is prohibited to use the software described in this document as a substitute for the
knowledge, skill and experience of the competent medical personnel who are its
intended users.
Caution: U.S. federal law restricts this device to sale by, or on the order of, a
physician.
eFilm RIS/PACS, eFilm Workstation, and eFilm Lite are trademarks of Merge
Healthcare. The names of other products mentioned in this document may be the
trademarks or registered trademarks of their respective companies.

Copyright 2008 by Merge Healthcare.

All rights reserved. Unauthorized use, reproduction, or disclosure is prohibited.
Merge Healthcare
6737 W. Washington Street, Suite 2250
Milwaukee, WI 53214

For assistance, please contact Merge Healthcare Customer Support:

In North America, call toll free 1-877-741-5369

Email | support@[Link]

Part Number 0905-274-0002-000 Rev. 1.0

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eFilm RIS/PACS User Manual Version 2.0

Contents
Chapter 1:

Accessing the System ................................................. 1

Accessing the System .................................................................................................. 1

Chapter 2:

System Information ..................................................... 3

System Overview .......................................................................................................... 3

Chapter 3:

Edit Functions .............................................................. 6

Accessing the Edit Functions ....................................................................................... 6

Change PW .................................................................................................................. 7
Insurances .................................................................................................................... 8
Modalities.................................................................................................................... 10
Outside Study ............................................................................................................. 11
Patients ....................................................................................................................... 13
Physicians .................................................................................................................. 15
Procedures ................................................................................................................. 17
Signature .................................................................................................................... 18
Templates ................................................................................................................... 20
User Options ............................................................................................................... 22

Chapter 4:

Workflow .................................................................... 24

Using the Workflow..................................................................................................... 24

Chapter 5:

Schedule ..................................................................... 30

Using the Schedule .................................................................................................... 30

Chapter 6:

Tools ........................................................................... 55

Accessing the Tools ................................................................................................... 55

Approve Dist., Delivery Log, Dist Mgr. ....................................................................... 56
DICOM In .................................................................................................................... 58
DICOM Out ................................................................................................................. 59
DOC Mgr..................................................................................................................... 60
Download .................................................................................................................... 61
File Mgr ....................................................................................................................... 62

Chapter 7:

Administrative Functions .......................................... 64

Accessing the Administrative Functions ..................................................................... 64

Clinics ......................................................................................................................... 65
Config ......................................................................................................................... 67
Data Mgt ..................................................................................................................... 74
DICOM Rules ............................................................................................................. 77
Email Rpts .................................................................................................................. 78
Logs ............................................................................................................................ 79
Export ......................................................................................................................... 80
Mgt Rpts ..................................................................................................................... 81
Servers ....................................................................................................................... 85
Services ...................................................................................................................... 87
Users .......................................................................................................................... 88
Utilities ........................................................................................................................ 91

Chapter 8:

Support ....................................................................... 92

Support Options.......................................................................................................... 92
Downloads .................................................................................................................. 93
Submit Ticket .............................................................................................................. 94
FAQs........................................................................................................................... 95
Manuals ...................................................................................................................... 96

Chapter 9:

Appendix .................................................................... 98

eFilm RIS/PACS User Manual Version 2.0

User Quick Reference Guide...................................................................................... 99
ActiveX Web Viewer Instructions ............................................................................. 100
Adding a referring physician login ............................................................................ 118
Backing up studies using a 3rd party application ..................................................... 124
Backing up studies in eFilm Workstation .............................................................. 129
HIS/RIS DLL ............................................................................................................. 133
Key Images ............................................................................................................... 144
DICOM Dir/eFilm Lite Prefetch ............................................................................. 148
How to allow pop-ups ............................................................................................... 156
How to import studies from media to eFilm Workstation ...................................... 158
Referring Physician Setup ........................................................................................ 160
Quick Setup Manual ................................................................................................. 167
Modality Worklist Setup ............................................................................................ 175
HL7 Export Specifications ........................................................................................ 177
eFilm Workstation Setup ....................................................................................... 191

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eFilm RIS/PACS User Manual Version 2.0

Chapter 1: Accessing the System

This chapter will guide the user through accessing PACS.

Accessing the System

Type the web address into the internet browser.
Note: If you do not know the address of your PACS system, please contact
your Administrator.
Log into system:
Username
Password (Figure 1)

Figure1

eFilm RIS/PACS User Manual Version 2.0

Chapter 2: System Information

This chapter will explain the main information screen of the system.

System Overview
Upon logging in, the user will see the main screen. There are 6 tabs (depending
on the user type) that will allow the user to perform functions and interact with the
system. Each tab EXCEPT the main, schedule and workflow tab has
submenus (sub buttons). (Figure 2)

Figure 2
The following is a brief description of the top level buttons. Each section is
detailed in the chapters of the manual.
The Main button displays the information center which includes a general
overview of the system.
The Edit button allows access to add/change system information, e.g., patients,
insurances, outside studies, procedures and modalities.
The Workflow button displays studies that have been received by DICOM
transactions or added as outside studies in the system. It includes several
workflow processes including, history of the patient, viewing methods and reports
The Schedule button allows access to the system RIS functions, e.g.,
scheduling, EMR, billing and patient tracking.
The Tools button contains several system tools, e.g., document, management,
DICOM transactions, file sharing, and report delivery.

eFilm RIS/PACS User Manual Version 2.0

The Support button displays system FAQs, manuals and the support ticket
submission.

eFilm RIS/PACS User Manual Version 2.0

Chapter 3: Edit Functions

This chapter will explain the system edit functions

Accessing the Edit Functions

EDIT TAB (Figure 3)

Figure 3

eFilm RIS/PACS User Manual Version 2.0

Change PW
To change the existing password, the user will choose this option. Follow the
instructions, and then click submit when finished. (Figure 4)

Figure 4
Note:

It is recommend that passwords contain a minimum of six (6) characters,

uppercase and lowercase letters and numbers/symbols. The system
requires a minimum of 6 characters including one number and letter.

eFilm RIS/PACS User Manual Version 2.0

Insurances
This section allows adding or searching for insurances in the system. To search
for an insurance company, type all or part of the name in the search box and
click search. (Figure 5a) After searching, a list of all insurances that meet your
search criteria will display. (Figure 5b) If an additional insurance needs to be
added to the list, click the add insurance button (Figure 5c) and a popup screen
will show. Fill in the necessary information. The web address must contain
http:// at the beginning of the entry. After adding/modifying information, click
Save. (Figure 5d)

Figure 5a

Figure 5b

eFilm RIS/PACS User Manual Version 2.0

Figure 5c

Figure 5d

eFilm RIS/PACS User Manual Version 2.0

Modalities
The system is pre-populated with several modalities. If there is a modality that
needs to be added to the system, click the add modality. (Figure 6a) In the
popup, fill in the fields and click save. (Figure 6b)
Caution: Please note that after a modality is added to the system it
cannot be deleted. Proceed with caution.

Figure 6a

Figure 6b

eFilm RIS/PACS User Manual Version 2.0

Outside Study
This feature is for studies that were performed at an outside facility that will be
read at your clinic. In addition, it can be used for studies that are not digital, but
need to be added to the worklist. While filling out the information for this option,
the patient ID is the ID that has been assigned to the patient through the RIS.
Please make a note of the patient ID before adding an outside study. RIS
information that can be added to the system will have a add link next to it.
(Figure 7a) Also, should there be a patient that was on the schedule and it
needs to be added to the workflow but there are no images to send, the user can
simply pull the study information over from the schedule by clicking the search
appointments link. (Figure 7b) Once the user searches for the specific patients
appointment, the fields will auto-fill with the information from the schedule. When
the user completes these fields, click save. (Figure 7c)

Figure 7a

eFilm RIS/PACS User Manual Version 2.0

Figure 7b

Figure 7c

eFilm RIS/PACS User Manual Version 2.0

Patients
To search for a patient or to add a patient into the system, use this feature. To
search for a patient that is already in the system, use the search field. Searching
can be done by patient ID, patient name, or date of birth. Depending on how the
user wishes to search for the patient, that information will be entered into the
blank field, and then choose the appropriate search feature from the drop down
menu.
Note: When searching for a patient by name, use ONLY the first OR the last
name, not both.
Click the search button to search. (Figure 8) If the user needs to add a patient
to the system, click the add patient button. (Figure 9) The screen will now
show different fields to fill in with the patients information.
Note: By leaving the Patient ID field blank, that will allow the system to
automatically assign an ID to the patient after the information is saved to the
system. This ID is attached to all information specific to that patient.
Once the user has the patient ID, fill in the necessary fields and click save.
(Figure 10)

Figure 8

eFilm RIS/PACS User Manual Version 2.0

Figure 9

Figure 10

eFilm RIS/PACS User Manual Version 2.0

Physicians
This is where the list of referring physicians will be entered. Once a referring
physician is entered in the system, they can be attached to a patients
appointment, the study in the workflow, the report and the user can also attach a
login which will allow the referring physicians to view their patients within the
system. To add a physician, click add physician at the bottom of the page.
When the Add Referring Physician window pops up, fill in the necessary fields. If
a field has the word skip to the right of it, which means that it is a required field
but there is the option to skip that particular field. To skip a field, simply click the
word skip. Once the necessary information has been added, click save.
(Figure: add physician screen 1)

eFilm RIS/PACS User Manual Version 2.0

Add Physician Screen 1

After the physician has been added to the system they will then show in the list,
once searched. (Figure: physician screen 2)

Physician Screen 2

eFilm RIS/PACS User Manual Version 2.0

Procedures
This is where the different procedures that will be used for scheduling are
entered. This is a list of the different procedures that your clinic performs. Once
these are entered, the user will be able to choose from the list when scheduling
an appointment. If there is a procedure that is not already entered, there is the
ability to add one. Click the add procedure button. (Figure 11) Fill out the
fields shown. Be sure that the modality field matches the type of procedure you
are entering. Just because the description says MRI, if the modality field is not
correct, it will not save in the system correctly. The procedure and description
fields can be the same, if desired. The duration of the appointment must be
entered in order to continue past this page. (i.e. if an MRI of the lumbar spine
takes an hour to perform, the duration would be 60) Once all fields are
completed, click save. (Figure 12)

Figure 11

Figure 12

eFilm RIS/PACS User Manual Version 2.0

Signature
This option allows the user to upload a JPEG image of the reading physicians
signature. Once the image is uploaded, the signature will then appear on all
reports created by the user that uploaded the signature. The signature must be
a JPG with the dimensions of 150 wide X 30 tall. (Figure: signature 1 and
signature 2)

Signature 1

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Signature 2

eFilm RIS/PACS User Manual Version 2.0

Templates
Templates are equivalent to macros and are useful for normal reports, etc. If a
study is not normal, the user can go in and edit what you wish to change. To
search to see if theres a template already entered in the system, type the name
of the template into the search field and click search. (Figure 13)

Figure 13
To add a new template, click the new template button. A new window will pop
up where different fields can be filled out, then click save template. (Figure 14)

eFilm RIS/PACS User Manual Version 2.0

Figure 14

eFilm RIS/PACS User Manual Version 2.0

User Options
The user options allow the user to select how many studies are returned to the
workflow page at one time. It also allows the user to set the default worklist view.
Based on what is selected, that is what will be seen as the default view each time
the workflow screen is viewed. (Figure: user options)

User Options

eFilm RIS/PACS User Manual Version 2.0

Chapter 4: Workflow
This chapter will explain the functionality of the Workflow.

Using the Workflow

When this tab is selected, the user will be able to view the list of patients and the
studies that have been performed. This is where the user can view whether the
report has been read, transcribed, etc. Here is a rundown of the column headers
for reference: (Figure 15)

Figure 15
ID: This is the patients ID that is assigned.
Acc#: This is the studies unique accession number..
Name: Patients name entered last name, first name
DOB: Date of Birth. For most studies the DOB will automatically show up. If it
does not, the system will default at DOB of 1/1/1900. To change this, click the
edit option on the right of the screen along the same line of the patient you are
editing. (Figure 16) A popup window will open to edit the information. Delete
the current DOB and enter the correct information. When completed, click the
save button. (Figure 17)

Figure 16

eFilm RIS/PACS User Manual Version 2.0

Figure 17
Sex and DOS (date of service): This should default from the original machine the
study was performed with.
Mod: This is modality. MR MRI, CT Cat Scan, PET Positron Emission
Tomography, US Ultrasound, OT other (i.e. x-ray) This should default as
well.
Study: This is the description of what was performed. (i.e. if a patient had an
MRI of the lumbar spine, this column would show up as lumbar spine)
Institution: This is the name of the facility where the study takes place.
Note: This field must be completed properly. If the institution name is not
entered then the system does not know where to send the study and there could
be a violation of privacy laws.
Ref Physician: This is the name of the physician that ordered the exam. This
field must be completed properly in order for the referring physician to have
access to the study.
Ser (series): How many different series of images there are in the study.
Img (images): How many different images there are in the study.
H/O (history of): This is a brief description of why the patient is having the exam.
Click on the number in this column and a window will pop-up where you can
enter the patient history.
Pre (preliminary): This is where the first copy of the radiologists interpretation
will be. Once there is a number under this column, the report can be viewed. To
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eFilm RIS/PACS User Manual Version 2.0

add a report, click on the number under this column. Select Upload Report or
Report Wizard from the popup window. Once the report has been created, it can
be saved as either a preliminary or final report. Should it be saved as a
preliminary report, the radiologist will then review the report and finalize it.
Fin (final): This is where the final report that has been approved by the
radiologist will be. Once there is a number under this column, you can print
and/or deliver the report.
Radiologist: Once the exam has been read by the radiologist, their name will
appear in this column
Status: This will show as read or unread. If the status shows read, then the
transcriptionist should be able to transcribe the report. If it shows unread then
the radiologist has not had a chance to view and dictate.
Action: This is where the user can choose to edit information by clicking the edit
button. Under the action column there is also the ability to assign more than one
physician to the patient. This is in the instance that the patient is referred to
another physician other than the one that ordered the study. The additional
physician can log into the system (they must have a username and password to
do so) and view the patients study and report. A study can also be marked
STAT and a user can assign a study to a reading physician. (Figure 18)

Figure 18
To assign an additional physician, click the target. In the popup screen, there will
be 2 boxes. The box on the left lists all of the referring physicians that are in the
system. The box on the right shows the referring physicians that are assigned to
the patient. To assign a physician, simply click on the name in the left box, then
click the add button. The physicians name will now move from the left box to
the right box. Should the user need to remove a physician from being assigned
to the patient, click the physicians name in the right box and click the remove
button. Once this is finished, click close. (Figure 19)

eFilm RIS/PACS User Manual Version 2.0

Figure 19
To mark a study STAT, click the ! under the Action column. This will turn the
entire row red and it will stay that way until a final report has been generated. If a
study is accidentally marked STAT that shouldnt be, just click the ! button again
and it will go back to normal. (Figure: STAT)

STAT
Assign Reading Physician
To assign a study to a particular reading physician, click the assign study
button. A window will popup that shows a list of the different reading physicians
in the system. Select the physician you want by clicking on their name. (Figure:
Assign Reading Physician)

Once the physicians name is selected, add any notes needed. When the
reading physician logs in, they will see studies assigned to them under the My
Studies filter.
Users can manually select what they wish to view by changing the filters. There
are 3 types of filters:
1. Date Filter. The selections are: Today, Yesterday, Last 3 Days, Last 7
Days, or Last 14 Days.
2. Additional Filter. This is to select what type of studies the user wishes to
view. Selections are: All, Unread studies, studies that have been read but
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eFilm RIS/PACS User Manual Version 2.0

have no report, studies that have preliminary reports, or My Studies. The My
Studies option is mainly for radiologists to get the specific studies that have
been assigned to them.
3. Viewing Method. This allows the user to select the default method in which
the studies are viewed through the system. Selections are: ActiveX Web,
which is the system web viewer. eFilm retrieve or eFilm Image Channel.
(Figure: Filters)

Filters
If the users change the filters from their defaults, they can set them back to
default by clicking the reset button.

eFilm RIS/PACS User Manual Version 2.0

Chapter 5: Schedule
This chapter explains the RIS scheduling functions.

Using the Schedule

Select the Schedule button.
To schedule a new patient, click the add patient button. (Figure 20)

Figure 20

The screen will now show different fields to fill in with the patients information.
Note: If the Patient ID field is left blank, the ID number will be automatically
generated once the demographic information is saved. This ID is attached to all
information specific to that patient.
When filling in the Insurance field, the user has the ability to search for insurance
companies that have already been saved to the system. To search these, click
the search link. (Figure 21)

eFilm RIS/PACS User Manual Version 2.0

Figure 21
Note: If the user tries to add a patient whose name and/or date of birth
matches a patient already in the system, they will be prompted to either choose
from a list of existing patients or to continue with new patient. (Figure 22) This is
to eliminate duplicate entries of the same patient.

eFilm RIS/PACS User Manual Version 2.0

Figure 22
There will now be a window that says Would you like to schedule a procedure
for this patient? Click schedule patient. (Figure 23)

Figure 23
The scheduling wizard window should now appear. Under modality click the
dropdown menu to choose the correct modality you need to schedule. (i.e. MR,
CT, OT, US) Once the correct modality is selected, click the search button.
(Figure 24)

eFilm RIS/PACS User Manual Version 2.0

Figure 24
A list of the pre-entered studies under the specific modality will now be listed.
Find the study description you need and click on it. (Figure 25)

Figure 25

The system will now show the screen where the date and time of the
appointment is chosen. Click the date needed on the calendar then choose from
the time slots listed. (Figure 26)

eFilm RIS/PACS User Manual Version 2.0

Note: The times that are available will be shown in white. If a time is shown in
green that means it is booked. Should the times show up in red that means that
the particular time slot is overbooked.

Figure 26
Once the desired time is selected, the system will show the screen in the
scheduling wizard to add additional information pertaining to the study. Here, the
user must enter the referring physician, CPT, ICD-9 and Insurance name by
clicking the search link. (Figure 27) Enter the search criteria in the search field
and click the search button. Find the information needed and click on it and it will
fill in the field. If any fields have the word skip to the right of it, click skip and it
will allow that field to be skipped. Once all fields are completed, click schedule.

eFilm RIS/PACS User Manual Version 2.0

Figure 27

The system will now ask if you would like to schedule another procedure. Click
schedule another or close. (Figure 28)

Figure 28
To schedule an existing patient that is already in the system, click the schedule
button. (Figure 29)

eFilm RIS/PACS User Manual Version 2.0

Figure 29
Search by either the name, patient ID, or DOB, then click the search button
(Figure 30) Find the patient from the list and click their name.

Figure 30

Follow the same instructions above to complete the scheduling process.

Under the action column on the schedule there are different actions that can
occur. Edit, confirm appointment, verify appointment, print patient information
sheet, status and if an appointment has an insurance entered and has a web
address, there will be a button to take you to the insurance companys website.

eFilm RIS/PACS User Manual Version 2.0

EDIT BUTTON
To delete, reschedule or edit appointment information, find the patients
scheduled procedure and click the edit link. (Figure 31)

Figure 31
If the appointment needs to be deleted/cancelled, click the delete appointment
button. (Figure 32)

Figure 32

Next, the user will be asked to select the reason for deleting the appointment.
Select from the dropdown menu and then click delete and the appointment will
be deleted. (Figure: Delete Appt)

eFilm RIS/PACS User Manual Version 2.0

Delete Appt
If the appointment needs to be rescheduled, click the new date and/or time on
the screen. If the appointment needs to be moved to a different time, but on the
same day, only click the new time. If the appointment needs to be moved to a
new day, click the desired day on the calendar, then choose the time. (Figure 33)

eFilm RIS/PACS User Manual Version 2.0

Figure 33
To search for a scheduled patient only, click the search button. (Figure 34)

Figure 34

Enter the patient name or ID, then click search. If the patient entered is
scheduled for a procedure, they will show here when the appointment is
scheduled. (Figure 35)

eFilm RIS/PACS User Manual Version 2.0

Figure 35
Click on the date/time link at the far left, and the system will be directed to the
schedule for that modality and day.
To print a schedule, select the print list, print full or print all buttons. Print list will
print the schedule of the specific modality that is chosen. Print full will print a
birds eye view of the schedule for the day. Print all will print the schedule for all
modalities. (Figure 36)

Figure 36

eFilm RIS/PACS User Manual Version 2.0

CONFIRM APPOINTMENT BUTTON

When the confirm appointment button is clicked, a popup will appear that shows
the appointment information along with a field to enter notes. Once notes are
entered and/or confirming the appointment, click the save button. (Figure 37)

Figure 37

Once the user has clicked save, the popup will close and the confirm
appointment button will change to a check-mark. If the mouse is placed over the
checkmark, a tool-tip showing the date and time the appointment was confirmed,
who it was confirmed by, and any notes entered, will appear on the screen.
(Figure 38)

eFilm RIS/PACS User Manual Version 2.0

Figure 38

VERIFY APPOINTMENT BUTTON

When the verify appointment button is clicked, a popup will appear that shows
the appointment and insurance information along with a field to enter notes.
Once notes are entered and/or the appointment is verified, click the save button.
(Figure 39)
Note: This is where information regarding precertification or any insurance
verification information will be entered.

eFilm RIS/PACS User Manual Version 2.0

Figure 39
Once the user has clicked save, the popup will close and the verify appointment
button will change to a check-mark. If the mouse is placed over the checkmark,
a tool-tip showing the date and time the appointment was verified, who it was
verified by, and any notes entered, will appear on the screen. (Figure 40)

Figure 40

eFilm RIS/PACS User Manual Version 2.0

PRINT PATIENT INFORMATION SHEET

When this button is selected, it will bring up a printable page with the clinic
letterhead at the top. The page will include the patient demographic information,
insurance information and appointment information.

DOCUMENTS BUTTON

When this button is selected, the user can scan or upload documents to the
patient. To do this, click the add document button. If the user wishes to upload
a document that is saved to the computer, click upload. From there, browse the
computer for the document and upload it. Documents cannot be larger than 2MB
and users can upload .doc, .pdf and .tif to the system. (Figure: Add Document1
and Add Document2)

Note:

If needing to scan a document, the PACS website must be added to the

list of trusted sites. To do this, in Internet Explorer, go to Tools/Internet
Options. (scan1) Select the security tab, click on Trusted Sites and
click the sites button. (scan2) Type the web address in the top field
and click the add button. (scan3) Once the site has been added, users
can now scan documents.

eFilm RIS/PACS User Manual Version 2.0

Scan1

Scan2

eFilm RIS/PACS User Manual Version 2.0

Scan3

To scan a document, select scan. Follow the prompts to scan the document.
(Figure: Add Document 1 and Add Document2)

eFilm RIS/PACS User Manual Version 2.0

Add Document 1

Add Document 2

Click the scan button. If the show scanning user interface box is checked, the
scanning interface for the installed scanner will show on the screen.

eFilm RIS/PACS User Manual Version 2.0

Select the scanner from the list of sources and click select.

Click scan.
Note:

Users must make sure that they are scanning in black and white in order
for the scanned document to show properly. Scanning application
interfaces will vary.

eFilm RIS/PACS User Manual Version 2.0

Once the document has finished scanning, it will appear on the screen. Click
ok.

eFilm RIS/PACS User Manual Version 2.0

If an additional document needs to be added, click ok when asked to add an

additional document. If no additional documents need to be added, click the
cancel button. The scanned document is now saved.

eFilm RIS/PACS User Manual Version 2.0

STATUS BUTTON

This button allows users to see when a patient arrived, was checked in, when the
study began and when they checked out. When the patient arrives, click the
button that looks like a door. (Figure: Arrive) The button will change to a single
line. (Figure: check-in) To check the patient in, click the single line button and it
will turn to a button with 2 lines. Once the patient is checked in, the appointment
will turn green. (Figure: check-in green) After 10 minutes, if the status has not
changed to show that the study began the appointment will then turn orange.
(Figure: check-in orange) After 20 minutes from when they were checked in, if
the study does not show that it began the appointment will then turn red. (Figure:
check-in red) Once the study has begun, click the button with 2 lines and it will
change to show 3 lines. (Figure: Start Study) Once the study is completed, click
the button with 3 lines to check them out. Once the patient has checked out,
place the mouse over the check-mark and a tool-tip will appear on the screen
showing the duration of their appointment with when they arrived, checked in,
began the study and checked out. (Figure: Time Line)

Arrive

Check-In

Check-In Green

Check-In Orange

Check-In Red

eFilm RIS/PACS User Manual Version 2.0

Start Study

eFilm RIS/PACS User Manual Version 2.0

Time Line
INSURANCE WEBSITE BUTTON

When a patient is scheduled, if the web address for the insurance company is
entered, this button will show up on the schedule. By clicking this button, it will
bring up a popup that takes you directly to the insurance website.
Note: This button will only show if the insurance companys web address was
entered in the system.

eFilm RIS/PACS User Manual Version 2.0

Chapter 6: Tools
This chapter will explain the system tools.

Accessing the Tools

Select the Tools button.
The tools tab is where users can manage the incoming and outgoing faxes,
where users can see what studies are coming in and going out and where files
can be uploaded. For outgoing faxes, there are 3 steps.

eFilm RIS/PACS User Manual Version 2.0

Approve Dist., Delivery Log, Dist Mgr.

Approve Dist., Delivery Log, and Dist Mgr allow management and interaction with
the system faxing and email delivery components
Distribution Manager
The Dist Mgr is where rules will added to allow a report to be auto faxed. To do
this, you will the add rule button. In the Referring Physician field, click the
dropdown menu to select the physician the rule will apply to.
Note: The physician must already be added to the system in order for them to
have a rule. See the instructions for adding a physician above.
In the Destination Type field, click the dropdown menu and choose fax or email.
In the Destination field, enter the fax number or email address for the physician.
To ensure that a report does not get faxed out until it has been finalized, click the
On Finalize box. If a report needs to be approved prior to it sending, click the
require approval box. Once these steps have been completed, click the save
button. (Figure 41)

Figure 41
Approve Distribution
If the Require Approval box was selected when adding a rule, the fax or email
will be in the Approve Dist. page. Here, to see what the fax/email contains, click
the patient name. The fax/email will not be sent until the user clicks approve. If
the report does not need to be sent, simply select cancel. (Figure 42)

eFilm RIS/PACS User Manual Version 2.0

Figure 42
Delivery Log
The Delivery Log is where the status of the fax or email deliveries can be
viewed. Processed means that it has been sent, Awaiting Send Approval
means that the user needs to go into the Approve Dist section and click the
approve link to send it. If the system says error, it did not go through. (Figure
43)

Figure 43

eFilm RIS/PACS User Manual Version 2.0

DICOM In
All incoming DICOM transactions are recorded in the DICOM In section.
The system will display complete and in progress transactions.

DICOM In
Users can search for received studies by date or by name. To search by name,
type the last name in the search field and click the search button. When
searching for a patient, the system will search the date listed in the date field. To
change the date, click either the calendar button or the arrows on either side of
the button labeled today. The DICOM In screen will auto refresh. Users can
set the desired refresh interval by selecting the number from the Page Refresh
dropdown list.
Studies can be selected (using the check boxes) and sent to DICOM nodes by
clicking on the Push button. A list of destination DICOM nodes will be
displayed.

eFilm RIS/PACS User Manual Version 2.0

DICOM Out
All outgoing DICOM transactions are recorded in the DICOM Out section.
Incoming studies that match DICOM rules, will display as Receiving.

DICOM Out
Users can search for studies sent by date or by name. To search by name, type
the last name in the search field and click the search button. When searching
for a patient, the system will search the date listed in the date field. To change
the date, click either the calendar button or the arrows on either side of the button
labeled today. The DICOM Out screen will auto refresh. Users can set the
desired refresh interval by selecting the number from the Page Refresh
dropdown list.
DICOM stores can be cancelled and resent by selecting the options under the
Action column.

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DOC Mgr
The Document Manager display received faxes and allows reports to be
uploaded/scanned into the system.
Next to the word unassigned there will be a list of numbers indicating
unassigned faxes/documents. Documents that were unassigned from a patient
will also display. Clicking on the unassigned numbers, will display the document.
The user can either print the document or assign it to a patient. Should the user
decide to assign the document to a patient, type the patient name in the search
field, click search and list of names will display. Find the name of the
appropriate patient and click assign document. The document is now assigned
to the patient.

Figure 44

eFilm RIS/PACS User Manual Version 2.0

Download
The Download section contains a log of studies downloaded using the eFilm Lite
Prefetch/DICOM Dir Client. The system displays downloaded studies by date.
The columns can be sorted by clicking on the appropriate heading.

Download

eFilm RIS/PACS User Manual Version 2.0

File Mgr
The file manager allows files and documents to be shared.
Files and documents can be uploaded and saved in the system. This is a secure
place for files to be stored. (Figure: File Mgr)

File Mgr

To upload documents, click the upload files button:

When this button
is selected, the user can browse the computer for the file to be uploaded. To
create a new folder within the File Manager, click the create new folder button:
When this button is selected, a new folder will be created and the user
can name it appropriately.
Files and documents can also be downloaded by selecting and right clicking
Download or Download and compress.

eFilm RIS/PACS User Manual Version 2.0

Chapter 7: Administrative Functions

This chapter will explain the system Administrative functions.

Accessing the Administrative Functions

Caution: The following section should only be completed by a qualified
IT/IS person. If you are unsure about the setup information below, please
contact your systems administrator. Proceed with caution.
Click on the Admin Button.

eFilm RIS/PACS User Manual Version 2.0

Clinics
This is where clinic information is entered. This is meant to list the different
clinics where the exams will be performed. (Figure 45).
Note: The Quick Setup Manual located in the Appendix section, provides
detailed information on configuring your system.

Figure 45

eFilm RIS/PACS User Manual Version 2.0

Under the action column, click the Edit button denoted as double boxes. Enter
the following:
Description

Entry

Clinic

Clinic Name

City

Clinic Street
Address
Clinic City

State

Clinic State

Phone

Clinic Phone

Fax

Clinic Fax

Prefix

Clinic Prefix

Report Header
Logo

Clinic Report
Logo

Report Footer

Clinic Report
Footer

Website

Clinic Website

Address

Notes
Enter the full clinic name, e.g., ACME
Imaging
Enter the full clinic address, e.g., 123
Street, Suite 105
Enter clinic city
Enter clinic state
Enter clinic phone number, e.g., 555555-5555
Enter clinic fax number, e.g., 555-5555556
Enter clinic patient ID prefix. Select
from the provided drop down. This
prefix will automatically be applied to
patients added to the system. For
example, if the clinic name is ACME
Imaging, the prefix A would be
appropriate.
Upload the logo that will be displayed
on reports generated by the report
wizard. Click the browse button to
upload the logo. (note the file must be
a JPG with maximum dimensions of
300px wide by 120px high)
Enter clinic report footer. The footer
must be entered in HTML format. See
example below.
Enter clinic website address, e.g.,
|[Link]
Leave the http:// prefix provided

Note: This table is only an example. Please use your unique information.
Report footer example is provided below.
Use your favorite HTML editor to create the footer for your reports. Here is a
sample that may be used:
ACME
Imaging 123 Bayou Blvd., Houston, Texas 77380 |
Phone 555.555.5555 | Fax 555.555.5556 Web <a
href="[Link]
</a> | Email <a
href="[Link]
[Link]</a>

eFilm RIS/PACS User Manual Version 2.0

Config
Caution: The following section should only be completed by a qualified
IT/IS person. If you are unsure about the setup information below, please
contact your systems administrator. Proceed with caution.

The first area is designed to give administrative users the ability to decide what
fields are required on specific pages (Figure: Skip Options). This area lists the
field name, the page name, and the option to require and/or be allowed to skip
that particular field. If the admin users choose only the required option and NOT
the skip option that means the specific field (as described in the far left column)
must be filled in, in order to proceed from that page. If the admin users choose
the option to require AND skip, then the ability to skip that field will be provided
(Figure: Skip). If any of these fields are skipped, then a red flag will show on the
schedule for that patient, notifying the user that information is missing. (Figure:
Flag)

Skip Options

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Skip

Flag

eFilm RIS/PACS User Manual Version 2.0

The next section is Clinic, Misc. Settings
Login Page Logo
Click default logo to browse/upload your logo. The image must be JPG with
maximum dimensions of 250px wide by 120px high.
eFilm ActiveX Settings
This option must be configured for the online image viewer to work. Please do
the following:
Click the hyperlink eFilm ActiveX Settings
Local Web URL Reference
Input your system NetBIOS name and local IP, e.g., PACSSERVER,
[Link]. If you are unsure how to do this, please contact your network
administrator.
Local Image Channel IP
Input your local IP, i.e., the IP of the PACS, e.g., [Link]. If you are unsure
how to do this, please contact your network administrator.
Remote Image Channel IP
Input your public IP (provided by your ISP), e.g., [Link]. This must
be a public, routable IP. If you are unsure how to do this, please contact your
network administrator.

Note: The following ports MUST be forwarded to your internal PACS server:
TCP 443, 3333. If you are unsure how to do this, please contact your network
administrator.

Click Save (you can always go back later to make changes)

Scanning DLL registration code
Click the hyperlink to input your registration code. To obtain your registration
code, you must email your full domain name, e.g.,
|[Link] to support. A registration code will be
provided within 72 hours of original email (excluding weekends/holidays). Upon
receipt of registration code, enter your full domain name, e.g.,
|[Link] , and registration code (provided by Merge
Healthcare) and click save.
Note: The full domain name must be included to generate a license key. If you
do not know what your domain name is, please contact your PACS
Administrator.

eFilm RIS/PACS User Manual Version 2.0

Schedule Settings
Click Schedule Settings to specify your operation hours. For example, if open
at 8:00 a.m. and close at 5:00 p.m., select the start time of 8:00 a.m. and 9 as
the length of hours. When this is complete, click Save.

Clinic, Misc. Settings

DICOM Service Settings:
DICOM Image Storage Server (NetBIOS name)
Click the name and verify it matches the NetBIOS name of your server. You can
view your NetBIOS name by right click on My Computer selecting properties,
clicking the Computer Name tab. The NetBIOS name of your system will be
displayed adjacent to Full computer name
Note:

Do not include the . at the end of the name

DICOM Image Storage Path

Do not change this value.
DICOM Image Storage Username
Password should match your Local Administrator account username, i.e.,
Administrator. Do not change this value.
DICOM Image Storage Server Password
Password should match your Local Administrator account password.
Modality Worklist Path
Do not change this value. It defines the path of the modality worklist files.
Modality Worklist Sending Server (DICOM Modality Worklist Server)
Do not change this value. Default = EFILMRISPACSWL

eFilm RIS/PACS User Manual Version 2.0

DICOM Service Settings

eFilm RIS/PACS User Manual Version 2.0

Key Image Convertor Service:
Key Image Layout
Select the number of columns/rows of key images on reports.
JPEG Path
Do not change this value. It defines the path of the key images directory.
Accession Separator (in powers of 10)
Do not change this value.
Default Command Line Arguments
Do not change this value.
SOPClassUID Exceptions
Do not change this value.

Key Image Converter Server Settings

Fax Service Settings
Local Area Codes (Area codes for which adding the dialing prefix '1' will not be
necessary.)
Enter area codes that do not require 1 to fax. Separate values by a comma,
e.g., 936,832,713, etc.
Report Wizard URL
Do not change this value
Report Document URL
Do not change this value
Update Status URL
Do not change this value
FTP Path
Do not change this value

eFilm RIS/PACS User Manual Version 2.0

Fax Service Settings

Backup/Restore Settings
This is the maximum number of studies that can be archived/restored for a
submitted job. Based on the number selected, the system will archive/restore up
to that many studies. It is recommended that these values not be changed as it
can affect the performance of the server if the number is too high. If the value
must be increased, it is recommended that it be done after hours.

Backup/Restore Settings

eFilm RIS/PACS User Manual Version 2.0

Data Mgt
The Data Management section allows DICOM studies to be Backed Up or
Restored from local online media.
Select the Data Mgt button and then backup or restore (Figure: Data Mgt).

Data Mgt
Backup Function
Generate a Media ID for your backup job, e.g., MEDXX-XX-XXXX.
Enter the local destination. The drive letter and path of your media device is
required. This information can be obtained by locating your media drive letter
and folder via My Computer in Windows.
Enter the desired dates in the format displayed, e.g., XX/XX/XXXX and
XX/XX/XXXX. These dates define the date of service for the backup job (Figure:
Backup).

Backup

eFilm RIS/PACS User Manual Version 2.0

Backup Job History displays the history and status of archived studies.

Backup Job History

Selecting the links under the Status column will display details of the backup
job.

Backup Job History Details

Restore Function
The restore function allows studies to be loaded back into the system. Search by
any of the displayed fields (Figure: Restore).

Restore

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Restore Job History displays the history and status of restored studies.

Restore History
Select the target studies to restore and click the Retrieve button.

Restore and Retrieve Selection

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DICOM Rules
DICOM Rules allow automated DICOM Store rules to be created.
When a study is received it will show in the DICOM In page (Figure: DICOM
Rules).

DICOM Rules
To add a rule, click the Add Rule button. The AE Title is based on the AE Title
from studies received. In the Target Server field, select from the list of servers
listed in the dropdown. This list is populated from the list of servers saved under
Admin/Servers. Select the priority (low, medium, high) and click save.
Note: The list of servers is populated from the entries made under
Admin/Servers. DICOM node destinations must be added before creating a
DICOM rule.

eFilm RIS/PACS User Manual Version 2.0

Email Rpts
The email reports section allows the user to designate the SMTP server
credentials for referring physician report notification emails.
This page is where admin users will enter the clinics email server information, as
well as the clinics email address and password for the email. This information is
used for the email distribution of reports. When a referring physician receives an
email notification that they have a report to review, it will come from the email
information that is saved in this page (Figure: Email Rpts).

Email Rpts
Note: Referring physician report email notifications DO NOT contain any
identifiable patient information. The email provides the referring physician with a
notification of a new report/images to review.

eFilm RIS/PACS User Manual Version 2.0

Logs
HIPAA and PHI require health information systems to audit and record
transactions within the software, e.g., access, editing, additions, deletions,
viewing, etc. The logs section contains detailed information regarding the access
and use of the system. The logs are displayed by date and include audits of
access to the system, modifications, viewing of images, errors, etc. The columns
(DateTime, User, Event, and Comment) can be sorted. The system also allows
searching by User. Figure: Logs

DateTime Date and Time of event

User User that performed the action

Event Type of action

Comments Details of action

Logs

eFilm RIS/PACS User Manual Version 2.0

Export
The system allows HL7 compliant flat files to be created. These files can be
used for billing or data sharing between other HL7 compliant systems.
Note: It is the responsibility of the clinic to determine if new or existing systems
are capable of importing HL7 flat files.
To export appointment information, select the desired date or date range. A list
of the appointments will generate on the screen. Click the export button and it
will prompt you to save the exported file. The file is saved to the specified
location. Cash patients can exclude from the flat file by selecting Exclude Cash
Appointments.

Export
Note: Detailed information on the HL7 Export standard are included in the
Appendix/HL7 Export Specifications.

eFilm RIS/PACS User Manual Version 2.0

Mgt Rpts
The system includes several useful management reports to aid administrators in
managing the system and the practice (Mgt Rpts1). Each report can viewed in a
browser or opened in a PDF file.

Mgt Rpts1
Modality Report
The modality report gives a breakdown of the number of studies separated by
modality. Users can select a specific date, date range, or full month to view
(Figure: Modality Report).

Modality Report

eFilm RIS/PACS User Manual Version 2.0

Referring Physician Report
The referring physician report gives a breakdown of the number of studies each
physician referred. Referring physicians can be searched by name, by typing the
last name in the search field. The system will return search results based on the
date selected. Users can select a specific date, date range, or full month to view.
(Figure: Ref Phy1)

Ref Phy1
By clicking on the physician name, a more detailed report will be provided
showing a breakdown of studies by modality (Figure: Ref Phy2).

Ref Phy2

eFilm RIS/PACS User Manual Version 2.0

Cancelled Appointment Reports
This report gives a list of all appointments cancelled/deleted from the schedule.
Cancelled appointments can be searched by specific date, date range or full
month view (Figure: Cancelled Appt Report).

Cancelled Appt Report

Reading Physician Studies By Modality Report
This report will list all reading physicians/administrative users on the system and
the number of studies they have marked read, broken down by modality (Figure:
Reading Phy1).

Reading Phy1
If the user clicks on the number listed under the modalities for each reading
physician, detailed information regarding the studies read will be displayed
(Figure: Reading Phy2).

eFilm RIS/PACS User Manual Version 2.0

Reading Phy2

eFilm RIS/PACS User Manual Version 2.0

Servers
The system is capable of performing a DICOM Store (DICOM Push) to other
DICOM compliant systems.
The list of DICOM destinations is displayed (Figure: Servers1)

Servers1
To add a new server to the list, click the add new server button (Figure:
Servers2).

Servers2
Fill in the fields listed. The description field will be what you will call the entry.
AE title is the AE title of the destination. Hostname is the IP address of the
destination. Server limit will be how many studies can send simultaneously to
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eFilm RIS/PACS User Manual Version 2.0

the same place. We suggest no more than 3 for the server limit. Retry limit is
how many times the system will retry to send the study if it is not successful.
Retry time is the amount of time between retries. Once the new server
information is added, click save.

eFilm RIS/PACS User Manual Version 2.0

Services
The system allows management and configuration of the core DICOM services,
i.e., DICOM Store Server, DICOM Query/Retrieve Server, Image Channel
Server, DICOM Modality Worklist Server (Figure: Services).
This is where the different services can be started or stopped.

Services
It is recommended that these values are not changed. If the values are changed,
a restart of the specified server is required.
It is highly unlikely the services will need to be stopped or restarted.
Caution: Managing the services should only be completed by a qualified
IT/IS person. If you are unsure about the setup information, please contact
your systems administrator. Proceed with caution.

eFilm RIS/PACS User Manual Version 2.0

Users
This is where users to the system are added. There are 6 different user types:

Administrator Unlimited functionality, access to all features

Reading Physician Basic functionality, ability to mark studies read
Referring Physician Limited functionality, view reports, images, and key
images explicitly assigned to him/her.
Technologist Basic functionality, tailored workflow for technologist
Transcriptionist Basic functionality, tailored workflow for transcriptionist
User Basic functionality

To add a user click add new user. A popup box will appear. Fill in the
requested fields and be sure that the appropriate role for the user you are adding
is selected. This field determines what information the user can see. Click next.
Add the username and password and click finish.

User 1

eFilm RIS/PACS User Manual Version 2.0

User 2
If the user that was just added is for a referring physician, go back to the
Physician page under the Edit menu and assign the login to the referring
physician. To do that, find the referring physicians name and click edit. In the
Ref Phy Login field, click the dropdown menu and select the name of the login
that you want to attach. Once the login is saved to the referring physician, the
Ref Phys Login field should now be filled in.

Note: It is imperative that the correct login is selected. If a login is attached to

the incorrect referring physician it could create a HIPAA violation, as the user will
then be able to view information they shouldnt.

Note:

It is recommend that passwords contain a minimum of six (6) characters,

uppercase and lowercase letters and numbers/symbols. The system
requires a minimum of 6 characters including one number and letter.

eFilm RIS/PACS User Manual Version 2.0

Ref Phy 1

Ref Phy 2

eFilm RIS/PACS User Manual Version 2.0

Utilities
The system Utilities section displays the current study capacity used.
The total studies allowed are based upon the agreement between the customer
and the sales team. The Utilities screen displays the total studies allowed, the
total studies stored, and the remaining number of studies allowed. Once the total
number of studies allowed is reached, the system will start deleting studies,
starting with the least recent accessed study. This means that studies will be
deleted starting with the study that has been dormant for the greatest amount of
time. When studies are deleted, only the images are deleted. All reports,
documents and information will remain.

Utilities

Note:

To increase the number of Total Studies Allowed, please contact the

Sales team.

eFilm RIS/PACS User Manual Version 2.0

Chapter 8: Support
This chapter will explain the system support functions including downloads, ticket
submission, FAQs and Manuals.

Support Options
Click on the Support button.

eFilm RIS/PACS User Manual Version 2.0

Downloads
The system will display available downloads. Add-ons and additional modules
are included. Click the file name to download.

eFilm RIS/PACS User Manual Version 2.0

Submit Ticket
The Submit Ticket option allows a support ticket to be submitted to the support
team.
Fill in the email address and phone field and choose the appropriate support
issue from the dropdown menu. Fill in the describe issue field and click submit
ticket. The more information provided to the Support staff the easier it will be to
resolve the issue. (Figure 46)

Figure 46

eFilm RIS/PACS User Manual Version 2.0

FAQs
Under the FAQ tab, there is a list of commonly asked questions. Locate and
click on the desired FAQ. The system will provide the appropriate answer.

eFilm RIS/PACS User Manual Version 2.0

Manuals
The manuals section provides user documentation.
System manuals are provided in PDF and HTML format. These can be printed
or saved to the computer, if desired.

eFilm RIS/PACS User Manual Version 2.0

Chapter 9: Appendix
The appendix contains ancillary documents for the system.

eFilm RIS/PACS User Manual Version 2.0

User Quick Reference Guide

Edit Menu
Insurances: Add new insurance by clicking add insurance button. Enter insurance information
in the fields and click save. Users can search for existing entries by typing the name in the
search field and click the search button.
Outside Study: Patient/study information is entered for patients without films. Fill in each field
and click save. Information will then show on the workflow screen.
Physicians: Add new referring physician by clicking add physician button. Enter referring
physician information in the fields and click save. Users can search for existing entries by typing
the last name in the search field and click the search button.
Procedures: Add procedures for each modality by clicking add procedure. Users must ensure
that they have the correct modality selected when adding a procedure to ensure that the
procedure is saved for the correct modality. Existing entries can be searched by selecting the
modality from the drop down list looking at the list on the screen.
Templates: Add new templates by clicking the new template button. Fill in fields and click save.
Existing entries can be searched by typing the name in the search field and click search.
Templates are like macros and can be used in lieu of transcription.
Workflow
Search for studies on the workflow by typing the first OR last name in the search field and click
search all dates. Alternatively, studies can be searched just by date by selecting single or date
range and selecting the date(s). Add histories by clicking the number under the H/O column.
Add/upload documents by clicking the number under the Pre or Fin column. Add/upload
documents by clicking the number under the Doc column. Under the Action column, users can
edit study information, assign additional referring physicians, assign studies to reading physicians
and mark a study STAT.
Schedule
Search for existing scheduled appointments by clicking the search button. Schedule
appointments for existing patients by clicking the schedule button. Schedule appointments for
new patients by clicking the add patient button. Once appointments are scheduled, documents
can be uploaded/scanned by clicking the documents button.
Tools
Dist Mgr: Reports can be delivered to referring physicians based on rules entered in the system.
Click add rule and fill in the fields and click save to save a delivery rule.
Approve Dist: If reports require approval to be delivered, they will appear on this page. To
approve reports to be delivered, click the approve link at the far right. If the report does not need
to be delivered, click the cancel link.
Delivery Log: Reports that have been delivered are listed here. Users can view the progress of
the delivery of the report and resend reports. This serves as a confirmation page.
Doc Mgr: If the system is used to answer incoming faxes, they will appear here. Incoming faxes
and other documents uploaded to the Doc Mgr will show as a number next to the word
unassigned. Documents/faxes can be assigned to existing patients on the system by typing the
last name of the patient in the search field to the left, then click the word search. Select the
patient you wish to assign the document to by clicking on the name once, then click the assign
button.

eFilm RIS/PACS User Manual Version 2.0

ActiveX Web Viewer Instructions

The ActiveX component allows studies to be securely viewed via Internet
Explorer. The following section will describe the application.
In the workflow, click the patient name to view in the ActiveX component.
Note:

The viewing method must be ActiveX Web to use the component.

After clicking the patients name, the ActiveX Web Viewer will open. To view and
manipulate the study, use the buttons at the bottom of the screen. (Figure 1)
Note: The series with the green border is the current focus of the tools you
specify. To change to the other series, click your mouse on the desired cell

To select different images or series, use the arrow buttons.

and

will

and
will select the previous
allow select the previous or next image.
or next series of images. Also, there are hot keys on the keyboard that can be
used as well. The Pg Up key on the keyboard can be used to take the user to
the previous image and the Pg Down key will take the user to the next image.
The End key on the keyboard will take the user to the last image in the current
series. The Home key on the keyboard will take the user to the first image in
the current series.
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To flip the image from left to right, or right to left, click the flip horizontal button.

will flip the image 180 degrees along the horizontal axis. (example Figure
2)

Figure 2

To flip the image from top to bottom, or bottom to top, you will click the flip
This will flip the image 180 degrees along the vertical
vertical button.
axis. (example Figure 3)

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Figure 3

To rotate the image to the left 90 degrees, click

. (example Figure 4)

Figure 4

To rotate the image to the right 90 degrees, click

102

. (example Figure 5)

eFilm RIS/PACS User Manual Version 2.0

Figure 5

To have the web viewer automatically cycle through all the images in a particular
series, click the cine button

To hide or display the study header information in the window, choose the toggle
overlay button.

(example Figure 6)

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Figure 6

To invert the color of the image to show black on white or white on black, use the
By default, the low intensity pixels are dark and high
invert button.
intensity pixels are light on the screen. By choosing this option, you are allowing
the low intensity pixels show light and the high intensity pixels show dark. By
selecting the invert button again, it will reset the image to its original view.
(example Figure 7)

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Figure 7

By choosing the auto window level button

, the image will automatically
adjust to show optimum window/level settings. If the brightness and/or contrast
have been manipulated, by choosing this button, it will reset to the original view.

allows the user to

The stack buttons, left and right respectively,
manually scroll through the images within a series. The L and R in the upper
corner of the buttons tell the user which mouse key the button corresponds to.
When any button with the L or R in the upper corner are chosen, or active,
As long as the buttons appear gold, that is the
they will be gold
current tool the corresponding mouse key will use. Choosing two different
buttons for the mouse buttons to use, you eliminate having to go back and forth
choosing the tool you need and can assign one tool to the left mouse key and
another tool to the right, or vice versa. While these buttons are still gold, other
buttons that do NOT show L or R in the upper corner can still be used.

or
. This allows the
To adjust the window level of the image, use the
user to change or adjust the brightness and/or contrast of the image being
viewed. To adjust the brightness of an image, place the cursor over the image
needing to be adjusted, right click and drag the cursor up or down over the
image. When the mouse button is released, the new values will be applied to all
the images within the specific series. The new values are displayed in the lower
left corner of each image. To adjust the contrast of the image, follow the same
steps, but drag the cursor left and right over the image. The adjustment of the
brightness, the new values will be displayed in the lower left corner of each
image. (example Figure 8) Using the left, right, up and down arrow keys on the
keyboard will accomplish the same task.

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Figure 8

The pan tool

allows the user to move the image around the selected
window. When choosing this tool, it will assign to the left mouse key when
. To use this tool, position the cursor over the
assigned it will look like this:
image needed to be moved, click and drag the cursor around the pane to move
the image. When the mouse button is released, the image remains where it was
positioned. (example Figure 9)

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Figure 9

The probe tool,

, when chosen
, will give a pixel coordinate for a
given point. To use, click anywhere on the image and hold the mouse button
down to view the value of that specific point. (example Figure 10)

Figure 10

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The magnifying tool

when selected will be assigned to the right mouse

. This allows the user to zoom in or out of the

button and look like this:
image being viewed. Hold the right mouse button down and move the mouse
accordingly. If the cursor is moved up, the image will zoom in. If the cursor is
moved down, the image will zoom out. (example Figure 11)

Figure 11

To measure a linear distance, use the measure line tool

or when chosen

This will measure in centimeters, from point A to point

it will look like this:
B. Choose where to start the measure by clicking a point. Next, drag the mouse
to where the measurement will stop. When the mouse button is released, the
final measurement will show on the image in green. Should the measurement
need to be stretched, right click either end of the existing measurement line, drag
the cursor and drop where the measurement needs to end. To move the line
completely to another area of the image, right click anywhere on the line, drag
and drop to the new point of interest. The actual measurement will appear in a
green box called the caption on the measurement line. To move the
measurement caption, right click and drag to the desired location. (example
Figure 12)

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Figure 12

The area measurement tool

is used to measure an elliptical region of

. To use this tool, position the

interest. When chosen it will look like:
cursor at the starting point of interest, right click and drag to the ending point of
interest. When the mouse button is released, the measurement caption will show
in green, with the Area, Mean, and Standard Deviation. To stretch the ellipse,
right click one of the corner markers (+), drag and drop to desired location. To
move the ellipse, right click anywhere on the ellipse and drag and drop to desired
location. To move the measurement caption, right click the caption and drag and
drop to desired location. ***An ellipse that shows in green is the selected ellipse
and is able to be manipulated. If the ellipse is orange, it is an unselected ellipse.
(example Figure 13)

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Figure 13

Angles can also be measured

. The angle measurement will appear in
gold, if it has been selected. (example Figure 14)
Note:

This tool will only work if there are 2 intersecting lines.

Figure 14

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To clear the last measurement (linear, elliptical, or angle), click the clear
measurement

button. To clear ALL measurements on an image, click the

clear all measurements

button. (example Figure 15 and 16)

Figure 15

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Figure 16

To show only the current reference line on an image, choose the toggle current
reference line

button. (example Figure 17)

Figure 17
To show only the first and last reference line on an image, choose the toggle
first and last reference line
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eFilm RIS/PACS User Manual Version 2.0

Figure 18

To show all reference lines on an image, choose the toggle all reference lines
button. (example Figure 19)

Figure 19

Note: While scrolling through the different images, the reference lines will
change accordingly. Users can view the first and last reference lines and the
current reference lines at the same time
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To be able to view more than 2 images on the screen, choose the add column
or add row
button. To view images on the additional spaces, right
click the mouse and choose the series that need to be viewed in the additional
pane. (example Figure 20 and 21)

Figure 20

Figure 21

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To reset the series/image back to its original settings, click the reset image
button.

To improve viewing performance, select the download all

button. This
function will cache the entire study to the system. After selecting the download
all button, the following screen will be displayed:
Note: After selecting download all, do not take the focus off of the progress
screen. If users go to another Internet window or another program, the
downloading process will be interrupted, resulting in a partial download of the
study.

Download All
Upon completion, close the progress window and to scroll through each image.

If the study has key images, select the key image button
. A new window
will open and if there are key images they will appear to be displayed. If there
are no key images, a message will be displayed No Key Images Available.

When reviewing of the study is complete, click the close and return
button.

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Note: If the user viewing the study is a READING PHYSICIAN, once the close
and return button is clicked, they will be asked if they would like to mark the
study as read. Choose yes or no.

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Adding a referring physician login

This section describes the process of allowing secure remote access to referring
physicians.
To access images, key images and reports, the referring physician must be
explicitly defined in the system. Referring physicians can be added under
Edit/Physicians.

On the Referring Physicians page, click Add Physician.

Enter in the requested information and click save. The referring physician is
now saved in the Referring Physician List.

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If the referring physician is already saved in the physician list, search for the
physician by typing in the last name and clicking search.

Add a username/password for the referring physician by going to Admin/Users.

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In the Users page, click Add User.

Enter in the requested information.

Note: It is imperative that when selecting the role that referring physician is
selected from the dropdown list. If this field is not filled out properly, the
physician trying to access the system will be unable to view his/her patients
studies.

After completing the appropriate fields, click Next.

Next, enter the username and password for the new user and then click Finish.

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The new user will now show in the list on the Users page.
After a login for the referring physician has been added, it must be assigned to
the appropriate referring physician login in the physician list. Go to
Edit/Physicians and search for the target physician.

After searching and selecting the physician, click the edit button.

When the physician information opens, click the dropdown menu next to Ref
Phys Login. Search for the name of the username needed to assign to the
referring physician. After finding the physician, select and click the save button.
*** It is extremely important that the correct login is selected from the dropdown
list. If a login is assigned to the wrong referring physician, the physician that logs
in will be able to view studies/patients not referred by them. ***

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Once the login is selected, the Ref Phys Login field will now be populated and
the referring physician can now login and view their patients.

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Backing up studies using a 3rd party application

This section describes how to backup studies using a 3rd party application in
conjunction with eFilm.
Open eFilm
When backing up studies using the medical grade media DVD, go to
Edit/Properties.

Go to the preferences tab and change the Max. Capacity size to 4000 MB and
click OK.

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Select a date range. Its recommended that only a week is selected at a time.
Selecting a larger date range may cause eFilm to freeze. Once the date range is
specified, highlight all of the patients. Click the Burn CD button.

Under CD Title, type in the title for what is being backed up. It may be best to
simply use the date range for the title. Under CD Packager Options, choose
DICOMDIR with eFilm Lite. Do NOT select the Burn CD option. Click the
Continue button.

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Once the images are packaged, it will show where they are located. (There
should be a shortcut on the tech workstation desktop) Click the OK button.

Open the shortcut to eFilm CDs files on the desktop.

Open the CD burning program, e.g. Nero.
Under what would you like to burn, choose data, then data disk.
Click the add button then in the select files and folders window that pops up,
choose the correct file needed to burn.
Once the date range name that you need is found, click the name to highlight it,
and then click the add button.
Click the next button.
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In the disk name field, enter what the disk will be named, (we recommend the
same thing that you used in eFilm) then click the burn button.

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Backing up studies in eFilm Workstation

This section explains how to backup a study using eFilm Workstation.
Begin by opening eFilm.
When backing up studies using the medical grade media DVD, go to
Edit/Properties.

Go to the preferences tab and change the Max. Set the capacity size to the size
of the backup media and click OK.

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Under CD Title, type in the media name for the backup job. It may be best to
simply use the date range for the title. Under CD Packager Options, choose
DICOMDIR with eFilm Lite. Select the Burn CD option. Click the Continue
button.

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Once the images are packaged and copied to the DVD, click the OK button.

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HIS/RIS DLL
The purpose of the HIS/RIS Interface is to facilitate eFilm and PACS to
communicate, thereby streamlining your workflow and expedite the reading of
studies.
Begin by logging into the PACS. Browse to Support/Download. Click eFilm
HIS/RIS Interface Installer and save the application do the desktop. (Note: If the
file is not saved to the desktop, please note where the file is located).

Browse to downloaded application. Double-click to install application.

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Installation wizard opens. Click Next

Select Everyone and click Next.

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The application will install.

Click close to complete installation.

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Open eFilm Workstation.

On the menu, click on Edit/Properties.

The properties screen is displayed.

Select the HIS/RIS Interface tab.

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Click Browse button and navigate to C:\Program Files\Merge
Healthcare\eFilmRISPACSInterface-Network. Select and open
[Link].

Click the Settings button.

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Input your Username, Password and Web Server address. Select Enable Open
Study Prompts, Enable Close Study Prompts and Enable Network
Connections. Set Network Timeout to 30 seconds. Click OK. Close eFilm
Workstation.
Note: If you do not know your username, password and/or web server address,
please contact your system administrator.

Reopen eFilm Workstation.

Return to Edit/Properties/HIS/RIS Interface.

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Click the Verify button. Click OK upon successful verification. (Note: If the
verification fails, please contact your system administrator to verify your
username, password and web server address.)

In eFilm Workstation, go to Local Studies tab and click Clear Filter and then
the Search buttons. The study status and user name fields will now update.

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The Status column will display the current status of the study. UNREAD will
display if the study has not been interpreted. READ will be displayed if the
study has been interpreted and marked READ by a physician. STAT will be
displayed if the study is UNREAD and marked as a STAT in the system.
The User column will be either blank or display a username. If a username
appears next to a study, it has been marked Read. If the row is blank, the study
has not been Read.

Open a study and the initial prompt is displayed. Click OK to view the study.
Click History to view the patient history (if it exists).

Study will now open. Click the Create Report button to create a report for the
study. The browser will open to the Report Wizard.

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Click the View Report button to open the eFilm RIS/PACS toolbar. The
History button will display the patients history if it exists. The Documents
button will display any documents associated with the patient. The Priors button
will display priors for the patient if they exists. The View Rpt Button will show
any reports for the patient if they exist. The Create Rpt button will open the
Report Wizard to generate a new report. The Close button will close the
toolbar. When a button is selected, the browser will open to display the selected
information.

Upon closing a study the system will prompt the user to Mark the study as read.
If the current user is not displayed under User, select the New User button.
Note: It is extremely important that the user checks to make sure who the
current user is in eFilm. If they are not listed as the current user and choose the
current user button, then whoever IS the current user will be whose name has
marked the study read. To check to see who the current user is, look just
above the current user button and it will be listed.

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To change the current user, input the User Name and Password of the current
user. If you would like to save the new user as default, select the check box next
to Set this as default user? and click OK.

Go to Local Studies and click Clear Filter and then the Search buttons. The
study status and user name fields will now update.
The Status column will display the current status of the study. UNREAD will
display if the study has not been interpreted. READ will be displayed if the
study has been interpreted and marked READ by a physician. STAT will be
displayed if the study is UNREAD and marked as a STAT in the system.
The User column will be either blank or display a username. If a username
appears next to a study, it has been marked Read. If the row is blank, the study
has not been Read.

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Key Images
The system allows key images to be selected and created for final reports and
web viewing. The DICOM files are converted to JPEG for web viewing. This
section describes the process of creating and accessing key images.
eFilm Workstation Key Image Creation
The user selects and views a study in eFilm Workstation. To select key images,
the user checks the box at the bottom right corner of each image/series. eFilm
will retain the manipulations made to key images, e.g., pan, zoom,
measurements, annotations, etc.
While viewing a study in eFilm, mark the appropriate images as key images by
clicking the image marker in the lower right corner of the image. Once an image
is selected, the marker will fill in yellow. Figure: Key Image 1

Key Image 1
Upon selection of all key images, click the create scrapbook button. Figure: Key
Image 2

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Key Image 2
When the Create Scrapbook window opens, be sure that the scrapbook type
selected is WYSIWYG (What You See Is What You Get) and click the create
button. When asked Do you wish to send the scrapbook images?, click Yes.
Select the Store Server entry to send the images back to eFilm RIS-PACS.
(Please refer to the eFilm Workstation Setup for more information on how to
setup the Store Server in the Remote Devices as a send-to destination)
After sending the key images to eFilm RIS-PACS, the images are accessible in
several methods.
1. In the ActiveX Web viewer, click the key button. (Please refer to the ActiveX
Web Viewer Instruction on more information regarding the buttons). The key
images are also available as a series.
2. View the printable report for the study with key images. The key images will
show on the pages following the text of the report. Figure: Key Image 3

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Key Image 3
3. The referring physician can view the key images by clicking on the Key
Image button. The key images are also available in the ActiveX viewer and
on the report.

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DICOM Dir/eFilm Lite Prefetch

The DICOM Dir/eFilm application allows studies to be securely received by
remote clients. This section describes installation and use of the software.
Download Application
Download the installer from Support/Downloads. On the Download page, click
on DICOM Dir Installer.

Click save to retrieve the file to your computer.

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Select the location to save the file, e.g., C:\Apps, and then click save.
Once the download is complete click close.

Install Application
Browse to where the file is saved and unzip. Once the file is unzipped, open the
target folder (where you unzipped the file) to access the installer.
To install, double click on the installer.

Click next

Select everyone and click next.

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Click next

The user will be prompted to enter the server name, username and password.

The server name is URL (web address or IP) of the PACS.

The username/password is the same as the PACS login. Select the set as
default button.
Click save to confirm the settings. Click the X to close the window.

Leave the folder name as the default and click save.

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When the user receives the prompt to wait while eFilm view is being copied, click
ok.
Note:

This may take several seconds.

Once the viewer is copied, click ok. After the settings are saved successfully,
click ok.

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Close the window by clicking the X. Upon completion of installation, click close.

Setup Application
The prefetch can first be accessed by going to Start/All Programs. After clicking
the icon, it will
show in the system tray. To access the settings, right click on the icon in the
system tray.

Launch eFilm Lite, will open the eFilm Lite viewer.

DICOMDir Directory shows the path of the directory. If you select cleanup
DICOM Directory,
it will delete all the files copied to the directory. If this is selected,
the user will then need to again copy the eFilm Lite Viewer. This can be done
by clicking the button on this screen.

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Configuration allows the user to enter changes to the server name, username
and password.
Watermark allows the user to change/set the percentage of studies allowed to
stay in the DICOM directory. When the high watermark is triggered, it will start
deleting the studied until it reaches the low watermark setting.

Interval determines the amount of time the application will wait before checking
for new studies.
Status shows the progress of the studies being transferred from the server to the
eFilm Lite Prefetch viewer.

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About displays the version and copyright information of the application.

Once studies are retrieved from the server to the eFilm Lite viewer, the icon in
the system tray will turn white.

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Icon Statuses:

No new studies

New studies

Double click on the icon to open the eFilm Lite viewer.

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How to allow pop-ups

To use the system, pop-ups must be enabled. This section describes the
process of allowing pop-ups in Internet Explorer.
Go to the tools menu, choose pop-up blocker, pop-up blocker settings.

Enter the site name of where pop-ups need to be allowed, e.g.,

|[Link] and click Add.

Once the site has been added, click Close.

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How to import studies from media to eFilm

Workstation
This section describes the process of restoring DICOM files to eFilm
Workstation.
Install your media device.
In eFilm, go to File/Import/DICOM Images

Select the appropriate media drive from the list (this is where you are importing
the images from). Double click on the drive, the click on the patient folder that
shows. Then click ok.

Once the ok button is clicked, the user will see the transfer of images. After that,
select the date of service that patient was seen and the user should be able to
now see the patient on the study list.

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Referring Physician Setup

This section describes the process of setting up a referring physician to access
the system. Authenticated referring physicians are able to securely view their
reports and images.
Type the web address into you internet browser
Log into system
Username
Password (see Figure 1)

Figure 1
Make sure that the pop-up blocker is turned off. If the pop-up blocker is turned
on, the referring physician will have problems viewing the system.
Follow these instructions to turn the pop-up blocker off.
To turn the pop-up blocker off, go to the tools menu in Internet Explorer, choose
Pop-up Blocker, and then choose Pop-up Blocker Settings.

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Enter the name of the site where pop-ups should be allowed, then click the add
button.

Once the site has been added, click the close button at the bottom of the
window.

Click on the Workflow tab. Find the study date that needs to be reviewed or the
user can search by name. To search by name type the last name in the Patient
Search field and select search all dates. (see Figure 2)
Note: The user may be prompted to install an ActiveX program. If prompted,
please select OK

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Figure 2
Click on the patients name whose study needs to be reviewed. (Figure 3)

Figure 3
Web viewer will open.
Note: The user may be prompted to install two (2)
ActiveX programs. If prompted, please select OK
When the web viewer opens, click the question mark (?) should the user need to
use the ActiveX user guide. (Figure 4) Once the user has completed reviewing
the study, click close and return.

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Figure 4
To view the corresponding report, click on the number under Fin. This stands for
Final Report. (Figure 5)

Figure 5
Click the report(s) needed to be viewed.
Note:

Adobe Acrobat Reader must be installed to view the reports

If there are key images that the radiologist selected, they can be viewed 1 of 3
ways. By clicking the key button while in the web viewer. (Figure 6) a new
window will open and if there are key images they will be here. If there are no
key images it will say No Key Images to Display.

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Figure 6

When viewing the report, the key images will appear at the end of the report.

Click on the key button in the Action column. A new window will open and if
there are key images they will be here. If there are no key images it will say Key
Images Not Available.

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Key Images Action Button

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Quick Setup Manual

Thank you for purchasing eFilm RIS/PACS. We appreciate your business and
look forward to working with you. The manual herein will serve as a guide to
setting up the system. We have made every effort to provide an easy quick
setup, however some items may require a qualified system administrator. If you
have any questions, please contact support or your system administrator. If you
contact support through the ticketing system or email, be sure to include your
name, company name, phone, fax, email and order number, so we can provide
prompt support. We also recommend you study the full system manual to
become familiar with the system.
Caution: The following quick setup manual should only be completed by a
qualified IT/IS person. If you are unsure about the setup information below,
please contact your systems administrator. Proceed with caution.

Hardware Setup
1) Unpack server and hardware components
2) Plug server into a battery backup (minimum of 1000VA)
3) Plug network cable into server
4) Install any peripherals, e.g., mouse, keyboard, LCD, etc.
5) If applicable plug fax line into the line in port on the modem
Server Setup
1) Power on server
2) Press control/alt/delete
3) Login to server with username/password provided (default =
Administrator/fusion123)
Note: Do not change the system password. It is required for the system to
function.

4)
5)
6)
7)

Click start/control panel/network connections

Right click on Local Area Network1 and click properties
Select TCP/IP and click properties
Enter an available private IP address, subnet mask, gateway, primary DNS,
secondary DNS

Note: DO NOT join the system to a domain. Any available IP on your local
subnet may be used. If you unsure about the IP settings of the system, please
contact support or your system administrator.

8) Click ok, ok and close

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9) Setup Modem(s):
Click start/control panel/phone and modem options
Input your local area codes and any prefix required for outbound dialing
10) Install a SSL certificate (https encryption for HIPAA privacy requirements):
Note: Customers are responsible for purchasing and obtaining an SSL certificate.
If you have questions about how to obtain a SSL certificate, please contact your
system administrator or Internet Service Provider (ISP). An example of a secure
certificate is |[Link] This will require a certificate
from a certificate authority and a DNS A record for your domain.

168

Click start/control panel/administrative tools/internet information services

(IIS)manager
Click the + next to your server name
Click the + next to websites
Right click on the default website
Click properties
Click the directory security tab
Click server certificate
Click next
Click create a new certificate
Click next
Click prepare the request now, but send it later
Type the name of your website that you are requesting a certificate for,
e.g., [Link]
Leave bit length at 1024 and select cryptographic service provider
(CSP) unchecked
Click next
Type in your organization name, e.g., ACME Imaging
Type in your organization unit, e.g., Diagnostic Imaging
Type in your common name, e.g., [Link]. Please
note this must be a fully qualified domain name that you own.
Click next
Select your country, state and city
Click next
Select where you would like to store the request, e.g., c:\[Link].
Make sure to note where you store the file. You will need the file/text to
order your secure certificate.
Click next, next, finish
The file is now available for you to request the certificate.
Contact your system administrator/ISP/domain name authority to order
the certificate
Upon receipt go back to the IIS services/default website as described
above
Under the directory security tab, click server certificate
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eFilm RIS/PACS User Manual Version 2.0

Select process the pending request and install the certificate

Click next
Locate and install the file provided by your certificate authority
Click next, next finish
Your certificate is now installed
Note: Upon successful installation of your certificate and the appropriate
DNS settings, outside users can securely access the system by using
the https protocol (TCP 443), e.g., |[Link]

PACS Access Setup

1) Using a computer on your local area network, open Internet Explorer
2) In the address bar, type the assigned local IP of the PACS server (as defined
above), e.g., |[Link] If a certificate is installed and the
appropriate DNS entries are made, you can access your system remotely by
using the domain name, e.g., |[Link]
3) The PACS login screen will be displayed
4) Type in the administrator username/password (default =
admin/yourpassword) See the note below for information on your unique
password.
Note: The unique password for accessing your system is provided in the traveler
that was included in the original shipment.

5) Begin by adding clinics. Navigate to Admin/Clinics

Add Clinic demographic information

Select the Prefix for your patient IDs. This is used to identify your
facility. For example if you are ACME Imaging, you may want to
select A.

Upload logo for Reports by clicking browse (note the file must be a
JPG with maximum dimensions of 300px wide by 120px high)

Use your favorite HTML editor to create the footer for your reports.
Here is a sample that may be used (copy and paste into a HTML
editor):
ACME
Imaging 
123 Bayou Blvd., Houston, Texas 77380 | Phone
555.555.5555 | Fax 555.555.5556 
Web <a
href="[Link]
om</a> |
Email <a
href="[Link]
.com</a>

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Add website information as defined above, e.g.,

|[Link]

Click Save.
6) Add your email server information by going to Admin/Email Rpts. This page
allows you to specify your mail server information to send support requests
and report notifications by email. Please note that report notifications sent by
email DO NOT contain patient identifiable information. They are provided to
notify referring physicians of a new report/images to review. Here are
sample entries and their descriptions:

From email address: |ReportNotification@[Link]

(This will be displayed as the sending email address)

Email username: |support@[Link] (This is your

username for your SMTP server specified below)

Email password: 123468 (This is your password for your SMTP

server specified below. Please note the characters/numbers will be
masked)

SMTP server: [Link] (This is the full DNS

address for your SMTP, i.e., outgoing server)

Web Server Address: |[Link] (This

address will be included on report/support notices as a hyperlink to
login and access reports/images)
7) Setup systems preferences under Admin/Config

Required Fields
o Select the demographic fields that will be required and/or skippable
(able to be temporary bypassed by users) by going to
Admin/Options

Clinic, Misc. Settings

o Login Page Logo
a. Click default logo to browse/upload your logo. The image
must be JPG with maximum dimensions of 250px wide by
120px high.

eFilm ActiveX Settings

a. This option must be configured for your online image viewer
to work. Please do the following:
b. Click the hyperlink eFilm ActiveX Settings
c. Local Web URL Reference: Input your system NetBIOS
name and local IP, e.g., PACSSERVER, [Link]. If
you are unsure how to do this, please contact your network
administrator.
d. Local Image Channel IP: Input your local IP, i.e., the IP of
the PACS, e.g., [Link]. If you are unsure how to do
this, please contact your network administrator.
e. Remote Image Channel IP: Input your public IP (provided by
your ISP), e.g., [Link]. This must be a public,
routable IP. If you are unsure how to do this, please contact
your network administrator.
f. Please note that the following ports MUST be forwarded to
your internal PACS server: TCP 443, 3333. If you are
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9)
10)

11)
12)

13)

14)
15)
16)

17)
18)
19)
20)
21)

unsure how to do this, please contact your network

administrator.
g. Click Save (you can always go back later to make changes)
Scanning DLL registration code
Click the hyperlink to input your registration code. To obtain your registration
code, you must email your full domain name, e.g.,
|[Link] to support@[Link]. A
registration code will be provided within 72 hours of original email (excluding
weekends/holidays). Upon receipt of registration code, enter your full
domain name, e.g., |[Link] , and registration
code (provided by Merge Healthcare) and click save.
Schedule Settings

Click Schedule Settings to specify your operation hours. For example,

if open at 8:00 a.m. and close at 5:00 p.m., you would select the start
time of 8:00 a.m. and 9 as the length of hours. When you are
complete, click Save.
DICOM Service Settings
DICOM Image Storage Server (NetBIOS name)
Click the name and verify it matches the NetBIOS name of your server.
You can view your NetBIOS name by right click on My Computer selecting
properties, clicking the Computer Name tab. The NetBIOS name of your
system will be displayed adjacent to Full computer name (Note: Do not
include the . at the end of the name)
DICOM Image Storage Path
Do not change this value
DICOM Image Storage Username
Password should match your Local System Administrator account username,
i.e., Administrator. Do not change this value
DICOM Image Storage Server Password
Password should match your Local Administrator account password, e.g.,
fusion123
Modality Worklist Path
Do not change this value. It defines the path of the modality worklist files.
Modality Worklist Sending Server (Modality Worklist AE Title)
Do not change this value. Default is EFILMRISPACSWL
Key Image Convertor Service
Key Image Layout

Select the number of columns/rows of key images on reports

JPEG Path
Do not change this value. It defines the path of the key images directory.
Accession Separator (in powers of 10)
Do not change this value.
Default Command Line Arguments
Do not change this value.
SOPClassUID Exceptions
Do not change this value.
Fax Service Settings
Local Area Codes (Area codes for which adding the dialing prefix '1' will not
be necessary.)
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22)
23)
24)
25)
26)

27)

28)

172

Enter area codes that do not require 1 to fax. Separate values by a comma,
e.g., 936,832,713, etc.
Report Wizard URL
Do not change this value
Report Document URL
Do not change this value
Update Status URL
Do not change this value
FTP Path
Do not change this value
Add any DICOM target servers that studies will be sent to by going to
Admin/Servers. These devices are known as DICOM hosts or nodes.
Specify the description, AE (Application Entity) Title, Hostname (IP), Port,
Server Limit (number of concurrent connections to server), Retry Limit
(number of retries upon fail), Retry Time (amount of time between retries)
and type of host. All DICOM devices that will be pulling using the
query/retrieve method must be in this list. See the eFilm Workstation
Setup below for further information. If you are unsure how to do this, please
contact your network administrator.
Setup your DICOM Servers Services by going to Admin/Services. Click the
edit button under the action column to make changes. This page is helpful to
see the status of the DICOM services and restart them if necessary. (Note:
We recommend that you do not change these values).
DICOM Store Server: Specify the AE Title and port for this DICOM store
server (AE Titles ARE case sensitive). The DICOM store server is used
by modalities and other devices to send, store or push studies to the
PACS server.
DICOM Query/Retrieve Server: Specify the AE Title and port for this
DICOM Q/R server (AE Titles ARE case sensitive). The DICOM Q/R
server is used by modalities and other devices to query and pull studies
to the PACS server. It also is used to manually/automatically transfer
studies.
DICOM Image Channel Server: Specify the AE Title and port for this
DICOM IC server (AE Titles ARE case sensitive). The DICOM IC server
is used by devices to compress and pull studies from the PACS server.
DICOM Modality Worklist Server: Specify the AE Title and port for this
DICOM modality worklist server (AE Titles ARE case sensitive). The
DICOM modality worklist server is used by modalities and other devices
to query and obtain patient scheduling information and demographics.
This is useful for productivity and data integrity, i.e., data is entered only
once. Note that modality worklist must be supported by the modality. If
you are unsure about the capabilities/programming of your modalities,
please contact your modality/network engineer. (Note: We highly
recommend you do not change these values).
Add users by going to Admin/Users. Users can be managed in this section.
You can add, edit, activate/deactivate users, and reset passwords based on
your organization needs. For more information on user types and policies,
please refer to the system manual.

eFilm RIS/PACS User Manual Version 2.0

29) Admin/Utilities will allow you to view the storage watermarks of your system.
When storage reaches the high watermark, i.e., number of licensed archived
studies, the last accessed/last viewed studies will be removed until the low
watermark, i.e., number of licensed archived studies is reached. For more
information, please consult the System Manual.
30) Edit/Password will allow users to change their passwords.
31) Add Modalities by going to Edit/Modalities (Note: If you have more than one
clinic or modalities of the same type, be sure that you provide unique names
for your modalities). The system is pre-populated with several modalities.
Please refer to the system manual for more information on setting up your
modalities. (Note: After a modality has been added it CANNOT be removed.
Proceed with caution).
32) Add Procedures and schedule time durations by going to Edit/Procedures.
The system is pre-populated with several common procedures. Please refer
to the system manual for more information on setting up your procedures.
33) Add any known referring physicians by going to Edit/Referring Physicians.
Please refer to the system manual for more information.
34) Add any known insurances by going to Edit/Insurance. Please refer to the
system manual for more information.
35) Add/modify report templates/macros under Edit/Templates. The system is
pre-populated with several common templates. This section is used to
create normals and frequently used reports to aid in operational efficiency.

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Modality Worklist Setup

The PACS System is capable of providing DICOM Modality Worklist for
Modalities that are capable of this function. DICOM Modality Worklist allows
Modalities to query the server for Schedule/Patient information, thereby negating
duplicate data entry and ensuring data integrity. Go to Admin/Services to locate
the AE Title and port. Record the modality worklist settings.

Modality Worklist Settings

The default information for DICOM Modality Worklist is:
AE Title:
Port:

EFILMRISPACSWL
106

Note: DICOM Modality Worklist is a feature of some Modalities. Please contact

your Modality manufacturer to determine if your modality is DICOM Modality
Worklist capable. In some cases the modality will not support this function or it
will require an upgrade that will result in additional costs by your modality
manufacturer. These costs are not included as part of the PACS. If the modality
is capable, it may be necessary to have the Modality Engineer program the
system to use this feature. Programming the modality may also result in
additional fees by your modality manufacturer. These costs are not included as
part of the PACS.
The IP of the server is also necessary to use the Modality Worklist server.
Please contact your system administrator if you are unsure of the IP.
Friendly Name

Hostname/IP

AE Title

Port

Modality Worklist

[Link]

EFILMRISPACSWL

106

Note: This table is only an example. Please use your unique information.
Modality Worklist Sample Information Table

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HL7 Export Specifications

eFilm RIS/PACS HL7 Export Specifications
Introduction
This document defines the Health Level Seven (HL7) interface specifications of
eFilm RIS/PACS s HL7 Export feature. eFilm RIS/PACSs appointments are
exported as ADT A01 messages.
Document Sources

HL7 standard version 2.3 and 2.3.1

Integrating the Healthcare Enterprise (IHE) technical framework year 2

Abbreviations and Symbols

The following symbols and abbreviations are used:
ADT Admission, Discharge and Transfer System
DICOM Digital Imaging and Communications in Medicine
HIS Hospital Information System
HL7 Health Industry Level 7 Interface Standard
IHE Integrating the Healthcare Enterprise
LLP Lower Layer Protocol
PACS Picture Archiving and Communications System
RIS Radiology Information System
TCP/IP Transmission Control Protocol/Internet Protocol
UID Unique Identifier
Functional Situations
eFilm RIS/PACS s exports ADT A01 message which contains patient, study,
guarantor and insurance information.
These messages are imported by other HL7 compliant applications, e.g., Billing
Systems, Hospital Information System, and Radiology Information System.
HL7 Message Specification
Message Export: ADT ^ A01

Functional
Situation

Message

Event

Description

Admission

ADT/ACK

A01

Admit a patient

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Message definition
Segments relevant to ADT A01 enumerated hereafter.
Admission, Discharge and Transfer

178

Segment

Name

Required

MSH

Message Header

PID

Patient Identification

NK1

Next of Kin

GT1

Guarantor

IN1

Insurance

ACC

Accident

DB1

Disability

IN2

Insurance

eFilm RIS/PACS User Manual Version 2.0

The following defines fields and if they are required in each segment. All required
fields will be present in the output message.
MSH Segment
Name

Field No

Field Name

Required

MSH

MSH-1

[Field Separator]

MSH-2

[Encoding Characters]

MSH-3

[Sending Application]

MSH-4

[Sending Facility]

MSH-5

[Receiving Application]

MSH-6

[Receiving Facility]

MSH-7

[Message Date/Time]

MSH-8

[Security]

MSH-9

[Message Type]

MSH-9-1

[Message Type]

MSH-9-2

[Trigger Event]

MSH-10

[Message Control ID]

MSH-11

[Processing ID]

MSH-12

[Version ID]

MSH-13

[Sequence Number]

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PID Segment

180

Name

Field No

Field Name

Required

PID

PID-1

[Set ID]

PID-2

[Patient ID External]

PID-3

[Patient ID Internal]

PID-4

[Alternate Patient ID]

PID-5

[Patient Name]

PID-6

[Mothers Maiden Name]

PID-7

[Date of Birth]

PID-8

[Sex]

PID-9

[Patient Alias]

PID-10

[Race]

PID-11

[Patient Address]

PID-12

[County Code]

PID-13

[Home Phone]

PID-14

[Business-Phone]

PID-15

[Language]

PID-16

[Marital Status]

PID-17

[Religion]

PID-18

[Account Number]

PID-19

[SSN Number]

eFilm RIS/PACS User Manual Version 2.0

PV1 Segment
Name

Field No

Field Name

Required

PV1

PV1-1

[Set ID]

PV1-2

[Patient Class]

PV1-3

[Assigned Patient Location]

PV1-4

[Admission Type]

PV1-5

[Preadmit Num]

PV1-6

[Prior Patient Location]

PV1-7

[Attending Doctor]

PV1-8

[Referring Doctor]

PV1-8-1

[ID Num]

PV1-8-2

[Family Name & Last Name Prefix]

PV1-8-3

[Given Name]

PV1-8-4

[Middle Initial or Name]

PV1-8-5

[Suffix]

PV1-9

[Consulting Doctor]

PV1-10

[Hospital Service]

PV1-11

[Temporary Location]

PV1-12

[Pre-Admit Test Indicator]

PV1-13

[Re-Admit Test Indicator]

PV1-14

[Admit Source]

PV1-15

[Ambulatory Service]

PV1-16

[Vip Indicator]

PV1-17

[Admitting Doctor]

PV1-18

[Patient Type]

PV1-19

[Visit Number]

PV1-20

[Financial Class]

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Name

182

Field No

Field Name

Required

PV1-21

[Charge Price Indicator]

PV1-22

[Courtesy Code]

PV1-23

[Credit Rating]

PV1-24

[Contract Code]

PV1-25

[Contract Effective Date]

PV1-26

[Contract Amt]

PV1-27

[Contract Period]

PV1-28

[Interest Code]

PV1-29

[Transfer To Bad Debt Code]

PV1-30

[Transfer To Bad Debt Date]

PV1-31

[Bad Debt Agency Code]

PV1-32

[Bad Debt Transfer Amount]

PV1-33

[Bad Debt Recovery Amount]

PV1-34

[Delete Account Indicator]

PV1-35

[Delete Account Date]

PV1-36

[Discharge Disposition]

PV1-37

[Discharged To Location]

PV1-38

[Diet Type]

PV1-39

[Servicing Facility]

PV1-40

[Bed Status]

PV1-41

[Account Status]

PV1-42

[Pending Location]

PV1-43

[Prior Temporary Location]

PV1-44

[Admit Date/Time]

PV1-45

[Discharge Date/Time]

PV1-46

[Current Patient Balance]

eFilm RIS/PACS User Manual Version 2.0

ACC Segment
Name

Field No

Field Name

Required

ACC

ACC-1

[Accident Date/Time]

ACC-2

[Accident Code]

DB1 Segment
Name

Field No

Field Name

Required

DB1

DB1-1

[Set ID]

DB1-2

[Disabled Code]

DB1-3

[Disabled Person ID]

DB1-4

[Disabled Indicator]

DB1-5

[Disability-Start-Date]

DB1-6

[Disability End Date]

DB1-7

[Return to Work Date]

DB1-8

[Unable To Work Date]

DB1-9

[]

EVM Segment
Name

Field No

Field Name

Required

EVM

EVN-1

[Event Type Code]

EVN-2

[Date/Time of Event]

EVN-3

[Date/Time Planned Event]

EVN-4

[Event Reason Code]

EVN-5

[Operator ID]

EVN-6

[Event Occurred]

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GT1 Segment

184

Name

Field No

Field Name

Required

GT1

GT1-1

[Set ID]

GT1-2

[Guarantor Number]

GT1-3

[Guarantor Name]

GT1-4

[Guarantor Spouse Name]

GT1-5

[Guarantor Address]

GT1-6

[Guarantor Phone - Home]

GT1-7

[Guarantor Phone - Business]

GT1-8

[Guarantor Date Of Birth]

GT1-9

[Guarantor Sex]

GT1-10

[Guarantor Type]

GT1-11

[Guarantor Relationship]

GT1-12

[Guarantor SSN]

GT1-13

[Guarantor Date - Begin]

GT1-14

[Guarantor Date - End]

GT1-15

[Guarantor Priority]

GT1-16

[Guarantor Employer Name]

GT1-17

[Guarantor Employer Address]

GT1-18

[Guarantor Employer Phone]

GT1-19

[Guarantor Employee ID Num]

GT1-20

[Guarantor Employment Status]

GT1-21

[Guarantor Organization]

eFilm RIS/PACS User Manual Version 2.0

IN1 Segment
Name

Field No

Field Name

Required

IN1

IN1-1

[Set ID]

IN1-2

[Insurance Plan ID]

IN1-3

[Insurance Co ID]

IN1-4

[Insurance Co Name]

IN1-5

[Insurance Co Address]

IN1-5-1

[Street Address]

IN1-5-2

[Other Designation]

IN1-5-3

[City]

IN1-5-4

[State Or Province]

IN1-5-5

[Zip or Postal Code]

IN1-6

[Insurance Co Contact Person]

IN1-7

[Insurance Co Phone]

IN1-8

[Group Number]

IN1-9

[Group Name]

IN1-10

[Insurance Group Employer ID]

IN1-11

[Insurance Group Employer Name]

IN1-12

[Plan Effective Date]

IN1-13

[Plan Expiration Date]

IN1-14

[Authorization Info]

IN1-15

[Plan Type

IN1-16

[Name of Insured]

IN1-17

[Insured Relationship To Patient]

IN1-18

[Insured Date of Birth]

IN1-19

[Insured Address]

IN1-20

[Assignment Of Benefits]

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Name

186

Field No

Field Name

Required

IN1-21

[Coordination Of Benefits]

IN1-22

[Coord of Benefits Priority]

IN1-23

[Notice of Admission Code]

IN1-24

[Notice of Admission Date]

IN1-25

[Report of Eligibility Code]

IN1-26

[Report of Eligibility Date]

IN1-27

[Release Info Code]

IN1-28

[Pre-Admit Certification]

IN1-29

[Verification Date]

IN1-30

[Verification By]

IN1-31

[Type of Agreement Code]

IN1-32

[Billing Status]

IN1-33

[Lifetime Reserve Days]

IN1-34

[Delay Before L R Day]

IN1-35

[Company Plan Code]

IN1-36

[Policy Number]

IN1-37

[Policy Deductible]

IN1-38

[Policy Limit - Amount]

IN1-39

[Policy Limit - Days]

IN1-40

[Room Rate - Semi-Private]

IN1-41

[Room Rate - Private]

IN1-42

[Insured Employment Status]

IN1-43

[Insured Sex]

IN1-44

[Insured Employer Address]

eFilm RIS/PACS User Manual Version 2.0

Sample HL7 ADT Export Files
MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100|
|ADTÂ01|1077301446|P|2.3|
EVN|A01|200708221100|||2018670553|
PID|0001|0000003|||PATIENT3||19700101|F|||ADDRESS||||ENG|A|PEN|0000000
03|
PV1|1|O|||||PHYSICIAN|Smith^John^^^M.D.||||||||||||||||||||||||||||||||||||8/21/2007
7:00:00 AM|8/21/2007 7:00:00 AM|
GT1|||husband|||||||||||||retired|||||
IN2||||Medicare|P.O. Box 4444^^Dallas^TX^12222||1-888-2005120||205|||||||self||19700101|||||||||||||||||||||||||F|
ACC||
DB1|||||||||
MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100|
|ADTÂ01|1077301446|P|2.3|
EVN|A01|200708221100|||2018670553|
PID|0001|0000007|||PATIENT7||19700101|M|||ADDRESS||||ENG|A|PEN|000000
007|
PV1|1|O|||||PHYSICIAN|Jacobson^John^^^M.D.||||||||||||||||||||||||||||||||||||8/21/2007
7:45:00 AM|8/21/2007 7:45:00 AM|
GT1|||||||||||||||||||||
IN2||||Self Pay|^^^^|||||||||||||19700101|||||||||||||||||||||||||M|
ACC||
DB1|||||||||
MSH|^~\\&|eFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100|
|ADTÂ01|1077301446|P|2.3|
EVN|A01|200708221100|||2018670553|
PID|0001|0000006|||PATIENT6||19700101|M|||ADDRESS||||ENG|A|PEN|000000
006|
PV1|1|O|||||PHYSICIAN|Smith^John^^^M.D.||||||||||||||||||||||||||||||||||||8/21/2007
8:00:00 AM|8/21/2007 8:00:00 AM|
GT1|||||||||||||||||||||
IN2||||CASH|^^^^|||||||||||||19700101|||||||||||||||||||||||||M|
ACC||
DB1|||||||||
MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100|
|ADTÂ01|1077301446|P|2.3|
EVN|A01|200708221100|||2018670553|
PID|0001|0000001|||PATIENT1^^^^||19700101|M|||ADDRESS||||ENG|A|PEN|000
000001|
PV1|1|O|||||PHYSICIAN|Doe^John^^Dr.^||||||||||||||||||||||||||||||||||||8/21/2007 8:30:00
AM|8/21/2007 8:30:00 AM|
GT1|||SELF|||||||||||||JOB|||||
IN2||||Aetna|P.O. Box 123^^Blue Bell^PA^19422||1-800-6666666||11235|||||||self||19700101|||||||||||||||||||||||||M|
ACC||
DB1|||||||||

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MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100|
|ADTÂ01|1077301446|P|2.3|
EVN|A01|200708221100|||2018670553|
PID|0001|0000002|||PATIENT2^^^^||19700101|M|||ADDRESS||||ENG|A|PEN|000
000002|
PV1|1|O|||||PHYSICIAN|Doe^John^^Dr.^||||||||||||||||||||||||||||||||||||8/21/2007 9:45:00
AM|8/21/2007 9:45:00 AM|
GT1|||SELF|||||||||||||n/a|||||
IN2||||BCBS|P.O. Box 660044^^Dallas^TX^77000||1-800-5555555||59903|||||||self||19700101|||||||||||||||||||||||||M|
ACC||
DB1|||||||||
MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100|
|ADTÂ01|1077301446|P|2.3|
EVN|A01|200708221100|||2018670553|
PID|0001|0000004|||PATIENT4||19700101|M|||ADDRESS||||ENG|A|PEN|000000
004|
PV1|1|O|||||PHYSICIAN|Washington^George^^^D.O.||||||||||||||||||||||||||||||||||||8/21/20
07 10:00:00 AM|8/21/2007 10:00:00 AM|
GT1|||||||||||||||||||||
IN2||||CASH|^^^^|||||||||||||19700101|||||||||||||||||||||||||M|
ACC||
DB1|||||||||
MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100|
|ADTÂ01|1077301446|P|2.3|
EVN|A01|200708221100|||2018670553|
PID|0001|0000005|||PATIENT5||19700101|M|||ADDRESS||||ENG|A|PEN|000000
005|
PV1|1|O|||||PHYSICIAN|Jacobson^John^^^M.D.||||||||||||||||||||||||||||||||||||8/21/2007
10:30:00 AM|8/21/2007 10:30:00 AM|
GT1|||SELF|||||||||||||HISD|||||
IN2||||cigna|1263 main^^houstonÂL^77007||713-4575632||33599|||||||self||19700101|||||||||||||||||||||||||M|
ACC||
DB1|||||||||
MSH|^~\\&|EFilmRISPACS|DEMO|BillingSystems|BillingSystems|200708221100|
|ADTÂ01|1077301446|P|2.3|
EVN|A01|200708221100|||2018670553|
PID|0001|000000009|||Leventhal^Lesli^^^||19780101|F|||ADDRESS||||ENG|A|PE
N|000000021|
PV1|1|O|||||PHYSICIAN|Doe^John^^Dr.^||||||||||||||||||||||||||||||||||||8/21/2007 11:00:00
AM|8/21/2007 11:00:00 AM|
GT1|||||||||||||||||||||
IN2||||Aetna|P.O. Box 123^^Blue Bell^PA^19422||1-800-6666666|||||||||||19780101|||||||||||||||||||||||||F|
ACC||
DB1|||||||||

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eFilm Workstation Setup

The following information will guide you through setting up eFilm Workstation to
interact with the PACS Server.
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
14)

Open eFilm
Go to Utility/Process Manager
Click Settings
Record AE Title
Record Port
Click Ok
Close the Process Manager
Go to Start/Run
Type cmd
In the black command box, type ipconfig
Click enter
Record your IP address (Note: All eFilm workstations must have a static IP)
Close the command prompt
Create a spreadsheet to define your eFilm Workstations (see Table 1)

Caution: Patient information is considered protected. If you are unsure

about how to setup DICOM nodes, please contact support or your PACS
Administrator. Proceed with caution.

191

eFilm RIS/PACS User Manual Version 2.0

Friendly Name

Hostname/IP

AE Title

Port

Type

Radiology WS 1

[Link]

RADWS1

4006

Workstation

Radiology WS 2
Tech Review
WS
Backup Archive

[Link]

RADWS2

4006

Workstation

[Link]

TECHWS1

4006

Workstation

[Link]

BACKUP1

4006

Server

Note: This table is only an example. Please use your unique information.
Table 1
15)
16)
17)
18)

Open eFilm
Click Edit/Properties
Go to the Remote Device tab
Enter the Store Server information:
a.
Description Enter the friendly name of your server, e.g.,
EFILMRISPACS-STORE (choose a name that is easily identifiable)
b.
AE Title Application Entity Title for your server, e.g.,
EFILMRISPACS (Note: AE Titles are case sensitive)
c.
Hostname Enter the IP address of your server, e.g., [Link]
d.
Port: Enter the server port for your server, e.g., 104
e.
Type: Select Server
f.
Default: Leave unchecked
g.
Click Add
h.
Select the server you entered
i.
Click Verify
j.
If the server does not verify, please repeat and verify the information
above.
19) Enter the Query/Retrieve QR Server information:
a.
Description Enter the friendly name of your server, e.g.,
EFILMRISPACS-QR (choose a name that is easily identifiable)
b.
AE Title Application Entity Title for your server, e.g.,
EFILMRISPACS_QR (Note: AE Titles are case sensitive)
c.
Hostname Enter the IP address of your server, e.g., [Link]
d.
Port: Enter the server port for your server, e.g., 105
e.
Type: Select Server
f.
Default: Check this box
g.
Click Add
h.
Select the server you entered
i.
Click Verify
j.
If the server does not verify, please repeat and verify the information
above.
20) Select the Image Channel tab
21) Enter the IC Server information:
a.
Description Enter the friendly name of your server, e.g.,
EFILMRISPACS-QR (choose a name that is easily identifiable)

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eFilm RIS/PACS User Manual Version 2.0

AE Title Application Entity Title for your server, e.g.,

EFILMRISPACS_QR (Note: AE Titles are case sensitive)
c.
Hostname Enter the IP address of your server, e.g., [Link]
d.
DICOM Port: Enter the Q/R server port for your server, e.g., 105
e.
IC Port: Enter the IC port for your server, e.g., 3333
f.
Timeout: Leave at 5 seconds
g.
Default: Check this box
h.
Click Add
i.
Select the server you entered
j.
Click Verify
k.
If the server does not verify, please repeat and verify the information
above.
22) Select the Modality Settings tab
23) Select Advanced
24) Select CR from the drop down menu
25) Check the While Stacking box
26) Repeat this process for each modality by using the drop down list
27) Close the Properties Screen
28) Repeat this process for each eFilm workstation (Please note that each eFilm
Workstation must have a different AE Title and IP address. The port can be
the same)
29) Login to the Server via Internet Explorer
30) Go to Admin/Servers
31) Add each eFilm Workstation to the server list per the spreadsheet you
created above. Refer to section PACS Setup #9 above for more information on
adding servers (DICOM destinations)
DICOM Transactions (sending, pushing, pulling studies) Figure 1
You are now ready to test your DICOM setup. We provide many different
methods for moving DICOM data. The information below will describe these
processes.
1) Manual DICOM Store, i.e., DICOM Push, from Server
a.
Open the PACS interface using IE
b.
Go to the Workflow
c.
Select the study(s) you wish to send by checking the far right check
box (Note: you can select multiple studies or all by clicking the top
check box)
d.
Scroll to the top of the Workflow
e.
Click Push
f.
Select the target friendly name of the device
g.
You will be prompted to select additional destinations
h.
Close
i.
Go to Tools/DICOM out to view the progress of your DICOM job.
(Note: You can click refresh to update the progress, you can also
sort the columns by clicking on their headings)
j.
Go to the target device and verify the study was received
2) Auto DICOM Store, i.e., DICOM Push, from Server using auto-routing
(DICOM Router) rules
193

eFilm RIS/PACS User Manual Version 2.0

3) Manual DICOM Store, i.e., DICOM Push, using eFilm Workstation to Server
a.
Open eFilm Workstation
b.
Go to Local Exams tab
c.
Select the studies you wish to push
d.
Click the Send button to the right
e.
Select the friendly name of your DICOM Store Server
f.
Do not check the encrypt button
g.
Click Send
h.
The eFilm Queue will now open to show you the progress
4) Manual DICOM Query/Retrieve (Q/R), i.e., DICOM Pull, using eFilm
Workstation from Server
a. Option 1 Using eFilm Workstation interface
i.
Open eFilm Workstation
ii.
Go to Remote Exams tab
iii.
Look for the servers list on the right, if it is not there click the
Servers button to the side
iv.
Your PACS Q/R server should be highlighted by default, if it
is not, please highlight it
v.
Search for the study you wish to pull by using the filter
options at the top
vi.
Select the studies you wish to pull
vii.
Click the Retrieve button to the right
viii.
The eFilm Queue will now open to show you the progress of
your push
b. Option 2 Using the PACS workflow
i.
Open the PACS interface using IE
ii.
Go to the Workflow
iii.
Verify the Viewing Method in the bottom right hand corner is
eFilm IC
iv.
Click the patient name to view the study (Note: The Q/R
server must be selected as default in
eFilm/Edit/Properties/Remote Devices. For more
information, refer to eFilm Workstation Setup #9 above.)
v.
The study will now be retrieved to your workstation
vi.
Go to Local Exams to locate and view the study
5) Manual Image Channel Retrieve (IC) using eFilm Workstation, i.e., Image
Streaming, from Server
a.
Option 1 Using eFilm Workstation interface
i.
Open eFilm Workstation
ii.
Go to Image Channel tab
iii.
Look for the servers list on the right, if it is not there click the
Servers button to the side
iv.
Your PACS Q/R-IC server should be highlighted by default, if
it is not, please highlight it
v.
Search for the study you wish to view by using the filter
options at the top
vi.
Select the studies you wish to view
vii.
Click the View button to the right
viii.
The eFilm study will now stream to eFilm and open
194

eFilm RIS/PACS User Manual Version 2.0

b. Option 2 Using the PACS workflow
i.
Open the PACS interface using IE
ii.
Go to the Workflow
iii.
Verify the Viewing Method in the bottom right hand corner is
eFilm Retrieve
iv.
Click the patient name to view the study (Note: The Q/R
server must be selected as default in
eFilm/Edit/Properties/Remote Devices. For more
information, refer to eFilm Workstation Setup #9 above.)
v.
eFilm will now open the Image Channel tab and
stream/display the study
6) eFilm ActiveX Web Viewing
a.
Open the PACS interface using IE
b.
Go to the Workflow
c.
Verify the Viewing Method in the bottom right hand corner is
ActiveX Web
d.
Click the patient name to view the study (Note: You must allow the
website in your pop-blocker list)
7) eFilm Lite Prefetch
a.
Download and install the eFilm Lite Prefetch from
Support/Downloads
b.
Start the application by clicking on the Desktop Icon or by going to
Start/Program Files/Startup/eFilm Prefetch
c.
Right click on sep icon in task tray
d.
Configure menu per below
i. Launch eFilm Lite
1. Opens eFilm Lite Application
2. Select study to view
3. Click view
ii. DICOMDR Directory
1. Folder Name: Default is C:\dt. Do not modify
2. Cleanup DICOM Directory: Delete all files in C:\dt
3. Copy eFilm Lite Viewer: Copies all necessary eFilm Lite files
to C:\dt
4. Save: Save settings
iii.
Configuration
1. Server: Enter the IP or domain of your server, e.g.,
|[Link]
2. UserName: Enter your PACS username
3. Password: Enter your PACS password
4. Set as Default: Use above login credentials as default
5. Prefetch Images Till: Studies before this date will be ignored
6. Verify Connection: Verify connection/credentials with server
7. Save: Save settings
iv.
Watermark
1. Low Watermark: Defines percentage of disk space that will
remain upon High Watermark is hit.
2. High Watermark: Defines percentage of disk space that will
initiate space cleanup
195

eFilm RIS/PACS User Manual Version 2.0

vi.
vii.
viii.

Interval
Server Interval Check (Minutes): Defines amount of time
client queries server for new downloads
Status
Shows current download progress
About
Software information
Quit
Quit application

If you have any questions, please contact support. Be sure to include your
name, company name, phone, fax, email and order number, so we can provide
prompt support. We also recommend you study the full system manual to
become familiar with the system.

196

eFilm RIS/PACS User Manual Version 2.0

197

Common questions

Essential steps for setting up PACS access for users include typing the web address into the browser, logging into the system with a username and password, and managing user roles and access through the administration section. Users must be defined in the system, and referring physicians need unique logins assigned to them under the admin users section to access patient studies and reports . A unique password is critical in this process to ensure secure access to the system. It prevents unauthorized access and helps maintain HIPAA compliance by protecting patient information. Passwords should contain a minimum of six characters, including numbers and letters, to enhance security .

When modifying system modalities by adding new ones, it is crucial to proceed with caution as once a modality is added, it cannot be deleted. This precaution is necessary to prevent irreversible errors and ensure stability within the system's modality configuration. It emphasizes careful planning and consideration before making changes to avoid negatively impacting operational workflows .

To add a physician as a referring physician in the eFilm RIS/PACS™ system, the physician must be explicitly defined in the system by adding them under Edit/Physicians. After entering the required information and clicking 'save', the physician is added to the Referring Physician List . Next, a username and password must be created for the referring physician by going to Admin/Users, where 'referring physician' must be selected as the role from the dropdown list . This login must be assigned to the referring physician in the system, ensuring they can securely access images and reports . The Referring Physician Login field is then populated, allowing the physician to view patient information and studies . The role and login credentials ensure referring physicians can only view information specifically assigned to them ."}

To add a new patient to the system, click the "add patient" button, which will prompt a screen showing various fields for patient information. It is important to leave the Patient ID field blank during this process, as this allows the system to automatically generate a unique ID for the patient once the information is saved . This automatically assigned ID is essential as it is linked to all specific patient data within the system, ensuring accurate tracking and management of patient information . After entering all necessary information, save to complete the process .

Not forwarding necessary ports to the internal PACS server can prevent remote access by external DICOM clients, as these ports are crucial for communication between connected systems . Without open ports, remote clients may not be able to perform essential operations like DICOM Push or Query/Retrieve, which are used for transmitting and accessing medical imaging data remotely . This could hinder radiologists and medical professionals from accessing and reviewing medical images from outside the local network, compromising timely diagnosis and patient care. Blocking these ports may also result in a failure to verify server connections, impacting the ability to add or manage external servers efficiently .

The system facilitates avoiding duplicate patient records during the patient addition process by prompting the user when a new patient entry has a name and/or date of birth matching an existing patient. The user must then decide whether to select from a list of existing patients or proceed with entering a new patient entry . This step is crucial to prevent duplicate entries, ensuring that each patient has a unique record in the system, which is essential for accurate tracking of medical history and demographic information .

To add a new insurance company to the eFilm RIS/PACS™ system, an administrator should click the "add insurance" button within the system's insurance section. A popup screen will appear where necessary information, including a web address, can be entered. It is crucial that the web address begins with 'http://' to ensure proper hyperlink functionality. This guarantees that the system correctly recognizes and accesses the web address, allowing users to navigate directly to the insurance company's website when needed . After entering the information, the administrator should click 'Save' to complete the addition of the insurance .

Setting up eFilm ActiveX settings in the eFilm RIS/PACS™ system is essential for enabling the viewing and interaction with medical images and data. ActiveX controls are used within Internet Explorer to facilitate access to various features of the eFilm system, such as image viewing and manipulation . Certain functionalities, including the access to the eFilm Workstation and the workflow processes for viewing medical images and studies, rely on these settings to operate correctly . Moreover, the system may prompt users to install an ActiveX program, which is necessary for the proper functioning of the web viewer functionalities, allowing seamless interaction with patient studies and data . Ensuring ActiveX controls are correctly set up supports the secure and efficient management of patient information in the PACS system.

The procedure for searching appointments in the eFilm RIS/PACS™ system involves entering the search criteria, such as patient name or ID, and clicking the “search” button . Once found, clicking on the appointment opens its details for further actions like confirming, editing, or printing . This streamlines workflow efficiency by providing quick access and the ability to perform multiple actions, such as verification and printing, directly from the schedule view . This comprehensive approach to managing appointments within the same interface minimizes the time required for administrative tasks, thus enhancing operational efficiency.

A user should add an 'Outside Study' in scenarios where studies are performed at an outside facility that need to be read at their clinic, or for studies that are not digital but need to be included in the worklist . Critical information that must be noted before adding it to the system includes the patient ID assigned through the RIS, which is necessary for correctly adding the outside study . Additionally, if a patient was on the schedule but no images are available to send, the user can pull the study information from the schedule by searching for the patient's appointment, which will auto-fill the necessary fields .

eFilm RIS/PACS™ User Manual Version 2.0

ii

This document has been prepared by Merge Healthcare for its customers. The

eFilm RIS/PACS™ User Manual Version 2.0

iv

Contents
Chapter 1:
Accessing the System .................................

v
Chapter 6:
Tools ........................................................................... 55
Accessing the Tools ..

eFilm RIS/PACS™ User Manual Version 2.0

vi

User Quick Reference Guide..................................................

eFilm RIS/PACS™ User Manual Version 2.0

1
Chapter 1: Accessing the System
This chapter will guide the user through acce

eFilm RIS/PACS™ User Manual Version 2.0

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