DICOM Importer III User Manual MAG

User Manual:

Open the PDF directly: View PDF .
Page Count: 130

Download
Open PDF In Browser	View PDF

VistA Imaging System
DICOM Importer III User Manual
August 2018 – Revision 15

Chapter 1: Introduction
DICOM Importer III User Manual
VistA Imaging
August 2018

Property of the US Government
This is a controlled document. No changes to this document may be made without the express written consent of the VistA
Imaging development group.
While every effort has been made to assure the accuracy of the information provided, this document may include technical
inaccuracies and/or typographical errors. Changes are periodically made to the information herein and incorporated into new
editions of this document.
Product names mentioned in this document may be trademarks or registered trademarks of their respective companies, and
are hereby acknowledged.
VistA Imaging Office of Enterprise Development
Department of Veterans Affairs
Internet: http://www.va.gov/imaging
VA intranet: http://vaww.va.gov/imaging
Revision History
Date

June 3, 2011
November
29, 2011
March 16,
2012
April 9,
2012
September
18, 2012
October 29,
2012
January 22,
2013
February 25,
2013
August 30,
2013
January 15,
2016
June 2, 2016

Rev

Notes

Document created for MAG*3.0*118. M. Kaji, D. White

Document updated to reflect changes to the GUI for Beta testing. Roy R. Seabolt

Major edit – Verified and updated procedures, edited content, and updated formatting and
styles. Mike Mitchell.

Document updated to reflect changes from the Formal Review WPR. Mike Mitchell

Major edit – Added and updated procedures, and edited content. Mike Mitchell, Jon
Louthian

Major content edit and update. Mike Mitchell, Jon Louthian

Incorporated comments from VA Formal WPR – P.Yeager, M.Mitchell

Incorporated comments from VA eWPR – P.Yeager, M.Mitchell

Updated in full for Patch 136. P. Yeager, L. Williams, C. Huth

10
11

Added the Configuring Maximum Number of Items to Return section under Chapter 2’s
Configuring the Importer III Client section in support of MAG*3.0*162. Marner, Stacey
Edits in support of MAG*3.0*162.

May 22,
2017

Edits in support of MAG*3.0*179. Added to the Prerequisites list and added section on
Window Registry (page 9). Also added new instructions for 2FA sign on with PIV (page
16).

March 20,
2018

Updated document with Patch 206 (Replacement of cancelled Patch 179); Same
Functionality

Edits in support of MAG*3.0*206.

Remove Patch reference from the title page and footer.

April 11,
2018
August 1,
2018

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 1: Introduction

Preface
Terms of Use
Use of the DICOM Importer III is subject to the following provisions:
Caution: Federal law restricts this device to use by or on the order of either a licensed
practitioner or persons lawfully engaged in the manufacture or distribution of the
product.
Caution: The FDA classifies VistA Imaging, and the DICOM Importer III (as a
component of VistA Imaging) as a medical device. Unauthorized modifications to VistA
Imaging, such as the installation of unapproved software, will adulterate the medical
device. The use of an adulterated medical device violates US federal law (21CFR820).

Document Conventions
This document uses the following typographic conventions.
Symbol/Typeface

Meaning/Use

Example

Bold

User input, selection, GUI
element (menu item, button,
field)

Click Finish.

Command-line sample or output
(such as character-based
screen captures and computer
source code), menus, file names

Navigate to the \Docs\Imaging_Docs_Latest
folder.

Italics

Emphasis, reference to section
in the document or another
document, or a variable

For more information, see the VistA Imaging
DICOM Gateway Installation Guide.

Square brackets,
monospace or italics

Variable, placeholder, VistA
menu

Access the Kernel Installation and
Distribution System Menu [XPD MAIN].

Monospaced font
(typically in a box)
(Bold indicates user
input or selection).

Choose Open from the File menu.
Type the user account name in the Name
field.

;;3.0;IMAGING;**[Patch List]**;Mar 19,
2002;Build 1989;Feb 21, 2011
MAG*3.0*.KID

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

iii

Chapter 1: Introduction

Getting Help
If you encounter any problems using the Importer III client, contact your local Imaging
Coordinator or support staff. If the problem cannot be resolved locally, use CA Service Desk
Manager to place a service request, or contact CPS (Clinical Product Support) at
1-888-596-4357.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 1: Introduction

Contents
Preface ........................................................................................................................................................ iii
Terms of Use .......................................................................................................................................... iii
Document Conventions .......................................................................................................................... iii
Getting Help ............................................................................................................................................iv
Contents ....................................................................................................................................................... v
Chapter 1: Introduction .............................................................................................................................. 1
How the Importer III Client Works........................................................................................................... 1
Workflow Wizards ................................................................................................................................... 1
Work Queues .......................................................................................................................................... 2
Features 2
User Roles .............................................................................................................................................. 2
Basic Media Staging User ...................................................................................................................... 3
Advanced Media Staging User ............................................................................................................... 3
Contracted Study Reconciliation Administrator ...................................................................................... 3
Artifact Reconciliation Administrator ....................................................................................................... 4
Report User ............................................................................................................................................ 4
Associated Security Keys ....................................................................................................................... 4
Chapter 2: Setting Up the Importer III Client ............................................................................................ 7
Prerequisites ........................................................................................................................................... 7
Microsoft .NET Framework ..................................................................................................................... 7
Windows Registry ................................................................................................................................... 9
Installing the Importer III Client ............................................................................................................... 9
Configuring the Importer III Client ......................................................................................................... 12
Configuring the Lockout Time............................................................................................................... 12
Configuring the Maximum Number of Items to Return ......................................................................... 13
Verifying the Installation ....................................................................................................................... 14
Starting the Importer III Client............................................................................................................... 14
Stopping the Importer III Client ............................................................................................................. 17
Chapter 3: Staging the Data ..................................................................................................................... 19
Intake Staging ....................................................................................................................................... 19
DICOM Correct ..................................................................................................................................... 19
Network Import ..................................................................................................................................... 19
Non-Compliant Media ........................................................................................................................... 20
User Roles for Staging ......................................................................................................................... 20
Staging Media when a Patient Record Exists in VistA Imaging ........................................................... 20
Staging Media When a Patient Record Does Not Exist in VistA Imaging ............................................ 25
Advanced Staging of Patient Data........................................................................................................ 28
Advanced Data Staging Overview ........................................................................................................ 28
Staging DICOM Only Media ................................................................................................................. 30
Staging Mixed Media ............................................................................................................................ 33
Staging Non-DICOM Media Only ......................................................................................................... 34
Chapter 4: Working with Studies and Orders (Reconciling) ................................................................ 37
Direct Import of Electronic Media ......................................................................................................... 37
Import Reconciliation Workflow Industry Standard for DICOM Import ................................................. 37
Importing Ordered Studies Using IRWF ............................................................................................... 37
Importing Unordered Studies Using IRWF ........................................................................................... 37
Reconciling ........................................................................................................................................... 38
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 1: Introduction
User Roles ............................................................................................................................................ 38
Entering the Reconciliation Workflow Through Staged Media ............................................................. 39
Entering the Reconciliation Workflow Through Direct Import ............................................................... 40
Reconciling Studies with Existing Orders ............................................................................................. 43
Reconciling Studies Requiring New Radiology Orders ........................................................................ 50
Adding and Changing Exam Details During Reconciliation ................................................................. 59
Adding and Changing Exam Details During Reconciliation of An Existing Order ................................ 59
Adding and Changing Exam Details During Reconciliation of a New Radiology Order ....................... 63
Reconciling Partially Imported Studies ................................................................................................. 67
Deleting Studies from Staged Media .................................................................................................... 69
Chapter 5: Managing Import Queues ...................................................................................................... 73
Reverting Items Stuck in Reconciliation ............................................................................................... 73
Viewing Importer Items Currently Being Processed by an HDIG ......................................................... 77
Viewing Failed Importer Items .............................................................................................................. 78
Viewing the Application Log File........................................................................................................... 81
Chapter 6: Viewing Study Data and Images ........................................................................................... 83
Optionally Viewing the DICOM Header and Group Information ........................................................... 84
Chapter 7: Running Usage Reports ........................................................................................................ 87
Sample Reports .................................................................................................................................... 87
User Role .............................................................................................................................................. 89
Running a Usage Report ...................................................................................................................... 89
Appendix A: Setting Up Outside Imaging Locations for the Importer III Client ................................. 93
Step 1 – Identify Imaging Types and Divisions that Need “No Credit” Imaging Locations................... 94
Step 2 – Create the OUTSIDE STUDY Entry in the CAMERA/EQUIP/RM File .................................. 96
Step 3 – Add New Outside Imaging Locations for Each Imaging Type to Divisions ............................ 98
Step 4 – Define Outside Imaging Locations Parameters ................................................................... 104
Step 5 – OUTSIDE STUDY Camera/Equip/Room for All Radiology Imaging Locations ................... 108
Step 6 – Populate VistA Imaging Outside Imaging Location File ....................................................... 109
Appendix B: Handling Parent-Descendent Procedure Orders with the Importer III Client ............. 111
How It Works ...................................................................................................................................... 111
Questions ............................................................................................................................................ 111
How Outside Fee-basis Imaging Contractors Work ........................................................................... 111
How to Use the Importer III Client for DICOM Images for Parent/Descendent Procedures .............. 112
Appendix C: Problems Seen in Importing DICOM Objects from Media ............................................ 115
Glossary ................................................................................................................................................... 117
Index ......................................................................................................................................................... 123

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 1: Introduction

Chapter 1: Introduction
The Digital Imaging and Communications in Medicine (DICOM) Importer III (hereafter referred
to as the Importer III client) is a client/server application that utilizes desktop client software,
supported by server software on the Hybrid DICOM Image Gateway (HDIG), to transfer
DICOM objects from studies performed outside the Department of Veterans Affairs (VA) into
the VistA Imaging system. The Importer III client supports sharing prior study images from:


VA Polytrauma clinicians



Imaging facilities outside the VA



Imaging facilities contracted to perform studies outside the VA

This software streamlines the reconciliation of patient names and study identifiers between the
outside study data and VA systems. The software breaks the processing down into three
independent steps:


Staging – A user with appropriate privileges copies studies (for example, CD, DVD, flash
drive, or external hard drive) to a network share for reconciliation by an authorized user.



Reconciliation – A user with appropriate privileges associates the images on the media
with the correct ordered study and the correct patient.



Importing –A user with appropriate privileges adds the images to the patient’s electronic
health record (EHR).

How the Importer III Client Works
The graphical user interface of the Importer III client is built on the VistA Imaging System
Architecture (VISA) within a desktop client.
The desktop-based approach allows multiple users to simultaneously perform
staging/import/reconciliation activities, using the client hardware (media drives) and software
(Importer III client), and to stage study data (external media) for later reconciliation and
importing. It eliminates the need to have direct access to a server to perform import activities.
In addition, the Importer III client provides administrative users with a tool for managing
problems as they appear in the DICOM Correct queue. All studies in the DICOM Correct queue
are managed from the Importer III client, which corrects the study and resubmits it to image
processing.
Workflow Wizards
Based on the user role of the individual who signs on, Importer III loads one of four workflow
wizards. The wizards walk the users through the necessary steps to perform their designated
duties.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 1: Introduction

Work Queues
Advanced users will use the Importer III client to perform reconciliation and importing activities.
As studies are processed, their status changes and they are placed in different workflow queues.
Features
The Importer III client:


Enables authorized users to manage, reconcile, and correct imported data from a single
easy- to-use interface.



Receives outside DICOM-compliant studies from portable media.



Receives outside DICOM-compliant studies through a network transmission.



Receives non-DICOM objects (such as .pdf files) and enables authorized users to add
them to patients’ EHRs.



For non-DICOM compliant media (that is, an invalid or missing DICOMDIR), attempts
to build a list of the studies on the media, and proceeds with the staging/importing of the
DICOM objects.



Manages the DICOM Correct functionality by placing studies that fail image processing
into a DICOM Correct work queue for resolution by the Imaging Administrator.



Gives multiple authorized users the ability to access, manage, and reconcile the imported
data based on the rights associated with their user role.



Provides a tool to display the status of a study within the reconciliation process.



Captures and stores DICOM objects received from multiple devices at different times.



Provides a reporting system that enables an authorized user to monitor and generate
usage or statistical reports.



Utilizes audit logging, application logging, and sensitive patient logging.

User Roles
The Importer III client is a role-based application. Regardless of a user’s job title, each role falls
into one or more of the following categories based on tasks required to handle patient data at the
site hospital. The following roles are associated with the Importer III client.


Basic Media Staging User (BMSU)



Advanced Media Staging User (AMSU)



Contracted Study Reconciliation Administrator (CSRA)



Artifact Reconciliation Administrator (ARA)



Report User (RU)

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 1: Introduction

Each chapter of this user manual provides the information necessary to perform a major task
associated with the Importer III client. Within each chapter is a discussion of how a particular
user role (or roles) applies to that task.
Note: Roles can be combined when performing these tasks. Refer to the individual chapters of
this manual to determine how roles can be combined for the described task.
Important: VistA Imaging users cannot access the Importer III client or data unless they have
the appropriate security key. See the section Associated Security Keys at the end of this chapter
for more information.
Basic Media Staging User
The BMSU is the person performing the staging. A BMSU may be file room staff, front desk
registration staff, or other staff having minimal medical knowledge. The responsibilities of the
BMSU are as follows.


Receive media from the patient.



Log into the Importer III client, search for the patient, and select the patient.



Copy contents from external media to the network staging location.

Advanced Media Staging User
The AMSU performs the staging. An AMSU may be file room staff, front desk registration staff,
or other staff having some medical knowledge. The responsibilities of the AMSU are:


Receive media from the patient.



Log into the Importer III client, search for the patient, select the patient, and optionally
view/select individual studies from the media.



Copy selected studies from external media to the network staging location.

Contracted Study Reconciliation Administrator
The CSRA is a clinician who identifies the original order for a contracted study, performed by an
outside facility, for the patient. A CSRA matches the outside contracted study to the original
order so that it can be imported. The CSRA also has the required medical knowledge to perform
reconciliation activities on orders placed in VistA, and to have a study performed at an outside
location. The responsibilities of the CSRA are:


Possess all of the capabilities designated to the AMSU.



Work with orders that already exist on VistA.



Select the procedure/study previously ordered by the provider and match the appropriate
staged study to the selected order.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 1: Introduction



Designate the study for “I”mporting.



Ensure that the imported study is in VistA Imaging for use by medical staff.

Important: The CSRA is not allowed to import and process unordered studies. If the CSRA
encounters an unordered study that needs to be imported, the workflow for the Staging user is
used.
Artifact Reconciliation Administrator
Note: This is the power-user role.
The ARA is a clinician with in-depth knowledge of the radiology workflow. ARA will identify a
VistA order that corresponds to a procedure performed by a non-VA imaging facility. The
responsibilities of the ARA are:


Manage all aspects of the reconciliation process, including the ability to create new
radiology orders, match artifacts to existing studies, update or delete information,
perform DICOM Correct functions, and perform all AMSU, CSRA, and RU functions.



Identify the VistA procedure that corresponds to the one performed on the outside for a
prior study.



Log into the Computerized Patient Record System (CPRS) and identify the patient and
procedure/study on the system or, if necessary, create and register a new procedure/study.



Use the patient’s identifying information to retrieve the staged data from the network
storage location.



Reconcile any staged data by matching it with orders and ensure that the reconciled
orders are released to the picture archiving and communication system (PACS) system.



Release the procedure/study to image processing for storage in the VistA Imaging file
system, ensuring the imported study is available to the medical staff treating the patient.



Reconcile studies sent to the DICOM Correct queue to ensure the information is available
to clinicians in a timely manner.

Report User
The responsibilities of the RU include generating reports on statistical data, such as the number
of studies imported, the number of studies requiring manual reconciliation, and so on.
Note: This role is for an administrator interested in gathering statistics on system processing.

Associated Security Keys
Each user role is associated with security keys that provide rights, from minimum rights (BMSU)
to maximum rights (ARA).
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 1: Introduction

Note: Users of any of the following security keys must also have access to the MAG DICOM
VISA secondary menu option.
KEY NAME

DESCRIPTION

MAGV IMPORT MEDIA STAGER

Users holding this security key may use the Importer III client to
stage (copy) from media to the staging persistent storage, where
it waits for reconciliation processing.

MAGV IMPORT STAGE MEDIA
ADV

Users holding this security key may use the Importer III client to
perform all functions of the MAGV IMPORT MEDIA STAGER
security key plus the following:

MAGV IMPORT RECON
CONTRACT



Stage (copy) studies from media to staging to persistent
storage.



View images on the media.

Users holding this security key may use the Importer III client to
perform all functions of the MAG IMPORT STAGE MEDIA
ADV security key. In addition, users may use the Importer III
client to associate study DICOM objects with an existing
Rad/Consult order for reconciliation.

MAGV IMPORT RECON ARTIFACT Users holding this security key may use the Importer III client to
perform all functions of the MAGV IMPORT RECON
CONTRACT security key plus the following:

MAGV IMPORT REPORTS

August 2018



Place new radiology orders through the Importer III
client.



Perform DICOM Correct activities to manage problem
studies in the DICOM Correct queue.



Perform queue management activities.



Perform reporting activities.

Users holding this security key may use the Importer III client to
view and print Importer reports, as well as save the contents of a
report to a text file.

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

Chapter 2: Setting Up the Importer III Client
This chapter provides information for setting up the Importer III client on a VistA Imaging
system.

Prerequisites


VistA Imaging system running MAG*3.0*136 or later



Microsoft .NET 2.0 and .NET 4 installed



“Servers” key in the Windows Registry

Contact system administration at your site for more information, and to perform any of the
following applicable tasks.


Permission may be required to use the CD/DVD on the local computer where the
Importer III client is going to be used for importing. Permission may be granted through
VA IT group permissions.



The computer containing the Importer III client must have the correct drivers installed to
use the drives on the computer.



If the Importer III client is installed on a Windows XP computer, then the correct codecs
must be installed to allow the reading of CDs and DVDs.



When the Importer III client is installed on a Windows 7 computer, the correct codecs
allowing the reading of CDs and DVDs are included.

Note: The Importer III client may be set to read CD-Rs and DVD-Rs by default. Issues may arise
if a CD-RW or DVD-RW is placed in a drive and Import is launched.
Microsoft .NET Framework
Microsoft .Net Framework 2.0 and 4 must be installed prior to installing the Importer III client.
1. To verify that .NET 2.0 and .NET 4 are on the PC, click Start | Settings | Control Panel |
Add or Remove Programs.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

2. Scroll to find Microsoft .NET Framework 2.0 and Microsoft .NET Framework 4. If they are
installed, then go to the next section, Installing the Importer III Client

3. To install .NET 2.0 (an earlier version of .NET), go to
ftp://ftp.imaging.med.va.gov/software/NET_Framework2_0-SP2-X86/ and download and run
the installation file. To install .NET 4, go to
ftp://ftp.imaging.med.va.gov/software/NET_Framework4_0Full/ and download and run the
installation file. Follow the instructions to complete the installs.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

Windows Registry
With the addition of the RPC Broker as part of the 2FA effort, Importer will now rely on VistA
server information available in the Windows Registry for each client computer that installs the
Importer application. This registry setting is a requirement of the RPC Broker and some other
VistA client applications; it is possible that the settings already exist on a client computer,
however it should be confirmed before installing Importer. As mentioned above, the following
may require support from local site administrators.
Open the Registry Editor and browse to the
\HKEY_LOCAL_MACHINE\SOFTWARE\Wow6432Node key. If a “Vista” key exists, expand
it, if not create it. If a “Broker” key exists, expand it, if not create it. If a “Servers” key exists,
expand it, if not create it so that the full path is:
\HKEY_LOCAL_MACHINE\SOFTWARE,Wow6432Node\Vista\Broker\Servers
Within this key, one (or more) String values are required. The name of Registry String should
contain the IP address or Fully Qualified Domain Name (FQDN) of the VistA server, a comma,
and then the port number that will accept remote connections. See the figure below:

Installing the Importer III Client
The Importer III client must be installed on any system where a user performs staging,
reconciliation, reporting, or DICOM Correct activities. Use of the Importer III client is security
key driven, so that only users who have the required security keys are able to log in and use it.
1. Retrieve the software directly to your desktop by using Secure File Transfer Protocol
(SFTP) from the ANONYMOUS.SOFTWARE directory at the following OI Field Offices:
Hines:

fo-hines.med.va.gov

Salt Lake City:

fo-slc.med.va.gov

2. Drag the MAG3_0PXXX_ImporterIII_Setup.exe file from the folder to the desktop.
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

Or
Right-click the file and click Copy, then move the cursor to the desktop, right-click again
and click Paste.
3. Double-click the MAG3_0PXXX_ImporterIII_Setup icon on the desktop.
4. At the Welcome to the InstallShield Wizard for VistA Imaging DICOM Importer screen,
click Next.

The installation begins.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

5. At the InstallShield Wizard Completed screen, click Finish.

The Importer III client and DICOM Viewer are installed.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

Configuring the Importer III Client
Configuring the Lockout Time
The DICOM III Importer application will automatically lock and display the log-in screen when
the application has been idle for 5 minutes. You may customize the lock-out time. Complete
these steps:
1. In Windows Explorer, go to C:\Program Files\VistA\Imaging\Importer (for Windows 7
users go to C:\Program Files(x86)\VistA\Imaging\Importer).
2. Right-click the ImagingShell.exe.config file.

3. Click Open With.
4. In the Open With window, select Notepad and click OK to edit the file.
5. Scroll to the UserIdle Timeout value entry.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

6. Enter the desired value in seconds between the quote marks after value= in the
UserIdleLogout value line.
7. Save the file.
Note: Importer III delivers a time-out warning to users before it closes the application. Click
the OK button to continue working.

Configuring the Maximum Number of Items to Return
The DICOM III Importer application will automatically attempt to retrieve all available work
items. When a significant large number of work items exist, it is possible to cause network
connection timeouts. This connection timeout induces an error and no work items appear in the
worklist. You may customize the number of work items return to avoid this connection timeout.
Complete these steps:
1. In Windows Explorer, go to C:\Program Files\VistA\Imaging\Importer. (For Windows 7
users, go to C:\Program Files(x86)\VistA\Imaging\Importer.)
2. Right-click the ImagingShell.exe.config file.

3. Click Open With.
4. In the Open With window, select Notepad and click OK to edit the file.
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

5. Scroll to the UserIdleTimeout value entry.

6. Add the new MaximumNumberOfItemsToReturn line under the UserIdleLogout line. The
value “300” is arbitrary. Change the value that best supports the site.
7. Save the file.

Verifying the Installation
To verify that the installation and configuration was successful, start the Importer III client using
the steps in the following section, Starting the Importer III Client. If you are able to get to the
DICOM Importer Home screen, the installation and configuration were successful.

Starting the Importer III Client
1. Click Start | All Programs | VistA Imaging Program | Importer to start the Importer III
client.
2. If more than one station number was configured at installation, then the “Connect To” dialog
box displays. If the dialog displays, select the desired station from the dropdown and click
OK. Otherwise, go to the next step.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

3. Make sure you have a valid PIV card attached to the computer. You will be prompted to
select a certificate: Then click on the OK button.

Doe, John

Doe, John, 000000

4. Next, you will be prompted to enter your PIN. Enter your PIN and click on the OK button.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

5. Upon successful authentication and login, the user will be allowed to continue to the
application. When an attempt to log in with PIV/PIN fails to authenticate two-factor
authentication (2FA), the application will revert the user to the Access/Verify screen. If the
VistA Sign-on box displays, type your access and verify codes in the Access Code and
Verify Code boxes, then click OK.

Note: DICOM Importer III will automatically lock and display the log-in screen after 5 minutes
of inactivity on the application. For instructions on how to configure the lockout time, see
Configuring the Lockout Time on page 12.
6. The system displays the DICOM Importer Home screen, as shown below. The application
enables buttons based on the security keys assigned to the logged-in user.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 2: Setting Up the Importer III

Stopping the Importer III Client
1. At the Importer window, go to the File menu and do one of the following:
Click Exit to close the Importer III client.
or
Click Log Out to log out and return to the log-in dialog box.
Note: In either case, if you are currently in the middle of the reconciliation workflow, you are
asked if you want to abandon your current work before the exit or logout continues.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data
There are three ways in which DICOM objects are staged and made available in the DICOM
Import List: intake staging, DICOM Correct, and network import.

Intake Staging
Importer III users utilize intake staging when patients deliver external media so that the VA may
import the studies into VistA Imaging.
Note: The media readers on the user’s computer must be unlocked before staging data. Contact
VA IT group permissions for help.
If the media is DICOM-compliant, the Importer III client allows the user to stage the data to the
Staging network share. If the media is not DICOM-compliant, the Importer III client attempts to
determine the issue and resolve the issue.
Note: DICOM Importer III displays a warning message for each issue with non-compliant
media.

DICOM Correct
The Importer III client includes a centralized work queue for studies requiring corrections
(DICOM Correct). Specifically, the Importer III client enables authorized users to centrally
manage and correct studies performed at the facility, but rejected by image processing for
various reasons. The ability to correct images from a single workstation significantly improves
workflow and simplifies the effort of correcting studies performed by the facility. The PACS
administrator at a site can view and correct all studies requiring correction in the Importer III
client user interface without having to log on to each imaging server. The centralized
management also improves server security.
Users who hold the MAGV IMPORT RECON ARTIFACT security key can use the Importer III
client DICOM Correct functionality to fix errors in studies in the DICOM Correct queue.
Note: Resolving items in the DICOM Correct queue follows the same workflow as reconciling
staged studies. Step-by-step instructions for reconciling a staged study needing DICOM Correct
can be found in the section Entering the Reconciliation Workflow Through Staged Media located
in Chapter 4: Working with Studies and Orders (Reconciling).

Network Import
When using network import, studies are transmitted directly from an outside facility to the VA
over a network (for example, a DICOM proxy server). For each incoming study, a new Importer
III client work item is created, and then the images are automatically staged under that work
item. For more information on setting up an import location through the AE Security Matrix, see
the DICOM Gateway Planning and Installation Instructions.

Chapter 3: Staging the Data

Non-Compliant Media
The following are examples of non-compliant media and how Importer III attempts to deal with
them:


Media contains no DICOMDIR file or contains an invalid DICOMDIR file
The Importer III client reads all of the DICOM objects on the media and attempts to build
a list similar to the DICOMDIR reference file. If successful, the study is staged. If
unsuccessful, the media is rejected and a message displays to the user.



Media contains a DICOMDIR file, but the number of images on the media does not
match the DICOMDIR record.
A warning displays and the user may choose to cancel or continue.



Media contains DICOM objects, but one or more of them are in a format not currently
supported by VistA.
–

If at least one DICOM object on the media is supported, a warning displays indicating
the number of unsupported images that will not be imported, and the user is allowed
to continue or cancel. The SOP class UIDs of the unsupported objects are written to
the log file for later reference by technical support.

 If none of the DICOM objects on the media are currently supported by VistA, the
user is notified that import is not possible.


Media does not contain any DICOM objects,
Media is rejected and staging is not possible.



Media presented is a medical CD/DVD in a vendor proprietary format.
Media is rejected and staging is not possible.



Media presented is a medical CD/DVD in an encrypted format,
If the password is unavailable, then the media is rejected and staging is not possible.

User Roles for Staging
Staging is primarily the task of the BMSU or the AMSU.
In addition, instructions are provided for advanced staging of patient data and for optionally
viewing the DICOM header and group information (see the section Optionally Viewing the
DICOM Header and Group Information in Chapter 6 for more information).

Staging Media when a Patient Record Exists in VistA Imaging
The following procedure describes how to stage media when a patient record exists on the local
VistA database.
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

Role: The BMSU’s task is to download all the supported DICOM and non-DICOM files on the
external media to a designated Staging storage location.
Note: Because most patients already have their medical records in the system, the assumption is
that patient data at intake is known.
1. When receiving media from a patient at intake, go to a designated machine to download from
the external media.
2. Start the Importer III client. (See Starting the Importer III Client for instructions on starting
the Importer III client.)
3. At the DICOM Importer Home screen, under Stage Media for Future Import, click Stage
Media to copy the media to your Staging storage location for import processing.
Note: The application enables buttons based on the security keys assigned to the logged-in user.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

4. At the Staging Media Category screen, select the type of media to be staged. The selections
are DICOM Only Media, Mixed Media, and Non-DICOM Only Media.

5. When you select the type of media to stage, the Importer III client lists the conditions under
which the media will be staged. In the following screen, Importer III lists the media category
details for import of Non-DICOM Only Media.

6. Click Stage Media.
7. DICOM Importer III provides a separate workflow for each of the three Media Category
options.
Note: For each workflow, DICOM Importer III selects the Patient is Known radio
button by default.


August 2018

For the DICOM Only Media option, select the DICOM Media Details from the Drive
drop-down menu and the Media Origin drop-down menu. Then, click Select Patient
to open the Patient Lookup dialog, search for and select the appropriate patient, and
click OK.

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

DICOM Importer III prompts you with messages from the Stage Media Import screen:



For the Mixed Media option, select the DICOM Media Details from the Drive dropdown menu and the Media Origin drop-down menu. Then, click Select Patient to
open the Patient Lookup dialog, search for and select the appropriate patient, and
click OK. Finally, click Add to browse the local hard drive of your computer to
locate the file containing the non-DICOM media you want to import.



For the Non-DICOM Only media option, select click Select Patient to open the
Patient Lookup dialog, search for and select the appropriate patient, and click OK.
Finally, click Add to browse the local hard drive of your computer to locate the file
containing the non-DICOM media you want to import.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

8. In the Staging Complete dialog box, click OK to confirm that staging completed
successfully.

9. Remove the media from the drive.
10. Exit or log out of the Importer III client by following the steps found in Stopping the
Importer III Client.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

Staging Media When a Patient Record Does Not Exist in VistA
Imaging
The following procedure shows how to stage media when a patient record does not exist in the
VistA database.
Role: The BMSU’s task is to download all the files on the media to a designated permanent
storage location.
1. When receiving media from a patient at intake, go to a designated machine to download from
the external media.
2. Start the Importer III client. (See Starting the Importer III Client for instructions on starting
the Importer III client.)
3. At the DICOM Importer Home screen, under Stage Media for Future Import, click Stage
Media to copy the media to your Staging storage location for import processing
The application enables buttons based on the security keys assigned to the logged-in user.

4. At the Staging Media Category Screen, select the type of media to be staged. The choices are
DICOM Only Media, Mixed Media, and Non-DICOM Only Media. When you make the
selection, the Stage Media button is enabled.
5. Select Stage Media.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

6. Importer III opens the Stage Media for Import screen. Under Patient, select Patient is
unknown.
7. Under Media Details, select the drive letter for staging media from the Drive drop-down list,
select the media origin from the Media Origin drop-down list, and click Stage for Import.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

Note: Making a selection from the Media Origin drop-down box is optional during media
staging; however, it is required during the reconciliation process. Selecting a value for the
media origin during staging allows this information to be pre-populated during the
reconciliation process performed by the ARA.
8. In the Staging Complete dialog box, click OK to confirm that you have seen the message that
staging has completed successfully.

9. Remove the media from the drive.
10. Exit or log out of the Importer III client by following the steps found in Stopping the
Importer III Client.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

Advanced Staging of Patient Data
The advanced staging features of DICOM Importer III enable users with the appropriate
permissions to choose selected studies from media and stage these studies for the use of
clinicians.
The following procedure shows how to perform advanced staging of media tasks.
Role: The AMSU can perform the same tasks as the BMSU. In addition, the AMSU’s task is to
check the media and download the studies needed for the clinician.
Advanced Data Staging Overview
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. At the DICOM Importer Home screen, under Stage Media for Future Import, click Stage
Media to copy the media to your Staging storage location for import processing. Buttons are
enabled or disabled based on the security keys assigned to the logged-in user.

3. At the Staging Media Category screen, select the type of media that will be staged. The
selections are DICOM Only Media, Mixed Media, and Non-DICOM Only Media.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

4. When you select the type of media to stage, the Importer III client lists the conditions under
which the media will be staged. In the following screen, Importer III lists the media category
details for import of Non-DICOM Only Media.

5. Click Stage Media.
6. Remove the media from the drive.
7. Exit or log out of the Importer III client by following the steps found in Stopping the
Importer III Client.
DICOM Importer III provides a separate workflow for each of the three Media Category options.
The workflow is detailed in the following sections.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

Staging DICOM Only Media
1. On the Staging Media Category screen, select the DICOM Only Media radio button. Click
the Stage Media tab.

Importer III opens the Stage Media for Import screen. In the DICOM Media Details
section, select the drive from which you want to stage the media from the Drive dropdown menu and the origin of the media from the Media Origin drop-down menu.

2. DICOM Importer III selects the Patient is known radio button by default.
3. Select click Select Patient to open the Patient Lookup dialog, search for and select the
appropriate patient, and click OK.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

Note: To select another patient, click Change Patient.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

4. At the Stage Media for Import screen, click Enable Advanced Options. DICOM Importer
III displays a list of the DICOM media on the drive you have selected.

5. Click on a row to select the studies to stage. Each study contains a row with Patient ID,
Patient Name, Date of Birth, Sex, Accession #, Study Date, Description, and Images.
6. Click the Stage for Import button.
Note: If DICOM Importer cannot locate DICOM media on the drive you have selected, the
application will display the following error message:

7. Remove the media from the drive.
8. Exit or log out of the Importer III client by following the steps found in Stopping the
Importer III Client.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

Staging Mixed Media
1. On the Staging Media Category screen, select the Mixed Media radio button. Click the
Stage Media tab.

2. Select the DICOM Media Details from the Drive drop-down menu and the Media Origin
drop-down menu. Then, click Select Patient to open the Patient Lookup dialog, search for
and select the appropriate patient, and click OK. Finally, in the Non-DICOM Media section,
click Add to browse the local hard drive of your computer to locate the file containing the
non-DICOM media you want to stage for import.

3. When you have located the file you want to import, click the Add button again.
4. Repeat steps 2 and 3 until you have located all the non-DICOM files you want to stage for
import.
5. Click Enable Advanced Options. DICOM Importer III displays a list of the DICOM media
on the drive you have selected.
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

6. Click on a row to select the studies to stage. Each study contains a row with Patient ID,
Patient Name, Date of Birth, Sex, Accession #, Study Date, Description, and Images.
7. Click the Stage for Import button.
Note: If DICOM Importer cannot locate DICOM media on the drive you have selected, the
application will display the following error message:

8. Remove the media from the drive.
9. Exit or log out of the Importer III client by following the steps found in Stopping the
Importer III Client.
Staging Non-DICOM Media Only
1. On the Staging Media Category screen, select the Non-DICOM Only Media radio button.
Click the Stage Media tab.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

2. Importer III opens the Stage Media for Import screen. A VA patient is required to import
non-DICOM media only. Click Select Patient, move to the Patient Lookup screen, select the
correct patient and click OK to return to the Stage Media for Import screen.

3. Click Add to browse the local hard drive of your computer to locate the file containing the
non-DICOM media you want to import. When you add the first file, the Stage for Import
button is enabled. Repeat until you have located all the non-DICOM media you want to
import to the patient record.
4. Click Stage for Import (now enabled). Importer III returns the staging complete message.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 3: Staging the Data

5. Remove the media from the drive.
6. Exit or log out of the Importer III client by following the steps found in Stopping the
Importer III Client.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders
(Reconciling)
Direct Import of Electronic Media
Media can be sent to DICOM Importer III electronically. In such a case, a CSRA or an ARA can
bypass the step in staging and perform a direct import of the media by accessing it in a
designated queue. In this way, files can be automatically loaded to a designated location (staging
share) so that studies can be reconciled with orders as part of the Importer III client
reconciliation process.

Import Reconciliation Workflow Industry Standard for DICOM
Import
The Integrating the Healthcare Enterprise (IHE) Import Reconciliation Workflow (IRWF)
integration profile specifies the industry-standard technique for importing DICOM objects.1 With
the IRWF, patient and study identification information is obtained from a study on the local
system. This information is then used to replace the values of the corresponding data elements in
the DICOM objects that will be imported. To provide an audit trail, the original DICOM values,
along with the import application attributes, are saved elsewhere in the DICOM header (see the
section Optionally Viewing the DICOM Header and Group Information in Chapter 6 for more
information). DICOM objects from the outside study, now containing the local patient and study
identification, are then imported and associated with the study on the local system.
Importing Ordered Studies Using IRWF
When importing ordered studies using IRWF, both the patient and the study are already
registered on the local system. The patient and study identification information, from each local
study, is used to update the DICOM objects from the original outside study. Importation then
takes place and the DICOM objects from each outside study are associated with the
corresponding ordered study on the local system.
Importing Unordered Studies Using IRWF
When importing unordered studies using IRWF, first make sure that the patient is registered in
the local system. Then create a corresponding equivalent study in the local system for every
unordered outside study to be imported. The patient and study identification information, for
each newly created local study, is used to update the DICOM objects from the original outside
study. The studies are imported, and the DICOM objects from each outside study are associated
with their corresponding newly created studies on the local system.

IHE Import Reconciliation Workflow, IHE Technical Framework, vol. I, Rev. 8.0, 200708-30.

Chapter 4: Working with Studies and Orders (Reconciling)

The Importer III client can handle both ordered and unordered studies.


Ordered studies are those that already have corresponding orders on the local VistA
system. There are three types of ordered studies.
–

Prior exam or historical study (physician performed a study on the patient)

–

Contracted study with the order already there (physician places an order with an
outside contractor to perform a study on the patient who is at a remote site)

 DICOM Correct – A study in the DICOM Correct work queue that has an information
mismatch and needs to be corrected


Unordered studies
The classic example is the unordered prior study that was performed while the patient
was being treated at an outside facility. The patient then brings the media containing the
prior study and presents it to the local VA at intake for treatment.
–

If CSRAs encounter this situation, then they must work with the ARA or the clinician
to resolve the problem.

–

If ARAs encounter this problem for a radiology-based study, then the software allows
them to place an on-demand radiology order and set the order status.

 If the study is a Consult, then ARAs navigate to the CPRS subsystem and place the
order. When they return to the Importer III client and refresh the screen, the order is
then listed.

Reconciling
The original patient/study information and the VA hospital information must be reconciled. For
example, the Patient’s ID may be different from the Patient ID assigned by the location where
the study was completed. In addition, the VA has an accession number associated with the
patient that is different from the accession number used when the imaging facility performed the
study. These two sets of data must be reconciled to match the patient’s data on the media with
the correct patient/study in VistA.

User Roles
The ARA has all rights including staging media, placing on-demand radiology orders, and
reconciling orders and staged studies. An ARA also has rights to correct studies that are in the
DICOM Correct queue.
The CSRA has the rights to stage media and reconcile studies with pending orders, and to
perform a direct import.
Important: Only an ARA can create radiology orders, generate reports, and review reports.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

Entering the Reconciliation Workflow Through Staged Media
Role: As the ARA or the CSRA, you choose to reconcile and import previously staged studies.
The first way to enter the reconciliation workflow is by selecting previously staged media. Media
is staged through one of the following processes.


You or another user staged media using the Importer III client, through one of the Media
Staging scenarios described in Chapter 3: Staging the Data.



An HDIG staged the media through a Network Import.



An HDIG staged the media because a DICOM Correct was necessary.

Regardless of how the media has been staged, the method for entering the reconciliation
workflow is as follows.
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. At the DICOM Importer Home screen, under View Import List, click Import List.

3. The DICOM Import List screen displays. The list contains a set of optional filters that you
can use to narrow down the results displayed in the list.


The Item Type drop-down filter lets you narrow down the results by staging method: All
Types, Direct Import, Staged Media, Network Import, DICOM Correct.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)



The Source drop-down filter lets you narrow down the list by the source of the work
item: a particular client machine, a particular HDIG, and so on.



The Patient Name filter lets you narrow down the list by patient name.



The two radio buttons also function as filters. You may choose to select Show New
Work Items or Show Processed Work Items with Remaining Studies.

Note: If you logged in as a CSRA, you will see only work items in the list that were staged as
FEE origin, or that came in through a network import as FEE origin. Items that were staged
with no origin specified, or with a different origin than FEE, will not be available for you to
reconcile. They must be reconciled by an ARA.

4. Once you have identified the Importer item of interest, select it from the list, and then click
Process Import Item (now enabled).
5. The Importer III client displays the Study List screen, containing all the studies on the
selected media. At this point, you have entered the reconciliation workflow. Refer to one of
the two Reconciliation scenarios (Reconciling Studies with Existing Orders or Reconciling
Studies Requiring New Radiology Orders) for further instructions.

Entering the Reconciliation Workflow Through Direct Import
The previous section discussed entering the reconciliation workflow by choosing a staged media
Importer item. However, you can directly enter the workflow without prior staging if you have a
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

CD or DVD containing the data, or a folder on a local drive containing studies you wish to
import. This is called a Direct Import.
Role: As the ARA or the CSRA, your task involves importing directly from physical media (CD,
DVD, local folder on a hard drive, and so on) without performing the staging step first.
1. Start the Importer III client. (See the section, Starting the Importer III Client for instructions
on starting the Importer III client.)
2. At the DICOM Importer Home screen, under DICOM Direct Import, click Direct Import.

3. At the DICOM Direct Import screen, choose the category of media that you want to import.


August 2018

Select the DICOM Only Media radio button for DICOM only media. DICOM
Importer III returns the message: Only DICOM files will be allowed to be imported
and enables the Direct Media Import button.

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)



Select the Mixed Media radio button for DICOM and non-DICOM media from the
same source. DICOM Importer III returns the message: Each non-DICOM file
selected must belong with a study in the same media bundle; at least one valid
DICOM and non-DICOM file must be selected in order to import and enables the
Direct Media Import button.



Select the Non-DICOM Only Media radio button for non-DICOM media, such as
.pdf files. DICOM Importer III returns the message: Only non-DICOM files will be
allowed to be imported; all Non-DICOM files selected must be for the same patient
and order, and enables the Direct Media Import button.

4. Complete the workflow for the media category selection you have made in step 3 as follows:


August 2018

For DICOM Only files, select Direct Import Media. On the Media Direct Import
screen, select the drive or the folder from which you are importing the files. Select
Reconcile Media. The Study List screen opens. Select and optionally view at least
one study on the study list. Click Reconcile Study. The Patient Selection screen
opens. Search for and select a patient. The Study Origin and Target Order page opens.
Select the study origin. Select to use an existing order or create a new radiology
order. Follow the appropriate workflow for the order choice. At the Reconciliation
DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

Summary Screen, review the details of the reconciliation. Return to the Study List
screen and complete reconciliation


For Mixed Media, select Direct Import Media. On the Media Direct Import screen,
select the drive or the folder from which you are importing the files. Under NonDICOM Media, select Add, and browse to the non-DICOM file you want to reconcile
with the exam. Repeat until all the non-DICOM files you require have been added.
Select Reconcile Media. The Study List screen opens. Select and optionally view at
least one study on the study list. Click Reconcile Study. The Patient Selection screen
opens. Search for and select a patient. The Study Origin and Target Order page opens.
Select the study origin. Select to use an existing order or create a new radiology
order. Follow the appropriate workflow for the order choice. At the Reconciliation
Summary Screen, review the details of the reconciliation. Return to the Study List
screen and complete the reconciliation.



For non-DICOM only files, select Direct Import Media. Under Non-DICOM Media,
select Add, and browse to the non-DICOM file you want to reconcile with the exam.
Repeat until all the non-DICOM files you require have been added. On the NonDICOM File Reconciliation screen, select Select Patient to search for and select a
patient. Click Next. The Study Origin and Target Order page opens. Select the study
origin. Select to use an existing order or create a new radiology order. Follow the
appropriate workflow for the order choice. At the Import Confirmation screen, review
the details of the reconciliation. Select Import.

Note: Refer to one of the two reconciliation scenarios (Reconciling Studies with Existing
Orders or Reconciling Studies Requiring New Radiology Orders) for further instructions.

Reconciling Studies with Existing Orders
The following procedure shows how to reconcile studies with pending orders. The reconciliation
workflow is the same for both staged media and direct imports.
Role: As the ARA or the CSRA, your task begins after selecting a staged Importer item, or
through direct import of media, and involves reconciling studies with pending orders.
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. Go to the Study List by selecting a staged Importer item (see Entering the Reconciliation
Workflow Through Staged Media), or by initiating a Direct Import (see Entering the
Reconciliation Workflow Through Direct Import).
3. Under Study List, select the appropriate study. Optionally, click View Study to verify that
you selected the correct study (see Chapter 6: Viewing Study Data and Images for details).
Once you are satisfied that you have selected the correct study, click Reconcile Study.
Study List Status Indicator Definitions
Letter Indicator (color)

August 2018

Definition

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

C (red)

Study is reconciled and all images are processed

P (yellow)

Study is reconciled and some images are processed, but not all images

I (green)

Study is reconciled and images are waiting for processing

D (pink)

Study is marked for deletion

Note: An order with a status of complete (C) cannot have images added to it. An
Administrative override must be performed to change the status of the order. The exception
is Radiology exams that have a credit method of “NO CREDIT.”
Important: DICOM Correct studies should be processed before they are reported as
completed (C).

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)
Status Indicators
C – Study is reconciled and all images are processed
P – Study is reconciled and some images are processed, but not all images
I – Study is reconciled and images are waiting for processing
D – Study is marked for deletion
Modalities
DX – Digital Photography
IO – Intra-oral Radiography
PX – Panoramic X-Ray
XC – External-camera Photography

4. The first step in the reconciliation process is the Patient Selection screen. The DICOM
Patient Information section displays patient demographic information as found in the
DICOM header. The VA Patient information section may or may not be populated for you
already, as described in the following three scenarios:


If a patient is selected during staging, then the VA Patient Information section is prepopulated with that patient’s information. Verify that the patient is correct. If the
patient is incorrect, click Change Patient to go to the patient search function and
change the selection.



If you have already reconciled a different study in the same Importer session, and the
patient demographics in the DICOM header for the current study identically match
the demographic information in the DICOM header for a previously reconciled study,
the Importer III client pre-populates the patient information for you, saving you the
time of searching again. If the patient is incorrect, click Change Patient to change
the selection.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)



If neither of the above scenarios is applicable, the Importer III client does not prepopulate a patient for you. You are required to search for and select the appropriate
patient before the system allows you to continue.

5. Once the patient is searched for (or verified if pre-populated), click Next.
6. If you are logged in as an ARA, the next step is to choose the study origin and target order. If
you are logged in as a CSRA, you will not see this step and are instead taken directly to the
Choose Existing Order screen, since the study origin is already set to FEE, and you do not
have the option to create a new radiology order.
7. Since in this scenario the order already exists, select Use an Existing Order for target order.
8. Click Next.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

9. At the Choose Existing Order screen, select the appropriate existing order. The list displays
both RAD (radiology orders) and CON (consults orders).

10. If a radiology order is chosen, the exam status is updated to EXAMINED by default. This is
to allow local workflow to be followed to close out the exam. If you know that the exam
should be completed as-is (no additional images need to be added, no diagnostic codes need
to be entered, and so on), then you may choose to advance the status to COMPLETE from
here by selecting the Set the exam to COMPLETE after import checkbox. This option is not
available for consults, only radiology orders.
Note: At this point in the reconciliation process, you may add one or more non-DICOM files
to the record of the patient whose studies you are reconciling. Follow these steps:


August 2018

Click Next. DICOM Importer III opens the Add Non-DICOM Files screen.

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)



Click Add. Browse to and select the correct file on your computer’s hard drive.
Repeat this process until you have selected all desired files.

11. Click Next. DICOM Importer III opens the Reconciliation Summary screen.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

12. At the Reconciliation Summary screen, verify that the study matches the order and then click
Return to Study List.
Note: Non-DICOM files you may have added to the patient record are not listed on the
Reconciliation Summary screen.
13. At the Study List screen, note the status indicators added in the Status column of the study. If
there are other studies on the media you wish to import, you can continue reconciling them.
When all studies of interest are reconciled, click Submit Import Request.
Status Indicators
C – Study is reconciled and all images are processed
P – Study is reconciled and some images are processed, but not all images
I – Study is reconciled and images are waiting for processing
D – Study is marked for deletion
Modalities
DX – Digital Photography
IO – Intra-oral Radiography
PX – Panoramic X-Ray
XC – External-camera Photography

14. At the Import Confirmation screen, verify that the studies you wish to import are displayed,
and verify that the reconciliation is correct. If it is not, you click Return to Study List to
update the reconciliations. If you are satisfied with the reconciliations, click Import.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

15. In the Queued for Import dialog box, click OK to confirm that the work item is queued for
import processing.

16. The system returns you to either the Direct Import home screen or the DICOM Import List,
depending on how you originally entered the reconciliation workflow. From here, you can
continue to work on other Importer scenarios, or you may exit or log out of the Importer III
client by following the steps found in Stopping the Importer III Client.

Reconciling Studies Requiring New Radiology Orders
The following procedure shows how to reconcile studies requiring new orders.
Role: As the ARA, your task begins after selecting a staged Importer item, or through direct
import of media, and involves creating a new radiology order during reconciliation. This
scenario is not available to the CSRA.
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. Go to the Study List by selecting a staged Importer item (see Entering the Reconciliation
Workflow Through Staged Media), or by initiating a Direct Import (see Entering the
Reconciliation Workflow Through Direct Import).

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

3. At the Study List screen, select the appropriate study. Optionally, click View Study to verify
that you selected the correct study (see Chapter 6: Viewing Study Data and Images for
details). Once you are satisfied that you have selected the correct study, click Reconcile
Study. Note: This step is not required if you are reconciling non-DICOM only media.

Status Indicators
C – Study is reconciled and all images are processed
P – Study is reconciled and some images are processed, but not all images
I – Study is reconciled and images are waiting for processing
D – Study is marked for deletion
Modalities
DX – Digital Photography
IO – Intra-oral Radiography
PX – Panoramic X-Ray
XC – External-camera Photography

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

4. The first step in the reconciliation process is the Patient Selection screen. The DICOM
patient information section displays patient demographic information as found in the DICOM
header. The VA Patient information section may or may not be populated for you already, as
described in the following three scenarios:


If the user selects a patient during staging, the VA Patient Information section is prepopulated with that patient’s information. Verify that the patient is correct. If the
patient is incorrect, click Change Patient to change the patient.



August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)



If neither of the above scenarios is applicable, the Importer III client does not prepopulate patient information for you. You are required to search for and select the
appropriate patient before the system allows you to continue.

5. Once the patient is searched for (or verified if pre-populated), click Next.
If you logged in as an ARA, the next step is to choose the study origin and target order. If you
logged in as a CSRA, you do not see this step. Instead, the system takes you directly to the
Choose Existing Order screen, since the study origin is already set to FEE, and you do not have
the option to create a new radiology order.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

6. To create a new radiology order, select Create Radiology Order under Target Order.

7. Select the study origin from the Study Origin drop-down menu. Add the study date at the
bottom of the screen if needed. The Next button is enabled.
8. Click Next. DICOM Importer III opens the Create New Radiology Order screen.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

The Create New Radiology Order screen consists of four groups of information.


Under VA Patient Information, there is identifying information for the patient selected in
the previous step, as found in the VA patient record.



Under Original Study Information, there is study information retrieved from the DICOM
metadata for the selected study.



Under VA Order Details, there are data entry fields.



Under Status Change Details, there is information regarding the exam status, standard
reports associated with the exam, and diagnostic codes associated with the exam.

9. Perform the following steps under VA Order Details.


Select the appropriate Ordering Provider.



Select the appropriate Ordering Location.



Select the appropriate Procedure.



Optionally, select any applicable Procedure Modifiers.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

10. Review the Status Change Details section. To change the entries, click Change Details, and
complete the steps detailed in the section titled Adding and Changing Exam Details During
Reconciliation of a New Radiology Order.
11. Click Next. DICOM Importer III opens the Add Non-DICOM Files screen. Use this screen to
add non-DICOM files to the patient record for this exam. When you have finished entering
non-DICOM files, click Next.

12. DICOM Importer III opens the Reconciliation Summary screen.
13. At the Reconciliation Summary screen, verify that the study matches the order and then click
Return to Study List.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

14. At the Study List screen, note the marker added in the Status column of the study. If there are
other studies on the media you wish to import, you can continue reconciling them. When all
studies of interest have been reconciled, click Submit Import Request.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

15. At the Import Confirmation screen, verify that the study or studies you wish to import are
displayed, and verify that the reconciliation looks correct. If it does not, you may return to
the study list to update the reconciliations. If you are satisfied with the reconciliations, click
Import.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

16. In the Queued for Import dialog box, click OK indicating that the work item is queued for
import processing.

17. The system returns you to either the Direct Import screen or the DICOM Import List screen,
depending on how you originally entered the reconciliation workflow. From here, you can
continue to work on other Importer scenarios, or you may exit or log out of the Importer III
client by following the steps found in Stopping the Importer III Client.

Adding and Changing Exam Details During Reconciliation
As part of the reconciliation process, DICOM Importer III enables users to change the status of
exams, the diagnostic codes associated with exams, and the standard reports ordered to
accompany the exams.
Role: As the ARA or the CSRA, you change the details of an exam during the process of
reconciling studies with patients.
Note: The workflow required to change study details is different for existing orders and for new
radiology orders created during the reconciliation process. See the sections titled Adding and
Changing Exam Details During Reconciliation of An Existing Order and Adding and Changing
Exam Details During Reconciliation of a New Radiology Order for details.

Adding and Changing Exam Details During Reconciliation of An Existing Order
To add or change exam details for an existing order during the reconciliation process:
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. Go to the Study List by selecting a staged Importer item (see Entering the Reconciliation
Workflow Through Staged Media), or by initiating a Direct Import (see Entering the
Reconciliation Workflow Through Direct Import). Click Reconcile Study.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

3. DICOM Importer III opens the Patient Selection screen. Confirm the patient selection and
click Next.
Or click Change Patient to go to the Patient Lookup screen and select another patient.
Then, click Next.

4. DICOM Importer III opens Study Origin and Target Order screen.

5. Select the origin of the study from the Study Origin drop-down menu.
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

6. Select the Use an Existing Order radio button.
7. Select an Imaging Location from the list at the bottom of the screen.
8. If required, add the study date in YYYYMMDD format.
9. Click Next.
10. DICOM Importer III opens the Choose Existing Order screen. From the Existing Orders list,
select the order you wish to reconcile.

11. Click Change Details. DICOM Importer III opens the Status Change Details pop-up box.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

12. In the Status Change Details pop-up box, select the primary diagnostic code from the dropdown menu, and select one or more secondary diagnostic codes from the drop-down menu.
An unlimited number of secondary diagnostic codes are allowed.
Note: Select Complete in the Exam Status drop-down menu. This enables selection of the
diagnostic codes and the standard report you want to associate with the exam.
13. Select the standard report to be associated with the exam from the Standard Report dropdown menu. Review the Standard Report Impression (summary) and Standard Report Text
(full text) to ensure you have selected the desired report.
Note: If the Exam Status drop-down is set to Examined, you will receive a warning message
to change the exam status to Complete before you can change the status details of the exam.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

14. Select OK. DICOM Importer II returns to the Choose Existing Order screen. Click Next.
At this point, you resume the reconciliation process.
Adding and Changing Exam Details During Reconciliation of a New Radiology
Order
To add or change exam details while creating a new radiology order during the reconciliation
process, follow these steps:
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. Go to the Study List by selecting a staged Importer item (see Entering the Reconciliation
Workflow Through Staged Media), or by initiating a Direct Import (see Entering the
Reconciliation Workflow Through Direct Import). Click Reconcile Study.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

4. DICOM Importer III opens Study Origin and Target Order screen. Select the origin of the
study from the Study Origin drop-down menu.
5. Select the Create Radiology Order radio button.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

6. Select an Imaging Location from the list at the bottom of the screen.
7. If required, add the study date in YYYYMMDD format.
8. Click Next.
9. DICOM Importer III opens the Choose Existing Order screen. From the Existing Orders list,
select the order you wish to reconcile.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

10. Click Change Details. DICOM Importer III opens the Status Change Details pop-up box.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

11. In the Status Change Details pop-up box, select the primary diagnostic code from the dropdown menu, and select one or more secondary diagnostic codes from the drop-down menu.
An unlimited number of secondary diagnostic codes are allowed.
12. Select the standard report to be associated with the exam from the Standard Report dropdown menu. Review the Standard Report Impression (summary) and Standard Report Text
(full text) to ensure you have selected the desired report.
Note: If the Exam Status drop-down is set to Examined, you will receive a warning message
to change the exam status to Complete before you can change the status details of the exam.

13. Select OK. DICOM Importer II returns to the Choose Existing Order screen. Click Next.
At this point, you resume the reconciliation process.

Reconciling Partially Imported Studies
Occasionally, a piece of media that you are attempting to import contains images for a study in
which some of the images on the media already exist in VistA, while others do not. This is
termed a partially imported study, and the system displays these studies in the study list with a
status indicator of P.
Role: As the ARA or the CSRA, your task begins after the media is staged or through direct
import of media, and involves adding additional images to a partially imported study.
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. Go to the Study List by selecting a staged Importer item (see Entering the Reconciliation
Workflow Through Staged Media), or by initiating a Direct Import (see Entering the
Reconciliation Workflow Through Direct Import).

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

3. At the Study List screen, select a partially imported study (P). The system displays the Study
Details panel for the selected study. The Study Information column shows patient and study
information obtained from the DICOM header. Since the study is partially imported, the
Order Information column is populated with the patient and order data that the existing
images were filed under. At this point, you can optionally click View Study, to verify that
you selected the desired study (see Chapter 6: Viewing Study Data and Images for details).
When you are satisfied that you have selected the desired study, click Reconcile Study.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

4. You are alerted that the study is partially imported, and offered a choice:
Would you like to import the remaining instances to the same patient and order?
Choose ‘Yes’ to import the remaining instances to the same patient and order.
Choose ‘No’ to reconcile the remaining instances to a different patient and/or order.


If you choose Yes, then the system creates a complete reconciliation automatically,
using the same patient and order that are displayed in the Study Details panel in the
previous step, and you are returned immediately to the Study List screen, bypassing
the manual reconciliation steps. Even though the reconciliation is created for you
automatically, you still have the option to reenter the reconciliation workflow to make
changes at any time, by selecting the study and clicking Reconcile Study.



If you choose No, the system takes you directly to the reconciliation workflow. The
patient is preselected for you on the Patient Information screen, but you are free to
change it if necessary.

5. Regardless of whether you chose automatic or manual reconciliation in the previous step,
once the reconciliation is complete the system gives the study a new status of PI. This
indicates that the study is partially imported and that the remaining images are reconciled and
ready for import. If there are other studies on the media you wish to import, you can continue
reconciling them. When all studies of interest are reconciled, click Submit Import Request.
6. At the Import Confirmation screen, verify that the study or studies you wish to import are
displayed, and verify that the reconciliation looks correct. If it does not, you may return to
the study list to update the reconciliations. If you are satisfied with the reconciliations, click
Import.
7. In the Queued for Import dialog box, click OK to acknowledge that the work item is queued
for import processing.

8. The system returns you to either the Direct Import screen or the DICOM Import List screen,
depending on how you originally entered the reconciliation workflow. From here, you can
continue to work on other Importer scenarios, or you may exit or log out of the Importer III
client by following the steps found in Stopping the Importer III Client.

Deleting Studies from Staged Media
A piece of staged media that you are attempting to import will occasionally contain multiple
studies. If you know that you do not need one or more of these studies, you can choose to delete
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

them from the staged media bundle. This has the benefit of freeing up space on the imaging
share, since Importer items and their extra studies remain on the system for a configurable
amount of time after submission and processing.
Role: As the ARA or the CSRA, your task begins after the media is staged, and involves deleting
unneeded studies from a staged media bundle. This workflow does not apply to Direct Import.
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. Go to the Study List by selecting a staged Importer item (see Entering the Reconciliation
Workflow Through Staged Media).
3. At the Study List screen, select a study that you wish to delete. At this point, you can
optionally click View Study, to verify that you selected the desired study (see Chapter 6:
Viewing Study Data and Images for details).
4. Once you are satisfied that the desired study is selected, click Delete. (This button is only
available for staged media, not direct import). The system gives the study a status of D, and
updates the text of the Delete button to Don’t Delete. If you decide that you do not actually
wish to delete the study, make sure it is selected, and then click Don’t Delete. Otherwise,
click Submit Import Request to continue the deletion process.
Note: The system does not actually delete the media until you submit the Importer item, so
you can toggle back and forth as often as you like on this screen.
5. At the Import Confirmation screen, the system displays the total number of studies that you
have marked for deletion, just above the list of reconciliations (if any) that you have
completed. Click Import to continue the deletion process.

6. In the Queued for Import dialog box, click OK to acknowledge that the work item is queued
for import processing.

7. The system returns you to the Direct Import screen or the DICOM Import List screen,
depending on how you originally entered the reconciliation workflow. From here, you can
continue to work on other Importer scenarios, or you may exit or log out of the Importer III
client by following the steps found in Stopping the Importer III Client.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 4: Working with Studies and Orders (Reconciling)

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues
Managing import queues involves performing periodic maintenance involving the following
tasks:


Reverting work items stuck in reconciliation.



Viewing the Importer items that are currently being processed by an HDIG.



Viewing failed Importer items.

Role: The ARA handles these tasks exclusively.

Reverting Items Stuck in Reconciliation
If a user selects an item from the Import List, and the user’s Importer III client or workstation
crashes before the item is cancelled or submitted for processing, the Importer item they were
actively working will be stuck in a status of In Reconciliation. When this occurs, the Importer
item no longer shows up in the Import List, and is therefore unavailable for subsequent
reconciliation attempts.
The Revert Import Item screen allows an administrator to identify Importer items that are stuck
in reconciliation, revert them back to a status of New, and delete reconciliations that were
partially completed, if any. This process restores the Importer item to a known good state, so that
it is available once again for selection in the Import List.

Use caution when reverting Importer items. The Revert Items list shows all Importer items that
are currently in reconciliation, including items that are not stuck and are actively being worked
on. The “stuck” items must be identified, using data such as the last person to modify the item,
the timestamp of the modification, or other identifying information. If an item that is currently
being worked is inadvertently reverted, then the user gets an error when they attempt to submit
the import, and will have to go back to the Import List and repeat the reconciliation process.
Note: As the ARA, the administrator tasks require the MAGV IMPORT RECON CONTRACT
security key.

Chapter 5: Managing Import Queues

To revert items stuck in reconciliation:
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. At the DICOM Importer Home screen, under Administration, click Administration.

3. At the DICOM Importer Administration Home screen, under Revert Importer Items, click
Revert Items.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues

4. At the Revert Import Item screen, select the Importer item that is stuck in reconciliation,
being especially careful not to select other import items that are not stuck, and click Revert
Import Item.

5. If the reverted item was the last one in the list, DICOM Importer III displays the message: No
Importer items are currently in reconciliation.

6. At the Revert Import Item screen, click Return to Administration Home.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues

7. At the DICOM Importer Administration Home screen, click Return to Importer Home.

8. At the DICOM Importer Home screen, under View Import List, click Import List to verify
the reverted item is now listed.
9. Exit or log out of the Importer III client by following the steps found in Stopping the
Importer III Client.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues

Viewing Importer Items Currently Being Processed by an HDIG
The Importer III client allows users to reconcile DICOM studies with the correct VA patient and
order data. However, the work of actually importing the studies into VistA is handled
asynchronously by an HDIG.
Administrators have the ability to view the current work status for each of the HDIGs for the
logged in station number.
To view the work status for the HDIGs:
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. At the DICOM Importer Home screen, under Administration, click Administration.

3. At the DICOM Importer Administration Home screen, under In-Process Imports, click InProcess Imports.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues

4. At the In-Process Importer Items screen, the system displays a list of items (if any) that the
HDIGs are currently processing for the logged in station number. The list shows high-level
details, including the IEN of the Importer item, the type, when the item was submitted, who
submitted the item, and which HDIG is currently processing the item.
5. The list does not refresh automatically, but you can click Refresh In-Process Import List at
any time to refresh the list manually. When you are finished working with in-process
Importer items, you can continue working on other Importer use cases, or you may exit or log
out of the Importer III client by following the steps found in Stopping the Importer III Client.

Viewing Failed Importer Items
The Importer III client allows users to reconcile DICOM studies with the correct VA patient and
order data. However, the work of actually importing the studies into VistA is handled
asynchronously by an HDIG. Because the import process is asynchronous, errors during import
cannot be displayed in real time when the user submits the studies for processing. Instead, the
Importer III client supplies functionality to view failed import items after the processing is
complete.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues

To see a list of failed work items for the logged in station number, and view details related to
each of the failures:
1. Start the Importer III client. (See the section Starting the Importer III Client for instructions
on starting the Importer III client.)
2. At the DICOM Importer Home screen, under Administration, click Administration.

3. At the DICOM Importer Administration Home screen, under View Failed Imports, click
Failed Imports.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues

4. At the Failed Import Items screen, the system displays a list of items (if any) that failed at
some point during import processing. When you select an item from the list, the system
displays the details of the item in the Importer Item Error Details scrolling text box. This data
gives you a significant amount of information to assist in resolving the issue.

5. Once an item is selected, you have several options:


To send the error details to support personnel in an email, you can select the error details
text and copy it to the system clipboard through the standard Ctrl+C keyboard
combination.



If you determine that the error is probably due to a transient condition (for example, a file
failed to copy because of a temporary network issue), you may resubmit the Importer
item by clicking Resubmit Import Item. This resubmits the Importer item to the HDIG
in order to attempt processing again. If it fails again, the Importer item reappears in the
Failed Import Items list after processing. Resubmission is only successful for a subset of
errors, as described above.



If you determine that the issue is resolved in another manner and that you no longer need
the Importer item, delete it by clicking Delete Import Item. For example, you may
determine that all images are successfully transmitted, but the Importer item failed
because the HDIG is not able to complete the exam automatically after import. If you are
able to complete the exam through some other means (for example, CPRS), then you may
safely delete the Importer item.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues

6. When you are finished working with failed Importer items, you can continue working on
other Importer use cases, or you may exit or log out of the Importer III client by following
the steps found in Stopping the Importer III Client.

Viewing the Application Log File
The Importer III client allows administrators to view log files from within the Importer III client.
1. Start the Importer III client. (See Starting the Importer III Client for instructions on starting
the Importer III client.)
2. At the DICOM Importer Home screen, under Administration, click Administration.

3. At the DICOM Importer Administration Home screen, under View Log, click Log.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 5: Managing Import Queues

4. At the Log screen, the system displays the contents of the latest application log file. You can
copy text out of the log to the system clipboard by selecting it and pressing the Ctrl+C key
combination on your keyboard.

5. The list does not refresh automatically. Click Refresh at any time to refresh the display
manually. When you are finished working with the application log, you can continue
working on other Importer scenarios, or you may exit or log out of the Importer III client by
following the steps found in Stopping the Importer III Client.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 6: Viewing Study Data and Images
This chapter describes the steps required for viewing study data and images. You can view study
data, images, and DICOM headers when performing advanced staging, or from the Study List
screen during the reconciliation workflow.
1. At the Study Details window, enter an image number or a range of image numbers in the text
box under Images.
2.

Click View Images.

The image or images display in the DICOM Viewer.

Chapter 6: Viewing Study Data and Images

3. You may select additional series to review the images and DICOM information.
Note: If you need to view the DICOM header and group information for details on the
institution, address, physician name, and so on, follow the steps in Optionally Viewing the
DICOM Header and Group Information. In addition, follow this procedure to resolve any
issues with the order.
4. In the File menu, click Exit to close the DICOM Viewer application.
5. In the Study Details window, click Close.

Optionally Viewing the DICOM Header and Group Information
To view DICOM header and group information:
1. On the ViewInfo menu in the DICOM Viewer window, click DICOM Header.
The DICOM Header window displays.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 6: Viewing Study Data and Images

2. Check the DICOM header information by clicking the Header tab. The displayed metadata
lists provide details such as the name of the institution and department, date, and physician
name.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 6: Viewing Study Data and Images

3. Click the Group 2 tab to view the technical information.

4. Close the DICOM Header, Importer, and Study Details windows.
The Importer window redisplays, so that the staging of media for import can continue.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 7: Running Usage Reports
Reports can be displayed on a screen, sent to a printer, or exported to a file. The Importer III
client can also generate a real-time report, which displays the total data imported into a network
share location, by showing the following:


Import Details



Totals by Location



Totals by Modality

DICOM Importer III writes all generated errors to the Application log.

Sample Reports
The Import Details report displays a statistical count for studies, series in a study, and objects
(images or reports), both successful and failed, that are imported on a specified date or a range of
dates.

Chapter 7: Running Usage Reports

The Totals by Location report displays a statistical count for studies, series in a study, and
objects (images or reports), both successful and failed, that are imported on a specified date for a
specified location.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 7: Running Usage Reports

The Totals by Modality report displays a statistical count for studies, series in a study, and
objects (images or reports) both successful and failed that are imported on a specified date. The
report also contains the breakdown by modality, as seen in the following example.

User Role
The role of the RU is to generate statistical reports at the Study level.

Running a Usage Report
To run a usage report.
Role: As the RU (or ARA), your task is to run usage reports.
1. Start the Importer III client. (See Starting the Importer III Client for instructions on starting
the Importer III client.)
2. At the Windows Security box, make sure you have a valid PIV card attached to your
computer and enter your PIN code to log in to the Importer III client.
3. Click OK.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 7: Running Usage Reports

4. If the site has more than one division, then select the division in the Select Division window
and click OK. Otherwise, go to step 5.
5. At the DICOM Importer Home screen, under Reports, click Reports.

6. At the Reports Home screen, under Filters, select one of the following report types from the
Report Type drop-down box.


Import Details



Totals by Location



Totals by Modality

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Chapter 7: Running Usage Reports

7. Click the calendar icon at the far right end of the Start Date and End Date text boxes to
specify the date range. Select dates from the corresponding pop-up calendars.

8. Click View Report to display the data, as seen in the following examples of the three report
types.
9. To print the report, click Print in the bottom-right corner of the Importer window.
10. In the Print dialog box, specify the printing preferences and click Print.
11. To save the report, click Save As in the bottom-right corner of the Importer window.
12. In the Save As dialog box, specify the path and file name, and then click Save.
13. Exit or log out of the Importer III client by following the steps found in Stopping the
Importer III Client.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Appendix A: Setting Up Outside Imaging Locations for
the Importer III Client
When a prior, unordered, outside radiology study is imported into VistA, an order is
automatically placed for it. The VistA order, created for the outside radiology study, should not
accrue workload statistics for VA technical or professional components, because the exam was
neither performed in the VA, nor interpreted by the VA. For this reason, the order created on
VistA should use a RADIOLOGY IMAGING LOCATION (#79.1) with a CREDIT METHOD =
No Credit.
The VistA Imaging OUTSIDE IMAGING LOCATION file (#2006.5759) is used by the
Importer III client to designate the entry in the Radiology IMAGING LOCATIONS file (#79.1)
with CREDIT METHOD = No Credit (which is to be used for the order created on VistA). There
has to be one entry in the VistA Imaging OUTSIDE IMAGING LOCATION file (#2006.5759)
for each enabled Radiology Imaging Type in each division.
The standard Radiology Package tools are used for creating the entries in the Radiology
IMAGING LOCATIONS file (#2006.5759). These include Parameter Set-up [RA SYSLOC] and
Division Parameter Set-up [RA SYSDIV] options of the System Definition Menu [RA
SYSDEF]. VistA Imaging provides the IMPORTER menu [MAG IMPORTER MENU] for
constructing the OUTSIDE IMAGING LOCATION file (#2006.5759).
A Radiology/Nuclear Medicine Automated Data Processing Coordinator (ADPAC) should
perform the modifications to Radiology Division and Imaging Locations files, as they should
have the necessary menu privileges.
Note: If a site already has a No Credit outside location established for a Radiology Imaging Type
for a division, it may be used instead of creating a new one.

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Step 1 – Identify Imaging Types and Divisions that Need “No
Credit” Imaging Locations
This step is performed by VistA Imaging site personnel.
Log into VistA and select the VistA Imaging System Manager menu [MAG SYS MENU]. Then
select the IMPORTER Menu [MAG IMPORTER MENU] and the Check Outside Imaging
Location file option [MAG CHECK OUT IMG LOC]. In this example, there are two enabled
Image Types (General Radiology and Nuclear Medicine) for the Salt Lake City Division.
IMAGing System Manager Menu
HL7

Imaging HL7 Messaging Maintenance ...

Image Index Conversion Menu ...

Edit Network Location STATUS

Telereader Menu ...
Ad hoc Enterprise Site Report
Configure AE Security Matrix Settings
Delete Image Group
Enter/edit Reason
Imaging Database Integrity Checker Menu ...
Imaging Site Reports ...
Importer Menu ...

Select Imaging System Manager Menu Option: IMPORTER Menu
Build Outside Imaging Location file
Check Outside Imaging Location file
Display Studies to be Imported
Select Importer Menu Option: CHECK Outside Imaging Location file
Checking the Radiology files...
Division: SALT LAKE CITY
GENERAL RADIOLOGY

- Define “No Credit” Imaging Location!

NUCLEAR MEDICINE

- Define “No Credit” Imaging Location!

Please define missing “No Credit” imaging locations for the aforementioned
divisions and imaging types (using the Location Parameter Set-up [RA
SYSLOC]
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

and Division Parameter Set-up [RA SYSDIV] options of the System Definition
Menu ... [RA SYSDEF] options) and then run this option again.

Note that the SALT LAKE CITY Division has two Imaging Types (GENERAL RADIOLOGY
and NUCLEAR MEDICINE) that need to have a NO CREDIT Imaging Location defined for
them. The Radiology ADPAC does this in Steps 2 – 4 of this appendix.
If the site has a No Credit imaging location already defined for the imaging type, the ADPAC
does not have to create a new No Credit imaging location. However, the ADPAC should create
the OUTSIDE STUDY Camera/Equip/Rm and assign it to the No Credit imaging location.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Step 2 – Create the OUTSIDE STUDY Entry in the
CAMERA/EQUIP/RM File
A Radiology ADPAC performs this step.
Select the System Definition Menu [RA SYSDEF] from the Supervisor Menu [RA
SUPERVISOR]. Edit the Camera/Equip/Rm parameters. Create a new OUTSIDE STUDY and
enter the description, Study performed outside of this facility.
Exam Entry/Edit Menu ...
Films Reporting Menu ...
Management Reports Menu ...
Outside Films Registry Menu ...
Patient Profile Menu ...
Radiology/Nuclear Med Order Entry Menu ...
Supervisor Menu ...
Switch Locations
Update Patient Record
User Utility Menu ...
Select Rad/Nuc Med Total System Menu Option: Supervisor Menu
HL7

Radiology HL7 Menu ...
Access Uncorrected Reports
Delete a Report
Delete Printed Batches By Date
Exam Deletion
Inquire to File Entries
List Exams with Inactive/Invalid Statuses
Maintenance Files Print Menu ...
Mass Override Exam Status
Override a Single Exam’s Status to ‘complete’
Print File Entries
Rad/Nuc Med Personnel Menu ...
Restore a Deleted Report
Search File Entries
Switch Locations

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

System Definition Menu ...
Unverify a Report for Amendment
Update Exam Status
Utility Files Maintenance Menu ...
Select Supervisor Menu Option: System Definition Menu
Camera/Equip/Rm Entry/Edit
Division Parameter Set-up
List of Cameras/Equip/Rms
Location Parameter List
Location Parameter Set-up
Print Division Parameter List
Select System Definition Menu Option: CAMERA/Equip/Rm Entry/Edit
Select Camera/Equip/Room: OUTSIDE STUDY
Are you adding ‘OUTSIDE STUDY’ as a new CAMERA/EQUIP/RM (the 10TH)? No// Y
(Yes)
CAMERA/EQUIP/RM DESCRIPTION: Study performed outside of this facility
CAMERA/EQUIP/RM: OUTSIDE STUDY//
DESCRIPTION: Study performed outside of this facility
Replace
Select Camera/Equip/Room:

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Step 3 – Add New Outside Imaging Locations for Each Imaging
Type to Divisions
A Radiology ADPAC performs this step.
For each division, enter the name of each outside imaging location; one for each Imaging Type
for the Division. The suggested naming convention is as follows:
OUTSIDE
Naming Convention Example
In this fictitious example, the facility has the following Imaging Types enabled.
Imaging Type (from IMAGING TYPE file #79.2)

Abbreviation

GENERAL RADIOLOGY

RAD

NUCLEAR MEDICINE

NUC MED

ULTRASOUND

MAGNETIC RESONANCE IMAGING

MRI

CT SCAN

ANGIO/NEURO/INTERVENTIONAL

ANGIO

CARDIOLOGY STUDIES (NUC MED)

CARD

VASCULAR LAB

VAS

MAMMOGRAPHY

MAM

Let us say that the facility has two divisions, SALT LAKE CITY VAMC and CLEAR WATER
LAKE VAMC. We chose SLC as the division mnemonic for the first, and CWL as the
mnemonic for the second.
Here is the list of Outside Imaging Locations that we need to add to the system.
OUTSIDE SLC RAD

OUTSIDE CWL RAD

OUTSIDE SLC NUC MED

OUTSIDE CWL NUC MED

OUTSIDE SLC US

OUTSIDE CWL US

OUTSIDE SLC MRI

OUTSIDE CWL MRI

OUTSIDE SLC CT

OUTSIDE CWL CT

OUTSIDE SLC ANGIO

OUTSIDE CWL ANGIO

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

OUTSIDE SLC CARD

OUTSIDE CWL CARD

OUTSIDE SLC VAS

OUTSIDE CWL VAS

OUTSIDE SLC MAM

OUTSIDE CWL MAM

End of Naming Convention Example.
In the rest of the examples, there is only the SALT LAKE CITY Division and two IMAGE
TYPES: GENERAL RADIOLOGY and NUCLEAR MEDICINE.
Select the System Definition Menu [RA SYSDEF]. Select a Division. Accept the defaults until
reaching the Imaging Locations Associated with this Division section. Enter the name of each
outside imaging location, one for each Imaging Type for the Division.
In this example, we are creating the Imaging Locations, OUTSIDE SLC RAD and OUTSIDE
SLC NUC MED (the others are created the same way). For each location, select HOSPITAL
LOCATION TYPE: CLINIC, HOSPITAL LOCATION TYPE EXTENSION: CLINIC//, and the
appropriate Imaging Type.
Exam Entry/Edit Menu ...
Films Reporting Menu ...
Management Reports Menu ...
Outside Films Registry Menu ...
Patient Profile Menu ...
Radiology/Nuclear Med Order Entry Menu ...
Supervisor Menu ...
Switch Locations
Update Patient Record
User Utility Menu ...
Select Rad/Nuc Med Total System Menu Option: supervisor Menu
HL7

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Print File Entries
Rad/Nuc Med Personnel Menu ...
Restore a Deleted Report
Search File Entries
Switch Locations
System Definition Menu ...
Unverify a Report for Amendment
Update Exam Status
Utility Files Maintenance Menu ...
Select Supervisor Menu Option: system Definition Menu
Camera/Equip/Rm Entry/Edit
Division Parameter Set-up
List of Cameras/Equip/Rms
Location Parameter List
Location Parameter Set-up
Print Division Parameter List
Select System Definition Menu Option: division Parameter Set-up
Select Division: 660
...OK? Yes//

SALT LAKE CITY

660

(Yes)

Division-wide Order Entry Parameters:
-----------------------------------ASK ‘IMAGING LOCATION’: NO//
TRACK REQUEST STATUS CHANGES: NO//
CLINICAL HISTORY MESSAGE:
Exam Entry/Edit Parameters:
--------------------------DETAILED PROCEDURE REQUIRED: no//
ASK ‘CAMERA/EQUIP/RM’: no//
AUTO USER CODE FILING: yes//
TRACK EXAM STATUS CHANGES: no//
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

100

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

TIME LIMIT FOR FUTURE EXAMS:
Films Reporting Parameters:
--------------------------ALLOW STANDARD REPORTS: yes//
ALLOW BATCHING OF REPORTS: yes//
ALLOW COPYING OF REPORTS: yes//
IMPRESSION REQUIRED ON REPORTS: yes//
ALLOW VERIFYING BY RESIDENTS: yes//
ALLOW RPTS ON CANCELLED CASES?: no//
WARNING ON RPTS NOT YET VERIF?: yes//
AUTO E-MAIL TO REQ. PHYS?:
ALLOW E-SIG ON COTS HL7 RPTS: no//
INTERPRETING STAFF REQ’D?: YES//
Miscellaneous Division Parameters:
---------------------------------PRINT FLASH CARD FOR EACH EXAM: no//
PRINT JACKET LBLS W/EACH VISIT: no//
CONTRAST REACTION MESSAGE:
RPHARM DOSE WARNING MESSAGE:
No existing text
Edit? NO//
HL7 Applications Associated with this Division:
----------------------------------------------Select HL7 RECEIVING APPLICATION:
Imaging Locations Associated with this Division:
-----------------------------------------------Select IMAGING LOCATION: TD-MAINRAD// OUTSIDE SLC RAD
Are you adding ‘OUTSIDE SLC RAD’ as
a new HOSPITAL LOCATION? No// Y
HOSPITAL LOCATION TYPE: C

(Yes)

CLINIC

HOSPITAL LOCATION TYPE EXTENSION: CLINIC//
Are you adding ‘OUTSIDE SLC RAD’ as
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

101

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

a new IMAGING LOCATIONS (the 3RD)? No// Y

(Yes)

IMAGING LOCATIONS TYPE OF IMAGING: ?
Enter an imaging type for this location.
Answer with IMAGING TYPE TYPE OF IMAGING, or ABBREVIATION
Choose from:
ANGIO/NEURO/INTERVENTIONAL
CARDIOLOGY STUDIES (NUC MED)
CT SCAN
GENERAL RADIOLOGY
MAGNETIC RESONANCE IMAGING
MAMMOGRAPHY
NUCLEAR MEDICINE
ULTRASOUND
VASCULAR LAB
IMAGING LOCATIONS TYPE OF IMAGING: GENERAL RADIOLOGY
Are you adding ‘OUTSIDE SLC RAD’ as
a new IMAGING LOCATIONS (the 3RD for this RAD/NUC MED DIVISION)? No//
Y
(Yes)
Select IMAGING LOCATION: OUTSIDE SLC NUC MED
Are you adding ‘OUTSIDE SLC NUC MED’ as
a new HOSPITAL LOCATION? No// Y
HOSPITAL LOCATION TYPE: C

(Yes)

CLINIC

HOSPITAL LOCATION TYPE EXTENSION: CLINIC//
Are you adding ‘OUTSIDE SLC NUC MED’ as
a new IMAGING LOCATIONS (the 4TH)? No// Y

(Yes)

IMAGING LOCATIONS TYPE OF IMAGING: NUCLEAR MEDICINE
** Caution: You are activating a new Imaging Type.

This means you will have to assign procedures to
this imaging type. Workload reports will be printed
separately for this Imaging Type.
Are you sure? YES

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

102

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Are you adding ‘OUTSIDE SLC NUC MED’ as
a new IMAGING LOCATIONS (the 4TH for this RAD/NUC MED DIVISION)? No//
(No)??
Select IMAGING LOCATION:
Division Parameters have been set!
Imaging Location TD-RAD is OK.
Imaging Location TD-MAINRAD is OK.
Imaging Location file #79.1 entry OUTSIDE SLC RAD has a missing
or invalid DSS ID. The Radiology/Nuclear Medicine ADPAC should
use the Location Parameter Set-up [RA SYSLOC] option to enter
a valid imaging DSS Code for this imaging location.

Select Division:
Camera/Equip/Rm Entry/Edit
Division Parameter Set-up
List of Cameras/Equip/Rms
Location Parameter List
Location Parameter Set-up
Print Division Parameter List
Select System Definition Menu Option:

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

103

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Step 4 – Define Outside Imaging Locations Parameters
A Radiology ADPAC performs this step.
Use the Location Parameter Set-up menu [RA SYSLOC] option to specify the
CAMERA/EQUIP/RM, and set the CREDIT METHOD to No Credit and the DSS ID to XRAY.
Select Rad/Nuc Med Total System Menu Option: supervisor Menu
HL7

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

104

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Select Supervisor Menu Option: system Definition Menu
Camera/Equip/Rm Entry/Edit
Division Parameter Set-up
List of Cameras/Equip/Rms
Location Parameter List
Location Parameter Set-up
Print Division Parameter List
Select System Definition Menu Option: LOC
1
Location Parameter List
2
Location Parameter Set-up
CHOOSE 1-2: 2 Location Parameter Set-up

Select Location: OUTSIDE SLC RAD
...OK? Yes// Y

(Yes)
(GENERAL RADIOLOGY-660)

Imaging Location: OUTSIDE SLC RAD

Flash Card Parameters:
---------------------HOW MANY FLASH CARDS PER VISIT:
DEFAULT FLASH CARD FORMAT:
No default flash card printer has been assigned. Contact IRM.
Jacket Label Parameters:
-----------------------As specified in the division parameters, no jacket labels will
be printed automatically upon a patient visit.
DEFAULT JACKET LABEL FORMAT:
No default jacket label printer has been assigned. Contact IRM.
Exam Label Parameters:
---------------------HOW MANY EXAM LABELS PER EXAM: 1//
DEFAULT EXAM LABEL FORMAT:
Exam label printer is always the same as the flash card printer.
Order Entry Parameters:
---------------------No default request printer has been assigned. Contact IRM.
Report Parameters:
-----------------DEFAULT REPORT HEADER FORMAT:
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

105

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II
DEFAULT REPORT FOOTER FORMAT:
REPORT LEFT MARGIN: 10//
REPORT RIGHT MARGIN: 70//
PRINT DX CODES IN REPORT?:
VOICE DICTATION AUTO-PRINT:
No default report printer has been assigned. Contact IRM.
Cameras/Equip/Rooms Used by this Location:
-----------------------------------------Select CAMERA/EQUIP/RM: ?
‘^’ TO STOP:
You may enter a new CAMERAS/EQUIP/RMS, if you wish
Enter all the cameras/equip/rms for this location.
Answer with CAMERA/EQUIP/RM, or DESCRIPTION
Choose from:
OR1
OR RM 1
OR2
OR RM 2
PORTABLE
MOBILE PICTURES
RM0
2150
RM2
RM 2151
RM3
CHEST UNIT
OUTSIDE STUDY
Study performed outside of this facility
TD RAD-EXAM1
This is the primary x-ray room.
TD RAD-EXAM2
Sonograms are done in this room.
TD RAD-EXAM3
Endoscopies are done in this room.
You may enter a new CAMERA/EQUIP/RM, if you wish
Enter a name for this camera/equip/rm, between 1 and 30 characters
in
length.
Select CAMERA/EQUIP/RM: OUTSIDE STUDY
Study performed outside of this
facility
Are you adding ‘OUTSIDE STUDY’ as a new CAMERAS/EQUIP/RMS (the 1ST for this
IMAGING LOCATIONS)? No// Y (Yes)
Select CAMERA/EQUIP/RM:
Default CPT Modifiers used by this Location:
-------------------------------------------+----------------------------------------------------------------+
| Your entry cannot be compared with a CPT CODE, so be very sure |
| that this is the Default CPT Modifier that you want to stuff
|
| into every registered exam from this imaging location.
|
+----------------------------------------------------------------+
Select DEFAULT CPT MODIFIERS(LOC): ?
You may enter a new DEFAULT CPT MODIFIERS(LOC), if you wish
VA local modifiers are automatically screened out (rejected.)
+----------------------------------------------------------------+
| Your entry cannot be compared with a CPT CODE, so be very sure |
| that this is the Default CPT Modifier that you want to stuff
|
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

106

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II
| into every registered exam from this imaging location.
|
+----------------------------------------------------------------+
Choose a CPT Modifier that should be automatically stuffed
into the exam record, when the following 2 conditions
are both met :
1-There is no default CPT Modifier for this exam’s procedure.
2-This location is the current sign-on (or switched-to) location
at the time of registration.
If your entry is invalid, then during exam registration, this
Default CPT Modifier will NOT be stuffed, instead, an error message
with the name of the rejected CPT Modifier would be displayed.
Answer with CPT MODIFIER, or NAME, or CODE, or BEGIN CPT RANGE, or
END CPT RANGE
Do you want the entire CPT MODIFIER List? N
Select DEFAULT CPT MODIFIERS(LOC):
Recipients of the ‘Stat’ Alert for this Location:
------------------------------------------------Select STAT REQUEST ALERT RECIPIENTS:
ALLOW ‘RELEASED/NOT VERIFIED’: no//
no
INACTIVE:
TYPE OF IMAGING: GENERAL RADIOLOGY//
CREDIT METHOD: 0// ?
Enter the type of credit this location will receive for this
examination.
Choose from:
0
Regular Credit
1
Interpretation Only
2
No Credit
3
Technical Component Only
CREDIT METHOD: 0// 2 No Credit
DSS ID: ?
Enter a valid stop code for this imaging location.
Only Stop Codes entered in the Imaging Stop Codes file may be
selected.
Answer with CLINIC STOP NAME, or AMIS REPORTING STOP CODE
Do you want the entire CLINIC STOP List?
DSS ID: X-RAY
105
Imaging Location OUTSIDE SLC RAD is OK.

Select Location:

Note: Update the other locations in exactly the same fashion.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

107

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Step 5 – OUTSIDE STUDY Camera/Equip/Room for All Radiology
Imaging Locations
A Radiology ADPAC performs this step.
Every Radiology Imaging Location that is used as a contract outside imaging facility needs to
have the OUTSIDE STUDY camera/equipment/room assigned to it. When the study is imported,
the examination/report status of the case is advanced to either, Examined/No Report if it is to
be read locally, or Complete/Electronically Filed if it is finished.
If DICOM objects are imported for a study with a Radiology Imaging Location that does not
have the OUTSIDE STUDY camera/equipment/room assigned to it, then a message like the one
that follows displays in the Importer III client session. The examination/report status then needs
to be manually advanced.
***********************************************************************************
*
*** WARNING: Exam/Report status not advanced to COMPLETE/ELECTRONICALLY FILED
***
***
***
*** The Camera/Equipment/Room “OUTSIDE STUDY” is not defined for the Radiology
***
*** Imaging Location “XXXXXXXXXX” that is used for this study.
***
***
***
*** The data required to advance the status of this case performed at an outside
***
*** location has not been entered.
***
***
***
*** Due to this condition, the status of the study had not been automatically
***
*** advanced. Please manually advance its status by entering the necessary data
***
*** using the Radiology package status tracking option.
***
***
***
*** Message generated at MUMPS line tag ERR1102+13^MAGDAIRC
***
************************************************************************************

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

108

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Step 6 – Populate VistA Imaging Outside Imaging Location File
VistA Imaging site personnel perform this step.
Log into VistA and select the VistA Imaging System Manager Menu [MAG SYS MENU]. Then
select the IMPORTER menu [MAG IMPORTER MENU] and the Build Outside Imaging
Location file option [MAG BUILD OUT IMG LOC]. In this example, there are two enabled
Image Types (General Radiology and Nuclear Medicine) for the Salt Lake City Division. Both of
these now have CREDIT METHOD = No Credit entries in the Radiology DIVISION and
IMAGING LOCATIONS file. The Build Outside Imaging Location file option interactively
helps to add/change entries in the file.
When finished, run the Check Outside Imaging Location file option [MAG CHECK OUT IMG
LOC] to verify that everything is set up correctly.

Select OPTION NAME: IMPORTER MENU
Build Outside Imaging Location file
Check Outside Imaging Location file
Display Studies to be Imported
Select Importer Menu Option: Build Outside Imaging Location file
Checking the Radiology files...
Division: SALT LAKE CITY
Checking the OUTSIDE IMAGING LOCATION file (#2006.5759)...
Division: SALT LAKE CITY
GENERAL RADIOLOGY
- Create record in file #2006.5759!
NUCLEAR MEDICINE
- Create record in file #2006.5759!
Please fix the aforementioned problems in the OUTSIDE IMAGING LOCATION
file
(#2006.5759) and then run this option again.

OUTSIDE IMAGING LOCATIONS for SALT LAKE CITY (660)
-------------------------------------------------GENERAL RADIOLOGY – (not defined yet)
OUTSIDE SLC RAD
 OUTSIDE SLC RAD
Use this value?? n// YES
NUCLEAR MEDICINE – (not defined yet)
OUTSIDE SLC NUC MED
Use this value?? n// YES

 OUTSIDE SLC NUC MED

Build Outside Imaging Location file
Check Outside Imaging Location file
Display Studies to be Imported
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

109

Appendix A: Setting Up Outside Imaging Locations for the DICOM Importer II

Select Importer Menu Option: Check Outside Imaging Location file
Checking the Radiology files...
Division: SALT LAKE CITY
Checking the OUTSIDE IMAGING LOCATION file (#2006.5759)...
Division: SALT LAKE CITY
GENERAL RADIOLOGY
NUCLEAR MEDICINE

- OUTSIDE SLC RAD
- OUTSIDE SLC NUC MED

Build Outside Imaging Location file
Check Outside Imaging Location file
Display Studies to be Imported
Select Importer Menu Option:

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

110

Appendix B: Handling Parent-Descendent Procedure
Orders with the Importer III Client
VistA Radiology2 supports the ability to order parent procedures. Parent procedures are
associated with two or more descendent procedures. When the patient is registered for the parent
procedure, a separate distinct radiology study, with its own unique accession number, is created
for each descendent procedure.
An example of a parent procedure may be ANKLES, BILATERAL, 2 VIEWS, which is
associated with two descendant procedures: LEFT ANKLE 2 VIEWS and RIGHT ANKLE 2
VIEWS. When the patient is registered for ANKLES, BILATERAL, 2 VIEWS, two studies are
created, one for LEFT ANKLE 2 VIEWS and one for RIGHT ANKLE 2 VIEWS.

How It Works
The provider orders the parent procedure through CPRS. This goes into the ORDER file (#100)
and when signed the same order is filed in the RAD/NUC MED ORDERS file (#75.1). When
this order is registered (for example, by the Importer III client or the REG EDIT menu option),
individual studies are created for each descendent procedure and are then filed into the
EXAMINATIONS (#70.03) multiple, which is a sub-file of the RAD/NUC MED PATIENT file
(#70). Unique accession numbers are created for each procedure of the study. The study for each
procedure is then treated as a separate entity for examination purposes.
Each study for each procedure may have its own unique diagnostic report (that is, being defined
as an Exam Set – the default) or there may be a single diagnostic report referenced by the
descendant procedures (that is, being defined as a Print Set). A parent procedure can be
designated as a print set by exercising the Procedure Enter/Edit option and setting the SINGLE
REPORT field (#18) of the parent procedure in the RAD/NUC MED PROCEDURES file (#71)
to Yes.

Questions
If the VA orders a parent procedure as a fee-basis contracted examination, then how does the
contractor perform the procedure, how are the resultant DICOM objects created, and how should
those DICOM objects be imported into VistA?
How Outside Fee-basis Imaging Contractors Work
The outside imaging contractor can execute an order of ANKLES, BILATERAL, 2 VIEWS by
two methods.


Method 1 – The contractor can perform two separate studies, one for the left ankle and
one for the right ankle.

Greg Cebelinski of the Radiology Development Team and Jeannie Jernigan of the Fayetteville, NC VAMC
contributed to this document.

Appendix B: Handing Parent-Descendent Procedure Orders with the Importer II



Method 2 – The contractor can perform a single study, which includes both ankles.

Depending upon how the contractor executes the order, there are two methods to represent the
DICOM images for the examination(s).


Method 1 – If the contractor performs the bilateral ankle order as two separate studies
(one for the left ankle and the other for the right ankle), then there is two different
contractor-assigned accession numbers (Study Instance UIDs, procedure names, and so
on) for each study. Each DICOM image must have either the Series Laterality or the
Image Laterality attribute.



Method 2 – If the contractor performs the bilateral ankle order as one study, then there is
one contractor-assigned accession number (Study Instance UID, procedure name, and so
on) for all the DICOM images.
–

The contractor may choose to use two separate series (one for the left ankle and the
other for the right ankle) and specify the Series Laterality for all of the DICOM
images in that series. In this case, each series has a unique Series Instance UID.

 The contractor may also chose to use one series for all of the ankle images, and
specify the Image Laterality for each DICOM image in the series. In this case, there is
only one Series Instance UID for the entire study.
How to Use the Importer III Client for DICOM Images for Parent/Descendent
Procedures
The choice of method used by the contractor to perform the examination(s), and how the
resultant images are represented in DICOM, have a great bearing on how the images should be
imported into another system.
The Importer III client does not handle parent/descendent procedures automatically. Some
manual effort is required to do this properly. The level of effort depends on how the study is
performed and how the DICOM images are created. The following procedure may be used as a
guideline.
1. Use Importer menu option 2 – Import Outside Contracted studies.
2. Using the Importer, determine whether the contractor chose to perform the bilateral ankle as
one study or as two separate studies.
3. If the contractor chose to perform the bilateral ankle as two separate studies, then the images
from the left outside study are imported to the left VistA study and the images from the right
outside study are imported to the right VistA study. Perform the following instructions to
complete Step 3.


Select the LEFT side study in the Importer.

Use the lookup in Radiology Order file option.
Select the patient and the order for the parent procedure.
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

112

Appendix B: Handing Parent-Descendent Procedure Orders with the Importer II

Import the LEFT side study.
Exit the Importer III client.
Using the VistA Rad application (the Radiology package to view by case) or CPRS Imaging
(local only) Reports tab, confirm that the second study for the right side study is created as a
result of the bilateral study order (parent/descendant). This study will be in a waiting for exam
status. Obtain the accession number for it.
Use Importer menu option 2 – Import Outside Contracted studies, and re-enter the Importer III
client.
Select the RIGHT side study in the Importer.
Use the Modality Worklist look up option.
Select the VistA RIGHT side procedure study for the patient by entering its accession number
for the query key.
Import the RIGHT side study.
Confirm that the RIGHT side images from the outside study are attached to the VistA RIGHT
side study, and that the study is completed (Exam Status = Exam Complete and Report Status =
Electronically Filed).
4. If the contractor performed the bilateral ankle order as one study, then there is only one
accession number, Study Instance UID, procedure name, and so on for all the DICOM
images. All of the outside images are imported to the LEFT VistA study. Perform the
following instructions to complete step 4.


Select the study in the Importer.

Use the lookup in Radiology Order file option.
Select the patient and the order for the parent procedure.
Import the study.
–

The Importer registers the parent procedure and automatically creates a study for the
LEFT ANKLE 2 VIEWS procedure and a study for the RIGHT ANKLE 2 VIEWS
procedure.

 The accession number for the study for the LEFT ANKLE 2 VIEWS procedure is
returned and all the images are imported to it.
August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

113

Appendix B: Handing Parent-Descendent Procedure Orders with the Importer II

In the Radiology package, insert your local combined standard report stub to indicate that the
images and report are uploaded to the LEFT study. Then update the status manually in the
Radiology package per local policy/procedures.
It is beyond the scope of the Importer III client to be able to identify which images are for the
left ankle and import them to the left procedure, and to identify which images are for the
right ankle and import them to the right side procedure. Two facets of this scenario are
difficult. First, the Importer III client works at the study level and not the series or image
level. Second, DICOM images from one study cannot be filed with two different studies in
VistA, because this would create duplicate Study Instance UIDs and possibly duplicate
Series Instance UIDs (if all the images were in the same series). This is a violation of the
DICOM Standard and not a limitation of the Importer III client or VistA Imaging.
Note: It is advantageous to require that the outside contracted vendor perform the bilateral ankle
as two separate studies. By implementing this requirement, the images can be properly
associated with the corresponding two VistA studies.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

114

Appendix C: Problems Seen in Importing DICOM
Objects from Media
The Importer III client is designed to work with media that is formatted according to the DICOM
Standard and the IHE PDI integration profile. DICOM objects on compliant media usually are
able to be imported. Those on non-compliant media may not be able to be imported.
Here is a list of some of the problems that one could expect to see.


The media is just blank.



The media is written improperly. Here is an example where the vendor did not enter the
files into the directory correctly:

E:\>dir
Volume in drive E has no label.
Volume Serial Number is 8B34-8C3C
Directory of E:\
The
The
The
The

parameter
parameter
parameter
parameter

is
is
is
is

The parameter is
The parameter is
6
2

incorrect.
12:00 AM
3,920
incorrect.
12:00 AM
759
incorrect.
12:00 AM
240
incorrect.
12:00 AM
105,320
01/15/2010 08:49 AM

incorrect.
01/15/2010 08:49 AM
incorrect.
01/15/2010 08:49 AM
01/15/2010 08:49 AM

File(s)
110,340 bytes4
Dir(s)
0 bytes free

DICOMDIR
DiscView.htm
QuickViewer.txt
Readme1st.htm
Readme1st_files
72 autorun.bat
29 autorun.inf
data

E:\>



There is no DICOMDIR on the media and the images are kept in separate sub-folders.
The Importer III client cannot be used directly.
If there are DICOM files on the media, then they might be able to be sent to a C-Store
process on the Importer III gateway. The BATCH_SEND_IMAGE.BAT batch file may
be able to be used to extract the DICOM files from the media and send them. Otherwise,
it may be necessary to use a commercial product (like Sorna3) to read the media and send
the DICOM files to the C-Store process.



There are errors in DICOMDIR.
–

The file name of each DICOM object uses forward slashes, rather than back slashes,
as required by the DICOM Standard.

http://www.sorna.com/

Appendix C: Problems Seen in Importing DICOM Objects from Media

–

The Referenced SOP Class UID is wrong. (One vendor used the Media Storage
Directory Storage SOP Class. Another vendor used the character string SOP UID. It
must be the same as the SOP Class UID of the DICOM object.)

–

The Referenced Transfer Syntax UID is absent even though it is a Type 1 (that is, a
required data element with a non-null value).

 The Modality is a DICOM Series attribute. It may not be defined in DICOMDIR for
the Series directory record type even though it is a Type 1.


DICOMDIR is fine, but the DICOM objects are not supported by VistA Imaging.
The subset of DICOM SOP Classes and Transfer Syntaxes that VistA Imaging supports
is specified in the AE Security Matrix. Here is a sample error message:
********************************************************************************
***
***
***
There are 871 DICOM objects that cannot be stored on VistA.
***
***
Each is flagged with a yellow question mark ? below.
***
***
***
*** SOP Class: CT Image Storage
***
*** Transfer Syntax: JPEG Lossless, Non-Hierarchical (Process 14): Default
***
*** Lossless JPEG Compression
***
*** Problem: The Transfer Syntax is not supported – 871 DICOM objects
***
***
***
********************************************************************************



Outside source places multiple patient exams on their same accession number (Skull,
hand, foot all done as one exam). This is difficult to handle when this study is imported
into VistA Imaging.



The media contains only JPEG2000 images and no DICOM images.



One, or more, images in a study are incomplete (for example, only the top half of a chest
x-ray). The image(s) fail(s) image processing.



The exam was not performed according to radiology best practices standard of care. For
example, a fee-basis contracted order for a “knee 3 views” only has two images.



The outside modality creates a study with a UID that is a duplicate of one, which is
already on VistA for another patient.



Some of the expected DICOM header information may be incorrect or blank (for
example, technician name, body location, radiology location, and so on).



The media is a copy of an earlier one. (This one is easy – the Importer III client
automatically prevents an imported DICOM object from being imported a second time.)

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

116

Glossary
Term

Definition

Application Entity

AE_Title

A unique name assigned to a DICOM device to identify it. AE_Title is used
to log machine-to-machine communication within this patch.

AGFA DICOM
Proxy Server

The conduit for the DICOM objects transmitted from the DoD to the VA
Polytrauma Centers.

AMSU

Advanced Media Staging User – See Media Staging

Application Log

The application log records information about activities in application
instances. This log may contain PHI.

Artifact

Any object stored within VistA Imaging. This includes images and reports.

Artifact
Reconciliation
Administrator

ARA – A user of MAG*3.0*118 software who has full rights to administer
and perform all import and reconciliation activities.

Audit Log

A chronological sequence of audit records, each of which contains evidence
directly pertaining to and resulting from the execution of a business process
or system function. This log does not contain any PHI.

BMSU

Basic Media Staging User – See Staging

Business Rules

Business rules authorize specific users or groups of users, to perform
specified actions on documents in particular statuses (for example, a
practitioner who is also the expected signer of the note may edit an Unsigned
Progress Note).
Note: Sites can modify or add to these rules to meet their own local needs.

CBOC

Community-based Outpatient Clinic – A CBOC is a VA-operated clinic (in a
fixed location), or a VA-funded or reimbursed health care facility or site that
is geographically distinct or separate from the parent medical facility.

Compact Disc

Contracted Study

A study ordered at the VA, but contracted to be performed at an outside
facility. After the examination, the DICOM objects from the outside facility
are delivered back to the VA for importing purposes.

Contracted Study
Reconciliation
Administrator

CSRA – An individual assigned the rights to use MAG*3.0*118
reconciliation activities on Contracted studies.

Glossary
Term

Definition

cPACS

Commercial PACS (see the definition for PACS)

CPRS

Computerized Patient Record System

Data Sources

Database structures or files that contain required information.

Decryption

A security tool used to decode protected information.

DICOM

Digital Imaging and Communications in Medicine – a protocol for sharing
and viewing medical images. DICOM has traditionally been used for
radiology images, and most recently used for images in other specialties such
as cardiology, dental, gastrointestinal endoscopy, and ophthalmology.

DICOM Correct

The name assigned to the software routine used to correct DICOM objects
that fail processing on the DICOM Gateway.

DICOM Gateway

Interface between VistA and external DICOM Application Entity

DICOMDIR

A file that is a unique and mandatory DICOM Directory file that contains the
Media Storage Directory SOP Class as described in DICOM PS 3.10 2008.

Direct Import

Copying DICOM objects from an external media bundle, matching it to the
VA study, updating necessary data sources, and sending the objects to the
HDIG for processing, bypassing Importer III Persistent Storage.

DoD

Department of Defense

DVD

Digital Versatile Disc

EMR

Electronic Medical Record

Encryption

The translation of data into a form that is unintelligible without a deciphering
mechanism.

GUI

Graphical User Interface

HDIG

Hybrid DICOM Imaging Gateway – A gateway that runs both the legacy
gateway and the VISA gateway.

High Impact Systems An information system in which a least one security objective (that is,
confidentiality, integrity, or availability) is assigned a FIPS 199 potential
impact value of high.
HIPAA

Health Insurance Portability and Accountability Act

HIS

Hospital Information System

IEN

Internal Entry Number

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

118

Glossary
Term

Definition

IHE

Integrating the Healthcare Enterprise

Imaging Type

A VistA Radiology Package entity that roughly designates a class of DICOM
modalities. For example, General Radiology consists of CR, DX, and RF.
CT, MRI, and Ultrasound are other examples of Imaging Types. The
Imaging Type must be specified when placing a radiology order.

Importer III client

Software that performs the automated DICOM import process from outside
facilities.

Importer III Persistent Storage area within Vista Imaging where DICOM objects awaiting
Storage
reconciliation or DICOM Correction are stored.
Importing

Accepting study data from an authorized source, updating relevant data
sources, and sending it to the HDIG for processing.

IRA

Initial Requirements Analysis

IRWF

Import Reconciliation Workflow

ISO

Information Security Officer – Individual responsible to the senior agency
information security officer, authorizing official, or information system
owner for ensuring that the appropriate operational security posture is
maintained for an information system or program.

Media Bundle

Used to reference all data on an external data source being processed by the
MAG*3.0*118 software,

Media Formats

Media Formats and Physical Media for Data Interchange (such as a CD,
DVD, flash drive, or external hard drive) are defined in DICOM PS 3.12
2008.

Media Storage
Application Profile

Defines a selection of choices at the various layers of the DICOM Media
Storage Model which are applicable to a specific need or context in which
the media interchange is intended to be performed as described in DICOM
PS 3.11 2008.

Modality Code

A code defined by the DICOM Standard that identifies the type of exam
being performed (for example, CR, CT, MR, US).

Modality Device

The type of DICOM device being used to generate or utilize DICOM
objects.

MUMPS

Massachusetts General Hospital Utility Multi-Programming System

NSR

New Service Request

Ordered Study

A study that is ordered at the VA and is performed at the VA or contracted to
be performed at an outside facility.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

119

Glossary
Term

Definition

Ordering Location

The VistA HIS location, which is recorded as the source of the order (for
example, for a Polytrauma patient, it would be the Polytrauma ward).

Ordering Provider

The VistA HIS provider who is recorded as the originator of the order (for
example, for a Polytrauma patient, it may be the chief of the Polytrauma
Service).

Outside Facility

External to the local facility. It can be another VA facility, a DoD facility, or
another institution.

Outside Imaging
Location

A VistA HIS/Radiology Package location where the examination is recorded
as being performed. For the Importer III client, this is designated as an
outside, no credit imaging location. Each radiology Imaging Type must have
a corresponding Imaging Location. The Imaging location must be specified
when placing a radiology order.

PACS

Picture Archive and Communications System

PDI

Portable Data for Imaging

PHI

Protected Health Information – is individually identifiable health information
transmitted by electronic media, maintained in electronic media, or
transmitted or maintained in any other form or medium. PHI excludes
education records covered by the Family Educational Rights and Privacy
Act, as amended, 20 U.S.C. 1232g, records described at 20 U.S.C.
1232g(a)(4)(B)(iv), and employment records held by a covered entity in its
role as employer.

PII

Personally Identifiable Information (see definition for Sensitive Personal
Information (SPI))

Previously Imported
Study

A study that already has some or all of its DICOM objects imported into the
VA’s system.

Queue

A storage location for imported artifacts

Reconciliation
Administrator

A user of MAG*3.0*118 software who has full rights to administer and
perform all import and reconciliation activities.

Report User

RU – A MAG*3.0*118 user who has the ability to generate reports that
summarize the activities performed by the MAG*3.0*118 software.

RIS

Radiology Information System

RPC

Remote Procedure Call

RSD

Requirements Specification Document

SCP

Service Class Provider

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

120

Glossary
Term

Definition

SCU

Service Class User

SDD

Software Design Document

SOP

Service Object Pair

SOP Class

Unique Id assigned by the DICOM Standard to identify DICOM objects.

SPI

Sensitive Personal Information – The term, with respect to an individual,
means any information about the individual maintained by an agency,
including the following: (i) education, financial transactions, medical history,
and criminal or employment history; (ii) Information that can be used to
distinguish or trace the individual’s identity, including name, social security
number, date and place of birth, mother’s maiden name, or biometric
records.

Staging

Copying study data from either media or an authorized network location into
temporary persistent storage for later reconciliation. There are two types of
staging (controlled by keys):


Basic Staging – an authorized user copies all study data from an
authorized source to Importer III Persistent Storage.



Advanced Staging – an authorized user can view source data by
study and copy data by study to Importer III Persistent Storage.

Supported SOP Class A DICOM Object that can be processed by the DICOM Gateway and
delivered to other Vista Imaging applications for use within Vista Imaging.
System Auditing

System audit logs must record sufficient information to establish what events
occurred, the sources, and the outcomes of the events. Additional details
such as type, location, and subject are also required for moderate and highrisk systems.

TCP/IP

Transmission Control Protocol/Internet Protocol

UID

DICOM Unique Identifier

UML

Unified Modeling Language

Unordered Study

An independently performed study from an outside facility and its DICOM
objects, which are delivered to the VA for importing purposes.

Department of Veterans Affairs

VA Sensitive Patients Patients tagged in VA systems as requiring additional measures to ensure
their health information is protected. Typically, these are employees or VIPs
receiving treatment through VA facilities.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

121

Glossary
Term

Definition

Validated

The process of successfully matching an order, DICOM images, and an
optional report of imported objects that allows the study to be processed by
the DICOM Gateway.

Verifying Provider

A VistA HIS provider who has permissions to verify radiology reports.

VISA

VistA Imaging System Architecture

VISN

Veterans Integrated Service Network

VistA

Veterans Health Information Systems and Technology Architecture

VistA HIS

A system that has the ability to store multimedia objects as part of its
electronic medical record (EMR). VistA includes the CPRS, which supports
order entry, tracking, result entry, and result reporting functions. VistA also
includes a complete RIS. VistA Imaging provides a full infrastructure to
acquire, store, archive, display, and communicate DICOM and other types of
multimedia objects, and is directly interfaced to both CPRS and the RIS.
This combination provides PACS capabilities with the VistA HIS for both
clinical specialties as well as radiology.

VistA Imaging
DICOM Gateway

A suite of software used to transfer image files from an acquisition modality
or a commercial PACS to VistA, or from VistA to a commercial PACS or
workstations.

VistA Study

A VistA Radiology study as identified by a corresponding Order and
Accession Number, CPRS Consult Request Tracking Consult, or a Procedure
Request.

August 2018

DICOM Importer III User Manual
VistA Imaging 3.0

122

Index
A
Advanced Staging Media User · 3, 25
Application logging · 2
ARA role · 4, 34, 35, 37, 40, 55, 60, 63
Artifact Reconciliation Administrator · 4, 34, 35, 37, 40, 47,
55, 60
ASMU role · 3
Audit logging · 2

B
Basic Staging Media User · 3
BSMU role · 3

C
CD/DVD media · 18
Contracted Study Reconciliation Administrator · 3, 34
Contracted Study Reconciliation Administrator (CSRA) · 40,
47, 55, 60
CPRS · 4
CSRA role · 3, 34, 35, 37

D
DICOM compliant · 17
DICOM Correct · 2, 17, 35
DICOM Header · 75
DicomCorrect · 35
DICOMDIR · 18
Direct import · 33

I
IHE · 33
Import Reconciliation Workflow · 33
Imported Details report · 77
IRWF · 33

M
MAGV IMPORT MEDIA STAG security key · 5
MAGV IMPORT RECON CONTRACT security key · 5
MAGV IMPORT REPORTS security key · 5
MAGV IMPORT STAGE MEDIA ADV security key · 5
Media
Compliant · 17
Non-compliant · 18

N
Network, direct import · 17

O
Ordered studies · 34

P
Pending orders · 40, 47, 55, 60
Proxy server · 17

R
G
Group details · 76

H
Header · See DICOM Header
Hybrid DICOM Image Gateway · 1

Reconciling data · 34
Report User · 4
Reports · 77
Imported Details · 77
Totals by Location · 77
Totals by Modality · 77
Roles · 2
RU role · 4, 79

S
Security keys · 4
Sensitive patient logging · 2
Staging
Advanced · 25
Basic · 19
Studies
Ordered · 34
Unordered · 34

U
Unordered studies · 34

V
VISA · 1
VistA Imaging System Architecture · 1

W
T
Terms of use · 3
Totals by Location report · 77
Totals by Modality report · 77

August 2018

Workflows
Queues · 2
Wizards · 1

DICOM Importer III User Manual
VistA Imaging 3.0

124

Source Exif Data:

File Type                       : PDF
File Type Extension             : pdf
MIME Type                       : application/pdf
PDF Version                     : 1.5
Linearized                      : No
Page Count                      : 130
Language                        : en-US
Tagged PDF                      : Yes
Title                           : DICOM Importer III User Manual
Author                          : VistA Imaging Product Development Silver Spring
Subject                         : MAG*3.0*206
Creator                         : Microsoft® Word 2010
Create Date                     : 2018:08:02 12:50:34-04:00
Modify Date                     : 2018:08:02 12:50:34-04:00
Producer                        : Microsoft® Word 2010

EXIF Metadata provided by EXIF.tools

DICOM Importer III User Manual MAG

Navigation menu

Versions of this User Manual:

Views

Navigation