PICSPlus User Guide - University of Pittsburgh Medical …dpig.upmc.com/PICSPlus/05132014/PICSPlus_v2013.01_User... · 2014-05-15 · PICSPlus User Guide Version 2013.01 2800 Rockcreek

Document Title: PICSPlus User Guide v2012.01 Document #: 30TRGEXT021635 Rev: 001 Eff. Date: July 2, 2013 Owner: CoPathPlus Development

Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner.

Cerner CoPathPlus™

PICSPlus User Guide

Version 2013.01

2800 Rockcreek Parkway Kansas City, MO 64117

Telephone: 866.221.8877

www.cerner.com/laboratory

www.cerner.com/laboratory

Page 2 of 6 Copyright



CoPathPlus, PICSLink and PICSPlus are trademarks of Cerner Corporation. All other products and brand names are

trademarks or registered trademarks of their respective companies.

© Copyright 1994-2013 Cerner Corporation. All rights reserved. Due to rapid advancements in technology,

specifications are subject to change without notice.

No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical,

including photocopying, recording, or any information storage and retrieval system, without permission in writing

from Cerner Corporation.

Contents Page 3 of 6



Contents

Chapter 1: Introduction .............................................................................................. 1-1

PICSPlus Overview .......................................................................................................... 1-1 PICSPlus AccuSoft Licensing ............................................................................. 1-1

PICSPlus Features ........................................................................................................... 1-2 PICSPlus User Settings ................................................................................................... 1-3 What Should I Know Before I Get Started? ..................................................................... 1-3 Requirements ................................................................................................................... 1-3

Chapter 2: Accessing PICSPlus From CoPathPlus ................................................. 2-1

PICSPlus Image Entry/Edit .............................................................................................. 2-1 PICSPlus Report Image Select ........................................................................................ 2-3 CoPathPlus PICSPlus Integration Activities .................................................................... 2-5 Image Gallery and Select Images Buttons ...................................................................... 2-5 CoPathPlus Form Sequences Eligible for PICSPlus Activities ........................................ 2-6

Chapter 3: Using the PICSPlus Gallery Manager .................................................... 3-1

PICSPlus Gallery Manager Menu Bar ............................................................................. 3-2 PICSPlus Gallery Manager File Menu ................................................................ 3-2 PICSPlus Gallery Manager Edit Menu ................................................................ 3-2

PICSPlus Gallery Manager Attachments Menu ............................................................... 3-3 Import from File ................................................................................................... 3-3 Export to File ....................................................................................................... 3-6 Import from Clipboard ......................................................................................... 3-7 Import from TWAIN ............................................................................................. 3-8 Import from Matrox .............................................................................................. 3-9

PICSPlus Gallery Manager Options Menu .................................................................... 3-10 Image Viewer .................................................................................................... 3-10 Default Import Action ........................................................................................ 3-11 Default Import Template ................................................................................... 3-11 PICSPlus Resolutions Calculator ...................................................................... 3-12 TWAIN ............................................................................................................... 3-15

Image Gallery ................................................................................................................. 3-16 Selecting an Image in the Image and Report Galleries .................................... 3-16 Image and Report Gallery Keyboard and Mouse Shortcuts ............................. 3-17

Parameters for Selected Item in Image Gallery ............................................................. 3-18 Linked to Reports ........................................................................................................... 3-19 Image Gallery Review .................................................................................................... 3-20

Adjusting the Review Display Options .............................................................. 3-20 Import From Button ........................................................................................................ 3-22 Task Button .................................................................................................................... 3-22

Chapter 4: Using the PICSPlus Report Manager ..................................................... 4-1

PICSPlus Report Manager Menu Bar .............................................................................. 4-2 PICSPlus Report Manager File Menu ................................................................. 4-2 PICSPlus Report Manager Edit Menu ................................................................ 4-2 PICSPlus Report Manager Attachments Menu .................................................. 4-3

Page 4 of 6 Contents



Import from File ................................................................................................... 4-3 Export to File ....................................................................................................... 4-6 Import from TWAIN ............................................................................................. 4-7 Import from Clipboard ......................................................................................... 4-8 Import from Matrox .............................................................................................. 4-8 PICSPlus Report Manager Options Menu .......................................................... 4-9 Image Viewer ...................................................................................................... 4-9 Default Import Action ........................................................................................ 4-10 Default Import Template ................................................................................... 4-10 TWAIN ............................................................................................................... 4-11

Image Gallery ................................................................................................................. 4-13 Selecting an Image in the Image and Report Galleries .................................... 4-13 Image and Report Gallery Keyboard and Mouse Shortcuts ............................. 4-14

Report Gallery ................................................................................................................ 4-14 Parameters for Selected Item in Image Gallery ............................................................. 4-15 Image Gallery Review .................................................................................................... 4-16

Adjusting the Review Display Options .............................................................. 4-16 Report Gallery Review ................................................................................................... 4-18 Import From Button ........................................................................................................ 4-18 Task Buttons .................................................................................................................. 4-19

Chapter 5: Using the PICSPlus View Manager ........................................................ 5-1

Maximize View ................................................................................................................. 5-2 Copy to Clipboard ............................................................................................................ 5-4 Print .................................................................................................................................. 5-4 Save ................................................................................................................................. 5-4 Zoom Controls .................................................................................................................. 5-4 Close ................................................................................................................................ 5-5 View Manager Toolbox .................................................................................................... 5-5

Marks Tab ........................................................................................................... 5-6 Working with Mark Tools ................................................................................... 5-19 Process Tab ...................................................................................................... 5-33 Crop to Selection .............................................................................................. 5-36 Colors Tab ......................................................................................................... 5-36 Info Tab ............................................................................................................. 5-38

Chapter 6: PICSPlus Express Capture ..................................................................... 6-1

PICSPlus Express Capture Introduction .......................................................................... 6-1 Setting Up PICSPlus Express Capture ......................................................................................... 6-3

PICSPlus Express Capture Window Painting Requirement ............................................ 6-3 Image Gallery Button With Express Capture Option .......................................... 6-3 Report Gallery Select Images Button With Express Capture Option .................. 6-4

Chapter 9: PICSPlus Dictionaries ............................................................................. 9-1

Dictionary Building Sequence Order ................................................................................ 9-1 PICSPlus Server Dictionary .......................................................................................................... 9-2

How to Add a New PICSPlus Server Dictionary Entry ..................................................... 9-2 Attachment Type Dictionary .......................................................................................................... 9-4

Attachment Type Dictionary Attributes............................................................................. 9-4 Attachment Type Dictionary Prerequisites ....................................................................... 9-5 How to Add a New Attachment Type Dictionary Entry .................................................... 9-6

Attachment Type Dictionary - Name Tab ............................................................ 9-6 Attachment Type Dictionary - Reports Tab ......................................................... 9-7

Contents Page 5 of 6



Attachment Type Dictionary - Notes Tab ............................................................ 9-8 PICSPlus Parameters Dictionary ................................................................................................ 9-10

How to Add a New PICSPlus Parameter Dictionary Entry ............................................ 9-10 PICSPlus Parameter Dictionary - Name Tab .................................................... 9-10 PICSPlus Parameter Dictionary - Notes Tab .................................................... 9-11

PICSPlus Template Dictionary .................................................................................................... 9-13 How to Add a New PICSPlus Template Dictionary Entry .............................................. 9-13

PICSPlus Template Dictionary - Name Tab ..................................................... 9-14 Parameters Tab ................................................................................................ 9-14 PICSPlus Template Dictionary - Notes Tab ...................................................... 9-15

Imaging Device Type Dictionary ................................................................................................. 9-16 How to Add a New Imaging Device Type Dictionary ..................................................... 9-16

Name Tab ......................................................................................................... 9-16 Details Tab ........................................................................................................ 9-17 Notes Tab .......................................................................................................... 9-18

Chapter 8: PICSPlus Management Reports ............................................................. 8-1

Accessing the PICSPlus Management Reports .............................................................. 8-1 Running the PICSPlus Management Reports ................................................................. 8-2

Case Diagnostic Reports .............................................................................................................. 8-3 PICSPlus Case Detail ...................................................................................................... 8-3 PICSPlus Image Search/Natural Language .................................................................... 8-3 PICSPlus Image Search/SNOMED ................................................................................. 8-3 PICSPlus Images with Annotations ................................................................................. 8-3

Logs ............................................................................................................................................... 8-4 PICSPlus Acquisition Workstations ................................................................................. 8-4

Chapter 9: PICSLink ................................................................................................... 9-1

PICSLink Overview .......................................................................................................... 9-1 Using PICSLink ................................................................................................................ 9-1 Configuring PICSLink ....................................................................................................... 9-3 PICSLink Device Setup .................................................................................................... 9-3 PICSLink Automatic Acquisition of Image Documents .................................................... 9-4

Chapter 10: Digital Slide Imaging ........................................................................... 10-1

Introduction .................................................................................................................... 10-1 Digital Slide Imaging Workflow ...................................................................................... 10-1 Configuring Digital Slide Imaging ................................................................................... 10-1 Imaging Device Type Dictionary .................................................................................... 10-2 Digital Slide Device Setup .............................................................................................. 10-2 Digital Slide Imaging in Specimen Activities .................................................................. 10-4

Chapter 11: PICSPlus Default Diagrams ................................................................ 11-1

PICSPlus Default Diagrams Introduction ....................................................................... 11-1 Configuring PICSPlus Default Diagrams .................................................................................... 11-2

Configuration and Diagram Storage .............................................................................. 11-2 Diagram Overview and Quality Considerations ............................................................. 11-3

PICSPlus Diagram Dictionary ..................................................................................................... 11-4 How to Add a New PICSPlus Diagrams Dictionary Entry .............................................. 11-4

Name Tab ......................................................................................................... 11-4 Diagram Image Tab .......................................................................................... 11-5 Notes Tab .......................................................................................................... 11-5

Setting a Diagram as a Default in the Part Type Dictionary ....................................................... 11-6

Page 6 of 6 Contents



Attaching Diagrams to a Specimen ............................................................................................. 11-7

Chapter 12: Site Diagram Module ........................................................................... 12-1

Site Diagram Module Introduction ............................................................................................... 12-1 Attaching a Site Diagram to a Specimen ....................................................................... 12-1

Entering Data on a Site Diagram ................................................................................................ 12-2 Attaching a Site Diagram to a Specimen ....................................................................... 12-2

Entering Data on a Site Diagram ...................................................................... 12-3 Previewing the Site Diagram ............................................................................. 12-3 Saving the Site Diagram ................................................................................... 12-4

Chapter 13: PICSPlus Maintenance Module .......................................................... 13-1

Accessing the PICSPlus Maintenance Module .............................................................. 13-1 Image Servers Activity Report .................................................................................................... 13-2 Acquisition Workstation Activity Report ...................................................................................... 13-4 Detect Lost Images by Specimen Number ................................................................................. 13-6 Detect Lost Images by Date Range ............................................................................................ 13-8

Introduction Page 1-1 of 3



Chapter 1: Introduction

PICSPlus Overview

PICSPlus gives the CoPathPlus user the tools to manage images within the currently active

record. Managing images includes: capturing, annotating, importing, and selecting images for

reports. Images can be digital camera images or pictures, drawings, diagrams, or text files that

have been scanned into an image format. Pathology department images are typically acquired in

the grossing room, at the microscope, or in an autopsy room.

PICSPlus AccuSoft Licensing

Image capabilities are assigned by workstation via Workstation Add-on or by user via the

Addons and Overrides Tab on the Person Dictionary (Refer to the PICSPlus Implementation

Guide for more information on Add-on). Licensing for the Accusoft software is required for

PICSPlus use.

There are two levels of licensing:

All CoPathPlus Licensed Devices are eligible to view PICSPlus Images. The number

of general Accusoft licenses is the same as the number of CoPathPlus licensed devices

(workstations and agents). This licensing structure is part of enabling PICSPlus on your

CoPathPlus system.

PICSPlus Capture Workstations: Selected CoPathPlus workstations will be used to

acquire and/or annotate images into the database, these workstations require an

Acquisition License. Image acquisition is done using Matrox Meteor II frame capture

card, Import from TWAIN, Import from Clipboard or Import from File. An acquisition

license is needed for each different workstation that will perform annotation or any

method of image acquisition. Only one acquisition license per workstation is required,

even if that workstation is enabled to acquire by more than one method and to annotate.

All acquisition workstations also include viewing functionality.

PICSPlus Gallery/PDF Tools Accusoft Version

The current version of the AccuSoft Tool software is 16.2. A quick upgrade will need to be run

on each PICSPlus workstation following an upgrade to CoPathPlus to initiate use of the new tool

version.

Refer to the Cerner CoPathPlus PICSPlus Implementation Manual for further details on

upgrading the AccuSoft version.

Page 1-2 of 3 Introduction



PICSPlus Features

With advanced imaging capabilities of PICSPlus, CoPathPlus becomes a truly image-enabled

pathology solution that greatly enhances departmental efficiency. The following is a summary of

the features of PICSPlus:

PICSPlus Gallery Manager: Images are securely linked to the proper specimen in

CoPathPlus and can be navigated quickly using the CoPathPlus database. Display a

gallery slide show using the manual or timer modes.

PICSPlus Report Manager: Include digital images of gross and microscopic specimens

and other images associated with the specimen record in your reports. Display a report

slide show using the manual or timer modes.

PICSPlus View Manager: An array of sophisticated tools are available to help clearly

pinpoint specific diagnostic details that accentuate your findings. In addition, tools are

available to perform color management, rotation and clarification on images.

PICSPlus Express Capture: Express Capture allows a user to acquire images without

opening the PICSPlus Imager Gallery or Report Gallery.

PICSPlus Dictionaries: Allow you to create new Image Server definitions, categorize

image types for the purpose of defaulting and linking images to specimen reports and

define custom parameters for images.

PICSPlus Management Reports: Provide PICSPlus-specific information, such as a

listing of case containing PICSPlus images and a log of workstations enabled for

acquiring PICSPlus images.

PICSLink: Part of the CoPathPlus Telepathology strategy, PICSLink allows PICSPlus to

launch stand-alone imaging devices to capture images, image documents and metadata

generated by imaging devices. PICSLink enables users to take advantage of features such

as measurements, calculations, remote-controlled Grossing Stations and remote-

controlled digital microscopes.

Digital Slide Imaging: Digital Slide Imaging in CoPathPlus is designed to work

seamlessly in the pathologist’s workflow by making it available from Specimen

activities. When combined with PICSLink, Digital Slide Imaging can capture snapshots

from digital slides into PICSPlus and can launch digital slide viewers from the PICSPlus

Gallery.

Default Diagrams: The PICSPlus Default Diagrams feature provides a fast and efficient

mechanism to assign default diagrams (images) based on part type.

Site Diagram Module: The Site Diagrams (Patent Pending) Module provides labs with

the ability to include diagrams displaying tumor involvement on patient reports, thus

increasing the value of the reports while also improving patient care. Using the Prostate

Biopsy Site Diagram, the initial diagram provided with the module, pathologists can

simply point-and-click to enter data, such as the Gleason Score, in each section of the

diagram. All entries are validated, which assists in preventing errors during data entry

thus avoiding incorrect data reporting.

PICSPlus Maintenance Module: Provides Image server scalability and load balancing

simplify storage management with minimal downtime.

Introduction Page 1-3 of 3



PICSPlus User Settings

System managers have two options for storing user settings for Fat Client Workstations. User

settings are selected radio buttons, checked boxes, resolutions, templates etc in PICSPlus. A

system setting is available to determine where to store user preferences for PICSPlus and Digital

Slides. The setting "Enable PICSPlus User preferences" is located in the Imaging category. If

the system setting is set to "No", all PICSPlus and Digital Slides settings are stored in

configuration files on the local hard drive. This is the original method of storing information and

is the default setting. If the system setting is set to "Yes", all settings are stored in the CoPathPlus

database linked to the current user.

This system setting is ignored for Thin Client workstations, which always store PICSPlus and

Digital Slides settings in the CoPathPlus database.

What Should I Know Before I Get Started?

You should have a good working knowledge of CoPathPlus. It is also recommended that the

user have an understanding and working knowledge of the various acquisition devices they plan

to use with PICSPlus. A basic understanding of digital photography would also be helpful,

including an understanding of terms such as pixels, resolution, magnification, color depth, screen

display resolution, white balance, and depth of field. There are also the obvious requirements

such as knowing how to use a computer, have a working knowledge of Microsoft®

software,

printers, some basic networking knowledge, and component connectivity.

Requirements

This guide assumes the user has a good working knowledge of Microsoft Windows, CoPathPlus,

cameras, and photography. In addition users who will be creating reports must have a working

knowledge of the Powersoft's InfoMakerTM

or another compatible report writer.

4) Configure the image device application, the one that will be used to import to PICSLink,

using the PICSLink Device Setup, available in the Options menu in the Image Gallery or

the PICSPlus Report Manager. Only one image device application can be used at a time.

If you would like to switch to a different device, you will then need to configure that

device.

5) If you would like PICSLink to be your default import action, you can configure it using

the Default Import Action in the Image Gallery or the PICSPlus Report Manager.

PICSLink can also be used with PICSPlus Express Capture. The option to Import from

PICSLink is also available in the Attachments menu in the Image Gallery or the

PICSPlus Report Manager.

Accessing PICSPlus From CoPathPlus Page 2-1 of 6



Chapter 2: Accessing PICSPlus From CoPathPlus

PICSPlus is accessed from CoPathPlus by the following activities.

PICSPlus Image Entry/Edit

PICSPlus Report Image Select

You may also be able to access PICSPlus by clicking the Image Gallery or Select Images

buttons that have been painted onto CoPathPlus Activity Windows.

If you are using PICSPlus Express Capture, you can capture images by clicking the "Import

From" button that have been painted onto CoPathPlus Activity Windows.

Note: The functionality of PICSPlus depends on the feature add-ons assigned to the workstation or the individual

user. Contact your CoPathPlus System Manager for information on the add-ons available at your site for your

workstation.

PICSPlus Image Entry/Edit

The PICSPlus Image Entry/Edit Activity allows you to access the Gallery Manager for the

selected specimen. From the Gallery Manager, you can:

Import Images from a file

Export Images from Image Gallery to a file

Import Images from TWAIN

Import Images from Matrox

Import Images from the Clipboard

Review/Modify parameters

Open the PICSPlus View Manager

See a List of Linked Reports

Run the Image Gallery Review

The PICSPlus Image Entry/Edit window also displays information pertaining to the selected

specimen. The information displayed is "grayed out" to indicate that the specimen data is not

editable on this form sequence. Scroll bars are active allowing all multi-instance information to

be viewed.

If your site is set up to automatically attach images at the procedure/addendum level, you will

still need to acquire images through the Procedure Entry/Edit activity.

The following is an example of the PICSPlus Image Entry/Edit window.

Page 2-2 of 6 Accessing PICSPlus From CoPathPlus



Press the Image Gallery button to access the Gallery Manager. Exiting from the Gallery

Manager will return the user to this display. The Save/Next Specimen button is used to save the

changes that were made within the Gallery Manager feature. Changes made in the Gallery

Manager are not retained unless this button is pressed.

If you are using PICSPlus Express Capture, you can capture images without accessing the

Gallery Manager. An "Import From" button and an Express check mark will display rather than

the Image Gallery button. To access the Report Manager, you’ll need to uncheck the Express

button. Refer to the “PICSPlus Express Capture" chapter for more information.

The above image displays the traditional PICSPlus method for acquiring images, the below

image is an example of the PICSPlus Image Entry/Edit with the Express Capture button.

To access the PICSPlus Image Entry/Edit Activity:

1) Press the Specimens command button on the CoPathPlus Application Manager.

The Select Specimen window appears.

2) Choose a specimen according to the procedure in "Using the Select Specimen Window"

in the CoPathPlus User Guide.




3) Select PICSPlus Image Entry/Edit in the Activity field on that window.

Note: PICSPlus Image Entry/Edit will only appear in the Activity field if a valid form sequence has been

assigned to the selected Specimen Class. Refer to "CoPathPlus PICSPlus Integration Activities" for more

information.

4) Press OK. The PICSPlus Image Entry/Edit window appears.

TIP! You can also access the PICSPlus Image Entry/Edit activity by selecting File > Browse Items or by placing it

in your Personal Menu and double-clicking on it from there.

PICSPlus Report Image Select

The PICSPlus Report Image Select Activity allows you to access the Report Manager for the

selected specimen. From the Report Manger, you can:

View the Report Gallery

Select/Unselect Images to be placed on the reports

Run the Report Gallery Review

You can also do many of the tasks available in the Gallery Manager:

Import Images from a file

Export Images from Image Gallery to a file

Import Images from TWAIN

Import Images from the Matrox Acquisition Manager

Import Images from the Clipboard

Review/Modify parameters

Open the PICSPlus View Manager

When accessing PICSPlus Report Image Select, the system will first prompt for the associated

report. Highlight the report you are working with and press OK. Images assigned to the report

during this session will be associated to the selected report.

The PICSPlus Report Image Select window will then be presented and also displays information

pertaining to the selected specimen. The information displayed is "grayed out" to indicate that

the specimen data is not editable on this form sequence. Scroll bars are active allowing all multi-




instance information to be viewed. The following is an example of the PICSPlus Report Image

Select window.

Press the Select Images button to access the PICSPlus Report Manager. Exiting from the Report

Manager will return the user to this display. The Save/Next Specimen button is used to save the

changes that were made within the Report Manager. Changes made in the Report Manager are

not retained unless this button is pressed.

If you are using the PICSPlus Express Capture button, you can capture images without accessing

the Report Manager. An "Import From" button and an Express check mark will display rather

than the Select Images button. To access the Report Manager, you’ll need to uncheck the

Express button. Refer to the "PICSPlus Express Capture" chapter for more information.

Once a report is signed out, the PICSPlus Report Image Select feature can only be used for

viewing and export purposes. The only option available on the Attachments menu is the Export

to File option. The Image Viewer will show the Info tab for all report images, both images

included on the report and images that are not. No modifications, additions, or deletions can be

made to images in this feature.

To access the PICSPlus Report Image Select Activity:

1) Press the Specimens command button on the CoPathPlus Application Manager.

The Select Specimen window appears.

2) Choose a specimen according to the procedure in "Using the Select Specimen Window"

in the CoPathPlus User Guide.

3) Select PICSPlus Report Image Select in the Activity field on that window.

Note: PICSPlus Report Image Select will only appear in the Activity field if a valid form sequence has

been assigned to the selected Specimen Class. Refer to "CoPathPlus PICSPlus Integration Activities" for

more information.

4) Press OK. The Select a Report pop-up window appears.

5) Chose the report from the list and click OK. The PICSPlus Report Image Select window

appears.




TIP! You can also access the PICSPlus Report Image Select activity by selecting File > Browse Items or by placing

it in your Personal Menu and double-clicking on it from there.

CoPathPlus PICSPlus Integration Activities

Specimen classes can be enabled for PICSPlus without altering form sequences specific to that

specimen class by using Link Tailored Windows to assign an applicable form sequence to either,

or both, of the new activities:

PICSPlus Image Entry/Edit: Allowing access to the Image Gallery

PICSPlus Report Image Select: Allowing access to the Report Gallery

Default form sequences for each of these two new activities are delivered with the version 2.5 or

above. The purpose of each of these activities is to access their respective PICSPlus galleries.

When you select each activity, the system will display non-editable specimen data helpful in

specimen confirmation. The internal names for these exported form sequences are:

p_pics_image (for PICSPlus Image Entry/Edit)

p_pics_report (for PICSPlus Report Image Select)

Note: These activities become available for a specimen class after a valid form sequence has been assigned to each.

When there is no assigned form sequence for a specific activity, that activity will not be included on the Specimen

Activity pop-up window. The version update does not pre-assign default form sequences to these new activities

onto any of your existing specimen classes. Use the Link Tailored Windows function to assign form sequences

corresponding to your workflow needs.

These specific form sequences may be assigned to any or all specimen classes that are enabled

for image capture. You may also elect to use either or both of these form sequences as a

"starting" point to create a custom form sequences to be utilized in the PICSPlus Image

Entry/Edit and/or PICSPlus Report Image Select activity.

For more information, refer to the "Window Painting" section of the Cerner CoPathPlus Tools

Training Manual.

Image Gallery and Select Images Buttons

The Image Gallery and Select Images Buttons can be painted on several different CoPathPlus

windows. Refer to "CoPathPlus Form Sequences Eligible for PICSPlus Activities " for more

information on the form sequences where PICSPlus can be accessed.

There are two types of Image Gallery or Select Images buttons.

Image Gallery or Select Images with Express Capture Option. For more information

about the Express Capture Option, refer to "Using PICSPlus Express Caprture".

Image Gallery or Select Images only. This was the only version of the Image Gallery or

Select Images buttons available prior to version 3.1 of PICSPlus.

For more information, refer to the "Window Painting" section of the Cerner CoPathPlus Tools

Training Manual. Refer to "CoPathPlus Form Sequences Eligible for PICSPlus Activities” for

more information on the form sequences where PICSPlus can be accessed.




CoPathPlus Form Sequences Eligible for PICSPlus Activities

Each of the integrated PICSPlus buttons is eligible to be placed on certain windows classes in

CoPathPlus

The following CoPathPlus Form Sequences are eligible for PICSPlus activities:

Accession Entry/Edit

Gross Description Entry/Edit

Final Diagnosis Entry/Edit

Hot Seat Diagnosis Entry/Edit

Signout (Electronic)

Cytology Results Entry/Edit (Cytotech)

Cytology Results Entry/Edit (Pathologist)

Pathologist Console

Procedure/Addendum Entry/Edit

Post-Signout Edit

Signout (Manual)

The Image Gallery Button, which invokes the PICSPlus Gallery Manager, is eligible to be

included on the following windows:

Accession Entry/Edit

Gross Description Entry/Edit

Final Diagnosis Entry/Edit

Hot Seat Diagnosis Entry/Edit


Cytology Results Entry/Edit (Cytotech)

Cytology Results Entry/Edit (Pathologist)

Pathologist Console

Procedure/Addendum Entry/Edit

Post-Signout Edit

Signout (Manual)

Inquiry

The Select Images Button, which invokes the PICSPlus Reports Manager, is eligible to be

included on the following windows:


Signout (Manual)

Refer to the CoPathPlus User Guide for information on accessing the above windows.

Using the PICSPlus Gallery Manager Page 3-1 of 23



Chapter 3: Using the PICSPlus Gallery Manager

When you click the Image Gallery button on a CoPathPlus activity window, the PICSPlus Gallery

Manager opens. Refer to "Accessing PICSPlus from CoPathPlus" for information on the

windows.

The PICSPlus Gallery Manager has an Image Gallery that provides the ability to view the images

that have been previously capture or imported into the active patient record. The Image Gallery

displays thumbnail images of the images that have been previously captured. If no image has

been previously acquired, the Image Gallery will be empty.

The following illustration is an example of the PICSPlus Gallery Manager.

The PICSPlus Gallery Manager contains the following component areas:

Menu Bar

Image Gallery

Parameters for Selected Item in Image Gallery

Linked to Reports

Page 3-2 of 23 Using the PICSPlus Gallery Manager



Image Gallery Review Button

Import from Button

Task Buttons

The PICSPlus Gallery Manager can be configured to use PICSPlus Express Capture. If the

Express check mark appears on the PICSPlus Gallery Manager, your system has been configured

to use this method. Refer to "PICSPlus Express Capture" for more information.

PICSPlus Gallery Manager Menu Bar

The PICSPlus Gallery Manager Menu Bar consists of the following menus. Each menu has its

own set of commands.

File Menu

Edit Menu

Attachments Menu

Options Menu

PICSPlus Gallery Manager File Menu

The File menu on the PICSPlus Gallery Manager displays a drop-down with one item: Close.

Selecting this closes the PICSPlus Gallery Manager and returns you to CoPathPlus.

PICSPlus Gallery Manager Edit Menu

The Edit menu on the PICSPlus Gallery Manager displays a drop-down with the following

items:

Delete Selected. Deletes the images that have been selected. To select a single image,

move the mouse cursor over the image and depress the left mouse button. To select

several, but not all, images hold the CTRL key on the keyboard down and depress the left

mouse button on top of each image that you want to select. As you select the image the

border of the image will become colored as opposed to gray (the unselected color).

Delete Selected may also be invoked by pressing the Del key.

Select All. Selects all the images in the gallery. To deselect all images, click on an empty

space in the gallery. . Selected All also be invoked by the keyboard strokes of Control +

A.




PICSPlus Gallery Manager Attachments Menu

The Attachments menu on the PICSPlus Gallery Manager displays a drop-down with the

following items, which are determined on a per workstation basis appropriate to the acquisition

devices assigned to the workstation:

Import from File

Import from PDF

Export to File

Import from Clipboard

Import from TWAIN

Import from Matrox

Note: The Import from Matrox option is only available to sites using the MIL-Lite version 7.5 drivers.

Import from PICSLink

Import from File

When selecting the import option, the following window will appear. This is the Import

Attachment Window. You should select the image format (file type) of the image to be

imported. Highlight the type and select it. All of the images with that type format contained

within that directory will appear in the display window.

Tip: Import from File can also be invoked from the Gallery Manager with the keystrokes of Control + F.

Highlight the image of choice. To select multiple images, use Shift-Click to select a sequential

list of images. Use CTRL-Click to select multiple images not necessarily sequenced together.

Press the Open button to import the images. This window will close, and then the thumbnail of

the image will appear in the Image Gallery. Depending on default configurations, imported

images may or may not automatically be indicated to display on patient reports.




The File of type field allows you to select the type of image that is going to be imported. Note

that if an (*.jpg) image file is in the directory and the image selection is (*tif), the (*jpg) files

will not be displayed in the window. Therefore, you will need to either select the All Files

option or select each type separately to filter to only selected image types in the directory.

Below are the image file types available in the Import Attachment Window and a brief

description of each:

Note: Refer to "PICSPlus Import File Types" for a complete list of file types that you can import

into PICSPlus.

Windows® Bitmap File (*.bmp). The bitmap file is a device-independent format

allowing Windows®

to display the image on any type of display device. The term

"device-independent bitmap" (DIB) means that the pixel color is in a format that is

independent of the methods used in a display device. The Windows®

Bitmap format is

also considered to be a raw (uncompressed or distorted image from some compression

algorithm.

Tagged Image File (*.tif). The Tagged Image File Format (TIFF) is a file storage

format most commonly used for the bit-mapped images stored onto a computer. The file

extension is (*.tif). One of most popular uses of the TIFF is imaging or document

scanning because it can be any resolution, and it can be black and white or color. Only

single-page TIFF files can be imported into PICSPlus.




Note: When possible, it is recommended that non-color images be obtained as grayscale images rather than

black and white images. The Grayscale mode should be used to scan medium or low quality printed

documents, hand-written documents (e.g. requisition forms) and faxes. You can also use this mode to save

space when scanning documents for which picture color is not important. Refer to documentation from

your scanning or other device manufacturer for configuration information.

JPEG Compliant File (*.jpg). This format takes advantage of the human vision to

interpolate information that is not present. It compresses images using a discrete cosine

transform algorithm. It eliminates redundancy of pixels that meet specific frequency

criteria. JPEG stands for Joint Picture Expert Group. This was the name adopted by the

original imaging experts. This group created the compression algorithms standards.

JPEG 2000 (*.j2k). This format was developed to provide low bit rate operation with

rate-distortion and subjective image quality performance superior to existing standards,

without sacrificing performance at other points in the rate-distortion spectrum. This is

the format PICSPlus uses to store images.

PDF. Refer to "Import from PDF" for more information.

Note: When creating diagrams or other image files that will be embedded into reports, it is advised that the images

are created using a graphic editing tool that has 24-bit color. The image pixel resolution should be created at 640 x

480 at 96 dpi. Larger dpi’s will appear smaller on the report than the designated area and smaller dpi’s will appear

pixelated.

PICSPlus Import File Types

Thirty-four file formats are supported in PICSPlus for importing. All of these images are

converted to JPEG 2000 format once imported. The list of PICSPlus eligible file formats now

includes the following formats:

Amiga (*.iff) Portable Pixelmap (*ppm)

Brooktrout Fax (*.brk, *.301) SciTex Continuous Tone (*.sct, *.ct)

CALS Raster (*.cal, *.cals) SGI Image File (*.rgb, *.bw, *.rgba, *.sgi)

CompuServe Graphics Interchange (*.gif) Sun Raster Image (*.ras)

Deluxe Paint (*.lbm) Tagged Image File Format (*.tif, *.tiff)

Dr. Halo (*.cut) True Vision Targa (*.tga)

Encapsulated Post Script (*.eps, *.ps – monochrome

with preview only)

Windows Clipboard (*.clp)

GEM Paint (*.img) Windows Enhanced Meta File (*.emf)

JPEG (*.jpg, *.jif, *.jpeg) Window Metafile (*wmf – save bimpap data only)

JPEG 2000 (*.jp2, *.j2c, *.j2k, *.jpc, *.jpx) WindowsOrCompuServeRLE (*.rle)

Macintosh PICT (*.pct) Windows or OS2 Bitmap (*.bmp)

MacPaint (*.mac) Windows or OS2 DIB (.dib)

NCR G4 (*ncr) Wireless Bitmap (*wbmp)

Photoshop (*.psd) Xwindows Bitmap (*.xbm, *.bm)

Portable bitmap (*.pbm) XWIndows Dump (*.xwd, *.wd)

Protable Graymap (*.pgm) XWindowsPixmap (*.xpm)

Portable Network Graphics (*.png) ZSoft Paintbrush (*.pcx)

Files can only be exported in JPEG, BMP, TIFF and JPEG 2000 formats.




Import from PDF

PICSPlus now offers the ability to convert and then import files that originate as electronic PDF

files. Import of PDF files requires that the file be rasterized or converted to an image file. When

a multi-page PDF is rasterized, each page will be converted, stored, and presented as a separate

image in the Image Gallery. Files stored as images files are not re-converted to PDFs if they are

exported.

Set the preferred resolution value in the "Resolution for PDF conversion into the raster image

(pixels/Inch)" field before acquiring a PDF image. The resolution of the PDF is set according to

this value when the PDF is acquired. The resolution cannot be changed on an already acquired

file. If you need an imported file to be retained at a different resolution, delete the originally

acquired file. Change the value in the "Resolution for PDF conversion into the raster image

(pixels/Inch) field" setting and then re-acquire that PDF.

Increasing the resolution value will provide better conversion quality but will also increase file

size and conversion time. Resolution cannot improve quality of the original document.

Experiment to determine the optimal value for your documents and set the default value

accordingly.

To modify the default resolution, press on the up arrow or down arrow spin control. Resolution

levels will change in increments of 50 and range between 100 and 600.

When the rasterization technology is used for saving a consult report to a case, you may wish to

include this image in a fairly large size on your patient report. As with other images, define an

attachment type with appropriate dimensions and set it to be allowed to print on patient reports.

When defining an image size, remember that the image must fit within the header, footer, and

side margins defined for your patient report template(s). In addition, you must also allow room

for the image title to print beneath the report. In circumstances where the defined height and

width of your image size in the Attachment Type Dictionary is not proportional to the image

itself, the image will resize itself to maintain proportionality. Do not define a image that is too

large to fit within your patient report borders. For example, for a report template that uses 1.2

inch header, footer, right margin, and left margin, a rasterized image of a PDF that was formerly

11 x 8.5 might be sized to 9.5 x 7.35. Perform your own experiments with rasterized images

that are both "busy" and "fairly light" on content to determine what works best for your lab.

Note: The Resolution for PDF Conversion field affects quality of the image (formerly the PDF) that is retained

within CoPathPlus. The Print Quality field in the Attachment Type Dictionary affects print quality of a specific

attachment type when it is printed on a patient report generated by the site’s text editor. Consider both your specific

requirements in image retention and report display, and then balance these needs against the required conversion

time, storage, and printer resources when setting these two parameters. For example, you might opt to retain the

image at a fairly high resolution, but realize you can set a relatively low print quality and still have an acceptable

report display. For formatted patient reports sent via a MIME or PDF interface that do not already use an already

created PDF, interface configuration determine image resolution within the patient report.

Export to File

Any images assigned to a CoPathPlus specimen may also be exported. Image can be exported at

a publishing quality if the camera used to take the image supported an adequate pixel count. To

verify that the image is publishing quality, you can use the PICSPlus Resolutions Calculator,

available from the Options menu. Refer to "PICSPlus Resolutions Calculator" for more

information




To Export an Image:

1) Access the Image Gallery.

2) Select the image(s) you want to export. If you are selecting multiple images, hold down

the CTRL key when selecting images in a list and CTRL + Shift when selecting non-

sequential images.

3) Select Export to File from the File menu or press CTRL + E.

The Export Attachment window appears.

4) Navigate to the drive and folder where the images should be saved. Enter the file name

and select the format (file type) of the image(s) to be exported. If you are exporting

multiple files, enter a prefix that will be applied as the first part of the name of all images

selected. Click Save. The system will provide a warning regarding imaging naming,

relating that all images will receive the same prefix that will then be followed by a dash

and a sequence number should the user continue with the export. Click OK to continue

with the export.

After saving the images, the Export Attachments Window will close and return to the Image.


You can directly images from a variety of image editors and viewers, including the web browser

using the Import from Clipboard option. This option will import an image that you have copied

to the Clipboard into PICSPlus. The Clipboard is the memory area (buffer) where data is stored

temporarily before being copied to another location. For example, if you copy a picture from a

web page and then use the Import from Clipboard option, you can paste the image into PICSPlus.

To import an image from the Clipboard, copy the image from the application where the image is

located. To copy an image from a web page using Internet Explorer, right-click the mouse over

the image and select Copy from the menu that appears. To copy images from other applications;

refer to the application’s user documentation. After you have copied the image, switch to the

PICSPlus Gallery Manager and select the Import from Clipboard option. The image will then

appear in the Gallery Manager.

Tip: Import from Clipboard can also be invoked from the Gallery Manager with the keystrokes of Control + B.




Import from TWAIN

You can acquire an image from a TWAIN device by clicking on the Import from TWAIN

option. This will launch the TWAIN compliant software acquisition application that

accompanied the TWAIN device. You should be familiar with the operation of the device. The

PICSPlus software will see the TWAIN information and open the image acquisition part of the

software. All software functionality will not be available during this activity within PICSPlus

since it only sees the information that allows the acquisition mode of the application.

Note: It is possible to have more than one TWAIN device attached to your workstation. If this is the case, assign

the desired TWAIN device prior to performing the TWAIN import. Refer to PICSPlus Gallery Manager Options

Menu: TWAIN, Select TWAIN Source for additional information.

It is recommended that before you execute the Import from TWAIN option that the object to be

acquired be placed on the scanner or within the camera’s view. Once the Import from TWAIN

option is executed, the TWAIN software will open and the familiar application window will

appear. It will begin the scan of the object on the scanner. If the device is a camera the live

image should appear in the viewfinder of the window.

After the image is acquired it will then be ready to edit by the TWAIN software with the limited

accessible software functionality. After you have edited the image it can then be sent to the

PICSPlus. There should an activity button (depending on the device) available to send the

acquired image to the PICSPlus.

When the application has finished acquiring the image, it will close and return you to the

PICSPlus View Manager where the image will be displayed. You can now perform all of the

functions normally available in the PICSPlus View Manager.

Tip: Import from TWAIN can also be invoked from the Gallery Manager with the keystrokes of Control + T.

Refer to “Fast Scanning With Automatic Document Feeder (ADF) Support” below for

information on importing from a scanner with Automatic Document Feeder (ADF) support.

Fast Scanning With Automatic Document Feeder (ADF) Support

PICSPlus supports scanners equipped with Automatic Document Feeder (ADF) support. An

ADF is used in scanners to feed pages into the machine. It allows multiple pages to be copied or

scanned at one time without the need to place each individual page in the copier or scanner. To

scan multiple batches, the TWAIN interface software that came with the scanner needs to be

configured for ADF (consult your scanner manual for more information). Images can be

imported using the Import from Twain button in the Image Gallery or Report Gallery or by using

Express Capture, which enables images to be scanned with one click of a button. Each page

scanned in from the ADF will appear as a single image in PICSPlus.

Please note that the following information is very important to keep in mind when using this new

feature:

Scanner manufacturers are required to indicate if the scanner has the ability to comply

with the TWAIN capabilities, which are used by TWAIN drivers and applications to

control the scanning device and the attributes of images to be acquired.

PICSPlus uses the TWAIN capability information provided by the scanner manufacturer

to determine if the functionality described above will work with PICSPlus.




After considerable testing of numerous scanners, we have discovered that the information

about the TWAIN capability provided by the scanner manufacturer is not always correct.

In these situations, PICSPlus will ignore the functionality if it does not work with the

scanner, for example if the scanner is not capable of hiding the user interface it will still

display, even if you have unchecked “Show User Interface”. In these situations, please

contact the scanner manufacturer for more information.

Import from Matrox

When using the PICSPlus Acquisition Manager associated Matrox, the Matrox Acquisition

Manager may be invoked via the following methods:

When a workstation has defined Matrox acquisition as the default acquisition method,

click on the Import from Matrox button. (Refer to "Default Import Action" for more

information.)

The following methods to invoke Matrox Import can be used whether the Matrox is the

default acquisition method or it the workstation is only used for occasional Matrox

acquisitions, thus the default acquisition method is defined to be a different import type:

Click on the Attachments menu and then select the Import from Matrox Item

Simultaneously press the CTRL and the M key.

The Matrox Acquisition Manager will be displayed after any of these methods are used. The

following is an example of the Matrox Acquisition Manager

This window is used to acquire (capture) the image. Position the display on your Matrox devices

to the appropriate position and acquire the image. The image is captured either by clicking on




the Acquire button, pressing Alt + Q or simply pressing the Enter key since the Acquire button is

the default key for the screen.

Following image acquisition, the screen display will either return to the Image Gallery or it will

open the PICSPlus View Manager, where annotations may be made.

The Attachments drop-down menu now also supports the import of image from the PICSLink.

An image from an imaging device interfaced to CoPathPlus can be imported via this menu or via

use of CTRL+ P.

When using an imaging device interfaced to CoPathPlus, PICSLink may be invoked via the

following methods:

When a workstation has defined PICSLink acquisition as the default acquisition method,

click on the Import from PICSLink button. (Refer to "Default Import Action" for more

information.)

The following methods to invoke PICSLink Import can be used whether the PICSLink is

the default acquisition method or it the workstation is only used for occasional PICSLink


Click on the Attachments menu and then select the Import from PICSLink Item

Simultaneously press the CTRL and the P key.



PICSPlus Gallery Manager Options Menu

The Options menu on the PICSPlus Gallery Manager displays a drop-down with two items:

Image Viewer

Default Import Action

Default Import Template

Resolutions Calculator

PICSLink Devices

TWAIN

Image Viewer

The Image Viewer menu display contains the following item:

Load with maximized view

This option lets you select to open images in the PICSPlus View Manager by default in

Maximize View or in Normal View. If you select this option and place a check mark next to it,

as displayed in the illustration below, when you open images from the Gallery Manager, the

images will open in Maximize View. If there is no check mark, the images will open in Normal

View.





The Import Action default is maintained on a per workstation basis. The acquisition method

(File, Clipboard, TWAIN, or Matrox) that is displayed at the time the Image Gallery is closed

will be the one automatically displayed when the gallery is re-accessed.

When using PICSPlus Express Capture, you must set the default import action

Specific Default Import Action menu display will vary at workstations. A full Default Import

Action menu would include the following:

Import from File


Import from TWAIN

Import From Matrox

Import From PICSLink

To define the default import action for the workstation, make the following selections.

1) Select the Options Menu from the Image Gallery

2) Select Default Import Action. A menu similar to the following appears.

3) Click on the appropriate "Import Action" option. A check mark will appear to the left of

the selected option.


The Default Import Template menu display is determined on a per workstation basis appropriate

to the acquisition devices assigned to the workstation. Workstation specific acquisition devices

are defined in the Workstation Setup. The template default may be defined based on a

combination of image acquisition method (Import, TWAIN, or Matrox). Once a template is

defined for an acquisition method on a specific workstation, that specific template is retained as

the default for that workstation for each specific acquisition method until the user specifically

modifies it.

Specific option menu display will vary at workstations. A full Options menu would include the

following:




Import from File


Import from TWAIN

Import From Matrox

Import from PICSLink

To define the appropriate default template for the workstation, make the following

selections.


2) Select Default Import Template.

3) Select the appropriate "Import from" option. The following pop-up window will appear.

4) Use the drop-down to select the desired template from the PICSPlus Template

Dictionary.

5) Click Save to make the choice the default for this workstation.

PICSPlus Resolutions Calculator

Publishers may request images be of specific minimal resolutions and compressions. The

resolution value will affects the printed image size. For example, a publisher may require that an

image be between four and six inches with a resolution of not less than 300 pixels per inch. The

Resolutions Calculator will allow you to ascertain the image size in inches when a specific

resolution is applied.

To determine whether your image may be exported at publishing quality and to prepare it

for export:

1) Select that image in the PICSPlus Image Manager or Report Manager.

2) Open the Image Viewer for that image and select the Info tab to see the height and width

of that image in pixels.

3) Return to the gallery to open the Resolution Manager from the Option dropdown menu or

press Control + Shift + S.

4) Enter the width and height in pixels into the fields provided.




5) Change the export resolution by pressing on the up or down arrows in the spin control

field until you reach the desired image size and then verify your image resolution is at or

above the publisher’s resolution request.

6) Press the Save button to copy the image with the updated resolution and close the

Resolution Manager.

7) Export the image by clicking the menu item of Attachments and then Export to File, or

use Control + E to export your image. Navigate to the desired folder, enter a file name

and select the desired file type of .bmp, .jpg, or .tif in the "Save as Type" dropdown.

The Resolution Manager will remember the resolution used for the last image and default to that

level the next time this feature is used.

The PICSLink Device Setup is available under the Options menu in the Image Gallery. The

PICSLink Device Setup is where the current application is selected and the user can control

application behavior after the image transfer.

To define PICSLink Device for the workstation, make the following selections.


2) Select PICSLink Devices.

The PICSLink Device Setup window will appear.




3) Enter the following fields:

Select Current PICSLink Device. Select a device from the drop-down menu. The

list of available devices is populated from the Imaging Device Type Dictionary.

EXE File Path. Click the Browse button to link to the EXE file for the imaging

device. PICSLink uses this connection to communicate with the imaging device.

User Name and Password. If required by the imaging device, enter a user name and

password so PICSLink can communicate with the imaging device.

After Data Transfer:

Close All Images in the Device Application. Select this option if you want the

image acquired through the image device to close after it has transferred to

PICSPlus. If you do not select this option, you will need to manually close the

images through the image device software.

Minimize the Device Application. Select this option if you want the window

displaying the imaging device software to minimize after the data has transferred

to PICSPlus.

4) Save the changes.




TWAIN

The TWAIN menu is used to allow definition of TWAIN parameters specific to the workstation.

Two options appear on the TWAIN Menu:

Multiple TWAIN Source Selection


Show User Interface

Keep User Interface Open


PICSPlus allows for image acquisition from more than one TWAIN source attached directly to

the same workstation.

When the Import from TWAIN feature is utilized under this circumstance, a Select Source

window will be presented. Highlight the desired source and then press the Select button.

TWAIN Force Buffered Memory Transfer

PICSPlus was designed to work with TWAIN Native data transfer. The TWAIN standard

stipulates that any device represented as TWAIN-compatible must support Native data transfer.

However, certain manufactures denote their devices as TWAIN compatible when Native data

transfer is not supported. While all TWAIN devices recommended by Cerner CoPathPlus use

Native data transfer, some clients wish to work with devices they owned before the PICSPlus

implementation that do not follow this specific standard.

Note: Use Force Buffered Memory Transfer switch on workstations that interact with TWAIN devices using

memory-buffered data transfer only. When the Force Buffered Memory Transfer option is selected, CoPathPlus




displays a warning related to loss of data and device instability. Cerner CoPathPlus cannot be responsible for device

instability.

Show User Interface

Turn this option on if it will be necessary to interact with the scanner’s interface during the

import process. When this option is selected a check mark will appear to the left of the option on

the menu and the scanner’s user interface will display .


Turn on this option on if interaction with the scanner’s user interface is required and multiple

images are being scanned.

Refer to “Fast Scanning With Automatic Document Feeder (ADF) Support” for more

information about scanning multiple images.

Image Gallery

The Image Gallery is an object on the PICSPlus Gallery Manager and PICSPlus Report

Manager that provides a place to review the thumbnails of the images that have been acquired

within the currently active patient record.

The image name for each thumbnail image is displayed in the upper portion of the image frame.

The image type abbreviation is displayed in the lower portion of the image frame for each

thumbnail. These abbreviations are defined in the Attachment Type Dictionary. Refer to

"Attachment Type Dictionary” for more information.

Selecting an Image in the Image and Report Galleries

To select an image from the Image Gallery or the Report Gallery, place the cursor over the image

and click the left mouse button once. This will highlight the border of the image. At the same

time, the list box within the Parameters for Selected Item in Image Gallery will appear. This will

list the parameters of the specifically selected image. For more information, refer to "Parameters




for Selected Item in Image Gallery". To deselect an image, click on a different image to be

selected or click on an empty space in the Image Gallery.

The following illustration displays examples of thumbnails in selected and unselected state:

Note: You can also select an image in the Image Gallery and press the CTRL + L shortcut to open the PICSPlus

View Manager.

It is also possible to select multiple images by pressing the Shift or CTRL key in conjunction with

clicking the mouse. This is useful for exporting multiple images. Refer to "Image and Report

Gallery Keyboard and Mouse Shortcuts” for more information.

Note: If multiple images are selected, the Parameter data will not display in the Parameter List Box.

Image and Report Gallery Keyboard and Mouse Shortcuts

The following table displays the Keyboard and Mouse Shortcuts for the Image Gallery. These

shortcuts also apply to the Report Gallery.

Action Mouse Keyboard Mouse and Keyboard

Select single thumbnail Left-click Ctrl + space bar (If

thumbnail has focus

indicator)

Ctrl + Left-click

Unselect single thumbnail Left-click on

empty space

(unselect all

selected

thumbnails)

Ctrl + space bar (If

thumbnail has focus

indicator)

Shift + Left-click

Move focus indicator

without selecting thumbnail

N/A Ctrl + Arrow (Left, Right,

Up and Down) or Home

(End) to move to the first

N/A




thumbnail or last thumbnail.

Select all thumbnails Right-click on any

place within the

Gallery and Left-

click on Select All

Menu Item.

Ctrl + A Select first

thumbnail and Shift

+ Left-click on last

thumbnail

Unselect all thumbnails Left-click on

empty space

Press Home (or End) and

after that Ctrl + space bar

Left-click on any

thumbnail and after

that Ctrl + space bar

Delete selected thumbnail

(thumbnails)

Right-click on any

place within the

Gallery and Left-

click on Delete

Selected Menu

Item.

Del N/A

Load PICSPlus Image

Viewer (Image Gallery

Only)

Double-click on

thumbnail

Ctrl + L N/A


This component of the PICSPlus Gallery Manager and Report Manager is a list box of the

parameters assigned to the selected image within the Image Gallery or Report Gallery. See the

figure below.

To select an image, place the cursor over the image and click the left mouse button once. This

will highlight the border of the image. At the same time, the list box within the Parameters for

Selected Item in Image Gallery will appear. This will list the parameters of the selected image.

There are two columns in this list: Name and Value. These values are either assigned by the user

or by the system, depending on the type of parameter. The names of the parameters are set-up in

the PICSPlus Template Dictionary. These parameters are attributes assigned to images. Some




information is automatically captured, other information will be manually entered. Parameters

may be defined as either mandatory or optional fields. If desired, parameters can be set-up under

the DICOM standard for image information. It is the user’s discretion as to which parameters

best suit the needs at the time the system is set-up. Some useful parameters include, but are not

limited to: Image Type, Image Title, Date of Capture, Person Acquiring Image, Type of Camera

Used, Image Format, Size of Image and Color Depth of Image.

For more information, refer to "PICSPlus Template Dictionary" in this guide.

Linked to Reports

The Linked to Reports display indicates whether an image is designated for inclusion on any

patient reports. When any specific image is highlighted (under focus) in the gallery, the Linked

to Report(s) datawindow display will present the report status. An empty datawindow denotes

that the highlighted image is not currently assigned to be included on any patient report. When

an image is indicated to be displayed on one or more reports, this datawindow will stipulate the

report type, such as FINAL or PROC (procedure) and will also display the status of this report,

such as PRE (preliminary), S/O (signed out), or AM (amended). When the report type is a

procedure report, the datawindow display also shows the procedure abbreviation and the Order

Date and Time of that procedure.

Images may either be linked automatically to Final Reports or manually assigned to any patient

report.

To assign images to reports:

Automatic Links to Final Reports

1) Automatic Links for Report Types must be defined in the Attachment Type

Dictionary. Images can only be automatically linked to Final Specimen reports. Use

the manual report assignment, described below, for Procedure or Addendum reports.

2) The Default Image Type template for the acquisition method used is set to that

particular Image Type.

Note: An image retains it automatic report linkage “status” even if the image type is changed after

acquisition. For example: Image type A is automatically placed on the Final patient report. Image type B

is eligible for patient reports, but does not automatically get linked to any report. An image that is acquired

as image type A gets changed to image type B. This image is still automatically associated to the report

until someone removes it in the Report Gallery. An image that is acquired as image type B gets changed

to image type A. This image is NOT automatically associated to the Final report. It must be manually

linked via the Report Gallery.

3) The activity in which the image was acquired is appropriate for the report type of the

specimen. For example, images acquired in the Final Diagnosis activity can be

eligible for automatic report inclusion on Final Reports. However, images acquired in

a Procedure activity would not be eligible to automatic inclusion on the Final

Specimen report.




Manual Links to Final, Procedure or Addendum Reports

Manual report assignment is accomplished by dragging the image from the Image Gallery

to the Reports Gallery in the appropriate signout activity. Images may be assigned to

Final Reports when a specimen is being signed out. Likewise, images may be assigned to

Procedure or Addendum Reports when the procedure or addendum is signed out.

Image Gallery Review

Image Gallery Review allows you to browse through all images in the Image Gallery from either

the Gallery Manager or the Report Manager using a Manual Display method or a Timer Display

method. Whichever method you choose, the images in the Image Gallery will display in the

order in which they appear in the gallery. When the last image in the image gallery is displayed,

the images will repeat in the same order.

If you select the Manual Display method, the image display will only change when you press the

spacebar. If you select the Timer Display method, the image display will transition using the

timer settings you select. Refer to "Adjusting the Review Display Options " for information on

selecting the display method and changing the display options.

To use the Image Gallery Review feature:

1) Click the Image Gallery Review button on the Image Gallery or the Report Gallery.

The Review Window will appear.

2) Press the space bar to begin the image gallery review. The review method will default to

the last selected setting for the display, either Timer or Manual. Refer to "Adjusting the

Review Display Options " for more information.

If you are using the Manual display option and have selected to use the Magnifier, you

can click the mouse to magnify a section of the image. You can set the options for the

magnifier using the Display Setup menu.

During the Image Gallery Review, you can press the Pause button on the keyboard to

pause the review and then press the spacebar to resume the review.

3) When you are finished with the review, click the Esc key.

Adjusting the Review Display Options

To adjust the review display settings:

1) Follow the steps outlined in "Image Gallery Review " or "Report Gallery Review" to

open the Review window.

2) Right-click the mouse to open the menu displayed below.




3) You can select the following display options from the menu available on the Review

Window:

Use Magnifier. This option only appears if you are using the Manual Display method

(pressing the spacebar to transition through the images). Select this option If you want

to be able to easily magnify a section of the image by clicking the mouse on it. You

can hold the mouse button down and scroll around the image to view any part in the

magnified view. You can set the options for the magnifier using the Display Setup

menu. See below for more information.

Use Timer. Select this option to automate the transition of images using the timer.

You can set the length of the timer using the using the Display Setup menu. See

below for more information.

Show Marks. Select this option if you want any marks that have not been burned on

the image to appear when you use the Image Gallery Review feature. Marks are

objects that can be placed on a PICSPlus image to bring attention to or focus on a

specific area of the image. You can mark PICSPlus images when using the PICSPlus

View Manager.

Display Setup. Select this option to make changes to the Timer or Magnifier. The

following illustration is an example of the Display Setup window.

4) You can configure the following settings on the Display Setup window:

Timer. Enter the number of seconds you want the image to display before advancing

to the next image. You can type a number or use the spin controls.

Magnifier. The following are options for configuring the magnifier:

Size (Pixels). Enter the Width and Height in pixels of the magnifier. You can type

a number or use the spin controls.

Shape. Select to view the magnifier in an eclipse shape or a rectangle shape.




Magnification. Enter the magnification level for the magnifier. You can type a

number or use the spin controls. The lowest number is 1 and the highest number

(the highest level of magnification) is 99.

The selections you make for the Review display options are saved as the default for the

workstation.

Import From Button

The Import From button on the Image Gallery and the Report Gallery provides a quick alternative

for the image acquisition method of choice. The specific action of this button may be "Import

from File", “Import from Clipboard", "Import from TWAIN" or "Import from Matrox". It is set

up on a per workstation basis via selection of the Default Import Action on the Options menu.

Task Button

The following button is available on the PICSPlus Gallery Manager and Report Manager:

Close. Closes the PICSPlus Gallery or Report Manager and returns you to CoPathPlus.




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Using the PICSPlus Report Manager Page 4-1 of 19



Chapter 4: Using the PICSPlus Report Manager

When you click the Select Images button on a CoPathPlus activity window, the PICSPlus Report

Manager opens. Refer to "Accessing PICSPlus from CoPathPlus" for information on the

windows.

The PICSPlus Report Manager has an Image Gallery that provides the ability to view the images

that have been previously capture or imported into the active patient record. The Image Gallery

displays thumbnail images of the images that have been previously captured. If no image has

been previously acquired, the Image Gallery will be empty.

The PICSPlus Report Manager also has a Report Gallery that displays the images designated to

appear in the patient report. If no image has been previously acquired, the Report Gallery will be

empty.

The following illustration is an example of the PICSPlus Report Manager.

The PICSPlus Report Manager contains the following component areas:

Menu Bar

Image Gallery

Page 4-2 of 19 Using the PICSPlus Report Manager



Report Gallery



Report Gallery Review

Import from Button

Task Buttons

The PICSPlus Report Manager can be configured to use PICSPlus Express Capture. If the

Express check mark appears on the PICSPlus Report Manager, your system has been configured

to use this method. Refer to "PICSPlus Express Capture" for more information.

PICSPlus Report Manager Menu Bar

The PICSPlus Report Manager Menu Bar consists of the following menus. Each menu has its

own set of commands.

File Menu

Edit Menu

Attachments Menu

Options Menu

PICSPlus Report Manager File Menu

The File menu on the PICSPlus Report Manager displays a drop-down with one item: Close.

Selecting this closes the PICSPlus Report Manager and returns you to CoPathPlus.

PICSPlus Report Manager Edit Menu

The Edit menu on the PICSPlus Report Manager displays a drop-down with two items:

Copy Selected. Copies the thumbnail images that have been highlighted in the upper

Image Gallery portion of the Report manager. These images can be copied in preparation

to paste them into the Report Gallery portion of the Report Manager.

Cut Selected. Removes the thumbnail images that have been highlighted in the lower

Report Gallery portion of the Report Manager. The thumbnail image is retained in the

clipboard.




Paste. After an image has been copied, the Paste option may be used to place the image

in the Report Gallery portion of the Report Manager. You can paste the image before a

current image in the Report gallery by clicking on the image and selecting the Paste

option. To paste an image at the end of the current selections, click in the empty portion

of the Report Gallery and select the Paste option.

Delete Selected. Deletes the images that have been selected. To select a single image,

move the mouse cursor over the image and depress the left mouse button. To select

several, but not all, images hold the CTRL key on the keyboard down and depress the left

mouse button on top of each image that you want to select. As you select the image the

border of the image will become colored as opposed to gray (the unselected color).

Select All. Selects all the images in the gallery.

PICSPlus Report Manager Attachments Menu

The Attachments menu on the PICSPlus Report Manager displays a drop-down with the

following items, which are determined on a per workstation basis appropriate to the acquisition

devices assigned to the workstation:

Import from File

Export to File


Import from TWAIN

Import from Matrox

Note: The Import from Matrox option is only available to sites using the MIL-Lite version 7.5 drivers.

Import from File

When selecting the import option, the following window will appear. This is the Import

Attachment Window. You should select the image format (file type) of the image to be

imported. Highlight the type and select it. All of the images with that type format contained

within that directory will appear in the display window.

Tip: Import from File can also be invoked from the Gallery Manager with the keystrokes of Control + F.

Highlight the image of choice. To select multiple images, use Shift-Click to select a sequential

list of images. Use CTRL-Click to select multiple images not necessarily sequenced together.

Press the Open button to import the images. This window will close, and then the thumbnail of

the image will appear in the Image Gallery. Depending on default configurations, imported

images may or may not automatically be indicated to display on patient reports.




The File of type field allows you to select the type of image that is going to be imported. Note

that if an (*.jpg) image file is in the directory and the image selection is (*tif), the (*jpg) files

will not be displayed in the window. Therefore, you will need to either select the All Files

option or select each type separately to filter for selected image types in the directory.

Below are the image file types available in the Import Attachment Window and a brief

description of each:

Note: Refer to "PICSPlus Import File Types" for a complete list of file types that you can import

into PICSPlus.

Windows® Bitmap File (*.bmp). The bitmap file is a device-independent format

allowing Windows®

to display the image on any type of display device. The term

"device-independent bitmap" (DIB) means that the pixel color is in a format that is

independent of the methods used in a display device. The Windows®

Bitmap format is

also considered to be a raw (uncompressed or distorted image from some compression

algorithm.

Tagged Image File (*.tif). The Tagged Image File Format (TIFF) is a file storage

format most commonly used for the bit-mapped images stored onto a computer. The file

extension is (*.tif). One of most popular uses of the TIFF is imaging or document

scanning because it can be any resolution, and it can be black and white or color. Only

single-page TIFF files can be imported into PICSPlus.




JPEG Compliant File (*.jpg). This format takes advantage of the human vision to

interpolate information that is not present. It compresses images using a discrete cosine

transform algorithm. It eliminates redundancy of pixels that meet specific frequency

criteria. JPEG stands for Joint Picture Expert Group. This was the name adopted by the

original imaging experts. This group created the compression algorithms standards.

JPEG 2000 (*.j2k). This format was developed to provide low bit rate operation with

rate-distortion and subjective image quality performance superior to existing standards,

without sacrificing performance at other points in the rate-distortion spectrum. This is

the format PICSPlus uses to store images.

PDF. Refer to "Import from PDF" for more information.

Note: When creating diagrams or other image files that will be embedded into reports, it is advised that the images

are created using a graphic editing tool that has 24-bit color. The image pixel resolution should be created at 640 x

480 at 96 dpi. Larger dpi’s will appear smaller on the report than the designated area and smaller dpi’s will appear

pixelated.

PICSPlus Import File Types

Thirty-four file formats are supported in PICSPlus for importing. All of these images are

converted to JPEG 2000 format once imported. The list of PICSPlus eligible file formats now

includes the following formats:

Amiga (*.iff) Portable Pixelmap (*ppm)

Brooktrout Fax (*.brk, *.301) SciTex Continuous Tone (*.sct, *.ct)

CALS Raster (*.cal, *.cals) SGI Image File (*.rgb, *.bw, *.rgba, *.sgi)

CompuServe Graphics Interchange (*.gif) Sun Raster Image (*.ras)

Deluxe Paint (*.lbm) Tagged Image File Format (*.tif, *.tiff)

Dr. Halo (*.cut) True Vision Targa (*.tga)

Encapsulated Post Script (*.eps, *.ps – monochrome

with preview only)

Windows Clipboard (*.clp)

GEM Paint (*.img) Windows Enhanced Meta File (*.emf)

JPEG (*.jpg, *.jif, *.jpeg) Window Metafile (*wmf – save bimpap data only)

JPEG 2000 (*.jp2, *.j2c, *.j2k, *.jpc, *.jpx) WindowsOrCompuServeRLE (*.rle)

Macintosh PICT (*.pct) Windows or OS2 Bitmap (*.bmp)

MacPaint (*.mac) Windows or OS2 DIB (.dib)

NCR G4 (*ncr) Wireless Bitmap (*wbmp)

Photoshop (*.psd) Xwindows Bitmap (*.xbm, *.bm)

Portable bitmap (*.pbm) XWIndows Dump (*.xwd, *.wd)

Protable Graymap (*.pgm) XWindowsPixmap (*.xpm)

Portable Network Graphics (*.png) ZSoft Paintbrush (*.pcx)

Files can only be exported in JPEG, BMP, TIFF and JPEG 2000 formats.

Import from PDF

PICSPlus offers the ability to convert and then import files that originate as electronic PDF files.

Import of PDF files requires that the file be rasterized or converted to an image file. When a

multi-page PDF is rasterized, each page will be converted, stored, and presented as a separate

image in the Image Gallery. Files stored as images files are not re-converted to PDFs if they are

exported.




Set the preferred resolution value in the "Resolution for PDF conversion into the raster image

(pixels/Inch)" field before acquiring a PDF image. The resolution of the PDF is set according to

this value when the PDF is acquired. The resolution cannot be changed on an already acquired

file. If you need an imported file to be retained at a different resolution, delete the originally

acquired file. Change the value in the "Resolution for PDF conversion into the raster image

(pixels/Inch) field" setting and then re-acquire that PDF.

Increasing the resolution value will provide better conversion quality but will also increase file

size and conversion time. Resolution cannot improve quality of the original document.

Experiment to determine the optimal value for your documents and set the default value

accordingly.

To modify the default resolution, press on the up arrow or down arrow spin control. Resolution

levels will change in increments of 50 and range between 100 and 600.

When the rasterization technology is used for saving a consult report to a case, you may wish to

include this image in a fairly large size on your patient report. As with other images, define an

attachment type with appropriate dimensions and set it to be allowed to print on patient reports.

When defining an image size, remember that the image must fit within the header, footer, and

side margins defined for your patient report template(s). In addition, you must also allow room

for the image title to print beneath the report. In circumstances where the defined height and

width of your image size in the Attachment Type Dictionary is not proportional to the image

itself, the image will resize itself to maintain proportionality. Do not define a image that is too

large to fit within your patient report borders. For example, for a report template that uses 1.2

inch header, footer, right margin, and left margin, a rasterized image of a PDF that was formerly

11 x 8.5 might be sized to 9.5 x 7.35. Perform your own experiments with rasterized images

that are both "busy" and "fairly light" on content to determine what works best for your lab.

Note: The Resolution for PDF Conversion field affects quality of the image (formerly the PDF) that is retained

within CoPathPlus. The Print Quality field in the Attachment Type Dictionary affects print quality of a specific

attachment type when it is printed on a patient report generated by the site’s text editor. Consider both your specific

requirements in image retention and report display, and then balance these needs against the required conversion

time, storage, and printer resources when setting these two parameters. For example, you might opt to retain the

image at a fairly high resolution, but realize you can set a relatively low print quality and still have an acceptable

report display. For formatted patient reports sent via a MIME or PDF interface that do not already use an already

created PDF, interface configuration determine image resolution within the patient report.

Export to File

Any images assigned to a CoPathPlus specimen may also be exported.

To Export an Image:

1) Access the Image Gallery.

2) Select the image(s) you want to export. If you are selecting multiple images, hold down

the CTRL key when selecting images in a list and CTRL + Shift when selecting non-

sequential images.

3) Select Export to File from the File menu or press CTRL + E.

The Export Attachment window appears.




4) Navigate to the drive and folder where the images should be saved. Enter the file name

and select the format (file type) of the image(s) to be exported. If you are exporting

multiple files, enter a prefix that will be applied as the first part of the name of all images

selected. Click Save. The system will provide a warning regarding imaging naming,

relating that all images will receive the same prefix that will then be followed by a dash

and a sequence number should the user continue with the export. Click OK to continue

with the export.

After saving the images, the Export Attachments Window will close and return to the Image.

Import from TWAIN

You can acquire an image from a TWAIN device by clicking on the Import from TWAIN

option. This will launch the TWAIN compliant software acquisition application that

accompanied the TWAIN device. You should be familiar with the operation of the device. The

PICSPlus software will see the TWAIN information and open the image acquisition part of the

software. All software functionality will not be available during this activity within PICSPlus

since it only sees the information that allows the acquisition mode of the application.

Note: It is possible to have more than one TWAIN device attached to your workstation. If this is the case, assign

the desired TWAIN device prior to performing the TWAIN import. Refer to PICSPlus Gallery Manager Options

Menu: TWAIN, Select TWAIN Source for additional information.

It is recommended that before you execute the Import from TWAIN option that the object to be

acquired be placed on the scanner or within the camera’s view. Once the Import from TWAIN

option is executed, the TWAIN software will open and the familiar application window will

appear. It will begin the scan of the object on the scanner. If the device is a camera the live

image should appear in the viewfinder of the window.

After the image is acquired it will then be ready to edit by the TWAIN software with the limited

accessible software functionality. After you have edited the image it can then be sent to the

PICSPlus. There should an activity button (depending on the device) available to send the

acquired image to the PICSPlus.

When the application has finished acquiring the image, it will close and return you to the

PICSPlus View Manager where the image will be displayed. You can now perform all of the

functions normally available in the PICSPlus View Manager.




Tip: Import from TWAIN can also be invoked from the Gallery Manager with the keystrokes of Control + T.

Refer to “Fast Scanning With Automatic Document Feeder (ADF) Support” in the “Using the

PICSPlus Gallery Manager” in this guide for information on importing from a scanner with

Automatic Document Feeder (ADF) support.


You can directly images from a variety of image editors and viewers, including the web browser

using the Import from Clipboard option. This option will import an image that you have copied

to the Clipboard into PICSPlus. The Clipboard is the memory area (buffer) where data is stored

temporarily before being copied to another location. For example, if you copy a picture from a

web page and then use the Import from Clipboard option, you can paste the image into PICSPlus.

To import an image from the Clipboard, copy the image from the application where the image is

located. To copy an image from a web page using Internet Explorer, right-click the mouse over

the image and select Copy from the menu that appears. To copy images from other applications;

refer to the application’s user documentation. After you have copied the image, switch to the

PICSPlus Gallery Manager and select the Import from Clipboard option. The image will then

appear in the Gallery Manager.

Tip: Import from Clipboard can also be invoked from the Gallery Manager with the keystrokes of Control + B.

Import from Matrox

When using the PICSPlus Acquisition Manager associated Matrox, the Matrox Acquisition

manager may be invoked via the following methods:

When a workstation has defined Matrox acquisition as the default acquisition method,

click on the Import from Matrox button. (Refer to "Default Import Action" for more

information.)

The following methods to invoke Matrox Import can be used whether the Matrox is the

default acquisition method or it the workstation is only used for occasional Matrox


Click on the Attachments menu and then select the Import from Matrox Item

Simultaneously press the CTRL and the M key.

The Matrox Acquisition Manager will be displayed after any of these methods are used. The

following is an example of the Matrox Acquisition Manager




This window is used to acquire (capture) the image. Position the display on your Matrox devices

to the appropriate position and acquire the image. The image is captured either by clicking on

the Acquire button, pressing Alt + Q or simply pressing the Enter key since the Acquire button is

the default key for the screen.



PICSPlus Report Manager Options Menu

The Options menu on the PICSPlus Report Manager displays a drop-down with two items:



TWAIN

Image Viewer

The Image Viewer menu display contains the following item:

Load with maximized view

This option lets you select to open images in the PICSPlus View Manager by default in

Maximize View or in Normal View. If you select this option and place a check mark next to it,

as displayed in the illustration below, when you open images from the Gallery Manager, the

images will open in Maximize View. If there is no check mark, the images will open in Normal

View.





The Import Action default is maintained on a per workstation basis. The acquisition method

(File, Clipboard, TWAIN, or Matrox) that is displayed at the time the Image Gallery is closed

will be the one automatically displayed when the gallery is re-accessed.

Specific Default Import Action menu display will vary at workstations. A full Default Import

Action menu would include the following:

Import from File


Import from TWAIN

Import From Matrox

To define the default import action for the workstation, make the following selections.


2) Select Default Import Action. A menu similar to the following appears.

3) Click on the appropriate "Import Action" option. A check mark will appear to the left of

the selected option.


The Default Import Template menu display is determined on a per workstation basis appropriate

to the acquisition devices assigned to the workstation. Workstation specific acquisition devices

are defined in the Workstation Setup. The template default may be defined based on a

combination of image acquisition method (Import, TWAIN, or Matrox). Once a template is

defined for an acquisition method on a specific workstation, that specific template is retained as

the default for that workstation for each specific acquisition method until the user specifically

modifies it.

Specific option menu display will vary at workstations. A full Options menu would include the

following:

Import from File





Import from TWAIN

Import From Matrox

To define the appropriate default template for the workstation, make the following

selections.


2) Select Default Import Template.

3) Select the appropriate "Import from" option. The following pop-up window will appear.

4) Use the drop-down to select the desired template from the PICSPlus Template

Dictionary.

5) Click Save to make the choice the default for this workstation.

TWAIN

The TWAIN menu is used to allow definition of TWAIN parameters specific to the workstation.

Two options appear on the TWAIN Menu:



Show User Interface



PICSPlus now allows for image acquisition from more than one TWAIN source attached directly

to the same workstation.




When the Import from TWAIN feature is utilized under this circumstance, a Select Source

window will be presented. Highlight the desired source and then press the Select button.

TWAIN Force Buffered Memory Transfer

PICSPlus was designed to work with TWAIN Native data transfer. The TWAIN standard

stipulates that any device represented as TWAIN-compatible must support Native data transfer.

However, certain manufactures denote their devices as TWAIN compatible when Native data

transfer is not supported. While all TWAIN devices recommended by Cerner DHT use Native

data transfer, some clients wish to work with devices they owned before the PICSPlus

implementation that do not follow this specific standard.

Use Force Buffered Memory Transfer switch on workstations that interact with TWAIN devices

using memory-buffered data transfer only. When the Force Buffered Memory Transfer option is

selected, CoPathPlus displays a warning related to loss of data and device instability. Cerner

DHT cannot be responsible for device instability.

Show User Interface

Turn this option on if it will be necessary to interact with the scanner’s interface during the

import process. When this option is selected a check mark will appear to the left of the option on

the menu and the scanner’s user interface will display .


Turn on this option on if interaction with the scanner’s user interface is required and multiple

images are being scanned.

Refer to “Fast Scanning With Automatic Document Feeder (ADF) Support” for more

information about scanning multiple images.




Image Gallery

The Image Gallery is an object on the PICSPlus Gallery Manager and PICSPlus Report

Manager that provides a place to review the thumbnails of the images that have been acquired

within the currently active patient record.

The image name for each thumbnail image is displayed in the upper portion of the image frame.

The image type abbreviation is displayed in the lower portion of the image frame for each

thumbnail. These abbreviations are defined in the Attachment Type Dictionary. Refer to

"Attachment Type Dictionary” for more information.

Selecting an Image in the Image and Report Galleries

To select an image from the Image Gallery or the Report Gallery, place the cursor over the image

and click the left mouse button once. This will highlight the border of the image. At the same

time, the list box within the Parameters for Selected Item in Image Gallery will appear. This will

list the parameters of the specifically selected image. For more information, refer to "Parameters

for Selected Item in Image Gallery." To deselect an image, click on a different image to be

selected or click on an empty space in the Image Gallery.

The following illustration displays examples of thumbnails in selected and unselected state:

Note: You can also select an image in the Image Gallery and press the CTRL + L shortcut to open the PICSPlus

View Manager.




It is also possible to select multiple images by pressing the Shift or CTRL key in conjunction with

clicking the mouse. This is useful for exporting multiple images. Refer to "Image and Report

Gallery Keyboard and Mouse Shortcuts” for more information.

Note: If multiple images are selected, the Parameter data will not display in the Parameter List Box.

Image and Report Gallery Keyboard and Mouse Shortcuts

The following table displays the Keyboard and Mouse Shortcuts for the Image Gallery. These

shortcuts also apply to the Report Gallery.

Action Mouse Keyboard Mouse and Keyboard

Select single thumbnail Left-click Ctrl + space bar (If

thumbnail has focus

indicator)

Ctrl + Left-click

Unselect single thumbnail Left-click on

empty space

(unselect all

selected

thumbnails)

Ctrl + space bar (If

thumbnail has focus

indicator)

Shift + Left-click

Move focus indicator

without selecting thumbnail

N/A Ctrl + Arrow (Left, Right,

Up and Down) or Home

(End) to move to the first

thumbnail or last thumbnail.

N/A

Select all thumbnails Right-click on any

place within the

Gallery and Left-

click on Select All

Menu Item.

Ctrl + A Select first

thumbnail and Shift

+ Left-click on last

thumbnail

Unselect all thumbnails Left-click on

empty space

Press Home(or End) and

after that Ctrl + space bar

Left-click on any

thumbnail and after

that Ctrl + space bar

Delete selected thumbnail

(thumbnails)

Right-click on any

place within the

Gallery and Left-

click on Delete

Selected Menu

Item.

Del N/A

Load PICSPlus Image

Viewer (Image Gallery

Only)

Double-click on

thumbnail

Ctrl + L N/A

Report Gallery

The Report Gallery is an object on the PICSPlus Report Manager that displays all of the images

selected to be on the report. The images have either been placed there by default (created in the

Attachment Type Dictionary), or they have been selected to be there by selecting image(s) in the

Image Gallery and transferred to the Report Gallery. To transfer the images from the Image

Gallery to the Report Gallery, first select the image to be placed on the report. Click on that

image in the Image Gallery and while holding down the left mouse button, drag the cursor to the

Report Gallery and release the button. This will transfer the thumbnail of the image to the

Report Gallery.




To remove image(s) from the Report Gallery, select the image by clicking the left mouse button

on the image. The image border will be highlighted. If more than one image is to be removed

hold down the keyboard Ctrl Key and select each image that is to be removed. Now each of the

images selected to be removed from the gallery will be highlighted. You can either click the

right mouse button to open a pop-up edit menu or select the edit menu from the menu bar. In

either case select the Delete Selected item and the images will be removed from the Report

Gallery. This does not delete images from the Image Gallery. The images removed from the

Report Gallery are still in the Image Gallery.

Refer to "Selecting an Image in the Image and Report Galleries" and "Image and Report Gallery

Keyboard and Mouse Shortcuts" for more information.


This component of the PICSPlus Gallery Manager and Report Manager is a list box of the

parameters assigned to the selected image within the Image Gallery or Report Gallery. See the

figure below.

To select an image, place the cursor over the image and click the left mouse button once. This

will highlight the border of the image. At the same time, the list box within the Parameters for

Selected Item in Image Gallery will appear. This will list the parameters of the selected image.




There are two columns in this list: Name and Value. These values are either assigned by the user

or by the system, depending on the type of parameter. The names of the parameters are set-up in

the PICSPlus Template Dictionary. These parameters are attributes assigned to images. Some

information is automatically captured; other information will be manually entered. Parameters

may be defined as either mandatory or optional fields. If desired, parameters can be set-up under

the DICOM standard for image information. It is the user’s discretion as to which parameters

best suit the needs at the time the system is set-up. Some useful parameters include, but are not

limited to: Image Type, Image Title, Date of Capture, Person Acquiring Image, Type of Camera

Used, Image Format, Size of Image and Color Depth of Image.

For more information, refer to "PICSPlus Template Dictionary" in this guide.


Image Gallery Review allows you to browse through all images in the Image Gallery from either

the Gallery Manager or the Report Manager using a Manual Display method or a Timer Display

method. Whichever method you choose, the images in the Image Gallery will display in the

order in which they appear in the gallery. When the last image in the image gallery is displayed,

the images will repeat in the same order.


spacebar. If you select the Timer Display method, the image display will transition using the

timer settings you select. Refer to "Adjusting the Review Display Options” for information on


To use the Image Gallery Review feature:

1) Click the Image Gallery Review button on the Image Gallery or the Report Gallery.




Review Display Options” for more information.




During the Image Gallery Review, you can press the Pause button on the keyboard to



Adjusting the Review Display Options

To adjust the review display settings:

1) Follow the steps outlined in "Image Gallery Review” or "Report Gallery Review" to open

the Review window.

2) Right-click the mouse to open the menu displayed below.




3) You can select the following display options from the menu available on the Review

Window:

Use Magnifier. This option only appears if you are using the Manual Display method

(pressing the spacebar to transition through the images). Select this option if you want to

be able to easily magnify a section of the image by clicking the mouse on it. You can

hold the mouse button down and scroll around the image to view any part in the

magnified view. You can set the options for the magnifier using the Display Setup menu.

See below for more information.

Use Timer. Select this option to automate the transition of images using the timer. You

can set the length of the timer using the using the Display Setup menu. See below for

more information.

Show Marks. Select this option if you want any marks that have not been burned on the

image to appear when you use the Image Gallery Review feature. Marks are objects that

can be placed on a PICSPlus image to bring attention to or focus on a specific area of the

image. You can mark PICSPlus images when using the PICSPlus View Manager.

Display Setup. Select this option to make changes to the Timer or Magnifier. The

following illustration is an example of the Display Setup window.


Timer. Enter the number of seconds you want the image to display before advancing to

the next image. You can type a number or use the spin controls.

Magnifier. The following are options for configuring the magnifier:




Size (Pixels). Enter the Width and Height in pixels of the magnifier. You can type

a number or use the spin controls.

Shape. Select to view the magnifier in an eclipse shape or a rectangle shape.

Magnification. Enter the magnification level for the magnifier. You can type a

number or use the spin controls. The lowest number is 1 and the highest number

(the highest level of magnification) is 99.

The selections you make for the Review display options are saved as the default for the

workstation.

Report Gallery Review

Report Gallery Review allows you to browse through all images in the Report Gallery from the

Report Manager using a Manual Display method or a Timer Display method. Whichever method

you choose, the images in the Report Gallery will display in the order in which they appear in the

gallery. When the last image in the Report Gallery is displayed, the images will repeat in the

same order.


space bar. If you select the Timer Display method, the image display will transition using the

timer settings you select. Refer to "Adjusting the Review Display Options” for information on


To use the Report Gallery Review feature:

1) Click the Report Gallery Review button on the Report Gallery.




Review Display Options” for more information.




During the Report Gallery Review, you can press the Pause button on the keyboard to



Import From Button

The Import From button on the Image Gallery and the Report Gallery provides a quick alternative

for the image acquisition method of choice. The specific action of this button may be "Import

from File", "Import from Clipboard", "Import from TWAIN" or "Import from Matrox". It is set

up on a per workstation basis via selection of the Default Import Action on the Options menu.




Task Buttons

The following button is available on the PICSPlus Gallery Manager and Report Manager:

Close. Closes the PICSPlus Gallery or Report Manager and returns you to CoPathPlus.

Using the PICSPlus View Manager Page 5-1 of 41



Chapter 5: Using the PICSPlus View Manager

To view an image from the PICSPlus Gallery Manager or Report Manager, double-click on the

thumbnail image of interest. This will open that image in the PICSPlus View Manager.

PICSPlus calculates the Zoom ratio of the displayed image to best fit the Image box thus opening

a “full size” image each time.

Note: You can also select an image on the Gallery Manager and press the CTRL + L shortcut to open the PICSPlus

View Manager.

PICSPlus can be launched automatically after acquiring an image when the View Image after

import check box is activated. This is the case for imported images from a file or the clipboard,

TWAIN acquisitions, and Matrox acquisitions.

The image will be displayed on the left side of the window.

The following features are available from the PICSPlus View Manager:

Maximize View

Copy to Clipboard

Page 5-2 of 41 Using the PICSPlus View Manager



Print

Save

Zoom Controls

Close

View Manager Toolbox

Maximize View

Clicking the Maximize View button gives you the largest possible space for displaying your

image. The menus and toolbars are hidden, except for the Normal View button. To restore the

menus and toolbars and return the screen to normal, click the Normal View button or the press the

ESC key

To magnify a portion of the view:

1) While the view is maximized, right-click on the image to open the Maximize View menu,

displayed below.

2) If it is not already checked, click Use Magnifier so a check appears to the left of the

menu item. This will allow you to easily magnify a section of the image by clicking the

mouse on it. You can hold the mouse button down and scroll around the image to view

any part in the magnified view.

Example of Non-Magnified view:

Example of Magnified view:




To Configure the Magnifier:

1) Right-click on the image to open the Maximize View menu.

2) Select Display Setup from the menu. The following illustration is an example of the

Display Setup window.


o Size (Pixels). Enter the Width and Height in pixels of the magnifier. You can type a

number or use the spin controls.

o Shape. Select to view the magnifier in an eclipse shape or a rectangle shape.

o Magnification. Enter the magnification level for the magnifier. You can type a

number or use the spin controls. The lowest number is 1 and the highest number (the

highest level of magnification) is 99.

The selections you make on the Maximize View menu are saved as the default for the

workstation.




Copy to Clipboard

The Copy to Clipboard feature allows you to copy the image that is displayed in the PICSPlus

View Manager into the Clipboard. It will copy the image with any marks (annotations). The

marks do not have to be burned into the image for them to be placed onto the Clipboard.

Print

The Print feature allows you to print the image displayed in the PICSPlus View Manager. When

the new Print button in the PICSPlus Viewer is pressed, a Print pop-up window is invoked

allowing the user to select a network printer and the number of copies. The Properties pop-up

allows definition of paper orientation, layout, and tray selection. The Image Settings pop-up

allows the user to specify where the image is positioned on the page. By default, ImageGear

software (parameters defined in the Print popup window and child windows) is used to render

the image. A check box is provided if you opt to use the designated Printer’s print driver

parameters to render the image. Print drivers on all printers may not provide the same parameter

options.

To preserve the aspect ratio of the printed image adjust sliders to eliminate the gray area.

Save

To save any marks or burns you have made on the image, click the Save button. If the Save

button is grayed out, there is nothing on the image to save. If you click the Close button before

you have saved the image, you will be prompted to save your changes.

Zoom Controls

The Zoom Controls on the PICSPlus View Manager let you increase or decrease the size of the

image in the Viewer.

NOTE: Increasing the size of the image will eventually distort the image from its original and true presentation

features – it will become pixelated. As the image is decreased in size, again the image will become distorted from

its original or true presentation features. As the size decreases any marks that have been burned into the image will

eventually become distorted and not display on the decreased image, The mark will appear normal once again if the

image is returned to original size.

The following table describes the menu buttons and keyboard shortcuts for the zoom actions on

the View Manager.

Action Zoom Button Zoom Shortcut

Zoom In

Press Numeric Keypad +

Zoom Out

Press Numeric Keypad -

Fit to Window

Press Numeric Keypad *




Normal 1:1

ratio

Press Numeric Keypad /

You can determine the zoom ratio by looking at the Zoom Level indicator located just above the

image on the left side. As the zoom ration increases, images will lose clarity.

Because the image is larger than the display area, there are scroll bars along the right vertical

border and the bottom horizontal border. This allows you to move the image around to see the

other areas unable to be displayed due to the size.

Close

Selecting this option closes the PICSPlus View Manager. Any marks that were placed on the

image will remain on the image when they have been saved. If the marks have not been saved,

the system will prompt the user whether or not to save the changes. and the system will prompt

whether these marks. The thumbnail will have an asterisk before the title in the upper portion of

the image frame to denote that a mark is on (but not burned into) the image.

View Manager Toolbox

The View Manager Toolbox appears on the left side of the View Manager screen. The toolbox

contains four tabs:

Marks Tab

Process Tab

Colors Tab

Info Tab




The Info Tab will always display. The following scenarios must be in place for the other tabs to

display:

Process An acquisition method (Image import, Matrox, or

TWAIN) has been enabled for the workstation.

The image is not on a signed out report.

Colors The image is a grayscale or color image.

An acquisition method (Image import, Matrox, or

TWAIN) has been enabled for the workstation.


Marks The image is a grayscale or color image.

The workstation has been enabled for annotations.


Marks Tab

The Marks tab is one of four tabs located on the right of the PICSPlus View Manager. The

Marks tab contains the Marks toolbar and six buttons, as shown below.

Note: You can click on the Marks toolbar and drag it off of the Marks tab to allow easier access to the tools. To

return the Marks toolbar to the standard display, click the X in the upper right corner of the toolbar.

Marks or annotations are objects that can be placed on a PICSPlus image to bring attention to or

focus on a specific area of the image. You can mark PICSPlus images when using the PICSPlus

View Manager.




There are 20 mark tools available from the Mark Toolbar and six buttons.

Each tool is different and provides a different approach to bringing attention to regions of

interest on the image. The name of each tool is displayed when the cursor moves over the tool

button and is held there for about two seconds.

Refer to "Mark Tools" for more information about the tools.

The six buttons allow you to perform the following functions:

Select All button. This button selects all of the mark objects placed on the image. It will

only select marks that have not been burned into the image. If there are no mark objects

on the image, this button is grayed out. If you want to burn or delete all of the marks at

one time, you can click this button and then click the Burn or Delete button, as

appropriate.

Defaults... button. After you select a tool from the toolbar, you can click this button to set

the attributes for the tool.

Burn button. When you select a mark object that has been placed on the image and click

this button it will "burn" the object onto the image. Unless undone, this means that the

mark will be permanently integrated into the image and it can no longer be edited. Refer

to "Burning Marks" for more information.

Undo Burn button. You can click this button to restore the mark that you have burned into

the image to its temporary state. Clicking this button will only restore the last image

burned. If you selected all the images and burned them at once, clicking this button will

restore all of the objects.

Delete button. Select an object or objects on the image and click this button to remove

them from the image. You cannot delete any objects that were burned into the image.

Undo Delete button. Click this button to return a deleted object to the image. If you

selected all the images and deleted them at once, clicking this button will return all of the

objects.

Mark Tools

The following topics describe each of the mark tools on the Mark Toolbar.

Arrow

Attach-A-Note

Filled Ellipse

Filled Polygon

Filled Rectangle

Freehand Line

Highlighter

Hollow Ellipse

Hollow Polygon

Hollow Rectangle




Hot Spot

Image Reference

Pin Up Text

Polyline

Protractor

Select Annotation

Straight Line

Text From File

Text Stamp

Typed Text

Arrow

The Arrow tool lets you bring attention to an area of interest by drawing an arrow pointing to a

particular spot on the image. To select the Arrow tool, click on the icon displayed below on the

Marks Tool bar

To draw an arrow, move the cursor to the desired location on the image and while holding down

the left mouse button, drag the tail of the arrow to the desired length and release the mouse

button. The Arrow mark will appear on the image.

Refer to "Working with Mark Tools" for more information on using this tool.

You can change the appearance of the arrow by right-clicking the mouse on the mark. The

Arrow mark has the following attributes that you can set:

Line Attributes

Color Attributes

Arrow Attributes

Refer to "Formatting and Changing the Default Attributes of Marks” for more information.

Attach-A-Note

The Attach-a-Note tool lets you bring attention to an area of interest by drawing a note

containing text next to the area on the image. To select the Attach-a-Note tool, click on the icon

displayed below on the Marks Tool bar.




To draw the note, move the cursor to the desired location on the image and while holding down

the left mouse button, drag the pointer to the diagonally opposite corner of the drawing area (or

until all the default text is visible, if any) and release the mouse button. The Attach-a-Note mark

will appear on the image. The blinking text cursor will be inside the text area, ready for you to

enter text if desired.


You can change the edit the appearance and text in the mark by right -clicking the mouse on the

mark. The Attach-a-Note mark has the following attributes that you can set:

Font Attributes

Color Attributes

Text Attributes


Filled Ellipse

The Filled Ellipse mark lets you bring attention to an area of interest by drawing a solid ellipse

on the image. To select the Filled Ellipse mark, click on the icon displayed below on the Marks

Tool bar.

To draw a filled ellipse, move the cursor to the desired location on the image and while holding

down the left mouse button, drag the pointer to the diagonally opposite corner of the drawing

area and release the mouse button. The Filled Ellipse mark will appear on the image.


You can change the appearance of the filled ellipse by right -clicking the mouse on the mark.

The Filled Ellipse mark has the following attributes that you can set:

General Attributes

Color Attributes





Filled Polygon

The Filled Polygon mark lets you bring attention to an area of interest by drawing a solid

polygon on the image. To select the Filled Polygon mark, click on the icon displayed below on

the Marks Tool bar.

To draw a filled polygon, move the cursor to the desired location on the image and click the left

mouse button to anchor the point. Move the mouse to the next corner and click left again to

anchor the second point. Repeat this process for each corner until the polygon is drawn to the

desired shape. When you return to the first point to complete the shape, double-click the left

mouse button to finish drawing the polygon. The Filled Polygon mark will appear on the image.


You can change the appearance of the filled polygon by right -clicking the mouse on the mark.

The Filled Polygon mark has the following attributes that you can set:

General Attributes

Color Attributes


Filled Rectangle

The Filled Rectangle mark lets you bring attention to an area of interest by drawing a solid

rectangle on the image. To select the Filled Rectangle mark, click on the icon displayed below

on the Marks Tool bar.

To draw a filled rectangle, move the cursor to the desired location on the image and while

holding down the left mouse button, drag the pointer to the diagonally opposite corner of the

drawing area and release the mouse button. The Filled Rectangle mark will appear on the image.





You can change the appearance of the filled rectangle by right -clicking the mouse on the mark.

The Filled Rectangle mark has the following attributes that you can set:

General Attributes

Color Attributes


Freehand Line

The Freehand Line mark lets you bring attention to an area of interest by drawing a freehand line

around a point on the image. To select the Freehand Line tool, click on the icon displayed below

on the Marks Tool bar.

To draw a freehand line, move the cursor to the desired location on the image and while holding

down the left mouse button, drag the pointer wherever you want and release the mouse button.

The Freehand Line mark will appear on the image.


You can change the appearance of the freehand line by right -clicking the mouse on the mark.

The Freehand Line mark has the following attributes that you can set:

Line Attributes

Color Attributes


Highlighter

The Highlighter lets you bring attention to an area by drawing a Highlighter at that region of

interest. To select the Highlighter, click on the icon displayed below on the Marks Tool bar.

To draw the highlighter, place the center of Precision Pointer at one corner of the Highlighter to

be drawn and while holding down the left mouse button, drag the mouse to the diagonally

opposite corner of the area to be drawn and then release the key. The Highlighter mark will

appear on the image.





You can change the color of the highlighter by right -clicking the mouse on the mark. The mark

will always display in a highlight mode; it will never be solid. The Highlighter mark has the

following attribute that you can set:

Color Attribute


Hollow Ellipse

The Hollow Ellipse mark lets you bring attention to an area of interest by drawing an ellipse

around the area on the image. To select the Hollow Ellipse mark, click on the icon displayed

below on the Marks Tool bar.

To draw a hollow ellipse, move the cursor to the desired location on the image and while holding


area and release the mouse button. The Hollow Ellipse mark will appear on the image.


You can change the appearance of the hollow ellipse by right -clicking the mouse on the mark.

The Hollow Ellipse mark has the following attributes that you can set:

Line Attributes

Color Attributes


Hollow Polygon

The Hollow Polygon mark lets you bring attention to an area of interest by drawing a hollow

polygon around the area on the image. To select the Hollow Polygon mark, click on the icon


To draw a hollow polygon, move the cursor to the desired location on the image and click the

left mouse button to anchor the point. Move the mouse to the next corner and click left again to

anchor the second point. Repeat this process for each corner until the polygon is drawn to the

desired shape. When you return to the first point to complete the shape, double-click the left




mouse button to finish drawing the polygon. The Hollow Polygon mark will appear on the

image.


You can change the appearance of the hollow polygon by right -clicking the mouse on the mark.

The Hollow Polygon mark has the following attributes that you can set:

Line Attributes

Color Attributes


Hollow Rectangle

The Hollow Rectangle mark lets you bring attention to an area of interest by drawing a hollow

rectangle around the area on the image. To select the Hollow Rectangle mark, click on the icon


To draw a hollow rectangle, move the cursor to the desired location on the image and while

holding down the left mouse button, drag the pointer to the diagonally opposite corner of the

drawing area and release the mouse button. The Hollow Rectangle mark will appear on the

image.


You can change the appearance of the hollow rectangle by right -clicking the mouse on the mark.

The Hollow Rectangle mark has the following attributes that you can set:

Line Attributes

Color Attributes


Hot Spot

The Hot Spot lets you bring attention to an area by drawing a Hot Spot at that region of interest,

appearing as a light mesh over the selected area. To select the Hot Spot, click on the icon





To draw the hot spot, move the cursor to the desired location on the image and while holding

down the left mouse button, drag the mouse to the diagonally opposite corner of the area to be

drawn and then release the key. The Hot Spot mark will be appear on the image.


You can change the appearance of the hot spot by right -clicking the mouse on the mark. The

Hot Spot mark has the following attribute that you can set:

Color Attributes


Image Reference

The Image Reference mark lets you include a bitmapped image by reference in a document or

image. To select the Image Reference, click on the icon displayed below on the Marks Tool bar.

To draw the Image Reference, move the cursor to the desired location on the image and while

holding down the left mouse button, drag the mouse to the diagonally opposite corner of the area

to be drawn and then release the key. The default image selected for the Image Reference mark

will appear on the PICSPlus image. To change the image, right click the mouse on the image

reference mark and click the Image Reference tab. Enter the image file name or browse to select

a new image.


You can change the appearance of the image reference by right -clicking the mouse on the mark.

The Image Reference mark has the following attribute that you can set:

Image Attributes

Image Reference





Pin Up Text

The Pin Up Text mark lets you bring attention to an area of interest by inserting a Pin Up icon

followed by a default line of text next to the area on the image. To select the Pin Up Text mark,

click on the icon displayed below on the Marks Tool bar.

To draw the pin up text, move the cursor to the desired location on the image and click the left

mouse button. The default text will appear immediately to the right of the Pin Up icon on the

image.



mark. The Pin Up Text mark has the following attributes that you can set:

Font Attributes

Color Attributes

Text Attributes


Polyline

The Polyline mark lets you bring attention to an area of interest by drawing a polyline (a multi-

segmented line) around the area on the image. To select the Polyline mark, click on the icon


To draw a polyline, move the cursor to the desired location on the image and click the left mouse

button to anchor one end of the line. Move the mouse to the next point and click left again to

draw the line segment. Repeat this process for each segment until the polyline is drawn to the

desired shape. When you reach the end of the last segment, double-click the left mouse button to

finish drawing. The Polyline mark will appear on the image.


You can change the appearance of the polyline by right -clicking the mouse on the mark. The

Polyline mark has the following attributes that you can set:




Line Attributes

Color Attributes


Protractor

The Protractor mark lets you bring attention to an area of interest by drawing a protractor (i.e., a

measured angle between points) on the image. To select the Protractor mark, click on the icon


To draw the protractor angle, move the cursor to the desired location on the image where the

point of the angle will be and click the left mouse button. This anchors the point at which the

two sides will be joined to form the angle. Next, hold down the left button and drag the mouse to

the desired length of one side and click the left mouse button again. This anchors one line (side)

of the angle. Next, move the mouse to the desired length of the second line (side) to rotate

against the apex point. As the second line is drawn, the angle between the two lines is displayed

and updated as the angle between the two lines changes. When the desired angle between the

two lines has been achieved, and when there is no more movement, the two lines forming an

angle and the angular number of degrees will be displayed.


You can change the appearance of the protractor by right -clicking the mouse on the mark. The

Protractor mark has the following attributes that you can set:

Line Attributes

Color Attributes

Font Attributes

Protractor Attributes


Select Annotation

The Select Annotation mark works like a standard mouse pointer, and is used to:

Select a mark from the Mark Toolbar.

Select a mark after it has been placed on the image.

Move a mark around on the image.

To select the Select Annotation mark, click on the icon displayed below on the Marks Tool bar.




Straight Line

The Straight Line mark lets you bring attention to an area of interest by drawing a straight line

between points on the image. To select the Straight Line mark, click on the icon displayed

below on the Marks Tool bar.

To draw a straight line, move the cursor to the desired location on the image and while holding

down the left mouse button, drag the pointer to the opposite end of the drawing area and release

the mouse button. The Straight Line mark will appear on the image.


You can change the appearance of the straight line by right -clicking the mouse on the mark. The

Straight Line mark has the following attributes that you can set:

Line Attributes

Color Attributes


Text From File

The Text From File mark provides the user the means of quickly adding a predefined text file as

an image annotation. If there is some standard text that you would like to frequently impose onto

selected images, define that data in a .txt file and save it the local workstation or within another

folder accessible to the PICSPlus user. Define the pathway to this .txt file in the default

properties of this icon.

To select the Text From File mark, click on the icon displayed below on the Marks Tool bar.

To draw the Text From File, place the center of Precision Pointer at one corner of the Text From

File to be drawn and while holding down the left mouse button, drag the mouse to the diagonally

opposite corner of the area to be drawn or until the default text is visibly displayed and then

release the key. The Text From File mark will be appear on the image.




This Marks feature does require initial configuration to use. If a pathway is not found, or the

defined pathway is invalid, you will receive an error message when you attempt to use this icon.

Acknowledge the error message (press the OK button) and then press the Defaults button, while

the Text From File button is still depressed, to define an appropriate pathway.



mark. The Text From File mark has the following attributes that you can set:

Font Attributes

Color Attributes

Text Attributes


Text Stamp

The Text Stamp mark lets you bring attention to an area of interest by inserting a text stamp (i.e.,

free-floating text) next to the area on the image. To select the Text Stamp mark, click on the

icon displayed below on the Marks Tool bar.

To draw the Text Stamp, move the cursor to the desired location on the image and while holding


area (or until all the default text is visible, if any) and release the mouse button. The Text Stamp

mark will appear on the image.



mark. The Text Stamp mark has the following attributes that you can set:

Font Attributes

Color Attributes

Text Attributes -You can use this attribute to automatically include the date and time.


Typed Text

The Typed Text provides the user the means of bringing attention to an area by drawing a Typed

Text at that region of interest. To select the Typed Text, click on the icon displayed below on

the Marks Tool bar.




To draw the Typed Text, place the center of Precision Pointer at one corner of the Typed Text to

be drawn and while holding down the left mouse button, drag the mouse to the diagonally

opposite corner of the area to be drawn and then release the key. The Typed Text mark will be

appear on the image. It will have the Text Pointer in the text area ready for the user to enter the

note text.

To edit the text on the View Manager screen, you need to click the mouse button three times.

The first time click to select the Typed Text mark containing the text you want to edit, the

second time click to enter the Edit mode and the third click is to edit the text. The speed in which

you click depends on your system, but usually it’s necessary to quickly click three times. When

the white background appears behind the text, you can edit the text. If you have difficulty editing

on the screen, you can edit the Text attribute to change the text. Refer to Text Attribute for more

information.



mark. The Typed Text mark has the following attributes that you can set:

Font Attributes

Color Attributes

Text Attributes


Working with Mark Tools

The following topics explain the ways in which you can work with the Mark tools on the

PICSPlus View Manager.

Scaling Marks

Closing the Editing Function

Deleting Marks

Moving Marks

Changing Mark Dimensions

Formatting and Changing the Default Attributes of Mark Tools

Burning Marks




Selecting Marks

You can select any unburned marks on the image.

To select marks:

1) Activate the Select Annotation tool by clicking its button on the Marks toolbar.

2) Select one object by doing either of the following:

o Clicking the object

o Dragging the cursor to create a rectangle around the object. The rectangle must

enclose the object completely to select it.

3) Select more than one object, do any of the following:

Press the <Shift> key while clicking each object

Drag the cursor to completely enclose the objects

On the Mark tab, press the Select All button

Scaling Marks

A mark placed on an image will be scaled to the size of the image. As the image gets smaller,

the mark gets smaller also. Conversely, as the image gets larger, the mark gets larger.

Therefore, when you add a mark, it is important to make sure that it will be legible to the

viewing audience.

Marks containing letters or pointers are critical to the audience. Therefore, you should place

marks on images when the image is at a 1:1 zoom level. Also, the width of mark lines should be

wide enough to be visible when the image is shrunk to fit in a 2" x 2" frame on the report. Large

microscopic images (1600 x 1200 pixel resolution and greater) when shrunk will need to have

larger marks to be seen.

If you are going to use marks, it is recommended to create a reference set of various marks on

different size images so that you can see how well they can be viewed on a report.

Closing the Editing Function

To close the Tool Editing Function, move the Pointer outside of the mark and click the left

mouse button. The Edit rectangle indicating the mark is an editable state will disappear.

The following is an example of a mark object that is in an editable state:

The following is an example of a mark object after the tool editing function has been closed:




Deleting Marks

To delete a mark from the image, select the mark and press the Delete button on the Marks tab.

To restore a deleted mark, click the Undo Delete button on the Marks tab. This will restore the

last deleted mark. To delete all the marks, click the Select All button and then click the Delete

button.

Moving Marks

To move a mark to a different location on the image:

1) Select the mark(s) you want to move. Make sure that you click on the mark but not on the

editing points of the mark object. If you click on the editing points, you may change the

dimensions of the mark.

2) Drag the mark to the desired location, and release the left mouse button.

Changing Mark Dimensions

To change the dimensions of a mark (i.e. change the size and/or shape):

1) Click the Select Annotation tool on the Mark toolbar.

2) Click the mark that you want to change to activate the edit points.

You can only change the dimensions of a mark when the edit points are visible.

3) Click on an edit point and drag the mouse to change the dimensions of the mark. For

example, you can enlarge a hollow rectangle by clicking on a corner and dragging it away

from the polygon. The following is a example:




You could also change the end point of a line by clicking on an end point dragging it to a

new location.

To change the shape of a hollow polygon, click each end point and drag it to the desired

location.

Editing Text on a Mark

To edit text on a mark:

1) Right-click the mouse on the mark containing the text you want to edit. You cannot edit

text on a mark that has been burned into the image.

2) Click on the Text Attributes tab.

3) Edit the text.

4) Click OK to save the changes.

Formatting and Changing the Default Attributes of Marks

Each mark has attributes, such as color or text, which affect the appearance of the mark. For

example, The Straight Line mark has a color attribute and a line attribute. The color attribute

defines the color of the line and the line attribute defines the thickness of the line. You can

change the default attributes of a mark so that each time you use the mark the attributes will

remain the same. After you have placed a mark on an image, you can select the mark and then

change the attributes. Once you have burned the mark to the image, you cannot change the

attributes of the mark.

To change the defaults for a mark:

1) Select the tool button on the Mark Toolbar.

2) Click the Defaults button and the Attributes dialog box will open for that tool. The

Attributes dialog box allows you to change the default appearance (color, size, font, etc.)

of the mark.

Note: The default selections you make for a mark will remain the defaults on the workstation. The only exception is

the Image Attribute defaults for the Image Reference mark, which revert to the system default each time you open

CoPathPlus. The only Image Attribute option that will remain a default is the Transparent option.

To change the attributes of a mark on the image:

After you have made a mark on the image, you can change the attributes by selecting the mark

and clicking the right mouse button.

The attributes available for a mark depend on the mark’s function. For example, the Straight

Line mark has a Color attribute and a Line attribute. The Typed Text mark has a Color attribute,

Font attribute and a Text attribute.




The following is a list of the available attributes:

Arrow Attribute (only available for the Arrow mark)

Color Attribute

Font Attribute (only available for marks with text)

General Attribute (only available for filled marks)

Line Attribute

Image Attribute (only available for the Image Reference mark)

Image Reference (only available for the Image Reference mark)

Protractor Attribute (only available for Protractor mark)

Text Attribute (only available for marks with text)

Arrow Attribute

The Arrow Attribute tab allows you to select the size of the arrowhead and the style of arrow for

the Arrow mark. The following image is an example of the Arrow Attribute tab:

Enter the follow fields on this tab:

Arrow Style. Select the style of the arrowhead.

Arrow Size. Select the size of the arrowhead by either typing in a number or using the

scroll bars to find a number. The resulting arrow will be shown in the Sample area.

When you are done, click OK to apply the attributes to the selected Arrow on the image or to

change the defaults for the Arrow attribute.




Color Attribute

The Color Attribute tab allows you to select a color for any marks with a color attribute, such as

the Hollow Rectangle mark or the Typed Text mark. The following image is an example of the

Color Attribute tab:

Enter the follow field on this tab:

Primary Color. Select the color for the mark. When selected, the color button will

appear to be sunken, indicating it is active.

NOTE: Use caution when choosing the color schemes for semi-transparency. Dark colors such as black, dark blue,

etc., may be less effective than the lighter colors such as, yellow, pink, light blue, etc.

When you are done, click OK to apply the attributes to the selected mark on the image or to

change the Color Attribute defaults for the mark.

Font Attribute

The Font Attribute tab allows you to select the font style for any mark that uses text, such as the

Push Pin mark or the Text from File mark. It also allows you to underline or strikeout the text.

The following image is an example of the Font Attribute tab:





Font. Select the desired font (a sample will appear in the Sample area below). Tab to the

Style field and select the style. Tab to the Size field and select the font size.

Underline. Check this box to apply underline formatting to the text.

Strikeout. Check this box to apply strikeout formatting to the text.


change the Font Attribute defaults for the mark.

General Attribute

The General Attribute tab allows you to make any of the Filled marks, such as the Filled

Rectangle, appear semi-transparent or solid. The following image is an example of the General

Attribute tab:





Highlight. Check this box to make the mark semi-transparent. If unchecked, the mark

will appear solid.

NOTE: Use caution when choosing the color schemes for semi-transparency. Dark colors such as black, dark blue,

etc., may be less effective than the lighter colors such as, yellow, pink, light blue, etc.


change the General Attribute defaults for the mark.

Line Attribute

The Line Attribute tab allows you to select the size of the line and to make marks using lines

semi-transparent or solid. Examples of marks using lines are the Straight Line mark and the

Arrow mark. The following image is an example of the Line Attribute tab:





Line Size. Select the line width (in points) for the mark by either typing in a number or

using the scroll bars to find a number.

Highlight. Check this box to make the mark semi-transparent. If unchecked, the mark

will appear solid.


change the Line Attribute defaults for the mark.

Image Attribute

The Image Attribute tab allows you to manipulate how the Image Reference mark is displayed.

The following image is an example of the Image Attribute tab:


Image Orientation. This field defines the postioning of the image reference mark.

Choose from the following four options:

o Original. This displays the image reference mark as it is actually positioned.

o Rotate to Right. The image reference mark is rotated at a 90° angle to the right.

o Flip. The image reference mark is reversed along its vertical axis.

o Rotate to Left. The image reference mark is rotated at a 90° angle to the left.

The following illustration demonstrates the options.

Vertical Mirror. Check this box to reverse an image reference mark. What was the left

side becomes the right side, and what was the right side becomes the left.




Transparent. Check this box if you want the image reference mark to be transparent.

When the image is transparent, any white in the image becomes invisible so the image

beneath the image reference mark is visible.

Fit Option. This field defines how the image reference mark fits into the device

rectangle, which is the invisible frame in which the image appears. Choose one of the

following four options from the drop-down list box:

o Fit to Device. The image reference mark is scaled to fit both the width and height of

the device rectangle.

o Fit to Width. The image reference mark is scaled to fit the width of the device

rectangle.

o Fit to Height. The image reference mark is scaled to fit the height of the device

rectangle.

o Actual Size. The device rectangle is ignored and the image reference mark is scaled

1:1.

The following illustration is an example of a device rectangle.

Align Option. This field defines how the image reference mark is positioned horizontally

and vertically within the device rectangle. Choose one of the following from the drop-

down list box:

Aspect. This field defines the ratio of the width of an image reference mark to its height.

The following illustration displays how the aspect ratio setting changes the display of an

image reference mark.




Image Reference Attribute

The Image Reference tab allows you to select an image from a file to display in the Image

Reference mark. The following image is an example of the Image Reference Attribute tab:


Image File Name. Enter the directory and file name of the image that you want to use for the

image reference mark.

To search for the file, press the Browse…. button. The Browse Picture File window will appear.




You can only select bit-mapped images for the Image Reference mark. To ensure you are

selecting a valid image, you should select the Picture Files option for the Files of type field so

only image files with a file extension of bmp or dib will appear.

NOTE: If you are setting the defaults for a mark, the image reference on this tab will appear as the default image

reference each time the mark is created.

Protractor Attribute

The Protractor Attribute tab allows you to select the precision and the arc radius for the

Protractor mark. The following image is an example of the Protractor Attribute tab:





Output Precision. Enter a value to determine precision of the protractor. If the number in

the box is two (2), then the precision will be to the second decimal place.

Arc Radius. Enter a value to represents the distance from the apex of the angle where the

arc will be drawn. This is a relative number and no unit of measure is available

(however, the number 100 is twice the distance from the apex as is the number 50).

When you are done, click OK to apply the attributes to the selected Protractor on the image or to

change the attribute defaults for the Protractor mark.

Text Attribute

There are two variations of the Text Attributes window. In the first, the Text Attribute tab

allows you to enter and edit the text in any marks that contain text, such as the Typed Text, Text

Stamp, or the Push Pin mark. The following image is an example of the Text Attribute tab:

The following image is an example of the Text Attribute tab for the Text Stamp tool.





The box on the top of the tab is where you enter the text that will be displayed in the

mark.

NOTE: If you are setting the defaults for a mark, the text on this tab will appear as the default text each time

the mark is created.

Wrap. Check this box to control the text flow in the mark. If this box is unchecked, the

text will continue on a single line.

Insert Date. Text Stamp only. Click this button to include the current date as text.

Appears as "%x" in the box, but will show up as the date on the image.

Insert Time. Text Stamp only. Click this button to include the current time as text.

Appears as "%X" in the box, but will show up as the time on the image.

When you are done, click OK to apply the attributes to the selected mark on the image.

The second variation of the Text Attributes display provides a mechanism to define a file path

and name to a text file saved on a local or networked drive. This parameter is used in the Text

From File mark. Define a .txt file on a local or networked drive first. Access the Text attributes

window within the Text From File Defaults configuration and enter the pathway to the defined

file or use the Browse button to locate it.




When you are done, click OK to apply the attributes to the selected mark on the image.

Burning Marks

The Burn Marks feature allows you to permanently apply the mark to the image displayed in the

PICSPlus View Manager. Once the mark is burned into the image and the user exits the Image

Viewer (for that particular image), it cannot be removed, it becomes a permanent and integral

part of the image and is no longer a separate object. If you want the annotations to appear on the

report, you must burn them into the image.

To burn a mark on the image, click on the mark and press the Burn button on the Marks tab. To

restore a mark to a temporary state, click the Undo Burn button on the Marks tab before exiting

the View Manager. This will restore the mark to a temporary mark which will not appear on the

report and which you can delete from the image. To delete all the marks, click the Select All

button and then click the Burn button.

Process Tab

The Process tab contains tools that allow you to sharpen the image and to adjust how it appears

on the screen. The following illustration is an example of the Process tab:




The Process tab contains the following display adjustment tools:

Clarification Filter

Orientation

Crop to Selection

Only burned marks on the image display when you press the Process tab. If the mark is burned

on the image, any adjustments you make to the image will also apply to the mark. For example if

you have an arrow mark burned on the image and you rotate the image, the arrow will rotate with

the image. However, if you did not burn the mark onto the image, the arrow will not display on

the Process tab at all.

Clarification Filter

The Clarification Filter is used to sharpen mid to high contrast edges without enhancing the noise

normally present in digital images. This effect locates adjacent pixels within the radius you

specify, and it increases their contrast by the strength you select.

The Clarification Filter has two settings:




Radius. Indicates the number of pixels around an edge that are affected. The Radius

range is 1 being the lowest range and 10 being the highest range. Stay at lower ranges for

on-screen images, higher ranges for high resolution printed images

Strength. Controls the intensity of the contrast, or sharpening effect. The Strength range

is 1 being the lowest range and 10 being the highest range. It is better to start with a low

number and re-apply the effect, if necessary.

The following is an example of an image in its original state and then the same image using the

Clarification Filter.

After you have selected the Radius and Strength values, click the Apply button to apply the filter to the image. You

can click the Undo button to return the image to its original settings.

Orientation

The Orientation box on the Process tab allows you to arrange the image by flipping, mirroring or

rotating it. You can choose from the following options:

Flip. Select this option to reverse the image along its horizontal axis. What was the

bottom will become the top, and what was the top becomes the bottom.

Mirror. Select this option to reverse an image along its vertical axis. What was the left

side becomes the right side, and what was the right side becomes the left.

Rotate. Select on of the following rotation angles to spin the image to the right around its

center point.

o 90

o 180

o 270

The following illustration provides an example of the rotation options.

After you have selected one of the orientation or rotation options, click the Apply button to adjust

the image position. You can click the Undo button to return the image to its original settings.




Crop to Selection

Users can manually crop images using the PICSPlus Image Viewer. Before cropping an image, it

is recommended that a duplicate be made of the original image using the Duplicate option,

available on the Edit tab on the PICSPlus Report Manager and the PICSPlus Image Gallery.

Note: Images can also be cropped automatically by configuring the Attachment Type Dictionary. Refer to the

“Attachment Type Dictionary” in the PICSPlus Dictionaries section.

To crop the image manually, place the mouse pointer at a corner of the area to be cropped and

drag to make the selection. A crop rectangle will appear on the image, and the area inside the

crop rectangle is shaded. The crop rectangle can be resized and moved by using the mouse

pointer. In the Crop to Selection area, click the Apply button to crop the selection.

The image below displays an example of the crop rectangle around the image being cropped.

Press the Undo button to return the image to it its original state, if desired.

If you have made any changes to the image, CoPathPlus will display a message asking if you

want to save the image when you close the Image Viewer window.

Colors Tab

The Colors tab provides you with tools for adjusting the color in the image displayed on the

PICSPlus View Manager.

The following illustration is an example of the Colors tab:




The Process tab contains the following color adjustment tools:

Intensity

Balance

The Colors tab will only display if there are colors in the image displayed on the PICSPlus View

Manager. If the image is gray scale, the Colors tab will not appear on the View Manager. You

can check to see what type of image is displayed by clicking on the Info tab.

If you want to re-use the color adjustments that you applied to a previous image, you can press

the Last Settings button.

Intensity

The Intensity section of the Colors tab contains three controls:

Brightness. A value of 0 displays the image at its original Brightness level. Drag the

slider to the right to lighten the image. Drag it to the left to darken it.

Contrast (%). A value of 0 displays the image at its original Contrast level. Drag the

slider to the right or type a positive number to increase the contrast and make the image

sharper. Drag it to the left or type a negative number to decrease it and make the image

more blurry.

Gamma (%). Corrects the brightness levels in an image. On a computer monitor, a

small change in brightness at a low brightness level is not equal to the same change at a

high level. Gamma correction compensates for the inequality.




The color adjustments will appear as you move the slides, but will not be applied until you press

the Apply button. To return the image to its original settings before the adjustments are applied,

press the Reset button. After you apply the adjustments, you can press the Undo button to return

the image to its original settings.

Balance

The Brightness section of the Color tab contains three slides to adjust the red, green and blue

levels in the image displayed on PICSPlus View Manager. By adjusting the levels of red, green,

and blue in an image or selection, you can change its overall color cast and correct color balance

problems.

To reduce the amount of color in an image, you can either increase its opposite color or reduce

the amount of the adjacent colors (on the color wheel). For example, to color correct an image

containing too much yellow, either increase the amount of blue or decrease the amount of red

and green.

Move the color slide to the right to increase the level of the color or move the slide to the left to

decrease the level. On the right of the slide, a number will appear to indicate the level of the

adjusted color.

The color adjustments will appear as you move the slides, but will not be applied until you press

the Apply button. To return the image to its original settings before the adjustments are applied,

press the Reset button. After you apply the adjustments, you can press the Undo button to return

the image to its original settings.

Info Tab

The Info tab displays the image parameter and edit permission information for the image

displayed in the PICSPlus View Manager. The following illustration is an example of the Info

tab.




The Info tab has two sections:

Image Parameters

Edit Permissions

Image Parameters

The Image Parameter section of the Info tab displays the following read-only information:

Type. Indicates the type of image. There are 3 types:

o Black/White

o Gray Scale

o Color

Note: If you burn a mark contain color onto a gray scale image, when you save the image, the type will change

to Color. In addition, the size of the file will increase to accommodate the colors now contained in the

image.

Bits per Pixel. Indicates the color depth of the image. Bits per Pixel is the number of bits

used to represent the color of a single pixel in an image. As the bits per pixel increase, so

does the size of the file.

o 1 bit - Black/White

o 8 bit -Gray Scale

o 8 bit - Color




o 24 bit - Color

Width (pixels). Indicates the width of the image by pixel.

Height (pixels). Indicates the height of the image by pixel.

Size (bytes). Indicates the size of the image file by bytes.

Edit Permissions

The Edit Permissions section of the Info tab displays the following permissions:

Mode. Indicates if the image is in an editable mode. Edit indicates that you can make

changes to the image. Read Only indicates that you can only view the image.

Colors. Indicates if the image contains colors. If Yes is displayed, the image contains

colors. If No is displayed, the image only contains black and white.

Marks. Indicates if you can make marks on the image. If an image contains colors and

you can edit the image, you can make marks on the image. If it is a black and white

image, you will not be able to make marks on the image.

Process. Indicates if you can use the tools on the Process tab. If the image contains colors

and you can edit the image, you will be able to use the tools on the Process tab. If it is a

black and white image and you can edit the image, you will only be able to use the

orientation tools on the Process tab.





PICSPlus Express Capture Page 6-1 of 4



Chapter 6: PICSPlus Express Capture

PICSPlus Express Capture Introduction

To address pathologist requests to acquire routine images using fewer keystrokes, an Express

Capture feature is offered. Express Capture allows a user to acquire images without opening the

PICSPlus Imager Gallery or Report Gallery. Use of Express Capture assumes the following:

Images are acquired via the workstation’s Default Import Action (acquisition method).

Acquired images use the workstation’s default Import Type and Template.

Images are not annotated.

Acquired images will be visually confirmed at some other point in the workflow. For

example, if they are placed on patient reports by default, they will be viewed when the

report is examined during Signout.

Express Capture uses alternative objects to the previously used Image Gallery and Report

Gallery Application User Object (buttons). This set of window objects offers dual functionality;

each gallery button can be used in two different capacities. When the Express Capture object is

used, the updated display shows an Express check box to the right of the Gallery button. When

the Express check box is clear, the Image Gallery and Report Gallery buttons display and

function according to established conventions, opening the designated PICSPlus Gallery.

However, when the Express check box is checked, the Gallery button becomes an image

acquisition button specific to the default method for the workstation.

Both the Image Gallery and Report Gallery buttons show the number of images already acquired

on a case regardless of the Express check box setting.

A user may "check on" the Express check box to quickly acquire images using workstation

default parameters without opening the Image Gallery or Report Gallery. Should a particular

image require annotation or update to any default parameter, simply click on the check in the

Express field to clear it and use the Gallery button to open the Image Gallery or Report Gallery

according to pre-established conventions.

Page 6-2 of 4 PICSPlus Express Capture



Tip!: If some of your pathologists plan to acquire images via the Express Capture feature in Electronic Signout, it

will be more efficient for them to open the Electronic Signout activity in the Edit mode rather than the Report mode.

This alternative can be configured using the Display Report before Editing System Setting located in the Electronic

Signout Category. If this configuration is only efficient for some of your pathologists, consider use of the

Workstation Group System Setting Override for the Display Report before Editing setting.

The Express check box value will persist on a per workstation basis. Specifically if the last

person to use the Image Gallery or Report Gallery button on a particular workstation leaves the

"check" on, the Express check box will be checked the next time someone uses that same

workstation.

PICSPlus Express Capture Page 6-3 of 4



Setting Up PICSPlus Express Capture

To set up PICSPlus Express Capture:

1) Paint the following buttons with the Express Capture feature onto the CoPathPlus

windows :

o Image Gallery Button on the PICSPlus Image Entry/Edit window

o Report Gallery Select Images Button on the PICSPlus Report Image Select window.

For information on additional windows you can paint the buttons, refer to "CoPathPlus

Form Sequences Eligible for PICSPlus Activities"

2) Set the Default Import Action from the PICSPlus Gallery Manager Option Menu or

PICSPlus Report Manager Option Menu.

3) Click the Express check mark on the window on which you painted the buttons with the

Express Capture feature.

You can then begin to quickly capture images in PICSPlus by clicking the Import From button.

PICSPlus Express Capture Window Painting Requirement

In order to implement the PICSPlus Express Capture feature, it is necessary to repaint your

windows to use one of the Application User Objects that include the add-on Express Capture

capability. The original Application User objects will continue to function according to

previously established conventions and do not include the Express check box. Update your

windows to use the respective Application User Objects for the Image Gallery and Select Images

buttons as desired.

Follow standard window painting guidelines to replace gallery objects, save, compile, accept,

and rebuild the applicable windows.

Note: If you have not been trained on window painting or are uncomfortable attempting it, you may pursue an

Arrangement Letter to have Cerner CoPathPlus personnel to window paint for you, or may opt to attend CoPathPlus

Customizer Training. Customizer Training is offered monthly; courses are alternately held in the Waltham office

and on the web. These classes are suitable for first time attendees as well as for students that need "refresher"

training. Due to the hands-on nature of the Customizer Training, our strong recommendation is that you attend this

class in person if possible, especially if you are a first time attendee. However, for those with travel constraints, the

web course alternative is offered.

Image Gallery Button With Express Capture Option

The Image Gallery buttons can be painted onto different CoPathPlus specimen activities.

However, only one model of this button (either the original or the Express Capture model) can be

included on any specific window. Activities that support the Image Gallery button include

Accession Entry/Edit, Gross Description Entry Edit, Final Diagnosis Entry/Edit, Hot Seat

Diagnosis Entry/Edit, Procedure/Addendum Entry/Edit, Post Signout Edit, and PICSPlus Image

Entry/Edit. When selected from the Insert an Application User Object tool in the Window

Painter, the original button is labeled "PICSPlus Imager gallery button" and the Express Capture

button is labeled "PICSPlus button for express gallery".

Page 6-4 of 4 PICSPlus Express Capture



Report Gallery Select Images Button With Express Capture Option

Both the original and Express Capture Select Images button may be painted onto the Signout

(Electronic), Signout (Manual), and PICSPlus Report Image Select activities. As with the Image

Gallery button, you may not use both the original and the Express Capture model of the Report

Gallery Select Images button on the same window; select one model or the other of this button.

When selected from the Insert an Application User Object tool in the Window Painter, the

original button is labeled “PICSPlus button to select images for reports” and the Express Capture

button is labeled “PICSPlus button for express report”.

PICSPlus Dictionaries Page 9-1 of 18



Chapter 9: PICSPlus Dictionaries

PICSPlus dictionaries are structures that store and maintain PICSPlus information.

Refer to the following for more information:

Dictionary Building Sequence Order

PICSPlus Server Dictionary

Attachment Type Dictionary

PICSPlus Parameters Dictionary

PICSPlus Template Dictionary

Imaging Device Type Dictionary

Note: Although the PICSPlus Keyword Dictionary appears in the menu, keyword functionality is not currently

implemented. This dictionary is intended for future use.

Dictionary Building Sequence Order

The PICSPlus dictionaries are interdependent and therefore should be built in a particular order. You should follow

the recommended building sequence, specified in the table below.

Order Dictionary

1 PICSPlus Server Dictionary

2 Attachment Type Dictionary

3 PICSPlus Parameter Dictionary

4 PICSPlus Template Dictionary

Page 9-2 of 18 PICSPlus Dictionaries



PICSPlus Server Dictionary

PICSPlus Server Dictionary lets you to create new Image Server definitions. Each dictionary

entry contains a unique name field that identifies the Image Server, and the UNC path to a shared

image storage directory where the images will be stored.

CoPathPlus determines which PICSPlus Server is used for image storage via a system setting

default or a Workstation Group-specific System Setting Override. The default PICSPlus server

is defined in the System Setting entitled "PICSPlus Image Repository". All images will be

written to this repository unless the acquisition workstation belongs to a Workstation Group that

has an override for this setting. In that case, the Image Repository defined in the respective

Workstation Group will be used for image storage. Refer to "Workstation Groups" in the

CoPathPlus System Manager Guide for further information about System Setting Overrides.

How to Add a New PICSPlus Server Dictionary Entry

Perform the following steps to add a new entry to the PICSPlus Server Dictionary:

1) Press Dictionaries on the CoPathPlus Application Manager.

See "How Do I Access a Dictionary" for more detailed instructions and information about creating and accessing dictionaries

2) Select the PICSPlus Server Dictionary from the list presented on the right side of the

Application Manager.

3) Press New on the Select a PICSPlus Server Window.

4) Fill in the following fields on the Name tab:

o Name. Enter a unique designation for this dictionary entry. Although you can enter

up to 100 alphanumeric characters, we recommend that you keep the keyword name

concise so that it displays completely in the image parameters list box.

o Abbr. Enter a unique, short code that you can use to quickly recall this dictionary

entry while you are entering data on a window. You can enter up to 15 alphanumeric

characters.

o Description. Enter text that describes this PICSPlus keyword entry. You can enter

up to 255 alphanumeric characters.

o Inactive. Select this check box if you want to make this entry not active. Inactive

entries will not appear on a lookup window, though they will appear at the end of an

accelerated drop-down list enclosed in angle brackets (e.g., <West 1>), which

indicate that the entries are not active and cannot be used. A clear check box means

that the entry is active.

o Path. Enter the fully-qualified file path to the shared network directory that holds the

PICSPlus repository (for example:

\\filebos1\mis\transfer\PICSPlus_shared\pics_images_v2.4\). This is the directory

where PICSPlus service files and thumbnail files will be stored. It should end with a

final back-slash character.




5) Lookup Values. Enter any lookup value that you want for this dictionary item, if

necessary. You may find it useful to enter two types of manual lookup values: one short

and the other more descriptive. Short lookup values are easier to remember and allow for

faster data entry. Descriptive lookup values help users when they are doing a partial

lookup. Note that Name and Abbr. automatically become lookup values for each entry.

6) Enter any information on the Notes tab that helps the CoPathPlus System Manager or the

dictionary administrator keep track of the history of a dictionary. For example, the way a

dictionary entry was set up, or when and why an edit was made to an entry.




Attachment Type Dictionary

PICSPlus allows your site to acquire images to print reports, archive information, and/or to

reference for teaching purposes. The Attachment Type Dictionary is a baseline CoPathPlus

Dictionary that is used for specific PICSPlus applications as well.

For example, a site might reference a library of images of anatomical diagrams, scan in

requisitions and reports and/or digitally photograph specimens and their slides (a digital camera

can be mounted above the grossing table or above a microscope) and then associate these images

with a specimen as attachments.

The Attachment Type Dictionary is used to categorize image types for the purpose of defaulting

and linking images to specimen reports. This dictionary references the attachment class, which is

the mode of acquisition of the attachment. Each attachment class is associated with a third-party

application that your site uses to acquire, review, edit and in some cases, delete attachments

belonging to that attachment class.

The Attachment Type Dictionary can also be used by for automatic cropping of images.

Automatic cropping is useful for document images that consistently have the same border size.

Values entered into the Page Border Removal Attributes, on the Report tab, are used by

CoPathPlus to crop the border automatically. When the image is inserted into the patient report,

it is resized to fit into the space between the header and footer. Removing some of the border

allows a larger version of the image to be displayed in the report.

It is common to refer to image-related attachments as simply specimen images or to use "image"

synonymously with "attachment".

Attachment Type Dictionary Attributes

While the Attachment Type dictionary will come preloaded with several representative entries,

each site will have to build the bulk of the dictionary.

The number of entries in the Attachment Type Dictionary will vary from site to site. Some sites

may choose to have as few entries as possible, while other sites may have many entries in order

to take advantage of the variations allowed.

Refer to "Attachment Type Dictionary Prerequisites" to learn what your site should consider

before building the Attachment Type Dictionary.

CoPathPlus allows you to automatically link an attachment of a particular type to patient reports

(e.g., Working Draft, Final Report, Procedure Report) through the To Report Type(s) field under

Automatic Links on the Reports tab in this dictionary. Then, when an image attachment is

acquired, it is automatically linked to all unsigned-out reports with a report type selected in this

field. There are some factors your site should consider when deciding whether or not to set up a

link to a report:

1) If the attachment type is for procedures in general, do not set up linking because it will

link an image to all procedures.




If the attachment type is for a specific procedure and it is rare that a specimen has more than one of these procedures, link the attachment type to a Procedure Report in the To Report Type(s) field and then identify the procedure in the To Procedure field.

2) If the attachment type is for any addendum, do not set up linking because it will link an

attachment to all addenda.

3) Compare the average number of images acquired for an attachment type to the number

that is usually printed on reports. If you end up doing more work by unlinking

attachments, then do not set up the automatic linking feature.

For example, a site may only acquire images that it intends to include on reports. In this case, the site would set up automatic links. Another site might acquire lots of images, some of which print on reports while others are used to build a database for research and teaching. This site might not set up automatic links.

NOTE: If a report's template does not include this attachment type, any attachment of this type linked to the report

will not print. Refer to "Patient Report Painter" in the Cerner CoPathPlus Online Tools Guide or the Cerner

CoPathPlus Tools Training Manual for more information on the Patient Report Painter.

In addition, if an attachment type is set up to automatically link to a report type but, when the attachment of this type

is acquired, there is no report for that report type, then no linking can occur. For example, procedure attachments

may be acquired before the procedure is ordered in CoPathPlus. In this case, the user will have to manually link the

attachment after the report has been created.

Refer to "How to Add a New Attachment Type Dictionary Entry" to learn how to create an entry

for this dictionary

Attachment Type Dictionary Prerequisites

Before building the Attachment Type Dictionary, your site should compile a list of all the kinds

of image acquiring it plans to do. Keep in mind the following tips when building this dictionary:

1) Create a list of basic attachment types to be acquired (e.g., Gross, Micro, Procedure).

2) Answer the following questions for each of these basic types and break out a basic type

into more specific types, if needed:

o Is the mode of acquisition (i.e., the attachment class) the same for all the attachments?

If not, create one attachment type per attachment class.

o Will all images be included on reports? If not, create one attachment type for those

that are included on reports and another for those that are not.

o Are the display width and height the same for all images of this type? If not, create

one attachment type for each set of display measurements.

o Should all images of this type automatically be linked to reports, and to the same

reports? If not, create one attachment type for each report setup.

Then you must consider how many workstations need to do what, and which workstations can

provide more than one service. For example, you might have a workstation that is hooked up to

a microscope and camera, as well as to a scanner.




How to Add a New Attachment Type Dictionary Entry

Perform the following steps to add a new entry to the Attachment Type Dictionary:

1) Press Dictionaries on the Application Manager.


2) Select the Attachment Type Dictionary from the list presented on the right side of the


3) Press New on the Select a Dictionary Entry Window.

The Attachment Type Dictionary has the following tabs:

Name Tab

Reports Tab

Notes Tab

Attachment Type Dictionary - Name Tab

NOTE: The first five fields on the Name tab are common ones for all dictionaries. If you have not read Name Tab

in Dictionary Basics, you should do that first as you will find more general information about these fields there.

Information provided here for these fields serves as a reminder and can include more specific details as to how they

pertain to this dictionary. Any fields after the Lookup Values field on the Name tab are unique to this dictionary's

Name tab.

Fill in the fields on the Name tab in the Attachment Type Dictionary as follows:

1) Name. Enter a unique attachment type designation for each dictionary entry. Remember

that you can enter up to 100 alphanumeric characters.

2) Abbr. Enter a unique, short code that you can use to quickly recall this dictionary entry

while you are entering data on a window. Remember that you can enter up to 10

alphanumeric characters.

3) Description. Enter text that describes this attachment type. Remember that you can

enter up to 255 alphanumeric characters.

4) Inactive. Select this check box if you want to make this entry not active. Inactive entries

will not appear on a lookup window, though they will appear at the end of an accelerated

drop-down list enclosed in angle brackets (e.g., <West 1>), which indicate that the entries

are not active and cannot be used. A clear check box means that the entry is active.





lookup.

6) Attachment Class. Select an attachment class for this attachment type. For use with

PICSPlus, you will always select the "Image in PICSPlus" option.

WARNING: The attachment class should not be changed once there are attachments on file that point to this

attachment type. The attachment class drives the data input when an attachment is acquired for a specimen,

as well as how it is viewed and printed.




7) Sort Order. Enter the order in which you want this image to appear in reports.

Attachment Type Dictionary - Reports Tab

Fill in the fields on the Reports tab in the Attachment Type Dictionary as follows:

1) Characteristics. Specify the characteristics of this attachment type.

o Allow on Reports. Select this check box if attachments of this type can be painted

onto printed patient reports. Certain attachments may not be appropriate on printed

reports (e.g., sound files). If this check box is not selected, the remaining fields on

this tab are ignored by CoPathPlus.

o Display Width. Enter the width of the display (in inches) for attachments of this type

when printed on reports. The default width is two (2) inches.

o Display Height. Enter the height of the display (in inches) for attachments of this

type when printed on reports. The default height is two (2) inches.

NOTE 1: If the actual size of the attachment is greater than the display size, CoPathPlus scales down the

attachment to the size specified in the above two fields but preserves the aspect ratio. If the actual size of

the attachment is less than the display size, CoPathPlus uses the actual size of the attachment in height and

uses the actual size plus white space to make up the specified Display Width.

NOTE 2: If your site uses Visual Writer as the text entry tool, the dimensions of the attachment image

display must be 2 in. by 2 in. so that the caption aligns correctly under the attachment on patient reports.

This allows a maximum of three attachments across the width of the report. Furthermore, attachment

images should be at least 250 pixels wide, and should have the width as the greatest dimension. For

example, an image 640 pixels wide by 480 pixels high will display better on the report than one 480 wide

by 640 high. Finally, any attachment that cannot conform to these rules should be placed last in the image

order.

o Print Quality. This field allows users to select the print quality of a PICSPlus image.

The range is 1 to 10, with 1 being the fastest printing with the lowest quality and 10

being the slowest printing with the highest quality. System Managers will have to

experiment with the image size and the quality of the image in the report to get the

appropriate image size/quality relation that fits their hardware specs and requirements

of printed reports.

2) Automatic Links. You use these fields to facilitate the automatic linking of image

attachments to printed reports. You can link attachments of a particular type to one,

many, or none of a specimen's reports. Refer to "Attachment Type Dictionary Attributes"

to determine if your site should set up an automatic link(s) for this attachment type.

o To Report Type(s). Select the report type(s) to which an attachment of this type

should automatically be linked. This link can be overridden for an individual

specimen attachment through the Attachments tab in a specimen activity.

3) Page Border Removal Attributes (Inches). You use these fields to facilitate the

automatic cropping if image attachments in printed reports. This is useful for documents

that consistently have the same amount of white space around the border that can be

cropped without affecting the image. Removing some of the border allows a larger

version of the image to be displayed in the report.

o Source Page Dimensions (Required). Enter the Width and Height of the document

image that will be cropped in the Source Page Dimensions fields. For example, if the




attachment type was for requisitions printed on US standard letter size paper, the

Width would be 8.5 (in inches) and the Length would be 11.

o Border Dimensions (Enter at least one). Enter the height and/or width in inches that

should be cropped from the border in the Border Dimensions fields. For cropping to

occur, at least one measurement must be entered in the Top, Bottom, Left or Right

fields. For example, the border could be cropped evenly by a quarter of an inch by

entering .25 in each field or if there was an extra inch of white space on the bottom of

the page, only the bottom of the page could be cropped by entering 1 in the Bottom

field.

When the attachment is inserted into the report, CoPathPlus will crop it using the

dimensions entered in the Attachment Type Dictionary. When cropping an image using

this method, the original image will not be affected.

The image below illustrates how the Border Dimension fields correspond to the borders

on the document image.

Attachment Type Dictionary - Notes Tab

Enter any information on the Notes tab in the Attachment Type Dictionary that helps the

CoPathPlus System Manager or the dictionary administrator keep track of the history of a




dictionary (e.g., why a dictionary entry was set up the way it was, when and why an edit was

made to an entry).




PICSPlus Parameters Dictionary

Image Parameters are data elements or characteristics associated to PICSPlus images. In

addition to assisting in image identification, parameters are also used to record and retain

information specific to each particular image.

Values for many image parameters are automatically captured. PICSPlus recognizes

elements such as image type and acquisition device based on your configuration of the

PICSPlus system. Other parameters such as Captured By and Capture Date default according

to standard CoPathPlus auditing features. Still other parameter information such as Image

Format and Size are automatically determined when each image is acquired.

The PICSPlus Parameters Dictionary is pre-loaded with numerous standard image parameters

already defined. If your institution would like to capture some image parameter that has not

been pre-defined, you may add it directly to this dictionary.

Some pre-defined records in the Parameters Dictionary are keyed and will not be editable.

How to Add a New PICSPlus Parameter Dictionary Entry

Perform the following steps to add a new entry to the PICSPlus Parameter Dictionary:



2) Select the PICSPlus Parameter Dictionary from the list presented on the right side of the


3) Press New on the Select a PICSPlus Parameter window.

The PICSPlus Parameter Dictionary has the following tabs:

Name Tab

Notes Tab

PICSPlus Parameter Dictionary - Name Tab

This illustration shows a sample Name tab in the PICSPlus Parameter Dictionary.




1) Name. Enter a unique designation for this dictionary entry. Although you can enter up

to 100 alphanumeric characters, we recommend that you keep the keyword name concise

so that it displays completely in the image parameters list box.


while you are entering data on a window. You can enter up to 15 alphanumeric

characters.

3) Description. Enter text that describes this PICSPlus keyword entry. You can enter up to

255 alphanumeric characters.





5) Non-user parameter. This check box is enabled if this data is automatically captured

and users may not alter the entry. This is typically only used for Cerner CoPathPlus

defined parameters.

6) Type of Data: Select the item from the drop-down list that defines the value type for this

parameter.

7) Choices. This free text field is used to stipulate choices when applicable. This field is

usually left empty.






PICSPlus Parameter Dictionary - Notes Tab

This illustration shows a partial view of a sample Notes tab in the PICSPlus Parameter

Dictionary.




Enter any information on the Notes tab that helps the CoPathPlus System Manager or the






PICSPlus Template Dictionary

The PICSPlus Template Dictionary lets you create different templates to associate the image

parameters in the Parameters for Selected Item list box that is found in the PICSPlus

Acquisition Manager, Gallery Manager, and Report Manager. You may want to show only

certain parameters for an image, depending on the situation. For example, you could create a

Grossing Template that is specific to the CoPathPlus Gross Description Entry/Edit activity. The

parameters may be different for the Final Diagnosis Entry/Edit activity window.

The Templates are linked to the various activity windows through the Window Painter. When

painting a window to include a PICSPlus object (i.e. adding the Image Capture, Image Gallery or

Report Gallery Application User Object) to the window, you will also define properties for this

object. Define the template from the PICSPlus Template Dictionary appropriate for the window.

Define "Button Push" for "When to Load Images". For a more detailed description of the use of

the Window Painter please refer to the "Window Painter" section in the CoPathPlus Online Tools

Guide.

A special template configuration may be defined in PICSPlus Template Dictionary to

automatically provide sequential titles for imported images. Refer to the "Parameters Tab" for

more information.

NOTE: PICSPlus templates should be created only after a detailed analysis of the workflow. Setting templates up

incorrectly could cause a significant performance downgrade. Cerner CoPathPlus recommends you use the option

of "Button Push" rather than "Specimen Load" when defining the properties of each PICSPlus Application User

Object (button). The templates that are predefined in the PICSPlus Template Dictionary are created as examples

only, and should not be used as actual templates.

How to Add a New PICSPlus Template Dictionary Entry

Perform the following steps to add a new entry to the PICSPlus Template Dictionary:



2) Select the PICSPlus Template Dictionary from the list presented on the right side of the


3) Press Search on the Select a PICSPlus Template window.

A list of the templates will be displayed in the list box.

4) Select the template of choice and double click or select Run from the command buttons.

The PICSPlus Template Dictionary has the following tabs:

Name Tab

Parameters Tab

Notes Tab




PICSPlus Template Dictionary - Name Tab

This illustration shows a sample Name tab in the PICSPlus Template Dictionary.






characters.

3) Description. Enter text that describes this PICSPlus keyword entry. You can enter up to

255 alphanumeric characters.





Parameters Tab

The following illustration shows a sample Parameters tab in the PICSPlus Template Dictionary.

The Parameters tab is where you define the list of parameters for the template. Refer to the

"PICSPlus Parameter Dictionary" for more information about image parameters.

A feature specific to the Title parameter is the ability to automatically provide sequential titles

for imported images. In the Default Value field adjacent to the Parameter of "Title", define a

standard value plus the string of {{seq}}. Sequential numbers will be inserted where the {{seq}}

placeholder is denoted. For example, on a Microscopic Image, the Default Value of "Micro

{{seq}}" might be defined. The first microscopic image imported on a specimen would receive

the title of "Micro 1". The second microscopic image imported would receive the title of "Micro

2", and so forth. The following illustration provides an example.




A system setting entitled Image Title Sequence # Style offers an alternative for sequential letters

to be used within this naming convention.

The Image Title Sequence # Style System Setting is located in the Imaging Category. Leave

this setting at its default value of "N" to continue using a number as the sequential enumerator.

Change the value to an "A" if you prefer to use an alpha enumerator.

PICSPlus Template Dictionary - Notes Tab

This illustration shows a partial view of a sample Notes tab in the PICSPlus Template

Dictionary.








The Imaging Device Type Dictionary support the different types of imaging devices or slide

scanners a site might use in connection with PICSLink and Digital Slide Imaging.

How to Add a New Imaging Device Type Dictionary

Perform the following steps to add a new entry to the Imaging Device Type Dictionary:

1) Press Dictionaries on the Application Manager.

2) Select the Imaging Device Type Dictionary from the list presented on the right side of the


3) Press New on the Select a Dictionary Entry Window.

Refer to "How Do I Access a Dictionary" for more detailed instructions and information about accessing dictionaries.

4) The Imaging Device Type Dictionary has the following tabs:

o Name Tab

o Details Tab

o Notes Tab

Name Tab

This illustration shows a sample Name tab in the Imaging Device Type Dictionary.









characters.

3) Description. Enter text that describes this Imaging Device Type keyword entry. You

can enter up to 255 alphanumeric characters.










6) Imaging Device Class. The following imaging device classes are supported:

o PICSLink Device. For use with remote-controlled Grossing Stations and remote-

controlled digital microscopes.

o Slide Scanner. For use with digital slide scanners.

7) Interface Link. Enter the code used by your imaging device software to refer to this

imaging device.

Details Tab

This illustration shows a sample Details tab in the Imaging Device Type Dictionary.

The fields on the Details tab of the Imaging Device Type Dictionary are for configuring the

XML messages used by CoPathPlus and the imaging device to communicate. The fields are

should only be edited by someone knowledgeable in XML and who understands the messaging

protocol. Normally these fields will only be edited when PICSLink or Digital Slide Imaging is

implemented at your site.




1) Imaging Device Handler Object. Enter the name of the vendor-specific Device Handler

Object. This object has to be inherited from v_nuo_img_device_handler_base.

2) Launch Parameter Prefix. Enter the launch parameter prefix to start the device EXE

file.

3) Message Root Tag. Enter the Root tag name for the device communication XML

message. If left blank, it will be defaulted to "Message".

4) Start File Extension. Enter the extension of device start file. If left blank, it will be

defaulted to "XML".

5) Message Image Tag. Enter the Image tag name for the device communication XML

message. If left blank, it will be defaulted to "Image".

6) Server Name or IP Address. Enter the Server Name or IP address if required by the

Imaging Device.

7) Authentication Tag. Enter the Authentication tag name for the device communication

XML message. If left blank, it will be defaulted to "Login".

8) Server Port Name. Enter the Authentication tag name for the device communication

XML message. If left blank, it will be defaulted to "Login".

9) Authentication Encode Flag. Click this check box to activate encoding of the

authentication string.

Notes Tab




PICSPlus Management Reports Page 8-1 of 4



Chapter 8: PICSPlus Management Reports

This guide provides descriptions of the following management reports, which are specific to

PICSPlus.

Case Diagnostics Folder

PICSPlus Case Detail

PICSPlus Image Search/Natural Language

PICSPlus Image Search/SNOMED

PICSPlus Images with Annotations

Logs

PICSPlus Acquisition Workstations

The following reports are described in the PICSPlus Maintenance Module section:

Image Servers Activity Report

Acquisition Workstation Activity Report

Detect Lost Images by Specimen Number

Detect Lost Images by Date Range

In addition, there are a number of management reports that are described in the Cerner

CoPathPlus User Guide. For more information, refer to "Report Descriptions" in that guide.

TIP! You can access any of the reports described here by placing the report in your Personal Menu and double-

clicking on it from there.

NOTE: You can run your site-created InfoMaker reports through the CoPathPlus InfoMaker Wizard. The

InfoMaker Wizard is a CoPathPlus application feature that lets you easily specify different types of selection criteria

for all reports using InfoMaker. People with permission can link site-created InfoMaker reports to the InfoMaker

Wizard through the InfoMaker Item Entry/Edit item found within the Folders and Items folder under the Setup

command button. Consult your System Manager for more information about this capability. To learn about this

item, refer to "InfoMaker Item Entry/Edit" in the "Setup" section of the Cerner CoPathPlus System Manager Guide.

For more information on reports, refer to the "Reports" section of the Cerner CoPathPlus User

Guide.

Accessing the PICSPlus Management Reports

To access the PICSPlus management reports in CoPathPlus:

1) Press the Reports command button on the CoPathPlus Application Manager.

Page 8-2 of 4 PICSPlus Management Reports



A list of folders (categories of reports) appears on the right side of the Application Manager.

2) Double-click on the Case Diagnostic Reports folder or double-click on the Logs folder.

A list of available reports or items available within that folder appears.

3) Double-click on the report you want to open.

Running the PICSPlus Management Reports

Once you choose the PICSPlus management report you want to run, as specified in "Accessing

the PICSPlus Management Reports", the InfoMaker Wizard for the report you chose appears.

The InfoMaker Wizard is a CoPathPlus application feature that lets you easily specify different

types of selection criteria for all reports using InfoMaker.

NOTE: You can schedule reports to run using the CoPathPlus Schedule Manager.

The following topics refer to selecting PICSPlus specific criteria for PICSPlus Management

Reports. For more information on configuring, viewing and printing the reports refer to the

following topics in the Cerner CoPathPlus User Guide:

Running the Management Reports

Data Fields and Selection Criteria

Viewing and Printing the Management Reports

PICSPlus Management Reports Page 8-3 of 4



Case Diagnostic Reports

The following PICSPlus Reports are located in the Case Diagnostic Report Folder:






The PICSPlus Case Detail report captures all cases with PICSPlus images. Retrieval arguments

are accession date, specimen class, part type, attachment type, and capture person. Detail

information is grouped by specimen number and includes accession date, patient name, and

MRN. The second group is attachment type and displays attachment type, title, description, who

captured, and capture date. The number of images per attachment type is indicated.


The PICSPlus Image Search/Natural Language report is a modification of the standard Natural

Language report with additional logic requiring the case to have one or more PICSPlus images.

Retrieval arguments are accession date, signout date, specimen class, text search, text type to

print, age, gender, part type, and attachment type. The detail includes specimen number,

accession date, signout date, patient demographics, final diagnosis, primary pathologist, and

primary cytotech, when present.


This report is a modification of the standard report SNOMED II Search No Race report with the

additional requirement to include one or more PICSPlus images. It also includes the additional

retrieval arguments of Part Type and Attachment Type. The Detail area is grouped by specimen

number, with accession date, signout date, and patient demographics. Detail data also includes

SNOMED codes and the final diagnosis.


The PICSPlus Images with Annotations report captures cases with PICSPlus images that contain

annotations. Retrieval arguments are accession date, specimen class, part type, and attachment

type. Detail information includes specimen number, accession date, patient name, attachment

type, attachment title, and description. The total number of images for each case, summary

calculations for total images, and summary calculations for total cases are also presented.

Page 8-4 of 4 PICSPlus Management Reports



Logs

The following PICSPlus report is located in the Logs folder:



PICSPlus Acquisition Workstations will search Workstation Set-up for all workstations that are

enabled for PICSPlus acquisition or annotation activity. Workstations are enabled only for the

PICSPlus Gallery will not be included on this report. The name of each enabled workstation is

presented along with the list of licensed PICSPlus add-ons as enabled in the Workstation Setup

function. Use this log to track workstations using a PICSPlus license.

PICSLink Page 9-1 of 6



Chapter 9: PICSLink

PICSLink Overview

Part of the CoPathPlus Telepathology strategy, PICSLink allows PICSPlus to launch stand-alone

imaging devices to capture images, image documents and metadata generated by imaging

devices. PICSLink enables users to take advantage of features such as measurements,

calculations, remote-controlled Grossing Stations and remote-controlled digital microscopes.

The following diagram displays the PICSLink workflow.

Using PICSLink

Steps for using PICSLink:

1) Setup the Device. The device must be compliant with PICSLink communication

specifications. Refer to the PICSPlus Implementation Manual for more information on

what imaging devices are compliant with PICSLink.

2) Install PICSLink as an add-on to a PICSPlus acquisition station in the Workstation Setup

activity. Your site needs to have an available acquisition station license to install

PICSLink. Please contact Cerner CoPathPlus to if you would like to purchase additional

PICSPlus acquisition licenses for your site.

Page 9-2 of 6 PICSLink



3) Make an entry in the Imaging Device Type Dictionary for the PICSLink imaging device.

This requires some knowledge of XML to interface CoPathPlus with the imaging device

application.

4) Configure the image device application, the one that will be used to import to PICSLink,

using the PICSLink Device Setup, available in the Options menu in the Image Gallery or

the PICSPlus Report Manager. Only one image device application can be used at a time.

If you would like to switch to a different device, you will then need to configure that

device.

5) If you would like PICSLink to be your default import action, you can configure it using

the Default Import Action in the Image Gallery or the PICSPlus Report Manager.




PICSLink can also be used with PICSPlus Express Capture. The option to Import from

PICSLink is also available in the Attachments menu in the Image Gallery or the

PICSPlus Report Manager.

Configuring PICSLink

PICSLink is installed as an add-on to a PICSPlus acquisition station in the Workstation Setup

activity. If your site does not have an available acquisition station license to install PICSLink

contact Cerner CoPathPlus to purchase additional PICSPlus acquisition licenses for your site.

PICSLink Device Setup

The PICSLink Device Setup is where the current PICSLink device application is selected and the

user can control application behavior after the image transfer. The setup activity is available in

PICSPlus Gallery Manager under Options > PICSLink Devices…

The following is an example of the PICSLink Device Setup window :

The following options are available on the PICSLink Device Setup window:




Select Current PICSLink Device. Select a PICSLink Device from the drop-down menu.

The list of available devices is populated from the Imaging Device Type Dictionary,

described above.

EXE File Path. Click the Browse button to link to the EXE file for the PICSLink Device

software.

User Name and Password. If required by the PICSLink Device, enter a user name and

password so CoPathPlus can communicate with the PICSLink Device software.


o Close All Images in the Device Application. Select this option if you want the


CoPathPlus. If you do not select this option, you will need to manually close the


o Minimize the Device Application. Select this option if you want the window

displaying the imaging device software to minimize after the data has transferred to

CoPathPlus.

PICSLink Automatic Acquisition of Image Documents

The PICSLink feature can be used for the transfer of image analysis reports along with image

snapshots. Image analysis reports can be supplied by compatible vendor-specific applications in

bitmap, TIFF, JPEG, or PDF form.

To use PICSLink to automatic acquire image documents:

1) Follow the steps outlined in "Using PICSLink" to setup PICSLink for your workstation to

acquire image documents.

2) In the PICSPlus Report Manager, set PICSLink to be the default import action.

3) Select the Options Menu from the Report Manager and select Default Import Template.

Chose the "Import from PICSLink" option.

4) In the PICSPlus Import Template Manager, select a default import template and default

report template.




Refer to the PICSPlus Implementation Guide for instructions on how to define a default

report template.

5) Use the stand-alone imaging device to acquire image documents through CoPathPlus.





Digital Slide Imaging Page 10-1 of 6



Chapter 10: Digital Slide Imaging

Introduction

Digital Slides are increasingly being used by sites to improve workflow by making slides

available after they are digitally scanned for storage, access, and analysis. Digital Slide Imaging

in CoPathPlus is designed to work seamlessly in the pathologist’s workflow by making it

available from Specimen activities. When combined with PICSLink, Digital Slide Imaging can

capture snapshots from digital slides into PICSPlus and can launch digital slide viewers from the

PICSPlus Gallery. Through the Advanced Barcoding and Tracking (AB&T) solution, slides are

tracked in CoPathPlus and multiple vendor-specific digital slide viewers can be launched

simultaneously from Specimen activities.

Digital Slide Imaging Workflow

The specimen is accessioned and proceeds through the sites typical specimen workflow. Slides

are labeled with a unique identifier in 2D barcode. The slides are then scanned in the digital slide

scanner which reads the barcode on the slide. Communication is initiated with CoPathPlus to

exchange patient/specimen information and the status of the slide. The slide is then attached to

the specimen and is ready for review by the pathologist. The pathologist can see the list of digital

slides associated with the specimen on the Digital Slide tab, which can be painted on specimen

activities, such as the Final Diagnosis Entry/Edit activity. Using PICSLink, the pathologist can

take snapshots of the digital slide to attach images the patient report.

Configuring Digital Slide Imaging

Sites interested in Digital Slide Imaging will need:

Cerner CoPathPlus activates the system setting

Vendor-specific digital slide viewer(s) compatible with the CoPathPlus Digital Slide

communication specifications. Contact Cerner CoPathPlus for more information on

compatible digital slide viewers.

Digital Slide HL7 interface for communication between CoPathPlus and the digital slide

viewer

CoPathPlus Advanced Barcoding and Tracking solution for tracking the slides using a 2D

barcode in CoPathPlus

Page 10-2 of 6 Digital Slide Imaging



PICSPlus and PICSLink (optional) for capturing snapshots from digital slides along with

metadata into PICSPlus and launching vendor-specific digital slide viewers from the

PICSPlus image gallery

If you do not currently have the Digital Slide Imaging solution but would like to pursue it, please

contact your Client Works Sales Executive.


Digital Slide Imaging, in addition to PICSLink, uses the Imaging Device Type Dictionary for

supporting devices with CoPathPlus. Below is an example of a digital slide entry for use with

Digital Slide Imaging. When selecting an Imaging Device Class for a digital slide, choose the

Slide Scanner option. Refer to "Imaging Device Type Dictionary " in the PICSPlus Dictionaries

section for more information

The following is an example of the Imaging Device Type Dictionary for a slide scanner entry:

Digital Slide Device Setup

The Digital Slide Device Setup is where the current digital slide device application is selected

and the user can control application behavior after the image transfer. The setup activity is

available under File > Browse Items.

The following is an example of the Digital Slide Device Setup window:




The following options are available on the Digital Slide Device Setup window:

Select Current Digital Slide Device. Select a digital slide viewer from the drop-down

menu. The list of available devices is populated from the Imaging Device Type

Dictionary, described above.

EXE File Path. Click the Browse button to link to the EXE file for the digital slide

viewer application. CoPathPlus uses this connection to communicate with the digital slide

viewer.

User Name and Password. If required by the digital slide viewer, enter a user name and

password so CoPathPlus can communicate with the digital slide viewer.


o Close All Images in the Device Application. Select this option if you want the


CoPathPlus. If you do not select this option, you will need to manually close the


o Minimize the Device Application. Select this option if you want the window

displaying the imaging device software to minimize after the data has transferred to

CoPathPlus.




Digital Slide Imaging in Specimen Activities

Sites with Digital Slide Imaging enabled can paint the Digital Slide tab on specimen activity

windows. In the following example, the tab has been added to the Final Diagnosis Entry/Edit

activity. From this window, the pathologist can view digital slides attached to the case.

The following is an example of Final Diagnosis Entry/Edit activity with a Digital Slide tab

painted on it.

In the detailed view, as displayed above, each slide for a part is displayed on the tab. If the slide

is digital, an icon displays that indicates this can be selected for viewing. If an displays, it

indicates that this digital slide is not available for viewing. If "none" appears, it indicates that the

slide is not digital and therefore cannot be viewed from this window. The detailed view also

displays the block, stain, status, date that the status was last updated, and the slide viewer from

which the digital slide was obtained. If only one viewer is in use, the Viewer field would not

display.

If a detailed view is not necessary, the display can be compressed by pressing the Collapse

button. If the detailed view is desired again, the Expand button is pressed to display information

similar to the above example. The individual scans can also be expanded or contracted by

clicking the +/- to the left of the scan.




On this window, you can do the following:

To select scans: click on an individual scan to select it or use Ctrl+Click to select

multiple scans or to deselect a scan. When a scan is selected, it is highlighted, as the

image above demonstrates. To load an individual scan into the digital slide viewer,

double-click on it.

After selecting the scans: use the Load Selected button to view the highlighted scans or

the Load All button to view all the scans. The Load Selected and Load All buttons also

display the number of scans they will load to alert the user if a large number of scans

have been selected.

Sites using Digital Slide Imaging with PICSPlus and PICSLink will also have the following

options on the Digital Slide tab:

Preload PICSPlus Image Gallery to accept captured images. Check this button to

allow PICSPlus to capture snapshots of the digital slide. If this is unchecked, you will

only be able to view images in PICSPlus.

Image Gallery button. Click this button to open the Image Gallery to capture a snapshot

of the digital scan.

Express check box. Click this check box to take advantage of the PICSPlus Express

capture option. This allows you to capture images by clicking the Image Gallery button

without having to open the Image Gallery. To use the Express Capture option, you will

first need to configure the Default Import action and template to "Import From

PICSLink."





PICSPlus Default Diagrams Page 11-1 of 8



Chapter 11: PICSPlus Default Diagrams

PICSPlus Default Diagrams Introduction

The PICSPlus Default Diagrams feature provides a fast and efficient mechanism to assign

default diagrams (images) based on part type. Both the PICSPlus Gallery Manager and

PICSPlus Report Manager offer a Diagrams button that may be used as a means to quickly

retrieve port pre-assigned default diagrams. A library of part type/organ diagrams is defined via

CoPathPlus dictionary entry with a copy of all diagram images retained on each PICSPlus image

server, optimizing diagram retrieval.

Note: Default Diagrams is an enhancement specific to the PICSPlus solution. This feature is enabled separately via

a system setting.

Organ diagram images are not supplied, redistributed, or recommended by Cerner CoPathPlus.

Obtain diagrams from a commercial source or create your own.

Page 11-2 of 8 PICSPlus Default Diagrams



Configuring PICSPlus Default Diagrams

The PICSPlus Default Diagrams feature is enabled by using the Enable PICSPlus Default

Diagrams system settings. This setting enables display of the Diagrams button in PICSPlus

Gallery and PICSPlus Report Manager. It must be set to a (Y)es to use this module. The

Diagrams button is invisible if you leave this setting at N(o). This setting is exported as (N)o to

ensure backwards compatibility.

This ability to use the Diagrams button is available only to workstations that are enabled for the

Import from File activity in Workstation Setup.

Configuration and Diagram Storage

Since existing diagrams are linked to the PICSPlus Diagrams Dictionary, rather than being

created within the dictionary, two different diagram storage considerations exist. The system

manger must:

1) Define a single location to store Source diagram files before they are linked to dictionary

records.

2) Add a folder named picsplus_diagrams to the root dictionary for every active image

server on the system.

Source Diagrams: Specify the pathway to the folder which stores the Source Diagrams in the

system setting entitled UNC Path to PICSPlus Diagrams Source Folder. This setting is located

in the Imaging category and holds the full UNC path to the shared folder where source files for

PICSPlus diagrams are stored. Since the only person who needs to access the diagram files

within this folder is the system manager when (s)he creates the PICSPlus Diagram Dictionary,

you may determine it appropriate to place some enhanced security on the Source diagram folder.

Source diagrams of image types such as JPEG, TIFF, or BMP, or other supported file types may

be imported into PICSPlus and then exported as a JPEG 2000 file to the Source Diagram folder.

Diagrams linked to dictionary records: Once diagrams are linked to dictionary records, they

need to be readily accessible to any CoPathPlus users who will order or work with diagram files.

Operation efficiency is enhanced by the convention of storing a copy of each PICSPlus diagram

on all active PICSPlus Image Servers. For example, your laboratory might operate in two

separate physical locations using a wide area network. To prevent excessive image transfer over

the network, you utilize two regional image servers allowing workstations that acquire images to

store those images onto their respective local Image Server. Diagram retrieval follows the same

reasoning. PICSPlus retrieves the requested diagram from the picsplus_diagrams folder on the

image server that is assigned to the user’s workstation group, minimizing traffic over the

network. When a diagram is saved to a specimen, it will be stored on the image server stipulated

via workstation setup along with the other image types saved on the specimen.

The root directory specified in the Path field of each active Image Server defined in the Image

Server Dictionary needs to have a picsplus_diagrams folder defined. I.e. if the path field in the

Default Image Server Dictionary record stipulates "\\aplab\images\labA\", navigate to this

location in windows and add a new folder named "picsplus_diagrams". You must use this exact

name for the folder. This picsplus_diagrams folder needs to have read and write permissions




(right-click on folder and open Security Tab to set) and be accessible to CoPathPlus users who

will work with PICSPlus diagrams.

Diagram Overview and Quality Considerations

There are several variables that affect the quality of PICSPlus diagrams. Image quality for

diagrams should be considered as it relates to patient report displays. These variables include:

Original image resolution

Original image creation method (Vector, Raster)

Print quality setting

Size of the images on the report

Available annotation fonts

Size of the PICS diagram

PICSPlus Diagrams should be 24 Bit color image files that are compressed using a standard

JPEG 2000 compression algorithm. Diagrams can be obtained from a commercial source or

created using Graphic editors that support JPEG 2000 such as Adobe Photoshop or Paintshop

Pro. Following is an example of an original, plus an annotated diagram of a size that may be

desired in a diagram. Specifics on this diagram are: size on report: 3.25", print quality: 10,

Resolution 640 x 480, Size on disk: 80 kb.




PICSPlus Diagram Dictionary

A entry must be created in the PICSPlus Diagrams Dictionary for each image you wish to use as

a diagram. All diagram images, whether they are used as default Part Type diagrams, or those

that are made available for individual cases selection are defined in this dictionary. Before

building this dictionary, create your Source diagram file and define the pathway to the Source

field in the UNC Path to PICSPlus Diagrams Source Folder System Setting.

How to Add a New PICSPlus Diagrams Dictionary Entry

Perform the following steps to add a new entry to the PICSPlus Diagrams Dictionary:


See "How Do I Access a Dictionary" for more detailed instructions and information

about creating and accessing dictionaries

2) Select the PICSPlus Diagrams Dictionary from the list presented on the right side of the


3) Press New on the Select a PICSPlus Diagrams window.

The PICSPlus Diagrams Dictionary has the following tabs:

Name Tab

Diagram Image Tab

Notes Tab

Name Tab

NOTE: The first five fields on the Name tab are common ones for all dictionaries. If you have not read Name Tab

in Dictionary Basics, you should do that first as you will find more general information about these fields there.

Information provided here for these fields serves as a reminder and can include more specific details as to how they

pertain to this dictionary. Any fields after the Lookup Values field on the Name tab are unique to this dictionary's

Name tab.

Fill in the fields on the Name tab in the PICSPlus Diagrams Dictionary as follows:

1) Name. Enter a unique diagram name for each dictionary entry. Use names that will be

clear to the individuals responsible for importing image diagrams. Remember that you

can enter up to 100 alphanumeric characters.


while you are entering data on a window. Remember that you can enter up to 10

alphanumeric characters.

3) Description. Enter text that describes this attachment type. Remember that you can

enter up to 255 alphanumeric characters.












lookup.

6) Template. Select a template type for this diagram. You might assign all diagrams to the

same template type, or could elect to use different template types if you need to have

different required images parameters for different diagrams. When assigning a template,

be sure to consider what this means in terms of diagram placement on patient reports.

Diagram Image Tab

Assign a diagram image to the entry as follows:

1) Press the Load New Diagram button to retrieve the specific diagram needed. This

navigation window will default to the location identified in the UNC Path to PICSPlus

Diagrams Source Folder system setting.

2) Click on the appropriate diagram and press the Open button to retrieve the diagram.

Once a diagram is linked to the dictionary record, this tab will show the diagram dimensions and

present a preview of the diagram, assuring the system manager that the intended diagram was

linked. Zoom buttons can be used to facilitate viewing the image within the dictionary.

When a record in the PICSPlus Diagram Dictionary is saved, CoPathPlus will verify that

picsplus_diagram folder exists on all active PICSPlus Image Servers. When a folder does not

exist, an error message indicates the full path to missing folder and prevents saving the entry to

any of the folders. You must add the missing picsplus_diagrams folder before saving the

dictionary record. If all picsplus_diagrams folders exist, CoPathPlus will attempt to save the

diagram to all folders. If it is unsuccessful in writing to any of the folders, such as if an authority

to write problem exists, an error message including the pathway to the problematic folder will be

presented. The image will not be saved to any image server picsplus_diagrams folder unless it

can be successfully saved on all folders. Correct any pathway or authority problems and retry

the dictionary record save. Images servers must be "up" and available when saving a record to

the PICSPlus Diagram Dictionary.

If you add an additional image server at a later time, copy the picsplus_diagrams folder from an

existing server to ensure the new server includes all PICSPlus diagrams.

Notes Tab

Enter any information on the Notes tab in the Diagrams Dictionary that helps the CoPathPlus

System Manager or the dictionary administrator keep track of the history of a dictionary (e.g.,

why a dictionary entry was set up the way it was, when and why an edit was made to an entry).




Setting a Diagram as a Default in the Part Type Dictionary

The More Defaults tab of the Part Type Dictionary includes a PICSPlus Default Diagram field.

This is an optional field; it does not have to be completed on all part types. Select a record from

the PICSPlus Diagram Dictionary for any part where you wish pre-define a specific diagram

image.

Perform the following steps to set a diagram as a default in the Part Type Dictionary:


See "How Do I Access a Dictionary" for more detailed instructions and information

about creating and accessing dictionaries

2) Select the Part Type Dictionary from the list presented on the right side of the


3) Press Search on the Select a Part Type Dictionary window.

A list of the part types will be displayed in the list box.

4) Select the part type of choice and double click or select Run from the command buttons.

5) Click on the More Defaults tab on the Part Type Dictionary.

6) Select a diagram that will default for this part type when a default Diagram is selected on

the Diagrams pop-up window. This field is linked to the PICSPlus Diagram Dictionary.




Attaching Diagrams to a Specimen

The PICSPlus Gallery Manager and Report Manager both offer access to the Default Diagrams

feature.

To attach a diagram to a specimen:

1) Open the PICSPlus Gallery Manager or Report Manager. Refer to "Accessing PICSPlus

From CoPathPlus" for more information.

2) Press the Diagrams button or use Control + D to retrieve diagrams associated to part

type(s) on a specimen. The Diagrams pop-up window appears.

3) In Filters, select on the following import alternatives:

o Default Diagrams Only. Displays the diagrams associated to the selected part type(s).

o All Available Diagrams. Displays all of the diagrams defined in the PICSPlus

Diagrams Dictionary.

The following is an example of the Diagrams pop-up window.

A list of unique diagrams associated to all part types on the case are presented. Duplicate

diagrams are suppressed whether they occur due to multiples of the same part type, or

when different part types are assigned to the same diagram. If there are no diagrams




assigned to any of the parts included in the specimen, the Diagram/Template datawindow

will be empty.

3) Depending on your selection in the Filters field, do one of the following:

o If you selected the Default Diagrams Only option, you can select Load All to select

all the displayed diagrams. You can also select specific diagrams and click the Load

Selected button. Upon diagram import, CoPathPlus will automatically load the part

type’s description into the Description field in the image Parameters datawindow

o If you selected the All Available Diagrams option, select the diagrams you want to

attach to the specimen and click the Load Selected button. Diagrams selected via the

All Available Diagrams radio button option will not have the Description field auto-

completed.

The selected diagrams will appear in the Image Gallery. When multiple diagrams are imported

via use of the Load All button, these diagrams will be sequenced following the sequence number

of the specimen parts. In the case of diagram duplicates, the second and subsequent diagrams are

disabled, so the remaining diagram will be presented according to its first sequential assignment.

When diagrams are imported via the All Available Diagrams option, they will be loaded

alphabetically according to diagram name. All diagrams will be loaded ahead of other images on

the case, even if those images already exist when the diagrams are imported. As with other

image types, acquired diagrams will follow the Sort Order defined in the Attachment Type

Dictionary.

Once imported, diagrams are then available for specimen-specific annotation using the standard

PICSPlus annotation features and conventions. When a diagram is saved to a case, it will be

assigned an internal file name following standard PICSPlus conventions other than for the

extension type. Diagram files saved to specimens will be saved with the extension type of .diag.

Site Diagram Module Page 12-1 of 4



Chapter 12: Site Diagram Module

Site Diagram Module Introduction

The Site Diagrams (Patent Pending) Module provides labs with the ability to include diagrams

displaying tumor involvement on patient reports, thus increasing the value of the reports while

also improving patient care. Using the Prostate Biopsy Site Diagram, the initial diagram

provided with the module, pathologists can simply point-and-click to enter data, such as the

Gleason Score, in each section of the diagram. All entries are validated, which assists in

preventing errors during data entry thus avoiding incorrect data reporting.

Once all data is entered and validated, the diagram can be attached to patient reports with the

click of one button. These diagrams provide physicians with information that helps guide

treatment decisions and are invaluable for patient consultation by providing a better

understanding of location and distribution of tumors.

Note: This is an optional module for PICSPlus requiring additional licensing and professional services.

Attaching a Site Diagram to a Specimen

The PICSPlus Gallery Manager and Report Manager both offer access to the Site Diagrams

Module.




2) Select Import Site Diagram from the Attachments menu or press CTRL + S. When one of

these options is selected, the Site Diagram selection window will appear. This window

will only display if there are multiple diagrams available. If only one diagram is

available, currently the only option, the site diagram will display and is available for data

entry.

3) Beginning making selections on the site diagram. Refer to "Entering Data on a Site

Diagram " for more information.

Page 12-2 of 4 Site Diagram Module



Entering Data on a Site Diagram

Attaching a Site Diagram to a Specimen

The PICSPlus Gallery Manager and Report Manager both offer access to the Site Diagrams

Module.




2) Select Import Site Diagram from the Attachments menu or press CTRL + S. When one of

these options is selected, the Site Diagram selection window will appear. This window

will only display if there are multiple diagrams available. If only one diagram is

available, currently the only option, the site diagram will display and is available for data

entry.

3) Beginning making selections on the site diagram. Refer to "Entering Data on a Site

Diagram " for more information.

Site Diagram Module Page 12-3 of 4



Entering Data on a Site Diagram

Previewing the Site Diagram

After making selections from the sites, you can preview the current image by selecting the

Preview button without saving any changes. The preview will look similar to the following

image.

Page 12-4 of 4 Site Diagram Module



A colored bar or NA displays in each site to indicate the diagnosis of the site. A color legend is

displayed above the menu bar to indicate which color pattern is used for each diagnosis. The

patterns can help differentiate the colored bars if the image is printed in black and white.

If any changes need to be made to the diagram, you can return to data entry and make the

necessary changes by pressing the Data Entry button.

Saving the Site Diagram

Once the site diagram is complete, you can save the site diagram by pressing the Submit button.

After pressing Submit, the site diagram will be available in the Image Gallery. At that point, it

can no longer be edited in the Site Diagram data entry window.

PICSPlus Maintenance Module Page 13-1 of 10



Chapter 13: PICSPlus Maintenance Module

The PICSPlus Maintenance Module supports server scalability. It provides various

informational tools that promote the System Manager’s ability to monitor, maintain and

troubleshoot operation of the PICSPlus System. The Maintenance Module can be used to

monitor usage for both image servers and acquisition workstations. Tools are also provided to

facilitate identification and removal of lost images.

The following is a list of the four operational modes available from the PICSPlus Maintenance

Manager:





Accessing the PICSPlus Maintenance Module

To access the PICSPlus Maintenance Module:

1) Press the Setup command button on the CoPathPlus Application Manager.

2) Double-click on the Imaging Items folder.

3) Select the PICSPlus Maintenance Module item

The PICSPlus Maintenance Module opens.

Page 13-2 of 10 PICSPlus Maintenance Module




The Image Server Activity feature provides an interactive report providing statistical information

on database activity within the last 30 days. This report will provide information that may be

important in making decisions involving Image Servers availability and distribution including

load balancing.

Note: The determination to specifically use a 30 day time frame for Image Servers Activity tool was made based on

internal evaluations and experience regarding image capture. If the timeframe is too short, the statistics could easily

be skewed by single days with either lighter than or heavier than normal workflow. Extended periods could render

the tool cumbersome due to potential delays in data retrieval.

The Image Servers Activity report may be generated for a single, or all, image servers. When the

Image Servers Activity Mode radio button is selected, the filter available on the right hand side

of the display provides a mechanism to filter by a single or all Image Servers. Select the desired

image server or elect to view this information on all servers. Press the Show button.

The system manager can use this information to verify:

The current status of Image Servers

Statistical information of Image Servers activity the last 30 days

Workstation assignments to each server

Workstation groups configurations and load balancing which may be useful when making

decisions and troubleshooting issues that involve Image Servers availability and

distribution.

The following is an example of the Image Server Activity Report window:

To view the Image Servers Activity Report:

1) Follow the procedures outlined in "Accessing the PICSPlus Maintenance Module" to

open the Maintenance Module.

2) Select Image Servers Activity from the Mode option buttons displayed on the left side

of the screen.




3) Select the server for which you to view activity from the Filter by Image Server drop-

down menu. To see all activity on all servers, select the "All Servers" option on the right

side of the screen.

4) Click the Show button to view the report.

The Image Server activity report will open in a new window. The following options are

available:

o Refresh. Click this button to re-run the report using the current settings.

o Print. Click this button to print the report. Refer to "Print/Send" in the Management

Reports section of the Cerner DHT CoPathPlus User Guide for information on

printing reports.

o Close. Click this button to close the report and the window displaying the report. You

will return to the PICSPlus Maintenance Module.

The following is an example of the Image Server Activity Report:





The Acquisition Workstations Activity feature provides an interactive report providing statistical

information on acquisition workstation activity within the last 30 days. This report may be

refreshed without leaving the display. It will provide important information regarding image

distribution when multiple image servers are used to promote load balancing.

Note: The determination to specifically use a 30 day time frame for Image Servers Activity tool was made based on

internal evaluations and experience regarding image capture. If the timeframe is too short, the statistics could easily

be skewed by single days with either lighter than or heavier than normal workflow. Extended periods could render

the tool cumbersome due to potential delays in data retrieval

The report provides the following information:

Number of active Acquisition Workstations

Number of Acquisition licenses

List of active Acquisition Workstations with Workstation Groups

Number of Acquisition Workstations in the each Workstation Group

Number of images acquired by each workstation in 30 days period

The following is an example of the Acquisition Workstation Activity Report window:

To view the Acquisition Workstation Activity Report:



2) Select Acquisition Workstation Activity from the Mode option buttons displayed on the

left side of the screen.

3) Select the acquisition workstation group for which you to view activity from the Filter by

Workstation Group drop-down menu. To see all activity on all workstations, select the

"All Workstations" option on the right side of the screen.





The Acquisition Workstation activity report will open in a new window. The following

options are available:




printing reports.



The following is an example of the Acquisition Workstation Activity Report:





The Detect Lost Images by Specimen Number feature is a utility to detect lost images and

thumbnails by specimen number. If PICSPlus cannot identify a specific image, (i.e. it has been

relocated, removed or has become corrupted) this feature will allow you to remove the

association on the specimen previously had to that image. Breaking this link will allow normal

processing to proceed on a specimen.

Note: Deletion is not allowed on incomplete records that belong to a report on signed out specimen.

The Lost Image report displays the Specimen number and status. It also displays the incomplete

image data associated with the specimen. This information includes Capture date; capture

workstation, location, if on report, and name of the physical files.

Note: Before searching for lost images, the system checks the workstation's accessibility to every Active and

Inactive Image Server. If inaccessible servers are detected a message appears warning that the information

displayed could be incomplete. The lost image information displayed is for available Image Servers.

The following is an example of the Detect Lost Images by Specimen Number window:

To detect lost images by specimen number:



2) Select Detect Lost Images by Specimen Number from the Mode option buttons

displayed on the left side of the screen.

3) Enter the specimen number to which the lost image is associated in the Specimen

Number field. You can also perform a look-up for the specimen by clicking the lookup

button . Refer to "Using the Select Specimen Window" in the Specimens section of

the Cerner DHT CoPathPlus User Guide for more information.


The Lost Image Files report will open in a new window.

The following options are available:







printing reports.



o The following buttons will only display if lost images are detected:

o Select All. Click this button to select all of the lost images for deletion. The Select to

Delete check box for each lost image will be checked when you press this button.

o Clear Selection. Click this button to clear the Select to Delete check box for all lost

images that have been selected.

o The following button will only display if a lost image is selected for deletion:

o Delete Selected. Click this button to clear this image from the database records

associated to this specimen. A warning message will appear before the system deletes

the record.

Warning: Before deleting an image, you should make every effort to restore the image from a backup file

or to manually locate the missing image.

The following is an example of the Detect Lost Images by Specimen Number Report:





The Detect Lost Image Files by Date Range utility is used to locate lost images by searching a

specified image capture date range. This option serves the same function as the Detect Lost

Images by Specimen Number feature, but it uses alternate search criteria providing a different

way to locate problematic images. Searching by date range allows the system manager to search

for lost or corrupted images in the event inadequate information regarding potential image-

related problems is received.

This report may be generated for any user stipulated date range. When the Detect Lost Image

Files by Date Range option is selected via the adjacent radio button at the left side of the screen,

the filter available at the right side of the screen becomes a Lost Image Files Date Range filter.

Select the desired date range for report generation.

Note: Deletion is not allowed on incomplete records that belong to a report on signed out specimen.

The Lost Image report displays the Specimen number and status. It also displays the incomplete

image data associated with the specimen. This information includes Capture date; capture

workstation, location, if on report, and name of the physical files.

Note: Before searching for lost images, the system checks the workstation's accessibility to every Active and

Inactive Image Server. If inaccessible servers are detected a message appears warning that the information

displayed could be incomplete. The lost image information displayed is for available Image Servers.

The following is an example of the Detect Lost Images by Date Range window:

To detect lost images by date range:



2) Select Detect Lost Images by Date Range from the Mode option buttons displayed on

the left side of the screen.

3) Enter the date range in which the lost images were captured. To enter a date range, enter

a From Date (the earliest date you want to search) and the To Date (the latest date you

want to search). You can quickly enter the current date by pressing the Set Today button.




If a date range greater than 30 days is selected, the system will provide a warning

regarding potential processing time requirements.

A message will also be display if the "From Date" is later than the "To Date". This type

of date entry error will need to be corrected to proceed.

Date selection conventions include:

o Press the respective Set Today button to refresh to the current day for either the From

Date or the To Date field

o Type in the desired date into either field

o Position your cursor within the month, day, or year portion of either the From Date or

the To Date field. Click the appropriate arrow:

Press the down arrow to the right of the date to move the selected date parameter

(month, day, or year) earlier

Press the up arrow to the right of the date to move the selected date parameter

(month, day, or year) later

For example, if the current date display is set to 08/26/05, position your cursor in the

month portion of the date and press the down arrow to move the date to 07/26/05. Then

position your cursor in the day field of this date and press the up arrow twice to change

the date to 07/28/05.


The Lost Image Files report will open in a new window. The following options are

available:







printing reports.



o The following buttons will only display if lost images are detected:

o Select All. Click this button to select all of the lost images for deletion. The Select to

Delete check box for each lost image will be checked when you press this button.

o Clear Selection. Click this button to clear the Select to Delete check box for all lost

images that have been selected.

o The following button will only display if a lost image is selected for deletion:

o Delete Selected. Click this button to clear this image from the database records

associated to this specimen. A warning message will appear before the system deletes

the record.

Warning: Before breaking a linking between a specimen and an image, also known as "deleting an image",

you should make every effort to restore the image from a backup file or to manually locate the missing

image.

The following is an example of the Detect Lost Images by Date Range: