• It allows the user to select the various sites, or sources, of exams to be viewed.
• It allows for the quick-and-easy search of any number of multiple sites for a specific exam, or series of exams to be viewed or read.
• It allows the automatic and “background mode” reception of “assigned” or “pending” exams. These are exams that are essentially being sent to a sub-specialty radiologist’s Worklist from any number of local or remote modalities. This routing can be manually performed by the user of an administrative version of the EXAM-Console or automatically sent to a specific Radiologist’s Worklist as soon as the exam leaves the modality.
• From the EXAM-Console screen you can instantly view the “history” of an exam.
• From the EXAM-Console screen you can instantly view any “related” or “attached” files.
• From the EXAM-Console you can launch the EXAM-Viewer^™ and proceed with either a “diagnostic read” or a “clinical review” of an exam, depending on the version of the EXAM-Console that you have access to.
• From the EXAM-Console you can send any exam to another authorized user of the EXAM-PACS. This other user can be picked from a pull-down list and could be another diagnostic radiologist, a referring physician, or virtually anyone with the need to view the exam and the right to access it. This user could be located anywhere in the world. The transmission of the exam to this user is automatic, encrypted, secure and performed in a “background mode”. The user will receive a pop-up message on his desktop when the exam has arrived, calling attention to it. He can then automatically launch his local copy of the EXAM-Console and perform any of the above functions.
• The EXAM-Console automatically keeps track of all access to, and movement of, every exam and updates the exam “history file” with each transaction.
• The EXAM-Console^™ monitors all “MOD” files and “attached” or “related” files associated with every exam and forwards all of these files whenever the exam is sent or received.
• The EXAM-Console sends all exams to and fetches all exams from any IMAGE-Server^™, EXAM-Server^™ or ARCHIVE-Server^™.
• The EXAM-Console allows a user to directly and automatically burn an EXAM-CD^™.
• The EXAM-Console is available in several versions with different functionality:
  • The Diagnostic EXAM-Console, designed for the radiologist, has full functionality and privileges including the Diagnostic version of the EXAM-Viewer^™ which allows an exam to be marked as “Read”. This version is also available with the CD-Burning Option.
  • The Clinical EXAM-Console, which is intended for technologists, referring or consulting physicians, has the same functionality as the Diagnostic Viewer, but includes the Clinical version of the EXAM-Viewer without the ability to mark an exam as “Read”. This version is also available with the CD-Burning Option.
  • The Administrative EXAM-Console has the same functionality as the Clinical version and is available either with or without a viewer and is intended for administrative personnel to assist in the sending and fetching of exams as well as adding attached or related files to the exam. This version is also available with the CD-Burning Option.

• The EXAM-Server receives exam images either directly from the various modalities or from a CoActiv IMAGE-Server and adds the exams to the PACS database, begins the history and creates the MOD associations, as well as the Related or Associated file configurations. The EXAM-Server also packages and encrypts the exam for transmission and storage.
• The EXAM-Server, the initial repository for all harvested exams, is the first of the four redundant locations of the exams, and oversees all database functions for the PACS.
• The EXAM-Server also serves as the point of interface for RIS, HIS and Information Scanning and Filing Systems as well as Dictation Systems.

The CoActiv EXAM-Sender, described in detail in both a separate document and an available white paper, is the obvious solution… and it is now available for the first time. And because the EXAM-Sender is so unique and innovative, a Patent has been applied for. The EXAM-Sender system sends full-resolution, uncompressed images, reports, voice clips, and any associated documents and information relative to the exam directly to the referring physician’s desktop… quickly, securely, reliably… and in a “background” mode. The referring physician gets a pop-up message after, the completed exam has arrived in his computer. No wasting time waiting for questionable images to slowly appear on-line, no fuzzy images or exams, no restarting when the connection fails, no complex logins or forgotten passwords. Everything is automated, and access is hard-coded for maximum security and privacy. Your referring physicians will love it… and love you for using it! And, best of all, the EXAM-Sender^™ can be integrated into many existing PACS systems.

• The EXAM-Viewer allows the radiologist to use both keyboard shortcuts and mouse controls to perform most the normal viewer functions such as:
  • Image Scrolling
  • Series Scrolling
  • Windowing & Leveling
  • Zooming
  • Panning
  • Rotating
  • Flipping
  • Inverting
  • Print Image
  • Copy to Clipboard
  • Overlay On/Off
  • Ruler On/Off
  • Reset Image
  • Fit-To-Window
  • View DICOM Header Information
  • Smoothing (pixel interpolation) On/Off
  • Win/Lvl Presets – 10 Fixed CT and unlimited user defined presets.
• At the unanimous request of our consulting radiologists we added some highly desirable and virtually never found controls to EXAM-Viewer such as:
  • Series Localizers, Non-Active-Window Localizers and Pop-Up Localizers
  • Single Key Series Layout Selection
  • Single Key Image Layout Selection
  • Single Key Report Viewing
  • Single Key Voice Clip Playing
  • One-Click Series Layout Customizing (Hanging Protocols)
  • One-Click Fixed-Zoom-Level Selection
  • One-Click Apply-To-All Selection

EXAM-Viewer^™ has exceptionally versatile and flexible annotation capabilities including:

• Measurements – six per image in six different colors. – movable and relocatable.
• Regions-Of-Interest Annotation:
  • Up to four per image, in four different colors – relocatable
  • Square, rectangular, circular, elliptical and freehand – in four colors, relocatable
• Arrows, pointers – unlimited number per image – relocatable
• Text annotations – unlimited number per image – selectable type style, size and color – relocatable and editable

Unique new features add to EXAM-Viewer functionality:

• Innovative and Automated Series Image Synchronization
• Auto-Load of all images and all series in preselected series and image layouts
• Fast, easy and flexible creation of collage of selected images – added to series list
• Ability to save and recall multiple MOD files:
• Any number of different MOD files can be created and recalled for viewing while never changing the original DICOM Images. MOD files with different Win/Lvl, Zoom, Rotation, and Annotation can be saved for instructional or teaching purposes or just for additional reference. Each MOD file is displayed with history of creator, date, etc.
• New MOD files can even be created after an exam is marked as “Read”, however the “Read” MOD file cannot be altered.
• Exclusive ability to easily save any number of associated or related files with each exam. These files can be reports, first impression voice clips, transcription audios, video clips, scanned prescriptions, scanned insurance card, insurance pre-certs, or any other images or documents that add to the completeness of the exam and that may be of interest to referring or consulting physicians. A complete history file is automatically maintained of all related files, who added or updated them, as well as date, location, etc.
• All MOD files and associated files are kept with the exam image files for posterity.

CoActiv EXAM-Viewer^™ is available in three versions:

• Diagnostic EXAM-Viewer — for the radiologist including the ability to mark an exam as having been “Read”.
• Clinical EXAM-Viewer — for the technologist, referring or consulting physician, or anyone with the need to view an exam and the legal right to do so. Fully featured – but without the ability to mark an exam as “Read”. This version can, however, add additional MOD files to the exam for later reference, and can also add associated files.
• CD EXAM-Viewer — This is the version of the viewer that is included for free on every EXAM-CD^™ created by the CoActiv EXAM-Filer^™ system. This version of the viewer has many of the features of the Clinical EXAM-Viewer, but cannot add MOD or associated files and cannot make any annotations.

While the CoActiv EXAM-Viewer^™ was designed for use within the CoActiv EXAM-PACS^™ System, it is available for OEM integration and licensing into other PACS or tele-radiology products, however it is not currently available as a free-standing viewer.

It is far less expensive and much quicker to burn an EXAM-CD^™ than it is to produce copies of hard-film studies. It is also much more convenient for the doctor to file the small CD in the patient’s file jacket than to store large, cumbersome and bulky film studies.

The EXAM-Filer, in addition to exam images, can also include the voice clips available from within some PACS systems, as well as, image-montages and the radiologist’s diagnostic report, either in a first-impression form or in a final report form, on the actual CD with the required appropriate access software. The EXAM-Filer is the only system that produces a completely self-contained study CD that can be accessed from virtually any CD or DVD equipped PC.

Your referring physicians and patients alike will really be impressed with the EXAM-CDs created by the EXAM-Filer. These CDs are self-booting and require that nothing be installed on any PC that is accessing the CDs. The splash screen that appears is customized with your practice’s logo and has a direct URL link to your website and also includes a HIPAA sensitive privacy notice which must be agreed to before the exam(s) can be viewed. The viewer included on each EXAM-CD is the new CoActiv Clinical EXAM-Viewer^™, which is the ideal clinical viewer for use by the referring doctor or the patient… it is exceptionally fast, intuitive and can be used with no training with only a few minutes of practice. This new viewer, written especially for the EXAM-CDs includes the most desired DICOM viewer features including: Slice, Window and Level, Series, Zoom, Pan, Reset, Fit-To-Window, Inverse, W&L Presets, Rotate, Flip, Overlay, Copy-To-Clipboard (for saving or printing) and a host of additional useful functions. All basic viewer functions can be instantly accessed and controlled from either mouse or keyboard. And, moving from series to series is a single keystroke operation.

The custom full-color CD labels that are automatically and instantly created for each EXAM-CD that you produce, include your practice name, logo, address, phone, website address, creation date, referring doctor name, patient name, exams(s) description, HIPAA privacy notice and other useful information.

The cost of this CD is under a $1.00, and takes less than 2 minutes of clerical time to produce. Each CD, in addition to the CoActiv Clinical EXAM-Viewer, also includes the necessary applications to access any reports, voice clips, dictation files, scanned information or other included data.

The complete CoActiv EXAM-Filer system, including all hardware and supplies, is competitively priced for the first unit, with substantial discounts for multiple systems going into the same practice. While the EXAM-Filer is capable of easily receiving from multiple modalities and/or a PACS, the typical installation includes interfacing with either one DICOM compliant modality or with your existing PACS or tele-radiology system. Interfacing with non-DICOM modalities requires the addition of a DICOM gateway, available separately.

As soon as an exam is received from any DICOM compliant modality, it is stored on the local EXAM-Server, and is instantly, and automatically, sent from the practice’s EXAM-Server to the primary datacenter archive in New York and is simultaneously mirrored to the redundant archive site in Connecticut. Exams in both sites reside on huge disk drive RAID arrays with hot spare redundant drives, redundant power supplies, redundant cooling fans and high-speed SCSI data transfer facilities. These arrays are outfitted with automatic remote monitoring, as well as, local technical staff monitoring. All exams are also permanently archived to digital tape storage. So, within seconds after the exam is finished on the modality in your imaging center, or hospital imaging department, it is stored on your local EXAM-Server for up to 6 – 12 months, instantly archived for permanent on-line storage on the redundant RAID units in the two datacenters and is then backed-up to digital tape on a regular schedule.

Restoration of any of hundreds of thousands of exams from the archive for comparison purposes, is instantly available from any workstation in any location on your CoActiv PACS Network. This exam retrieval can be either manually or automatically pre-fetched by an integrated RIS system.

You no longer have to be concerned about maintaining local archives; clumsy tape drives or easily scratched local archive CDs or DVDs. And of course, expensive, clumsy and hard-to-store film is history. All exams are also instantly available for automatic transmission to your referring physicians, and all exam retrieval from the archive is performed utilizing our huge bandwidth resources rather than your expensive and usually limited local practice bandwidth… a tremendous cost savings to the practice.

This quad-redundant exam archiving is available for as little as pennies per exam per year. Compare this to the cost of film or local archiving!

EXAM-PACS^™ Configuration Guide