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Stay informed about common issues, resolutions and workarounds identified by Customer Support.



Downloading “24-Hour pButtons” in Instrument Manager (IM) can help you monitor the performance of your IM system. You can check baseline performance information and troubleshoot performance issues if they arise. Read on to learn how to download, install, and remove the “24-hour pButtons” task.

To Install:

  1. Download the 24hourpbuttons.xml file onto each Instrument Manager system that you want to monitor. You can download from:
    • My DI Community by searching for “pbuttons” (For Data Innovations’ (DI) North American customers)
    • Customer Web Portal (CWP) by changing the “Resource” to “All” and searching for “pbuttons” (For all DI customers not in North America)
    NOTE We suggest placing this file in the Instrument Manager or InterSystems folder, not on the User Desktop.
  2. Log into the Caché terminal as a user in the “IM Security Administrators” group.
  3. Run the following command from the %SYS namespace:
    %SYS>do setlogdir^pButtons("24-Hour_pButtons")
    command
  4. Close the terminal and log into the Caché Management Portal.
    cache management portal
  5. Log in with a Caché Admin User ID from step 2.
    cache admin
  6. Select System Operation, Task Manager, Import Tasks, then select Go.
    system operation
  7. Select Browse.
    browse
  8. Locate the 24hourpbuttons.xml that you saved in the first step.
    xml
  9. Select OK.
  10. Select Perform Action Now, you will see a line like the one shown below.
    NOTE The ID may vary from system to system. (Always >1000 though)
    perform action now
  11. The html files will be created in the 24-Hour_pButtons folder in the Caché MGR directory.
    C:\Intersystems\Cache\mgr\24-Hour_pButtons
    NOTE The task will run by default at midnight and every 24 hours after that. For example, if you import the file on Friday, the task will run on Saturday at midnight. It will run for 24-hours, and the results file will be created on Sunday morning.

To Remove:

  1. Log-in to terminal as an admin and run the following command from the %SYS namespace:
    %SYS>do clrlogdir^pButtons()
    command2
  2. Select Yes when prompted.
  3. Close the terminal window.
  4. Log into the Caché Management Portal.
    cache management portal2
  5. Log in with a Caché admin user.
    cache admin2
  6. Select System Operation, Task Manager, Task Schedule, then select Go.
    system operation2
  7. Locate the imported task and click on the name.
    import task2
  8. On the Task detail pane, select Delete.
    task delete
  9. Select OK when prompted.

For more information about the ^pButtons utility within Caché, please visit the InterSystems Documentation page on this topic.




Instrument Manager™ (IM) License Files are a key component to ensuring your IM functions properly.

NOTE If this is your first time seeing the term IM License File, we suggest reading the December 2020 article titled “Licensing and Installation” as it provides a foundational understanding of the specific files needed for IM.

Now before we delve further into IM License Files, you may need clarification between license files and security keys. If so, let’s use a car example to better illustrate an IM License File.

  • Imagine IM as a car.
  • License files are like your driver’s licenses.
  • Security keys are like the car keys.

License files and security keys are two independent things, but you need both to drive a car. With that image in mind, license files are just that: a license for your IM to work properly.

So, what exactly are IM License Files? It is a catch-all term for the three files (license.cache, cache.key, and IM-License.rpt). In particular, “license.cache” and “cache.key” are the two important files needed. The IM-License.rpt is a file detailing your system’s licensed features.

You can open IM License Files by using Notepad. We recommend only viewing them because editing can lead to unexpected behavior from the license files.

Here is a Q&A for common license file questions:

  • Can I use my license files for a different IM version?

    License file versions should not be cross matched. For the best IM experience, ensure your IM version matches your license file version. Example: If the version is 8.17.10.06, this should be found on both of your license files.

  • How do I check my license version?

    You will receive an email from our Sales team that includes both the license files and your license version. You may have spotted the “License Generator” and the “IM Core” if you opened your IM-License.rpt file, but this information does not reflect the true version you are using.

  • How do I upgrade my license file?

    You can email your region’s Data Innovations (DI) Sales representative. Please include:

    • IM License Number
    • Site Name
    • What IM version you are in
    • What IM version you will be upgrading to
    • If you plan to change from USB Hardkey to Softkey

    License file upgrade requests can take up to 10 business days to process. We would suggest that you apply at least two weeks before you intend to use the license to allow ample time for processing your request.

  • Do I need to renew my license?

    This depends on whether you have an expiring license or a perpetual license.

    To determine if your license is expiring or perpetual, you can check the Expiration Date of your license file by viewing it in Notepad. If you are unsure, you can check with your assigned implementation resource or sales representative.

    If your license is perpetual, you do not need to change the license files, unless you plan to upgrade.

    If your license is expiring, we suggest contacting your assigned implementation resource or sales representative for further assistance of the renewal.

  • My license files are in the correct folders, but when I start IM, it says missing files. Why?

    Folder permissions are a common cause of this. IM needs to be given permission to read the files inside the folder. You can try ensuring the SYSTEM user has Full Control to both the Instrument Manager and Intersystems folders. Once you do, restart Cache and startup IM again.

  • Do I need a different license file for my shadow/mirroring PC?

    You do not need a different license file for the shadow/mirroring PC, you use the same license file as Primary

    information  The IM Getting Started Guide and Installer’s Guide have detailed steps regarding the license files and how to install them. If your IM has shadow/mirroring setup, you can also refer to the Shadow/Mirroring Manuals on how license files interact with your Backup system. Access these files where you download other products and product-related documentation, typically through either My DI Community or the Customer Web Portal (CWP).

If you have further questions, feel free to contact your regional support team or your sales representative for assistance and we would be happy to clarify.




Are you using the following data elements in rules?

  • Run Count
  • Previous Test Error
  • Previous Test Dilution
  • Test User Persistent Field 1-5

If you are, it should be noted that these data elements are stored in the Specimen Routing database not in the Specimen Management database. This is important because the Purge setting for the Specimen Routing database can be set differently than the Specimen Management Database Purge setting. If you need to retain information in these Data Elements for future use, you may need to retain Specimen Routing data longer than you previously thought.

If Specimen Routing is Disabled, then Purge will use the SM Purge setting for SR data.

If Specimen Routing is Enabled, then Purge will use the SR Purge setting for SR data.

If the above data elements are being used, in the Purge Configuration screen we recommend setting the 'Days to keep - Specimen Routing data' to match the same value for 'Specimen Data – Specimen Management Data'.


cepheid genexpert configuration

If you would like to set up a Purge review, please contact your regional Sales Representative. For all other questions about the contents of this article, please contact your regional Support Team.




NOTE These instructions apply for Data Innovations’ North American customers. If this is your first time installing IM, please contact Data Innovations Sales to acquire the appropriate license files. If you already have the appropriate license files and are installing the same version of IM a subsequent time, please follow these instructions.

Step One: Log in to My DI Community

Follow the instructions in the My DI Job Aid to log into My DI Community.


Step Two: Navigate to the installation file

    1. Select Self Service to display a list of topics.
      self service

    2. From the IM section, select Software Downloads.
      software downloads

    3. From the Articles column, select the title of the Core Software version you wish to install.
      articles column

    4. In Files, select View All.
      view all

    Step Three: Download the installation file (.iso)

    For IM [version] Full Install drop-down and select Download.


    download

    The file begins to download.

    Step Four: Download the Installer’s Guide

    1. In the search bar at the top of the screen, enter IM [version] - English.
      search
    2. Select the title that matches.
    3. In Files, select View All.
    4. Scroll to Instrument Manager Installer’s Guide.
    5. Select drop-down and select Download.

    6. download

    Step Five: Complete the installation

    Use the instructions in What is an ISO to install the software. Refer to the Installer’s Guide that you downloaded.

    For more information

    If you have any questions about these instructions, contact:
    Data Innovations Customer Service
    802-658-1955
    northamerica-support@datainnovations.com

    If you would like to learn how Data Innovations can perform the installation or provide assistance through a dedicated Installation Service resource, contact:
    Data Innovations Sales
    802-658-2850
    northamerica-sales@datainnovations.com




When Data Innovations (DI) Support Engineers review a technical case, they consider data from several tools such as: the Specimen Event Log (SEL), Communications Trace (Comm Trace), Global Configuration, and the Driver Configuration. Providing data from these sources can be beneficial in expediting the troubleshooting process.

Questions to answer in the case submission:

To help us expedite the troubleshooting process, provide the following information during your initial submission:

  • Description of the issue or problem being experienced. If applicable, go ahead and copy/paste the error into the description.
  • Is the system a Live Production System?
  • Is this a new setup?
  • Did the software ever function as expected?
  • What has changed?
  • What troubleshooting has already occurred, if any?
  • License # of affected Instrument Manager™ (IM) software.
  • If connection or instrument/LIS specific:
    • What is the instrument/LIS?
    • What driver & driver version is being used?
  • Contact name, number, and email of person to contact to begin troubleshooting.

Best Methods for Submission and Considerations:

For customers in North America - Submitting a case to support by email (northamerica-support@datainnovations.com) or via My DI Community is an excellent way to explain the issue, quickly and completely. For more information or clarification on these considerations, please contact DI Customer Support via email or by phone 802-658-1955.

For customers in Asia Pacific, EMEA, or Latin America - Please contact your regional support team for more information or clarification on the considerations mentioned in this article.

A few key considerations:

  1. Escalation procedures vary from site-to-site. Being familiar with your own internal escalation procedure (directly to DI or through a Business Partner), could minimize the amount of time it takes to resolve your case.
  2. Know the physical location of the IM server so it can be accessed, if necessary.
  3. Know who has access to the IM server and their availability to assist in the troubleshooting process, if necessary.
  4. Know your IM License number so that DI may identify the license in our systems quickly and review all aspects of the software features.

This information helps DI provide you with a more rapid solution and significantly decreases the interruption time leading to productive use of the software.

What to Provide and How to Obtain:

DI Customer Support (CS) attends to your cases as quickly as possible. We often ask for very specific data to identify and resolve the issue rapidly. Below are some of those items and how to obtain them.

Specimen Event Log (SEL) - This is a diagnostic tool in IM that tracks the events of a specimen's data as it flows through IM. If you happen to know of one Specimen ID (SID) that exemplifies the issue you are encountering, you can follow the steps below to send that data to us.

  1. Log into IM.
  2. Select Diagnostics then Specimen Event Log.
  3. In the upper left corner, enter your Specimen ID and select the magnifying glass.
  4. When the data appears in the upper and lower panes, select the red wrench in the tool bar to "create a support file". Save the file and send that to Customer Support.
    wrench

Communications Trace (Comm Trace) - This tool can be used to review the raw data being transmitted to and from a connection. Your CS case owner uses it to review that the message being transmitted is in the format that the driver or instrument expects, and it can be used to recreate specific issues.

It is not necessary or recommended to keep Comm traces always running, but if you have questions about the exact data being sent or received from an interface, turning the Comm trace on for the connection(s) in question is recommended.

Communications traces only capture the data to the log when the trace is turned on. If you find that there is an issue of an order or result not crossing, follow the steps below to send that data to us.

  1. Log into IM.
  2. Select System then Status.
  3. Find the connection(s) you wish to start capturing data on (usually the LIS Orders/Results and Instrument in question). Right-click on that connection and select Start Communication Trace.
  4. Once enabled, you can view the Comm trace data by right-clicking on the connection again and selecting View Communications Trace.
  5. Send data through the representative connections.
  6. Once you feel like you have captured the data in question, from the Comm Trace window, select the blue disk icon to save the text file out. Send that to Customer Support.
    save

Global Configuration - The Global Configuration retains all the configuration options and connection assignments. It also retains every rule on the system along with the Specimen Management (SM) Workspace. Often this is used to recreate the issue you are experiencing on a systemic scale, rather than looking at an individual configuration (see below). Typically, this file is large so it might not be easily attached to an email/uploaded to a ticket. The CS case owner will work with you to get the Global Configuration.

To obtain the Global Configuration:

  1. Log into IM.
  2. Select Configuration then Save Configuration to File.
  3. Save the file and send that to Customer Support.

Driver Configuration - The Driver Configuration export will provide only the configuration options and rules set-up for your individual instrument/LIS configuration. Although it does not give a complete picture like the Global Configuration, we can still glean helpful troubleshooting data from it.

To obtain the Driver Configuration:

  1. Log into IM.
  2. Select Configuration then Configuration Editor.
  3. Select the configuration that you want to send to DI.
  4. Select Export in the bottom of the window.
  5. Save the file and send that to Customer Support.



Instrument testing can be a touchy subject. All labs are concerned about downtime. The purpose of this document is to provide the beginning of a discussion between the people doing the testing, and the lab techs responsible for getting results out the door.

Testing for a new system eventually means testing every test that is run on an instrument. This is not a quick process. Taking shortcuts can mean extended downtimes at go-live as unforeseen/untested workflows crash into the reality of the system. Thorough testing is painful, but beneficial.

Here are a few ways you can minimize the pain for testing the new system.

  • Work with the lab to determine the best times to test.
  • If there are duplicate instruments of the same exact model, test one at a time.
    • You may run a subset of tests on one instrument in a pair, and other tests on the other instrument, but if they are emergency backups of each other, you must eventually run everything you could want to run on both.
  • Barcode numbers must NEVER overlap.
  • If the system is advanced enough, it may be able to interface to two different systems at the same time.
    • On track systems, some container status/storage messages cannot be blocked so some messages meant for one system may accidentally make it to the other system.
    • Always check with the instrument vendor to make sure this is possible/safe.
  • An instrument can be connected for a short while to allow orders (or instrument queries) to cross, then switched back to production while tests run. Once the tests are done, switch again and retransmit the results.
  • If an instrument is being tested with the new system, it may be possible to still load a sample from the old system and manually program the instrument with the tests to be run. When the interface is swapped back, retransmit the results.
  • If a STAT comes in and swapping the interface back is not feasible, manually running the test and manually entering the results is less than ideal but possible.
  • Have a list of tests you plan to test beforehand. You can order them beforehand as well. If you have a barcode printer, even better. DI will hold orders for at least 2 days beforehand, although it is best not to order on Friday to run Monday.
  • Make sure the lab has a sample or can make a sample that matches what you want to run ahead of time.
    • If you are testing GLUCOSE with a beyond linearity flag, make sure they can do so ahead of time (Examples: Run a QC sample with the Beaker barcode? Doctor up a sample?).
    • Some instruments can “fake” results (but this is rare).
    • Best to have the lab tech work with the Vendor to figure out if this is possible, how to do it, and ensure the instrument id will match the testing done on the real instrument.



This guide describes the test code mapping required to report the interpreted results (POS/NEG) for the SARSCOV2, FLUA, FLUB, and RSV tests, as well as how to send an order for the panel from your LIS/EMR. This document assumes that the Cepheid GeneXpert is configured with the default codes as shown here:

ADF Name / Assay Name ADF Version Suggested Host Order Codeb(Assay Host Test Code) Analyte Common Name Suggested GeneXpert Result Code
Xpert Xpress_SARS-CoV-2_Flu_RSV 3 SARSCOV2FLURSV SARS-CoV-2 SARSCOV2
FLU A FLUA
FLU B FLUB
RSV RSV

For information on configuring the GeneXpert codes, see the Operator’s Manual or contact Cepheid Support.

Driver Configuration

The first step is to open Driver Properties and check Parse Interpreted Results as separate Test Code. If this is not enabled, the interpreted results will not be parsed as a test result value.

cepheid genexpert configuration


Result Code Mapping

A SARSCOV2FLURSV result message from the GeneXpert contains 31 observations, but you should only map the tests that you will be reporting. This section explains how to map the GeneXpert result codes so that you can report the interpreted results for SARSCOV2, FLUA, FLUB, and RSV.

Analyte Common Name Instrument Test Code
SARS-CoV-2 SARSCOV2-Xpert Xpress_SARS-CoV-2_Flu_RSV-SARS-CoV-2-I
FLU A FLUA-Xpert Xpress_SARS-CoV-2_Flu_RSV-FLU A-I
FLU B FLUB-Xpert Xpress_SARS-CoV-2_Flu_RSV-FLU B-I
RSV RSV-Xpert Xpress_SARS-CoV-2_Flu_RSV-RSV-I

Open the Test Code Mapping window for your GeneXpert configuration and select Add. For Instrument Code enter “SARSCOV2-Xpert Xpress_SARS-CoV-2_Flu_RSV-SARS-CoV-2-I” and enter a description for the Covid test code. Select Add and then Close.

test code add


Select the newly created “SARSCOV2-Xpert Xpress_SARS-CoV-2_Flu_RSV-SARS-CoV-2-I” in the Select Instrument Test Code field. In the lower Results mapping section, select the existing Instrument Test Code, then select Remove.

test code mapping


In the Select or Add IM Test Code field, enter the test code for Covid used by your LIS/EMR. Change Select Test Resulting Option to Default (D). Select Add. Your screen should look like this:

test code mapping


Repeat the above steps to add the other three instrument test codes.

Order Code Mapping

This section explains how to add an order mapping so that you can send an order for the Xpert Xpress_SARS-CoV-2_Flu_RSV assay to the GeneXpert. It is assumed that you completed the Result Code Mapping section above.

Open the Test Code Mapping window for your GeneXpert configuration and select Add. For Instrument Code enter “SARSCOV2FLURSV” and enter a description for the COVID panel code. Select Add and then Close.

test code add


Select the newly created “SARSCOV2FLURSV” in the Select Instrument Test Code field. In the upper Orders mapping section, select the existing Instrument Test Code, then select Remove.

test code mapping


In the Select or Add IM Test Code box, enter the test code for Covid used by your LIS/EMR. Change ‘Select Fluid Type’ to “Other”. Click Add. Your screen should look like this:

test code mapping



Instrument Manager System Preventative Maintenance
Volume 2

This Tips & Tricks is a repost of the July 2017 article that was the second installation of Preventative Maintenance recommendations intended to help you maintain a stable and operationally efficient Instrument Manager system. This includes recommended practices which, if performed proactively, can help reduce the risk of unexpected operational interruptions and promote improved performance. This list of suggestions has been organized by the Data Innovations' Customer Support Team from some of the most common issues reported and the understanding of what could have helped prevent them. This series includes topics on System backup practices in the event that an issue does arise and Instrument Manager needs to be restored to resume production. For volumes 1 and 3 of this series, refer to the June and August 2017 Tips & Tricks articles.

Daily monitoring of a Hot Backup System

If you are currently utilizing a Data Innovations Hot Backup system, it is important that you monitor the system to ensure it is operating as expected. To check the status of your Hot Backup (Shadow) system do the following:

  • Within Instrument Manager, go to the 'System' Menu and select 'Status'.
  • You will be presented with the Status Display.
  • You should see an entry under 'Connection' for the name of your Hot Backup System (e.g. Shadow).
  • The Status for the Shadow Connection should be 'Processing'.

A Status of 'Processing' is an indication that data is flowing between your Primary Production System and Hot Backup Shadow system. Any other status should be reported to Data Innovations Customer Service to begin an investigation into the issues affecting the normal processing of your Hot Backup.

This simple practice of monitoring the status of your Hot Backup systems will ensure that a fail over to a properly maintained Shadow System will return your lab to operating status with little disruption if your production system were to experience an issue.

The Hot Backup User's Guide provides additional detailed instructions for maintenance and monitoring recommendations. They may also be found in the Instrument Manager Help files.

Data Innovations introduced Mirroring in Instrument Manager version 8.15. This improved backup system allows seamless automatic failover when an issue is detected with the primary IM.

Backups should be run frequently and moved off the system regularly

To properly maintain your Instrument Manager system, Data Innovations recommends regularly creating and updating backup copies of the critical files on a CD, Flash Memory Device, network drive or some other storage media. These files will aid you in rebuilding your system if necessary.

The automatic backup feature allows for the scheduling of backups of the IM system. The Backup Settings will be used in the Automatic and when performing a manual back up. This backs up the following files:

  • License Files (standard)
  • Configuration Files (standard)
  • Report Layout Files (standard)
  • Driver Files (standard)
  • Database Files (optional)

To check or configure your Backup Setup:

  1. Turn off the Purge Connection from the Display window.
  2. From the Configuration menu, select Backup Setup.

Backing up the optional Databases, will consume much more disk space than the space required to back up the standard files. You will require available disk space of more than the selected databases current files sizes multiplied by the number of backups to be performed plus one (1). Consult with your IT Department before selecting the backup of databases.

It is best practice to configure your backups to save to a separate location other than the Instrument Manager server. If your Backup Setup is saving the backup to the same computer that hosts IM, it is recommended that with some frequency, a copy of the backup folder is made to another file storage system or media.

It is important that backups be checked to make sure that they are completing on a daily basis. To verify that the previous day's backup completed, navigate to the Diagnostic Menu, select the System Log option. From the System Log create a filter for Backup Events. If your Backup completed you will see a line item with a description with "Started" and a second line item with a Description of "Backup Finished" followed by the location of the backup file.



Should you not be able to find the event indicating that the backup has completed or see an error in Purge connection, contact Data Innovations Customer Support.

The Getting Started Setup Guide and IM Help provide additional information on the Backup and Restore features of Instrument Manager.


Licensing and Installation

Instrument Manager™ (IM) License Number

Every base Instrument Manager system has a license number tied to the system. The license number can be found in the bottom left hand corner of your Instrument Manager screen. It can also be found under the license report in the Reports Tab > License Information and the Help > About Instrument Manager. The license report contains valuable information such as licensed number of connections, End User Workstations, and features of IM. Your IM License number is required when logging tickets with Customer Support.



License Files and Installation

There are two license files required for an Instrument Manager system to launch after the installation is complete. License files are “shipped” virtually through the Data Innovations Production department and will arrive by email. Within the shipped files a customer will receive a License.cache file, Cache.key file, and IM-License.rpt file. Upon installation of the Instrument Manager software, the License.cache and Cache.key files are placed in specific folders. Instrument Manager will fail to start if license files are not placed in the appropriate directories.



Cache.key file is placed on the Instrument Manager server in the x:\Intersystems\Cache\mgr folder where the Intersystems Caché application is installed.

License.cache file is placed on the Instrument Manager server in the x:\Instrument Manager folder where the Instrument Manager application is installed. In both cases, x:\ indicates the installation drive for that directory, which is often C:\ or D:\.

With versions 8.16 and higher, no restart of Cache is necessary if no new features are added to the new license. This requires specific steps to accomplish and are documented in the Getting Started Setup Guide. Otherwise follow the proper shut down procedure for IM and restart Cache.

A customer will have separate license files for test and production systems. Customers with High Availability or Disaster Recovery system will share the same license files on each server.

NOTE License files can be labeled expiring or perpetual in relation to financial milestones. You should contact your assigned implementation resource or sales representative if you receive a pop-up warning of an expiring Instrument Manager license.





IM Software Key

Once license files are in place, assuming that this system did not previously have a valid IM Software key and the license number has not changed between files, a customer must activate Instrument Manager using a software key. New or upgraded license files are shipped with a 90-day activation key in text file format that allows the application to run. A permanent key must be requested by the customer and requires 5 days to process, so plan accordingly. The permanent software keys tie together the installation of an Instrument Manager system with specified hardware and computer name. Temporary keys are installed, and permanent activation key requests are gathered using the “IM Security Key Installer.exe” found in the root Instrument Manager folder on the server where IM is installed. Each server where IM is installed must have its own individual permanent key requested.

For example, a customer with an IM Test System, Prod System, and High Availability without Disaster Recovery would request three permanent keys, one from each of the three servers.

An invalid or expired software key will prevent the QMGR connection inside of Instrument Manager from moving to an ON status. You may also see errors increment on the QMGR connection.



As a customer you may receive a pop up when launching Instrument Manager warning of an expiring software activation key if a valid permanent key is not in place.



Installation and request steps for the software activation key can be found in the Instrument Manager Installer’s Guide available for download on the Customer Web Portal.

NOTE Laboratory Intelligence and Report servers do not require a software security key.


Security Notification Update:
Increased Cybercrime Threats to U.S. Hospitals and Healthcare Providers

In a joint alert sent on October 28th, the Cybersecurity and Infrastructure Security Agency, the Federal Bureau of Investigation, and the U.S. Department of Health and Human Services said they have "credible information" that cybercriminals are taking new aim at healthcare providers and public health agencies even as the coronavirus pandemic reaches new heights.

To quote the agencies press release, "CISA, FBI and HHS have credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers," officials said. "Malicious cyber actors" may soon be planning to "infect systems with Ryuk ransomware for financial gain" on a scale not yet seen across the American healthcare system.

The agencies recommended that hospitals, practices and public health organizations take "timely and reasonable precautions to protect their networks from these threats" which they said include targeting with Trickbot malware, "often leading to ransomware attacks, data theft, and the disruption of healthcare services" just as hospitals are also hard-pressed to respond to a third wave of the COVID-19 crisis.

The CISA, FBI and HHS agencies offered fundamental guidelines for how hospitals and healthcare organizations can harden their defenses to help protect against ransomware and other cyberattacks:

  • Patch operating systems, software and firmware as soon as manufacturers release updates.
  • Check configurations for every operating system version for HPH organization-owned assets to prevent issues from arising that local users are unable to fix, due to having local administration disabled.
  • Regularly change passwords to network systems and accounts and avoid reusing passwords for different accounts.
  • Use multifactor authentication where possible.
  • Disable unused remote access/Remote Desktop Protocol ports and monitor remote access/RDP logs.

In combination with the government agencies suggestions, DI is recommending that our customers follow our guidelines for the best practices in securing your Instrument Manager applications, as described in our Secure Configuration Guidance White Paper located within IM help.

Please let us know if you have any questions or concerns. As always, we are committed to ensuring your protection, and recommend the continued adherence to application configuration best practices.


Rules – Using Persistent Data Elements

It is sometimes necessary to recall or utilize information from a previous result or sample when writing rules. For example, Hepatitis testing typically requires the review of the results from three runs to make a final determination. It may also be desirable to evaluate whether a test was rerun.

This article will explore how Instrument Manager™ (IM) accommodates this type of workflow. First, it is important to understand that there are three categories of data elements within IM: Patient, Specimen, and Test. There are also general data elements that are not explored in this article.

Persistent data elements store data and may be recalled from run to run. Patient and Specimen data elements are described as persistent because IM stores the data and recalls it each time that test is processed on the same Patient or Specimen.

Test-level data elements tend to not be persistent. That data comes into IM and is not remembered the next time that test is processed on that same patient or specimen. However, there are some exceptions to that:

  • In older versions of IM, there were only two persistent test-level data elements available that were repurposed from their original use: Previous Test Dilution or Previous Test Error.
  • Newer versions of IM have a much wider array of available data elements that can be used to store and remember data from run to run. There are 20 Patient and Specimen User Fields (15 regular fields and five indexed fields) that may be used to store data from run to run and specimen to specimen. Additionally, there are 5 Test User Persistent Fields available. Each of these data elements may be set via rules to store the desired content to be recalled later.
    Example:
    Storing run 1 for Hepatitis testing to be evaluated later
    If: ( {Test Resulted} "HepB1" )
    Then: {Add Test} "HepB" {AND} {Set} {Test User Persistent Field 01} {On Test} "HepB" = {Result} {On Test} "HepB1"
  • There are also several other fields that are set by IM that can be used to recall previous information. Those include Previous Run Result 1-3 and Previous Patient Result 1-3. These fields are automatically populated and recalled by IM if appropriate for the test that is being resulted. These fields cannot be manipulated with rules but often contain the information that rule writers leverage without having to write rules to set or recall that information.
    Example:
    Evaluating if a PLT was rerun
    If: (( {Test Resulted} "PLT" ) {AND} ( {Previous Run Result 1} {On Test} "PLT" {NOT} = "" ))
    Then: {Set} {Hold Test Flag} {On Test} "PLT" = "RERUN"

NOTE To ensure that the rules function as intended, it is critical that rules be validated by the user prior to being moved into the Live Rule set and put into practice in the laboratory setting. Refer to the Instrument Manager Rules Manual (included with Instrument Manager software) for additional recommendations regarding testing.

Data Innovations’ Technical and Professional Services team is available to assist customers with specific rules development and/or evaluation. For more information, please contact northamerica-sales@datainnovations.com or call 802.658.2850.
For syntax assistance or minor rule questions, please contact support at northamerica-support@datainnovations.com or call 802.658.1955. Support will evaluate if further services are required.


Run as Administrator FAQ

Running as Administrator is occasionally required by DI Software. Here are answers to our most frequently asked questions on this topic:

  1. What does Run as Administrator mean?

    The Run as Administrator option is a method of launching an application as an "Administrator" by elevating the permissions of the user logged into Windows. By default, if you are logged into Windows as a user with administrative rights, any application that is being run does not use the administrative rights to execute. It takes specific actions by the user to run the application as an administrator to use these rights.

  2. How do you launch a program as Run as Administrator; aka elevate the permissions of the user logged into Windows?

    Users can do this by right-clicking on the application shortcut and selecting Run as Administrator.

  3. Why do you need to Run as Administrator?

    Instrument Manager and EP Evaluator require Administrator-level permissions to access certain features within the software. Specifically, some actions (e.g. installing the application, loading drivers, activation, etc.) require that a user has the permissions necessary for the application to write to the Windows Registry, and/or write to specific files/folders on the Windows server, which normally requires Administrator-level permissions.

  4. I launched the application as Run as Administrator, but it doesn't appear to be working. How do I check if I have administrator access?

    Keep in mind that a site's Server/Security policies may restrict or even prevent users from gaining true Administrator privileges even after selecting Run as Administrator. In such cases, users who select Run as Administrator may discover that they still don't have the permissions necessary to access certain features. If this occurs, please check with your IT team about providing the necessary permissions for your user.

    Notes:
    • For Instrument Manager, Data Innovations recommend that when loading a driver for the first time on the Standalone or Acting Primary system, do so by right-clicking on the Instrument Manager shortcut and selecting Run as Administrator to prevent any permissions-related issues when loading the driver for the first time. The first time a driver configuration is opened, this process will need to be repeated for each driver for each Thin Client. Defining an Application Server to limit the number of times this action would need to be performed is an alternative solution.
    • For Instrument Manager, when running the installer, right-click on the setup.exe and use Run as Administrator.
    • For EP Evaluator, installing the application the first time requires it to be Run as Administrator in order to write to the registry. If you do not have true Administrator privileges, then a 'Cannot write to registry' message will occur.
  5. What are some examples that require Run as Administrator?
    1. Loading drivers
    2. Configuring drivers
    3. Installing EP Evaluator
    4. Installing Instrument Manager
    5. First launch of EP Evaluator after install
    6. Activation of the EP Evaluator software, including reactivation after the current activation expires
    7. In general, if one is launching an executable (.exe) file it requires true Administrator privileges

Tips for using the Advanced Configurable Delimited Instrument driver

Data Innovations develops drivers that are instrument model and vendor specific. With a driver library of over 1000 drivers, most Data Innovations drivers have been developed based on exact specifications from vendors. Within the clinical laboratory and beyond, custom or specialty software and instrumentation may exist where customers reference the driver library and cannot find a match. In those cases, it may be possible for the customer to use a configurable driver for interfacing. The Advanced Configurable Delimited Instrument driver offers the opportunity for a customer to interface nonstandard, customized inputs and outputs.

The Advanced Configurable Delimited Instrument driver has a wide variety of features:

  • File paths may be set for incoming and outgoing files. These files may exist on the Instrument Manager server, a network drive, or on the instrument itself. Proper authentication is needed for file transfer.
  • File extensions may be defined.
  • Delimiter of choice may be used for field, component, and repeats.
  • The driver configuration supports FTP and File I/O.

With bi-directional capabilities, users can build the message structure of the file requirements for outgoing orders and incoming results using data elements that define the type, field, and field component to position data appropriately.

Outgoing orders:

  • Order files can be created at specific time intervals or a new file can be created for each specimen ID.
  • Worklists can be created in conjunction with the Instrument Manager worklist driver to set up plate maps.
  • Many data elements are available for use in the order as well as hard-coded free text that is user-defined.

Incoming results:

  • Results can be processed starting at specific line numbers or after specific text values within a file.
  • Sequence numbers can be added to test codes that have previously been resulted within a specimen. This functionality is helpful for testing that is run in duplicate.
  • Multiple lines of a file with the same specimen ID can be grouped together in one event which will enable more flexibility for the use of the rules engine.
  • Result files may be stored in an archive file after results are processed.

Connectivity is established through File I/O. For result outputs, testing of the driver configuration can be accomplished using the Instrument Manager server without the need to establish connectivity to the network location.

The driver is available for download on the Customer Web Portal under "Data Innovations".

Note: If your instrument or software is not currently set up with CSV or TXT formatting, refer to vendor specifications and instruments settings to see if one of these compatible file types are available.

If you have questions about the use of the Advanced Configurable Delimited driver or about how you could use it in your laboratory, contact your service or sales representative.



Mirroring: Auto-Failover

An auto-failover is triggered if the Acting-Primary or Arbiter determine that a primary can no longer function. The most common reasons are:

  • The Acting-Primary lost contact with the Failover and Arbiter, but the Failover and Arbiter maintained contact with each other
  • The Acting Primary runs into a critical problem, such as an inability to write to disk or major database corruption
  • InterSystems Caché on the Acting-Primary was shut down or restarted without selecting “Don’t fail over.” The following image shows “Don’t fail over” selected as a best practice for continued functionality of the primary
  • Cache Shutdown Box
  • The operating system on the Acting-Primary was shut down for any reason while running InterSystems Caché

Failover process overview:

  1. The mirror determines that the Acting-Primary can no longer fulfill its duties
  2. The mirror confirms that the Failover is able to take over the duties of the Acting-Primary. Once this test is passed, the Auto-Failover cannot be cancelled
  3. The Failover is promoted into the Acting-Primary role
  4. If the previous Acting-Primary is still running, its InterSystems Caché will be forced to shut down. It will stay down until manually turned back on

What to do after the failover:

  1. Confirm the new Acting-Failover has every connection in the “On” state. Some connections might not have made the transition
  2. Turn InterSystems Caché on the previous Acting-Primary back on
  3. If the failover was unwanted, gather the cconsole.log file from each system and send them to Support. They are the best way to determine the root cause of the auto-failover
    1. Location: C:\Intersystems\Caché\mgr on both IM systems. The letter might be “D:,” or another letter
    2. If there are any cconsole.old files, include them also
      Console.old Files
    3. Please label the files by system of origin for clarity
  4. If the failover was unwanted, work on preventing the root cause


Understanding Test Code and Fluid Code Mapping

Instrument Manager uses mapping as a mechanism for translating information between the LIS and instruments. This mapping can apply to four types of data elements: fluid codes, test codes, error codes, and/or instrument IDs. Not every driver supports all four data elements, but test code mapping is typically supported. Here are some tips to help with mapping questions:

  • To access mapping, find the name of the configuration you want to review and access it by selecting Configuration from the menu and selecting Configuration Editor on the configuration editor window. Select the configuration you wish to review and then select Properties. This will show you what mapping events are available for this specific driver.
  • Test codes are an identifier or name for a test. Test code mapping is the process of associating instrument test codes with LIS test codes.
  • Fluid codes refer to the specimen type (for example, Plasma, Serum, or Urine). Fluid code mapping is the process of associating instrument fluid codes with LIS fluid codes.
    • Not all instruments require fluid code mapping, but if available and part of your process, complete this mapping first. If fluid code mapping has not been completed for a specific test code, that test code mapping will not occur.
    • Instruments with fluid code mapping may or may not come with default mapping. Default mapping means that if the LIS fluid code is not correctly mapped or missing from the fluid code mapping, the driver will default to a particular fluid code for the rest of the mapping.
  • IM Test Codes and Instrument Test Codes typically display as a one-to-one mapping when the instrument driver includes pre-defined test codes. For example, if an instrument test code is 300 and the driver has default test code mappings present, you will see IM Test Code 300 mapped to Instrument Test Code 300.
    • If 300 is not a code that your LIS would send for this specific orderable, you will need to map a different IM Test Code to the Instrument Test Code.
    • It is possible to have more than one LIS code mapped to the same instrument orderable code.
  • Here is an example of why you might need to review your mappings:

The image below shows that the LIS has ordered test code LISSentTest. Instrument Manager reads that and determines from the mapping (shown in the upper right of the graphic) that IM Test Code LISSentTest is mapped to Instrument Test Code TEST. The instrument runs the test and sends the result TEST-R. The example originally had TEST-R mapped to TEST-R which the LIS does not recognize. By changing the mapping so that the Instrument test code TEST-R is mapped to the IM test code LISSentTest, a translation can occur so that the result is sent to the LIS in a way that the LIS will accept it.



For more information on mapping, please see the Getting Started User Guide chapter 6 titled “Mapping,” or contact the DI Support for your region.



Day Light Savings Preparation

Data Innovations has changed the requirements around time changes for versions 8.07 and higher.

After careful consideration we no longer require sites to manually change the system time or turn off IM/Cache during the time change, as we have confirmed that there are no risks prevented by those processes.

This means that sites can now re-enable the operating systems Automatic time change setting.

The daylight savings time change will affect any feature that uses a time difference calculation, this has not changed. Spring will add an extra hour, and fall will subtract an hour from any such calculation. This has the potential to cause anomalous and unwanted behavior.

It is recommended that sites watch for these behaviors and take any needed preventative action.

Examples of features that use a time difference calculation:

  1. Rules using date-time calculations, such as Delta Checks
  2. Turn Around Times
  3. Any driver using Hold Until Complete logic
  4. Drivers with tricklefeed workflow
  5. Drivers with custom timer logic of any kind.

If you require assistance check with your internal IT/IS department or you may direct any questions or concerns related to this issue to your regional Data Innovations support team during their regular office hours. If you purchased Instrument Manager from one of our business partners, please contact that business partner for support.



Network Installation of EP Evaluator®, Release 12.0

With the release of EP Evaluator 12, this Tips and Tricks will review the network installation/upgrade process.

Installation of EP Evaluator Release 12 for Network Installation
  1. Download the EP Evaluator (EE) installation Media from eedownload.datainnovations.com
  2. Choose where the installation will be on the network. This should be a shared folder which has correct permissions for the users to access, read, write and modify for the EE12 folder.
  3. Install EE in that location. Following the prompts, select the location of the installation directory.
  4. Create a shortcut to the program file (ee12.exe) located in the EE12 folder using a Universal Naming Convention (UNC) path (e.g. \\Server\Directory\) to that location. This shortcut should be sent to all the people who have access to the Network EP Evaluator, Release 12.
  5. Activate EP Evaluator on a computer with Internet Access
  6. Note: Only one activation is needed. You are activating the EP Evaluator installation, not the individual users.

    Right-click the shortcut created in Step 4 above, and choose “Run as Administrator.”


    If the activation screen does not come up immediately, you can get to it by clicking on Help → Renew Subscription.


    When you activate, you will need to change the Department, Institution, and Location to be correct for your site. Copy/paste the Activation code (provided to you via email) into the Activation Code box.

  7. Activate EP Evaluator on a computer without Internet Access
    Note: Only one activation is needed. You are activating the EP Evaluator installation, not the individual users.

If the computer with EE installed on it does not have access to the internet access, you can generate an activation code using the Web activation and System ID appearing at the bottom of the window. Then go to activate.epevaluator.com on any computer with internet access.

To move your data from a previous release of EP Evaluator to EP Evaluator 12, please follow the steps in Bring Data Forward to a New Major Release section of the EP Evaluator, Release 12 – Getting Started Guide.



Instrument Manager System Preventative Maintenance (volume 3)

Instrument Manager is a robust program that can run for long periods of time without issue. However, there are some things that can be done to make sure your system is running at peak performance. This month's Tips & Tricks is the third in a series focused on Preventative Maintenance recommendations, which if followed, can help reduce the risk to the operations of your Instrument Manager system. Following these recommendations may allow you to find issues before they turn into bigger problems that may affect laboratory productivity.

The list of recommendations was created by our Customer Service Team and will help to address some common problems that are reported. This month's recommendations focus on monitoring of Instrument Manager and hardware systems for indications of potential problems.

Monitor System Errors

It is recommended that Instrument Manager be checked daily for system errors. The Instrument Manager Status screen displays the current status of various system features. Some of the errors on the Status screen are non-critical, such as 'No Order for [Specimen ID]: Message Suppressed' - this is an indication that no order was placed for the Specimen ID being queried. Other errors could be critical, such as a bug in the driver causing the connection to error. Identifying errors quickly may help prevent unnecessary down time by taking action to address the cause of an error.

To check for errors: from the Instrument Manager main page, click on System Menu and select Status. By default the Errors column will be on the far right of the screen. If the number of errors is greater than zero, select that Connection and then review the details in the Errors window.

If the Errors detail window is not displayed, select the Yellow Triangle with the Exclamation point in it in order to display it.

Example of a non-critical error:


Example of a critical error:


NOTE: In this example, the connection has a Status of Error, this indicates a critical error and the connection is not running.

A support incident should be submitted to Data Innovations' Customer Service for any error that is not already known and understood. Data Innovations Customer Service will assist in the research and resolution of errors.

Monitor System Issues Through Helpful Data On The Status screen

The Instrument Manager Status screen provides functionality which allows users the ability to edit the view of system functions. For example, adding the 'Communication Trace' status will display what traces are turned on. This visibility is useful because running communications traces consumes disk space and should be turned off if the data capture is not necessary. Another useful status to monitor is the 'Driver version' and 'Driver name' to quickly find drivers that could be updated with a more recent version of the driver.

To add additional columns, select the Field Chooser on the Status Display window, then check the additional fields to be displayed on the Status Display.


Additional customizations can be done as well, from a variety of status choices. For more information on customizing the status screen, search the User's Guide for keywords "Customizing the Status Display Window"

Performance Tuning

Is your system running slow? Making sure your Instrument Manager has enough physical memory to perform at the highest level will ensure your systems are not waiting for results or orders when processing samples.

Performance tuning, is accomplished by confirming and setting your Cache Memory properly and should only need to be done once, unless there is a significant change in the volume of samples that are processed or number of connections licensed, in which case tuning should be reviewed and memory settings altered.

Should the Specimen Management Workspace continue to be slow when refreshing windows after Cache Memory has been properly set, the IM_SM database tables should also be tuned. Tuning the IM_SM database tables will increase the performance of the queries that are being performed to display the data. For specific instructions on both types tuning, search the User's Guide for keywords "Caché Memory Settings" and "Tune Instrument Manager Tables".

Monitor Disk Usage and Database Size

The available disk space on the system should be checked often to ensure a healthy system. If the disk runs out of space it can cause downtime and possibly database corruption. Disk usage can be checked manually by opening an IM client and going to the Reports Menu and selecting 'Drive Space' and 'Usage Report'.

To avoid filling up the disk, by default Instrument Manager will shut down all communication traces once the system reaches 90% and shut down all connections at 95% full. IM Notifier can also be configured to monitor disk usage and send messages when the disk space hits certain milestones. Many IT departments have professional monitoring tools that can be used to monitor the IM server and send notifications.

For questions related to the topics above, please contact Data Innovations' Customer Support for your regional location.



Instrument Manager System Preventative Maintenance (volume 2)

This month's Tips & Tricks is the second installation of Preventative Maintenance recommendations intended to help you maintain a stable and operationally efficient Instrument Manager system. This month's version of Tips & Tricks includes more recommended practices which, if performed proactively, can help reduce the risk of unexpected operational interruptions, and promote improved performance. This list of suggestions has been organized by the Data Innovations' Customer Support Team from some of the most common issues reported and the understanding of what could have helped prevent them. This series includes topics on System backup practices in the event that an issue does arise and Instrument Manager needs to be restored to resume production.

Daily Monitoring of a Hot Backup System

If you are currently utilizing a Data Innovations Hot Backup system, it is important that you monitor the system to ensure it is operating as expected. To check the status of your Hot Backup (Shadow) system do the following:

Within Instrument Manager, go to the 'System' Menu and select 'Status'.
You will be presented with the Status Display.
You should see an entry under 'Connection' for the name of your Hot Backup System (e.g. Shadow).
The Status for the Shadow Connection should be 'Processing'.

A Status of 'Processing' is an indication that data is flowing between your Primary Production System and Hot Backup Shadow system. Any other status should be reported to Data Innovations Customer Service to begin an investigation into the issues affecting the normal processing of your Hot Backup.

This simple practice of monitoring the status of your Hot Backup systems will ensure that a fail over to a properly maintained Shadow System will return your lab to operating status with little disruption if your production system were to experience an issue.

The Hot Backup User's Guide provides additional detailed instructions for maintenance and monitoring recommendations. They may also be found in the Instrument Manager Help files.

With the latest version of Instrument Manager, version 8.15, Data Innovations has introduced Mirroring. This improved backup system allows seamless automatic failover when an issue is detected with the primary IM.

Backups should be run frequently and moved off the system regularly

To properly maintain your Instrument Manager system, Data Innovations recommends regularly creating and updating backup copies of the critical files on a CD, Flash Memory Device, network drive or some other storage media. These files will aid you in rebuilding your system if necessary.

The automatic backup feature allows for the scheduling of backups of the IM system. The Backup Settings will be used in the Automatic and when performing a manual back up. This backs up the following files:

  • License Files (standard)
  • Configuration Files (standard)
  • Report Layout Files (standard)
  • Driver Files (standard)
  • Database Files (optional)

To check or configure your Backup Setup:

  1. Turn off the Purge Connection from the Display window.
  2. From the Configuration menu, select Backup Setup.

Backing up the optional Databases, will consume much more disk space than the space required to back up the standard files. You will require available disk space of more than the selected databases current files sizes multiplied by the number of backups to be performed plus one (1). Consult with your IT Department before selecting the backup of databases.

It is best practice to configure your backups to save to a separate location other than the Instrument Manager server. If your Backup Setup is saving the backup to the same computer that hosts IM, it is recommended that with some frequency, a copy of the backup folder is made to another file storage system or media.

It is important that backups be checked to make sure that they are completing on a daily basis. To verify that the previous day's backup completed, navigate to the Diagnostic Menu, select the System Log option. From the System Log create a filter for Backup Events. If your Backup completed you will see a line item with a description with "Started" and a second line item with a Description of "Backup Finished" followed by the location of the backup file.


Should you not be able to find the event indicating that the backup has completed, contact Data Innovations Customer Support.

The Getting Started Setup Guide and IM Help provide additional information on the Backup and Restore features of Instrument Manager.



Instrument Manager System Preventative Maintenance (volume 1)

Instrument Manager is a robust software application with a proven track record of operational stability. However, as with any software solution, there are recommended practices that, if performed proactively, can help reduce the risk of unexpected operational interruptions and promote improved performance. This Tips & Tricks notification is the first in a series of preventative maintenance recommendations to help increase the chances of proactively identifying potential issues before they turn into bigger problems.

The list of suggestions has been organized by the Data Innovations' Customer Service Team from some of the most common issues reported and the understanding of what could have helped prevent them. These topics cover a wide range topics from Operating System changes to functionality within the application that you may not be aware of.

Update Instrument Manager Drivers and Core software

Data Innovations is constantly striving to improve our product offerings. DI delivers a core software upgrade and a maintenance release once a year. Both types of updates provide customers with new or improved functionality as well as corrections and performance upgrades. In addition, Driver issues are fixed when identified or reported, and enhancements are added to drivers throughout the year. Being on the latest driver or core version may provide that new feature you are looking for, or address an issue you have been experiencing. We encourage you to check our website frequently to see what updates are available and review the Driver Update emails distributed on the DI Tips & Tricks email listserv. Review all of the DI email notification listservs and suggest them to others in your organization.

Apply Microsoft Windows Updates & Patches

Updating your Operating System (OS) with Microsoft (MS) provided updates will proactively address OS issues that MS has identified. MS addresses possible security concerns with the security updates published by Microsoft on a regular basis. With the recent well publicized ransomware attacks and increasing risk of similar malware, remaining current on OS and other application (i.e. anti-virus) releases is strongly recommended.

DI validates MS OS patches to ensure they will not cause any problem with your system. Rebooting your system after applying a MS OS patch is an added benefit to overall system health.

We are recommending that customers apply the monthly update when it is released by Microsoft. DI will test the patches as well and post the testing summary in the DI Customer Web Portal (CWP) as a Knowledge Topic within 21 days of the patch releases. DI also sends out a notification email (Tips & Tricks listserv) once the validation of the patches is complete. The Data Innovations notification includes instructions on the proper sequence of steps to apply a patch (specifically, shut down IM and Cache before running the patch and be sure to reboot the system after the patch is applied).

Follow proper shut down sequence

Make sure to always perform the Instrument Manager shut down procedure and then stop Cache before bringing the system down for a hardware reboot. This sequence of events is necessary to ensure that Instrument Manager and Cache have time to do all the shutdown steps before the system turns off. Failing to follow this order of steps, could result in corruption of the data or a number of other issues. Refer to the Instrument Manager's Troubleshooting Guide for more information on the proper technique to shut down an Instrument Manager system.

For questions related to the topics above, please contact Data Innovations' Customer Support for your regional location.



Evaluation Rules for Clinical Ranges Precaution

When building an Autoverification Rule Set it's common to include evaluation rules for Clinical Ranges. These rules typically set test reference ranges, abnormal flags, critical ranges, and critical flags for each test result according to your laboratory's established ranges.

Many labs have established ranges for certain analytes which also take into account the patient's Sex and Age. These patient demographics are typically provided to Instrument Manager (IM) in the LIS Test Order. However, there are some instruments which may also provide Sex and/or Age patient demographics to IM within the results message which may overwrite the information from the original LIS Test Order. If the Sex and/or Age sent from the instrument, in the result message, are incorrect, this could have a direct effect on Sex and/or Age based evaluation rules for Clinical Ranges in terms of applying the correct test ranges and flags for that patient's test.

When constructing evaluation rules for Clinical Ranges, it is highly recommended that this possibility be taken into consideration. As a precaution, ensure that the 'Overwrite Patient Data' option in the Connection Configuration, for the instrument connection, is set to unchecked. . In addition, it's also recommended that the Overwrite Patient Data setting is set to unchecked on ALL instrument connection configurations if patient demographics from the instrument are not required to populate IM Patient Demographics. The 'Overwrite Patient Data' option is a feature available on IM Version 8.14.10 or greater.

For customers on an IM Version prior to version 8.14.10 an Incoming Result rule which qualifies the Patient Sex and Age prior to result evaluation is highly recommended to be included as part of your evaluation rules for Clinical Ranges:

Incoming result - Before Message Queued Internally which includes a Hold all Tests Rule in instrument configuration to verify Age in Days is populated and Sex matches an expected value from the LIS order (for example, "M" or "F" are the defined Sex types configured in the LIS vs blank or "U").

  • This helps ensure Clinical Ranges Evaluation Rules which evaluate Sex and Age function as expected on test results
  • If an unexpected value is present the rules will hold all results for further evaluation.

EXAMPLE RULE:
If: ( {Test Resulted} "WBC" ) {AND} ( ( ( {Sex} {NOT} = "M" ) {AND} ( {Sex} {NOT} = "F" ) ) {OR} ( {Patient Age in Days} = "" ) )
Then: {Hold all Tests for Verification} {AND} {Set} {Specimen Comment(s)} = "DO NOT REPORT - VERIFY AGE & SEX"
Else:


Important: It is critical that Rules be validated by the user to ensure that the Rules function as they are intended prior to being moved into the Live Rule set and put into practice in the laboratory setting. Refer to the Instrument Manager Rules Manual for additional recommendations regarding testing.

Data Innovations Technical Professional Service Team is available to assist customers with specific rules development and/or evaluation. For more information, please contact northamerica-sales@datainnovations.com or call 802.658-2850.

For questions related to the 'Overwrite Patient Data' option, the rules noted here or Instrument Manager Rules in general, please contact support at northamerica-support@datainnovations.com or call 802.658.1955.

Resources:

  • Instrument Manager - Rules Manual (included with Instrument Manager software).
  • Instrument Manager - Getting Started Setup Guide (included with Instrument Manager software).



How to help Data Innovations help you when requesting Support

Data Innovations' Tips & Tricks are intended to promote the effective and productive use of Instrument Manager. Fortunately, Instrument Manager is a very stable product and problems are infrequent. However, despite the best intentions and efforts of all involved, systems can succumb to a variety of issues and productivity could be affected.

In order to minimize the impact to your laboratory's production and to expedite the implementation of a solution when an issue arises, being prepared with certain pieces of information when you contact Data Innovations' Support will help our representatives identify the problem and determine a solution more effectively.

Whomever is calling DI Support to report the issue should be prepared with several key data points that are crucial to the support process.

A few key considerations:

  1. Escalation procedures vary from site-to-site. Being familiar with your own internal escalation procedure, be it directly to Data Innovations or through a Business Partner, could minimize the amount of time it takes to resolve your issue.
  2. Know where your Instrument Manager server is physically located so it can be worked on directly if necessary.
  3. Know who has access to your Instrument Manager server and their availability to assist in the troubleshooting process, in case the need arises.
  4. Know your Instrument Manager License number so that we may identify you in our systems quickly and review all aspects of the software features.

Being able to provide this information could significantly decrease the amount of time the productive use of the software is interrupted. Data Innovations is ready to assist you when you require support and having this information will help us work with you to provide a more rapid solution.

In addition, Data Innovations will begin the troubleshooting process by gathering information. Providing this information during your initial submission of an issue will help expedite the troubleshooting process:

  • Description of the issue or problem being experienced.
  • When did the issue start?
  • Is the system a Live Production System?
  • Did the software ever function as expected?
  • What has changed?
  • What is the clinical impact?
  • What troubleshooting has already occurred, if any?
  • License # of affected Instrument Manager software
  • Release level of affected license.
  • If connection or instrument/LIS specific:
    • What is the instrument/LIS?
    • What driver & driver version is being used?
  • Contact name, #, email of person to contact to begin troubleshooting.

Submitting your incident for support by email (northamerica-support@datainnovations.com) or via the Data Innovations Customer Web Portal is an excellent way to explain your issue, quickly and completely. For more information or clarification on these suggestions, you may contact Data Innovations Customer Service via email or by phone at: 802-658-1955.