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



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.