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Electronic Signature Information: Name Revision Type Title Originator Release Date Obsolete Date

The document provides information about new features in the enCORE v18 software for Windows 10, including: - Advanced Analytics which allows users to create custom equations and set thresholds to classify patients. - Integrated Trabecular Bone Score (TBS) measurement. - New total body regional analysis options and CoreScan-SAT functionality. - Enhancements to trending, sarcopenia assessment using SPPB, and new security features including DoD security. The Windows 10 global PC, enCORE installation process, and user interface are also summarized.

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Jhon Lopez
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0% found this document useful (0 votes)
74 views43 pages

Electronic Signature Information: Name Revision Type Title Originator Release Date Obsolete Date

The document provides information about new features in the enCORE v18 software for Windows 10, including: - Advanced Analytics which allows users to create custom equations and set thresholds to classify patients. - Integrated Trabecular Bone Score (TBS) measurement. - New total body regional analysis options and CoreScan-SAT functionality. - Enhancements to trending, sarcopenia assessment using SPPB, and new security features including DoD security. The Windows 10 global PC, enCORE installation process, and user interface are also summarized.

Uploaded by

Jhon Lopez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 43

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Electronic Signature Information

Name DOC2259551

Revision 1

Type Controlled Document

Title v18 service and application training

Originator 212019256_darrell_d_gorsuch

Release Date 05/09/2019 04:56:00 PM

Obsolete Date

File Name File Description File Size (Bytes)


V18 training.pptx V18 training 4476923

Route Signer Function Status Comments Completion Date


Approved without 9 May 2019 16:52:02
R-9404831 212019019_paul__markwardt Approve
Comments GMT
Approved Without 9 May 2019 16:55:59
R-9404831 212019256_darrell_d_gorsuch Approve
Comments GMT

Periodic Review
There are no signatures or routes related to this business object.

Obsolesence Approval
There are no signatures or routes related to this business object.

* Printed versions are For Reference Only *


+ Indicates a task was reassigned from an original assignee
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enCORE v18 for Windows 10


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enCORE v18 for Windows 10


• Windows 10 Operating System
• enCORE Installation Changes
• New enCORE User Interface
• Advanced Analytics
• Integrated Trabecular Bone Score (TBS)
• DXAVision
• Adult TBLH and New Total Body Regional Options
• CoreScan – SAT
• Trending Improvements
• Sarcopenia - SPPB
• New Security Features
• Department of Defense (DoD) Security
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• InSite (Virtual Assistant) – RSvP for Windows 10


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Global PC with Windows 10 Operating System (OS)


New Windows 10 Global PC:
• OS is Windows 10 2016 LTSB (Does not force periodic upgrades to the customer)
• HP Z2 G4 Windows 10, 64-bit, Intel Core i3, DVD Read/Write, No Sea Level Card, No internal archive drive,
No modem
• Prodigy and iDXA use the same Global PC
• Includes 24” monitor
• A secure USB external Hard drive for archiving is available
• F11 functions the same but has one extra confirmation screen to choose Recover From Hard drive or
Cancel. Note that there is only one image available so there is nothing to select.

Only difference between the two PCs


• LU45691-USA (English keyboard with X-ray warning sticker)
• LU45692-ROW (English keyboard)

Prodigy and iDXA installation procedures and PC Replacement Procedure updated for Windows 10 Global PC.
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enCORE 18 Installation Changes


• enCORE 18 only supports Prodigy P9-P11 and iDXA2
• enCORE 18 is only supported for the Windows 10 operating system
• enCORE 18 is on a single DVD
• Simpler Install - Entering of destination folder and feature code is
combined in one screen and moved up in the process.
• New SQL Server version - SQL Server Express 2016 SP2
• Microsoft security patch strategy has changed to one monthly roll-up.
Only one patch to install, but it is large. Security patch installation can
take roughly 90 minutes, with significant time after the reboot.
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New enCORE User Interface


New UI, same efficient user
workflow!

• Patient information block moved


to top right of screen.
• X-ray and shutter icons during
Measure and QA move to top of
screen.
• No main screen in enCORE
• The four Screens include:
 Directory
 Measure
 Analyze
 QA
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Advanced Analytics
Advanced Analytics allows you to create custom equations using existing data from your DXA
system, set user-defined classification thresholds based on these equations, and establish
actionable patient goals based on evaluation of the results.

There are three Advanced Analytics options based on feature code:


● Advanced Analytics Bone – Gives access to all bone related data parameters
● Advanced Analytics Body Comp – Gives access to all composition related data parameters
● Advanced Analytics Full – Gives full access to all data parameters
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Advanced Analytics
Advanced Analytics feature can be enabled and configured at:
Tools > User Options > Analyze tab > Total Body Analysis Options.
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Advanced Analytics
Advanced Analytics Main Window

Note: Once a new Analytic is


created the Enable button must
be toggled to use the analysis.

Buttons Description
New Create a new analytic.
Edit Edit an existing analytic.
Duplicate Duplicate an existing analytic
Delete Delete an existing analytic.
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Thresholds Set classification thresholds based on the selected Advanced Analytic equation.
Change Folder Change the folder where the Advanced Analytics definition file is stored. If no file is found, a new file will be created in the selected folder.
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Advanced Analytics
New Analytic window options:

Buttons Description
Insert Value Insert a new measurement, patient, or numerical value.
Edit Change the selected equation item.
Delete Delete the selected equation item.
Math Operators +,-,*,/ Change the math operator of the selected item.
Add Remove Add or remove parentheses for the selected item to indicate math operator precedence.
Up/Down Reposition the selected equation item up or down.
Thresholds Setup classification thresholds for an analytic including thresholds, classification text with color formatting, and evaluation text for displaying
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analytic data on a chart.


Equation Test Display the Equation Test dialog to allow manual data input for testing the analytic equation.
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Advanced Analytics
Sample of New Analytic Setup: BMI
1. Set Name to BMI.
2. Set Description to Body Mass Index.
3. Set Unit to kg/m2.
4. Set Precision (Number of digits displayed past decimal) to 1.
5. Click the button Insert Value.
6. Select the following values in the Value dialog and click OK.
a. Set Measurement to (Patient Information).
b. Set Value to Weight.
c. Set Use Unit to kg.
7. On the Analytic dialog, click Math Operator divide.

8. Click button Insert Value.


9. Select the following values in the Value dialog and click OK.
a. Set Measurement to (Patient Information).
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b. Set Value to Height.


c. Set Use Unit to m2.
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Advanced Analytics
Sample of New Analytic Setup: BMI (continued)
10. Click the Threshold to open Classification Thresholds
(Will show 3 threshold levels).
a. Click More >> button to show additional levels
11. Fill in the Classification description and the Threshold
values.
12. Click the Font Color and Background hyperlinks to
display a color selection dialog.
13. The Copy Female settings to Male button will copy
Female Classifications, Thresholds, Font and
Background colors to Male settings.
14. Click OK when done to return to Analytics window.
15. Click Equation Test… button to manually input data to
test the analytic equation.
16. Once all the Test Value fields are entered, click
Calculate button and a window displays the calculated
results.
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17. Click OK to return to the Advanced Analytics dialog. If


not already enabled, click the Enable toggle switch and
then click OK to close the dialog
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Advanced Analytics
Advanced Analytics Results
To see the Advanced Analytics results, open an exam and select the Analytics tab. The Advanced Analytics
results are displayed including equation results, classification, and thresholds in numerical and graphical format.

If the patient has multiple measurements, the Display selection will include Trend: Change vs. and Trend:
Reference options to view Advanced Analytics results trending information.
Note: If an Advanced Analytics equation is based on single or multiple measurement sites, the result will only
be available if the exam contains the required site(s) and results to fulfill the equation.

Advanced Analytic Reports


Advanced Analytics chart and result field codes can be added to a patient report and sent to a printer or other
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destinations such as HL7 or DICOM.


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Integrated Trabecular Bone Score (TBS)


The Integrated TBS feature integrates the standalone Medimaps TBS iNsight application
into the enCORE software for improved workflow.

Trabecular bone score (TBS) is a gray-level textural


metric extracted from the two-dimensional
lumbar spine DXA image. TBS is related to bone
microarchitecture and provides additional skeletal
information that is independent of BMD. See the
TBS User Guide for additional information.
TBS User Guide and Calibration Instructions are
found in enCORE Help dropdown menu.
With the correct feature code, the TBS feature can
be enabled and configured in enCORE software at:
Tools > User Options > TBS tab
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Integrated Trabecular Bone Score (TBS)


The Integrated TBS controls available via the User Options Menu
Controls Description
Enable TBS Enable or disable TBS results

Manage Licenses Manage TBS licenses and calibration


and Calibration
Import TBS insight Import existing TBS results from a TBS insight database.
Database
Reference Select TBS reference population. See the TBS OPTION IN
Populations: Female ENCORE SOFTWARE USER GUIDE for more information
and Male
ROIs: Use excluded If enabled, excluded ROIs will not be used in the TBS
ROIs if defined calculation, otherwise all lumbar spine ROIs are included
ROIs: Default Select between L1-L4 or L2-L4 for TBS calculations

Report Image If checked, only the TBS image map will be displayed on the
Mapping: TBS Only report, otherwise the TBS image map will be displayed as an
overlay on top of the AP Spine image
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FRAX: Adjust for TBS If enabled, FRAX will be adjusted for TBS
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Integrated Trabecular Bone Score (TBS)


License and Calibration
The Manage Licenses and Calibration dialog allows you to manage the TBS license and TBS calibration. A
valid license and TBS calibration is required for calibrated results. You can use TBS without a calibration for
demo or training purposes, but “Not Calibrated” text is displayed on the TBS results screen and report.
The license key may be added by either:
 Manually enter TBS License key in the field and click Add.
 Import and browse to a license key file (The Import license option is for customers with
multiple systems and license keys)
The Calibrate button launches the TBS calibration tool to compute the TBS calibration. The
calibration process is described in the TBS Calibration Instructions
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Integrated Trabecular Bone Score (TBS)


TBS CALIBRATION TOOL USER GUIDE – Found on enCORE Help window
Calibration Overview (See TBS CALIBRATION TOOL USER GUIDE for full
instructions)
 Acquire 6 AP Spine scans of TBS Phantom using TBS Patient Parameters
(recommend reposition after 3 scans)
 iDXA 12.6 cm x 12.7 cm (Length x Width)
 Prodigy 11.8 cm x 12.7 cm (Length x Width)

 Go to User Options > TBS > Manage Licenses


and Calibration > Calibrate
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Integrated Trabecular Bone Score (TBS)


Calibration Overview (Continued):
 Click New Calibration… button and enter TBS Phantom Serial
Number followed by Continue button.

 Click Add phantom scans.. button


 Browse to and select TBS Calibration Scan files (Min of 6 files)
 Click Compute button and then Save button
 Click Report button to display TBS Calibration Report

 The User Options > TBS > Manage


Licenses and Calibration window will
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display the Calibration Date and Status.


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Integrated Trabecular Bone Score (TBS)


TBS Results: AP Spine Analysis has a TBS tab to display the TBS results

• AP Spine image with TBS map overlay


• Reference Chart
• Results table: Region, TBS Value, TBS T-Score,
and TBS Z-score
• If the patient has multiple measurements, the
Display selection will include Trend: Change
vs. and Trend: Reference options to view TBS
results trending information.

FRAX Adjusted for TBS: If the Adjust for TBS option is enabled, the FRAX values will be adjusted for TBS and text FRAX
Adjusted for TBS will be shown for a Spine/Femur exam on the FRAX tab and report .

Reports:
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• A default report titled (DXA) AP Spine TBS is available for reporting TBS results.
• TBS field codes can also be added to custom reports
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DXAVision
DXAVision combines multiple measurements (Spine, DualFemur,
Total Body) in one exam, simplifying workflow.
The DXAVision feature provides a complete bone and body
composition assessment in one optimized exam including BMD
with TBS, Fracture Risk, Adiposity/Metabolic status, and
Sarcopenia status. Note that TBS, Adiposity and Sarcopenia
require additional features (TBS, CoreScan, Sarcopenia).
Options to exclude the head and lower legs from the Total Body
measurement are available to improve patient throughput while
still capturing the core body composition results. Total results are
estimated from the area measured (neck to knees).
Bone and composition results are available in a single,
comprehensive, patient-focused report.
DXAVision is a purchased software option.
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DXAVision
Measurement: The DXAVision protocol can be found
at the top of the Exam list on the New Measurement
screen.
• The exam protocol includes the AP Spine,
DualFemur, and Total Body measurement sites.
• With the DXAVision feature, the Total Body
Measure screen includes two options
 Exclude Head from scan field
 Exclude Head and Lower Legs from scan field
• If excluding the head, position chin at the top line
of the pad. Use pillow if necessary. Otherwise, use
the positioning switches on the scan arm control
panel to center the scan start position over the
patient’s chin. (The laser remains off during this
positioning.)
• Note that the operator can scan the full total body
if desired.
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DXAVision
Analysis: The images included in the exam are displayed in a tab view on the left-
hand side of the screen. Follow the standard analysis practice for each image type.

Report: Bone and


composition results are
available in a single,
comprehensive,
patient-focused report.
• The DXAVision report
includes bone (BMD
with TBS, Fracture
Risk) and
composition
(Adiposity/Metabolic
, Sarcopenia).
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New Total Body Regional Options


The Adult TBLH and Small Body Comp ROIs features are part of the Sports Athletics Package.
• The Adult TBLH feature allows the option to calculate Total Body Less Head (TBLH) results
• Small Body Comp ROIs feature, the option to calculate upper and lower arm and leg results
• Both features are located in Tools > User Options > Analyze tab > Total Body Analysis Options.
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New Total Body Regional Options


Option to exclude the head from the Total Body measurement is available to reduce scan
time and allow scanning of taller patients that might not otherwise fit within the scan
window. Total results are estimated from the area measured.
The regions are selectable on the Total Body Measure Screen.
• Exclude Head from Scan Field
(only available with Adult TBLH & DXAVision)
• Exclude head and Lower Legs from scan field
(is only available with DXAVision)

Note that when either of the “Exclude Head”


options are selected the joystick buttons
are now active but the laser does not turn on.
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New Total Body Regional Options


New Small Body Comp ROIs:
 Upper and Lower Arm Cut
 Upper and Lower Leg Cut
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CoreScan
enCORE 18 extends the existing CoreScan feature by providing additional
results. In addition to VAT Mass and Volume, VAT Area and SAT Mass, Volume,
and Area results are reported. The CoreScan software option estimates the SAT
(Subcutaneous Adipose Tissue) content within the android region as well as VAT
(Visceral Adipose Tissue)
VAT mass, area, and volume and the SAT mass, area, and volume and displayed
on the CoreScan tab. The results are also found on the Total Body Composition
Ancillary and CoreScan Reports, and Composer field codes are available.
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Trending Screen Improvements


Densitometry & Composition tabs will handle trending without separate tabs. There is an
option on the Analysis tab for selecting Current Results or Trend (Change vs. or Reference).
• Specialty cases will still use separate tabs for trending:
• Pediatrics, Morphometry, Custom Analysis, and Estimated Composition
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Sarcopenia - SPPB
Sarcopenia Definition: Allow user to enter Short Physical Performance Battery (SPPB) inputs and calculate SPPB score
In Sarcopenia Definition Advanced Options, SPPB is a new Measurement option available in the drop down selection
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New Security Features

FIPS 140-2 Exam File Encryption


enCORE provides the user option to use FIPS 140-2 validated cryptography for
patient exam files that are stored on the hard drive.
• To enable this feature, select Tools > User Options >
Systems tab > Exam File Options
• Enable Encrypt Exam Files
• Enable USE FIPS 140-2 Cryptography

Warning: Exam files that are saved using this encryption mechanism will not be
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compatible with older versions of enCORE Software


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New Security Features


Internet Protocol version 6
IPv6 for DICOM and HL7 transactions is available for DXA systems running enCORE
v18 or later. IPv6 will only work for systems that are connected to IPv6 capable
networks
To enable IPv6 for DICOM (and Lunar DICOM),
select Tools > Connectivity Options > DICOM
tab and disable Restrict IP Type to IPv4

To enable IPv6 for HL7, select Tools > Connectivity


Options > HL7 tab > Reporting and click Use IPv6.
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New Security Features


DICOM Transport Layer Security
Transport Layer Security (TLS) is a protocol that provides end-to-end communications
security over networks using encryption and authentication. It begins with a handshake
that enables the client and server to authenticate each other before sending data.
• Lunar DICOM & enCORE provide a built-in certificate manager for client-side certificates
• The system can be configured to send or not send its certificate to the server for
verification using the ‘Send Certificate to Server’ option in the TLS Settings dialog.
• To configure TLS for these roles,
select Tools > Connectivity
Options > DICOM tab >
Configure Connections > TLS
Settings.
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New Security Features


Audit Trail
Audit trails help keep a record of application use and activity. enCORE software supports audit event
generation for DICOM, SQL Server, and user events within enCORE.
• enCORE uses the Audit Trail Message Format Profile described in the DICOM standard Section A.5 to send
audit messages using the XML schema specified in Section A.5.1
• Windows Event Viewer Application Log is used to log SQL Server and enCORE application events
Access the Windows Event Viewer to view the logs. Windows To enable any of the audit trails select Tools >
search > Event Viewer. Expand the Windows Logs folder and User Options > Systems tab > Security Settings button.
select Application.
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Department of Defense (DoD) Security


The DoD feature provides additional security to meet the US Department of Defense Risk
Management Framework (DoD RMF) requirements. The DoD User Manual included in enCORE
18, describes the security features of the DXA workstation and details how to put the
workstation into a DoD RMF compliant state.
During the enCORE installation, if a feature code with the ‘DoD’ feature is entered, the user will
be asked if they are sure they want to apply Department of Defense settings. If yes is selected,
the installation will apply Department of Defense settings. This process configures:
• Windows Registry
• Local Security & Computer Policies
• Group Policies
• 3rd party Whitelisting software to comply

Warning: These settings cannot be undone. The only way to bring the system back to a
fresh state after applying settings is through system recovery.
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Department of Defense (DoD) Security


Application Whitelisting
Application whitelisting is a technology created to keep computer systems safe
from unwanted software, including malware. It involves specifying a list of trusted
entities or applications and blocking everything else
• McAfee Application Control (MAC) installed on the image as a whitelisting
solution
• Whitelist has an extension called Solidcore, this utility (sometimes called
“Solidifier”) controls the whitelist on the computer
• Updaters are entities that can make changes (create, modify, delete) to files
protected by MAC.
• Dexa.exe, DexaStart.exe, and all files signed with GE Healthcare and Microsoft
digital certificates are updaters by default
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Department of Defense (DoD) Security


Updating the Whitelist
If the DoD user needs to install additional software on the system, they will need to manually
update the whitelist.
To add a file or executable to the whitelist, the solidifier will need to be put into update mode. In
update mode, all changes performed by any process or user are allowed. Changes performed in
update mode are dynamically reflected in the whitelist.
• Open Administrator command prompt (right click | run as Administrator)
Enable Update Mode End Update Mode

• Note: To update the whitelist, request the whitelist password from GE Service.
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• Warning: Be sure to end Update Mode the whitelist again once you are done updating.
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Department of Defense (DoD) Security


Application Whitelist Password
The DoD user may want to change the whitelist password. Changing the McAfee Solidifier
Password is a two-step process. It must be changed in both enCORE and the McAfee
Solidcore command line interface
• Recommend changing the solidifier first using the
command line
• Note: To update the whitelist, request
the whitelist password from GE Service
• To change the whitelist password in enCORE (must have DoD feature code),
select Tools > User Options > Security Settings >
Change McAfee Whitelist Password
• Make sure it is the exact same password for both or
you may experience problems with enCORE install/uninstall
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InSite (Virtual Assistant) – RSvP for Windows 10


• RSvP is the InSite ExC replacement service tool for Win 10
• Similar/same functionality as InSite ExC
• Simplified – grabs state, country, address, etc. from CRM
• Automatic logging to Data Lake (Errors, Information, Exam info, Configuration)
• Installed as part of Windows 10 image, but not configured
• Provides capability to disable x-rays when remote desktop tunneling is active
• Provides needed RSvP functionality (configuration, starting/stopping the RSvP
agent) through a more user friendly UI than the InSite supplied UI
• Administrator privileges are required for RSvP functions
• New Service Procedure for RSvP: DXAP0043 - InSite RSvP Work Instructions
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InSite (Virtual Assistant) – RSvP for Windows 10


RSvP Overview
Customer System
• enCORE v18 or higher installed at
customer site by FE
• GE Connect installed as part of
Windows 10 image, but not configured.
Configured by FE.
• Remote Desktop Server is installed with
the RSvP Agent as part of Windows 10
image
Service Engineer Laptop
• Field Force Automation (FFA) and CRM
are standard Service tools
• If Remote Desktop Client isn’t installed,
a message on the FFA website will
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appear along with a hyperlink to


download the installer
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InSite (Virtual Assistant) – RSvP for Windows 10


Default Configuration
• Display Name: LU_XX###### ###### = System Number
• Serial Number: XX_###### XX = Product Prefix
• CRM Number: XX+######

Access Rights
• RSvP service interfaces with a custom Windows service
• Applications that talk to Windows services require administrator privileges
• With Windows 10, administrator users do not default to running applications with
administrator privileges
• Must “Run as” administrator for processes using elevated rights
• Unfortunately no work around – data will not be received to Data Lake and RSvP cannot
be used for service unless the user is running under an administrator account
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InSite (Virtual Assistant) – RSvP for Windows 10


Configuration on the Customer Computer
• enCORE software must be installed before running GE Connect configuration
• GE Connect configuration will detect the last version of enCORE software installed and
extract the system number from the configuration file
• Launching GEConnect.exe or double-click the GE Connect icon on the desktop of the customer’s
computer begins the configuration.
• Service Password is required for configuration
• Serial Number and Display Name is automatically generated using the current system number.
• Setup adds the LU_ prefix and strips the +/- because InSite servers do not support +/- in serial numbers.
• The CRM number will replace a – with a +.

• Note: If the customer will place this system on


their own network and domain, this username
and password must be a valid account for said
network and domain
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InSite (Virtual Assistant) – RSvP for Windows 10

If the customer Cares CRM number, or


any configuration setting, is different
from the default generated by
configuration, it can be modified by the
Unlock Settings button.
The service password is required.
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InSite (Virtual Assistant) – RSvP for Windows 10


Customers may create a Request for Service (RFS) on
their device for a Service call back with GE Connect
(desktop icon or Help in enCORE)
• Customer can click Contact GE (iLinq) button and
enter the service request details on the web page.

iLinq Connectivity Configuration


• iLinq connectivity is enabled for the system through
Field Force Automation.

• The DXAP0043 document instructs how to enable


iLinq on the GE Connect Console Messages tab,
if the Contact GE button is not visible and iLinq
should be enabled on this system.
• Service password is required
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InSite (Virtual Assistant) – RSvP for Windows 10


Start/Stop InSite RSvP and Remote Desktop Services
• Customer can initiate InSite RSvP by starting enCORE in
Administrative mode and selecting
Help-->Connect to GE..
• Customer clicks Restart RSvP Agent on the dialog.
• Once refreshed customer can click Start Remote Desktop Server
• Service engineer can connect to the
customer’s system via Field Force
Automation with valid Service Event ID
• Customer clicks Stop Remote Desktop
Server on the dialog to stop InSite RSvP and
Remote Desktop services
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