2JointsA templating software designed by Medstrat that is web based but requires a core download to run on your computerRequires a user name and password that can be assigned by Tom Tjalsma or Bill ShermanThis includes sales force, hospital, offices or physiciansCan be added to a hospital, surgeons office or home for no cost or fee.All xrays in Joints can be imported directly into Zimmer SMS, printed or exported to a DICOM or JPEG fileIf you want a Joints account, please Bill Sherman with your: First and Last Name and your address
3Why use JointsOnly takes about 3 minutes of your time to template and import into SMSIf you import into SMS, all of your team can see your sizes and templated xraysIf “Relay” is set up it let’s you obtain xrays in a matter of minutes with little effortGives you an accurate measurement of implants+ or – 1 implant size 95% of the time (Odell Woods/ Daniel)Let’s you tailor your implant requestIf using DICOM you do not need magnification markersSurgeons can have templating software on their home, office or hospital computers for no cost or fee
4Definitions/Modality PACS: Picture archiving and communications systemDICOM: Digital Imaging and Communications in MedicineCR: Computed Radiography; uses an xray plate that is reusableDR: Digital Radiography; uses a plate that is directly connected to a server (either wired or wireless)Most images are taken either CR/DR but they are all DICOM. All DICOM images can be printed to look like regular film xraysSome offices still use the old xray hard xrays
5Software Download Go to www.Medstrat.com Click on Downloads tab and log in with your user name and password
6Software DownloadUsername: first name initial then last example:Password: Zimmer1 (you can change it if you want to)
7Software DownloadIf downloading Joints select either MAC or Windows BrowserIf downloading Joints Relay select either Mac or WindowsThe viewer is for viewing only and not templating
8Software Download Follow Software Download Wizard You will need your username and password to log on to JointsProduct Key (Joints Relay does not need a product key)3T-4U-AC-ZS-SV-99-9DDownload and Install TemplatesSee next slide
9Download and Install Templates Click on the Manage tab, then Manage Templates
10Download and Install Templates Click on Show all Available then Install; to install all templates at once, highlight alltemplates Then Click Install (it takes about 20 minutes depending on internet speed)
11Upload an Image or Series Three ways1. Push directly from PACS or imaging system (via Joints Relay): DICOM only2. Drag and Drop (via Joints Relay): DICOM Only3. Import to Joints: DICOM or JPEGIf DICOM you do not need mag marker but you can if you want toIf JPEG you will need a mag marker
12“Push” Image upload How to: is specific to PACS software Must always have Joints Relay running when doing a “push” or “Drag and Drop” uploadDICOM images load directly to specified user’s“To-Do” tab in Joints.Must set up Joints Relay at office or hospitalNeed administrative privileges to download and run software.May need to speak directly to imaging software help desk to learn how to add a “push” uploadNeed IP Address, AE Title, AE portWhen relay is configured it will display all three items above
13Drag and Drop UploadWhen images are dragged and dropped into Relay Folder they will be added to your “To Do” tab in JointsRelay Folder will automatically appear on desktop once Joints Relay is opened and runningDICOM images onlyJoints Relay must be up and running
14Import an ImageClick on Study, Import, then either DICOM or Plain Images (for JPEG Images), findFolder assigned to images (either a CD/DVD/USB or on the hard drive and click onImport.
15Import an ImageDICOM images will automatically import the patient information but JPEG image information will have to be manually inputted.DICOM images do not need a magnification markerBut you can use one if you want to.For DICOM find folder and upload images.JPEG images need a magnification marker
16Import a JPEG ImageClick “Ok” when: Import to… Zimmer-Great Lakes window comes upClick on Manual EntryAdd Patient Name and ID then click AcceptPatient ID can be whatever you want butI always make it the name
17Import a JPEG ImageType in Study Description and Body Part Examined then click accept. Image will begin to upload
18Tabs Everything: Everything you have in your “personal” Joints server To Do: All images waiting to be templatedTemplated: All images templated but not “Planned”Planned: All images templated and linked to a case in SMSTraining: All images added to your “personal” Joints server to practice withZimmer -Great Lakes: All images you have in your “personal” Joints server
20How to Template Click on “To Do” tab Double click on patient to be templatedIf you want to have theAP and Lateral in the same windowclick on box cut into 4 quadrants ontop left of the Joints Viewer pageAnd select 1x2.
21Templating Click on the crossed wrench and screwdriver DICOM: you do not need to calibrateMake sure Magnification is 115% for knees and 120% for hipsJPEG: Click calibrate and manipulate red calibration marker to appropriate magnification markerIf you want a full circle make: Arc Length 180 degType diameter or length of marker in the Diameter box in mmClick submit
22Templating Ensure correct planning items are checked Body Part, Zimmer, Plane, Side, OrientationSelect Implants you wish to template
23TemplatingFrom this point you can do multiple things. Click on file and one of the tasks belowSave: Saves templated Films but they can still be adjusted (all templated xrays must be saved in order to print or send to SMS)Print: Allows you to print the xrays with templates on themDuplicate: Allows you to copy the image with the templates burned into them. This allows you to export images with templates on them.Export: Export allows you to export one image or the entire series in either a DICOM or JPEG formatManage: Allows you to send the templated images to SMS.Other administrative functions.
29Sending Images to SMS You must first ensure you preferences are set. When you have the image opened: Click on Edit, preferencesCase with patient info must be in SMS before sending images to SMS
30Sending Images to SMSAdd your SMS user name and password under the “CASE” tab.
31Sending Images to SMSBefore sending to SMS ensure you have saved your images. They do not need to be labeled anything specific. Click file, then saveSelect file, manage plan, type in surgeons name, click add
32Sending Images to SMSHighlight the images to be sent to SMS and click acceptJoints will automatically send images to SMS but not in the case yet. Click save once all images have been sent.
33Adding Images to SMS Case Open SMS and find the case in which images are to be added.On the bottom, select plans and link plan
34Adding Images to SMS Case Find patient to be added to SMS and click on the plan number. The plan will be added to your SMS case.
35Viewing Images in SMSFind case to be viewed. Go to bottom of screen and select the planselect the plan numberSelect Files and open up the images
36Setting up a RelayDownload relay from Mestrat website just like you did with Joints
37Setting up a Relay Open up Relay via the link created on your desktop Label the organization whatever you wantSelect Configure
38Setting up a Relay Under physician; select add Add physicians information and click okYou can add as many surgeons as you like to send images from that relay
39Setting up a RelayUnder Joint Reps select “Username” and in “contains” type the username you want images sent to.Select “search” and it will ask for your Joints username and password, enter it and click okHighlight the name and select add
40Setting up a Relay Change AE name to Zimmer_Surgeon Click Accept You can add as many reps as you likeYou can close this screen
41Setting up a RelayNotice each surgeon has there own AE Title and AE Port regardless of how many Reps.The IP Address, AE Title and AE Port are what is needed when setting up a “Push” from an office or hospital PACS. This is why it is important to change the AE title to the surgeon name
42Drag and DropNotice the folders that are created for each surgeon when they are added to Relay. This is where you drag and drop your DICOM images to be sent to Joints.The folders will go away when Relay is closed. All files that are dragged into these folders will disappear once they are sent to Joints.
43Tips Preferences: Set knee magnification to 115% and hips to 120% Select “compressed” on Joints main screen. This lets the images download faster.If you are going to export a DICOM image, ensure you create a duplicate study so the images are burned on the xray