1. Features And Functions Of  M/R v1.4 (ServicePak) ----------------------- Dated 05/18/98
2.  M/R 1.4.2 PTF ------------------------------------------------------------Dated 02/12/99

3. RIS Interface Specification Document ------------------------------------- Dated 03/20/98

4. Latest RIS Interface Agent ------------------------------------------------ Dated 01/20/99

5. Modified DB2 Backup Instructions ---------------------------------------- Dated 02/13/98

6. The MedSpeak/Radiology "CHANGEPW.EXE" Program ----------------- Dated 07/18/97

7.  Microphone Options ------------------------------------------------------ Dated 03/29/99

 
8.  IBM MedSpeak/Radiology Supported Sound Cards And Drivers  -------- Dated 08/20/99 

9. Latest Ensoniq AudioPCI 64 Sound Card Drivers ------------------------- Dated 07/27/98

10. Click Here To Send An E-Mail To IBM MedSpeak/Radiology Technical Support

RIS Interface Specification Document:

• This document is intended for the software application developer, and systems integrator wishing to interface Radiology Information Systems (RIS), with IBM MedSpeak/Radiology. Also included in this document will be a description of IBM MedSpeak/Radiology, and the reason for the RIS interface requirement.

 
• For all HL7 segment definitions in this document, the table columns are denoted as follows:

• Click  here to download the document.

• The following changes have been made to the latest "Agentapp.exe" file:

1. The ability to add addendums to "Accepted & Signed" reports by adding the line DeleteAccepted = No to the Agentapp.ini file.
2. User fields were fixed so that they are sent in all OBR segments; not just the primary one in a combined result.
3. The OBXUserField#  (where # is a number from 1 to 5) will only be sent if the OBXUserField# is filled in.
4. The ability to set a maximum length of the OBX segment to a specified number of characters by adding the line  OBXMaxLength = # to the Agentapp.ini file (where # is a numeric value). The  OBXMaxLength value can be any number, but typically it is set to 72 or 80.
5. The ability to specify an  acknowledgment timeout and/or a connection-retry timeout period by adding the following lines to the  agentapp.ini file: AckTimeout = 90 and/or ConnectTimeout = 90. The timeout is in seconds and 90 is our recommended value.
6. You can change the preliminary status id, in the agentapp.ini file by entering either of the following two lines; PreliminaryStatusId = P or PreliminaryStatusCode = P.  Note that PreliminaryStatusCode has precedence.
7. You can keep the connection alive to the RIS Interface Agent, based on the AckTimeout received.  This can be done by entering the line KeepAlive = Yes in the agentapp.ini file.  You must also enter the line InitRptTimeout = 180 in the agentapp.ini file.  When looking in the agentapp.log file, you will see an entry at the top stating that KeepAlive is either On or Off.

• Click  here to download the file.

• The "CHANGEPW.EXE program is used to modify the DB2 Administrator's password. To change this password, follow the steps listed below:

1. Log on to the Server machine as "db2admin."
2. Using standard Windows NT facilities (e.g., User Manager), change db2admin's password.
3. Open an MS-DOS window and change directory (cd): cd \medspeak\radiology\server\bin
4. Run the changepw program (it will prompt you for the new db2admin password).
5. Implement this change by restarting all MedSpeak/Radiology Clients: either stop/start the program or logoff/logon.

• Click  here to download the file.

• The following features and functions have been incorporated into MedSpeak/Radiology v1.4 "ServicePak".  Also, most known bugs that were present in MedSpeak/Radiology v1.3 were addressed and corrected.

1. Auto Logoff - MedSpeak/Radiology V1.4 provides the ability to have the MedSpeak application shutdown if there has been no activity after a specified number of seconds have elapsed. The shutdown occurs from any screen within the application. Reports that may be in progress will not be saved. The setting is maintained at the institution level. The Radiology application looks to the system (institutional) ini file spchapp.ini for this option setting.

 
2. Auto Microphone Off - MedSpeak/Radiology V1.4 provides an option that automatically turns off the microphone after a specified number of seconds has elapsed with no application activity. This option setting is maintained at the institution level. The Radiology application looks to the system (institutional) ini file spchapp.ini for the setting.

 
3. Multiple Logon Detection - MedSpeak/Radiology V1.4 automatically detects when a user is already logged onto a MedSpeak session at another machine. When this situation occurs, the user is presented with a message box indicating the name of the machine the user is already logged onto and instructs the user to logoff the existing MedSpeak session before attempting to initiate another MedSpeak session. NOTE: If a machine running a MedSpeak session is shut down abnormally the user logged on MedSpeak at that machine will NOT be able to initiate another MedSpeak session at any other machine until the "crashed" machine has been restored.

 
4. Saving Text Of Report During "Accept & Sign" - If during the process of "Accepting & Signing" a report, a doctor suffers a workstation crash, the text of the report will be saved in a text file (ASCII text file) called  LastText.doc in the path \MedSpeak\Radiology\Client\Radiology on the workstation.  This way a doctor can copy the text from this file and paste it back into another report and "Accept & Sign" the report again.

 
5. Preliminary Report List Sign-Off - A doctor has the capability to accept and sign multiple reports in a row from the Report List window. This task is accomplished by allowing the doctor to sort the list of reports by STATUS either Ascending or Descending thus providing all reports with the same report status to be listed together. The doctor can then select the first Preliminary report in the list, view it and then accept and sign it. Once the acceptance process is complete, the doctor is put back into the Report List window with the NEXT Preliminary report selected ready for to be viewed and accepted. The Report List window no longer has the SORT icon (previously located on the secondary toolbar). Sorting is now available for all column heading displayed in the Report List window. This is achieved by clicking on the column heading for the desired sort or saying the corresponding sort command. See the list of speech commands in the User Guide. Each time a column heading is pressed or the corresponding speech command is spoken, the sort will toggle between the ascending and descending order. The Report List window column headings and their associated speech commands are listed below:

 
Field                                                         Command
Date                       "SortByDate"
Patient ID                 "SortByID"
Patient Name               "SortByName"
Order                      "SortByOrder"
Procedure                  "SortByProcedure"
Status                     "SortByStatus"
 
6. Status for Report Addendums - The new report status 'Addendum/Corrected' has been added to this ServicePak Release. This status occurs when an 'Editor' corrects an addendum that has been Saved as Preliminary by an 'Attending' or 'Resident' physician. Once a report with the 'Addendum/Corrected' status has been Accepted and Signed, the report status will go to either 'Final/Addendum' (if going to the RIS) or 'Accepted/Addendum' (if not going to the RIS). As in previous MedSpeak/Radiology releases a report with a status of either 'Final/Addendum' or 'Accepted/Addendum' CANNOT be modified.

 
7. Select Order List - added Date - The Select Order List window has been enhanced to include the date an order was accessioned in the select order display. The date, order number and description are displayed with orders sorted by date, the most current date at the top of the list.

 
8. Keystroke to Move to Next Template "Fill-In" - Templates have been enhanced to allow a user dictating Template "Fill-In's" to move from fill-in to fill-in by pressing the TAB key in addition to using the voice commands 'MoveOn' or 'NextTab'. This feature enables the user to program a button on the Phillips SpeechMike to move to the next fill-in during dictation of template fill-ins.

 
9. Set Microphone Volume Levels (various mics) - The MedSpeak/Radiology V1.4 application has been enhanced to accommodate saving the Microphone Input Volume setting for up to 4 microphones. (ex: Philips SpeechMike, Sennheiser, etc.). These settings are saved at the user level in the appropriate user.ini file. To activate a particular microphone setting the user selects the desired microphone from the "Select Microphone Type" pulldown list. This list is accessible at logon time when the "Select Microphone Type" check box on the logon window is checked or from the Customization window anytime after logon is completed. Once a microphone has been selected and the selection saved by clicking on the "continue" button in the customization window, the settings for that microphone (for that user) will become active.

 
The four microphones of choice are set at the Administrator level. The administrator adds a 'label' for each microphone being offered to the users. This label is defined in the spchapp.ini file. These labels will be displayed in the user Customize window and the Mic Customization window. The spchapp.ini file microphone definitions look like the following:
 
MicLabel1 = Sennheiser
MicLabel2 = Philips SpeechMike
MicLabel3 = Shure Headset
MicLabel4 = Shure Wireless


If there are at least two microphones added by the Administrator and a user has NOT saved a microphone configuration for either of these, the Mic Customization window will be displayed at user logon. This window allows the user to go set the appropriate volume for one of the available microphones. To set the volume follow these steps:
 
1. With the volume slider in the default position click on the Test Volume Button and speak into the microphone in your normal dictating voice. Watch the volume indicator in the microphone icon. If the horizontal lines are yellow, move the volume control slider up (to the right). If the horizontal lines are consistently red, move the volume control slider down (to the left).
2. Once you have adjusted the volume control slider click on the Test Volume Button and dictate again.
3. Continue adjusting and dictating until the volume indicator registers consistently in the green.
4. When step three above is successful click on the continue button. This will complete saving your microphone volume setting. You may only set the volume of one microphone at a time.

 
10. Enrollment changing - MedSpeak/Radiology V1.4 allows a user to change between existing user enrollments, from the customize screen, without the need to log off of MedSpeak and back on to activate the enrollment change. Once a new enrollment has been selected from the dropdown list on the customize screen the new enrollment selection is now active, and the user will be brought back to the customize window to finish making any changes to their settings.

 
11. Print reports to multiple printers - MedSpeak/Radiology V1.4 gives the user the ability to print a report to multiple printers if so chosen. The option will be configurable at the user level through the Customize window. A checkbox in the Customize window, if checked, indicates that when the Print function is invoked a standard printer dialog box appears from which the user may select a printer. The user must select a (ONE) printer and continue. The report is then printed to the selected printer. The user can invoke the Print function again, on the same report if desired, and choose another printer to which the report is then sent. The printer dialog box is NOT to be speech-enabled since it is an XVT standard printer dialog and not a MedSpeak created printer dialog. If the checkbox is NOT checked in the Customize window and the Print function invoked, the report will be printed to the default Windows NT printer. The default for the Printer checkbox is UNCHECKED. The user ini file entry is named MultiplePrinters with settings YES or NO. The XVT print dialog box does not include the ability to attach headers or footers to the report being printed.

 
12. Pronounce Word Dialog - An entry field has been added to the Pronounce Word dialog called 'Sounds Like". When a new word is being added to the vocabulary, the Pronounce Word dialog appears with this entry field displaying the spelling of the word that is being pronounced and added. To ensure the 'Sounds Like' spelling of the word is the correct sounding pronunciation, the user has the ability to type into the 'Sounds Like' entry field the spelling they wish to pronounce. With this additional ability, the MedSpeak application can better determine the correct word and associated pronunciation that is being added to the system.

 
13. Debug Version - MedSpeak/Radiology V1.4 has the ability to run in 'debug' mode when the following is set in the spchapp.ini file:

• Click  here to download the M/Rv1.4SP file.

 
• Click  here to download the text file associated with the ServicePak file.

 
• Questions??? Click  here to send an E-Mail to IBM MedSpeak/Radiology Technical Support.

1. Ability To Save The Last Sort - The last sort will be stored in each user's profile.  If a user changes their sort display, it will redisplay the last sort the next time the user logs into the MedSpeak system.

2. Three New Fields Available In The Print.Form And Screenheader.Form Files:

3. Better Handling Of Accept & Sign Problems - In rare cases, the application had terminated at the point of accept and sign.

4. Report Editor Problem Viewing Reports - The report list was not always displaying all of the user's reports.

5. Caching/Learning Improvements - correct miss-recognized words by highlighting the incorrect word and typing the entire correct word (not the entire sentence).  The "learning" mechanism will look for short sections of typed text when caching and "correct" the recognition error thereby next time correctly recognizing the dictation.  If more than 10 typed words are seen in a row it is assumed the decision was made to type rather than dictate, in that case, a "correction" to a recognition error does not take place.

6. Additional Debug Logging To Assist In Resolving Spchapp.exe Errors.

7. Enrollment Training Fix For Sites With Updated *.dll Files For Windows NT

• Click  here to download the M/R 1.4.2 PTF "Self-Extracting" file.

 
• Click  here to download the text file associated with the PTF file.

 
• If you do not already have M/Rv14SP installed, click  here to go to the M/Rv14SP information and files.

• The following document was created to provide a fix to the "TBACK" command. There are problems with DB2 trying to write its block size onto certain tape drive units and causing a failure. This modified version of the "TBACK" command eliminates this error by writing the DB2 backup to a file that can then be captured on a full server backup.

 
• The modified DB2 Backup instructions will provide the ability to run one backup tape for your server instead of a separate tape for DB2 and NT backups, respectively.
• The MedSpeak and DB2 files/directories that should be backed up to tape are:

• The \DB2\SQL00001\SQLOGDIR directory.
• The DB2Back directory.
• The \MedSpeak\Radiology\Server\Shrdir directory.
• The \MedSpeak\Speech\Spch_rw\Users directory.

• MedSpeak now offers two types of backup options; On-line and Off-line backups:
• If your site is a 24 x 7 site and cannot allow uninterrupted usage of MedSpeak/Radiology on any of its workstations than an on-line backup is needed.  During this backup DB2 SQL log files are created that will need to be captured during the backup process and are also necessary during the DB2 database restoration phase.

Click  here to download the document describing how to create the modified backup procedure for an on-line backup.

• If your site is able to allow an interruption of M/R usage, during the backup procedure, then an off-line backup might be better suited towards your needs.  The off-line backup does not create any DB2 SQL log files and therefore is slightly faster but the consequence is that no one can use the software while backups are in progress.

Click  here to download the document describing how to create the modified backup procedure for an off-line backup.

• Here is the proper way to test if your current Ensoniq AudioPCI 64 sound card driver is working properly.

1. Move the microphone slider in the Recording properties of NT's volume control while the Ensoniq Mixer is up.
2. You should see the Ensoniq Mixer's microphone slider move with it.
3. If you do not, you do not have the latest driver.

• Install the sound card driver in the order listed below:

1. Uninstall the current sound card driver
2. Re-boot the workstation
3. Install the latest sound card driver
4. Re-boot the workstation

  Click  here to download the latest version of the Ensoniq AudioPCI 64 sound card driver.
  Note:  The file "Ensq.exe" is a "Self-Extracting" file.  Place the file in a temporary directory and type "Ensq.exe".  The file will expand into eight files.  You can then install the latest drivers from this temporary directory.