How it Works
GE
Loading...
Quantitative Sentinel
User manual
164 pgs2.55 Mb2
Table of contents
Loading...

GE Quantitative Sentinel User manual

Download
ServiceManual
AClinicalInformationSystem
QUANTITATIVESENTINEL
REF2002033-023
RevisionA
®
QuantitativeSentinel®ServiceManual
GEMedicalSystemsInformationTechnologies
8200Wes tTowerAvenue
Milwaukee,WI53223USA
Customer Support Department—Americas and Southeast Asia
24-HourEmergencyToll-FreeService
Call1-800-433-2009
Authorized Representative in the European Union
GEMedicalSystemsInformationTechnologiesGmbH
MunzingerStrasse3
D-79111FreiburgimBreisgau
Germany
CAUTION: IntheUnitedStatesofAmerica,FederalLawrestrictsthisdevicetosalebyorontheorderofa
physician.
FirstPrinting:March2003
QuantitativeSentinelandQSareregisteredtrademarks.Allotherproductandbrandnamesaretrademarksorregistered trademarksoftheirrespectivecompanies.
©2003 General Electric Company. All rights reserved.
REF2002033-023 RevisionA
QuantitativeSentinel®ServiceManual
CEMarkingInformation

COMPLIANCE

The Quantitative Sentinel (QS) product bears the CE Mark
indicating its conformity with the provisions of the Council Directive 93/42/EEC concerning medical devices and fulfills the essential requirements of Annex I of this directive.

EXCEPTIONS

Users should be aware of known RF sources, such as radio or TV stations and hand-held or mobile two­way radios, and consider them when installing a medical device or system.
Be aware that adding accessories or components, or modifying the medical device or system may degrade its EMI (electromagnetic interference) characteristics. Consult with qualified personnel regarding changes to the system configuration.
REVISIONHISTORY
The following table summarizes this manual’s revision history by providing the revision label, effective date, QS software version and comments appropriate for each release.
Table of Revision History
Revision Date QSVersion Comments
AMarch2003 6.60.0 InitialRelease
AREF2002033-023
RevisionA
Pageintentionallyleftblank.
REF2002033-023 B RevisionA
QuantitativeSentinel®ServiceManual
Table of Contents
CE MARKING INFORMATION
COMPLIANCE ..................................................................................................................................... A
EXCEPTIONS ...................................................................................................................................... A
REVISION HISTORY .......................................................................................................................... A
PREFACE
INTRODUCTION TO THE QUANTITATIVE SENTINEL (QS) ....................................................xiii
User Interface ...............................................................................................................................xiii
Interface Customization ................................................................................................................xiii
Supported Interfaces .....................................................................................................................xiii
USER BACKGROUND .....................................................................................................................xiii
DISCLAIMERS ..................................................................................................................................xiv
Data Collection .............................................................................................................................xiv
Design Changes ............................................................................................................................ xiv
Patient Care ...................................................................................................................................xiv
References to Persons, Places, and Institutions ............................................................................xiv
Reproduction Rights .....................................................................................................................xiv
SAFETY SUMMARY
WARNINGS, CAUTIONS, AND NOTES ......................................................................................... xv
General Definitions ........................................................................................................................ xv
QS Safety Summary .....................................................................................................................xvi
Potential Electrical/Mechanical/Physical Hazards .................................................................xvi
Internet/Intranet Considerations ............................................................................................xvii
Surveillance/Monitoring Concerns .......................................................................................xvii
Erroneous Data Entry/Calculations ......................................................................................xviii
Security Considerations .........................................................................................................xix
CHAPTER1
QS SYSTEM OVERVIEW
QS DESCRIPTION ................................................................................................................................1
Capabilities ......................................................................................................................................1
Intended Users of the QS .................................................................................................................1
User Environment ............................................................................................................................2
Patient Applicability ........................................................................................................................ 2
HIPAA Conformance ......................................................................................................................2
QS Features ............................................................................................................................................ 2
Manual Patient Data Recording ....................................................................................................... 2
Charts ........................................................................................................................................ 2
Forms ........................................................................................................................................3
Chalkboard ................................................................................................................................3
MAR (Medication Administration Record) .............................................................................. 3
Automated Patient Data Recording ................................................................................................. 3
iREF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
Table of Contents
Hospital Information Systems (HISs) ....................................................................................... 3
Devices ......................................................................................................................................3
Fetal Heart Rate (FHR) Notifications .............................................................................................. 4
Printing and Faxing ......................................................................................................................... 4
Index Calculator .............................................................................................................................. 4
Compute ...........................................................................................................................................4
On-line Help .................................................................................................................................... 4
Security ............................................................................................................................................4
Export ..............................................................................................................................................4
Archive ............................................................................................................................................4
QS Architecture ...................................................................................................................................... 5
User Interface Facilities .........................................................................................................................8
QS Processes .......................................................................................................................................... 9
Archive ............................................................................................................................................9
BRelay .............................................................................................................................................9
CDATS .......................................................................................................................................... 10
CDSS ............................................................................................................................................. 10
HIS .................................................................................................................................................11
LAS ................................................................................................................................................ 11
LOGS ............................................................................................................................................. 12
PDATS ........................................................................................................................................... 12
PDSS .............................................................................................................................................. 13
PFILS .............................................................................................................................................13
PMS ............................................................................................................................................... 14
PtD .................................................................................................................................................14
QPM ............................................................................................................................................... 15
SPP ................................................................................................................................................. 15
System Functions .................................................................................................................................15
Log files .........................................................................................................................................15
Storage Configuration ....................................................................................................................16
Single Server Systems - Windows NT ....................................................................................16
Single Server Systems - Windows 2000 .................................................................................17
Dual Server Systems (Windows NT Only) ............................................................................. 18
File Naming Convention .........................................................................................................19
QS Directory Structure ............................................................................................................20
D:\QS\Archive.................................................................................................................. 20
D:\QS\Archive\Image....................................................................................................... 20
D:\QS\Data ....................................................................................................................... 20
D:\QS\Exe......................................................................................................................... 20
D:\QS\HL7Out ................................................................................................................. 20
D:\QS\Logs....................................................................................................................... 20
D:\QS\MSAccess.............................................................................................................. 20
D:\QS\Pfils ....................................................................................................................... 20
D:\QS\Release\NT............................................................................................................ 20
D:\QS\Site......................................................................................................................... 20
D:\QS\SPP ........................................................................................................................ 21
D:\QS\Tools...................................................................................................................... 21
REF2002033-023 ii RevisionA
QuantitativeSentinel®ServiceManual
Table of Contents
D:\QS\Web ....................................................................................................................... 21
Archive and Restore ...................................................................................................................... 21
The archiving process ............................................................................................................. 21
The archive database ............................................................................................................... 22
Patient file size considerations ................................................................................................ 22
How Archive initializes disks .................................................................................................23
What happens when one of the CD-R drives is not operational .............................................23
CD-R life expectancy ..............................................................................................................23
Other important things to know about Archive ......................................................................23
Files used by Archive .............................................................................................................. 24
In the staging area:............................................................................................................ 24
In the image directory:...................................................................................................... 24
Archive Admin Commands .................................................................................................... 25
QPM Restore ........................................................................................................................... 25
Problems restoring due to CD drive dirty / CD-R media problems ........................................ 26
Printing ..........................................................................................................................................27
Batch printing ......................................................................................................................... 27
Scheduled printing .................................................................................................................. 27
OB Link .........................................................................................................................................28
QSWeb .................................................................................................................................... 29
Internet Information Server (IIS from Microsoft) ................................................................... 30
Log files ..................................................................................................................................30
Strings Files .............................................................................................................................30
OB Link web files ................................................................................................................... 31
Strip chart applet and screen size applet ................................................................................. 31
Browser setup .......................................................................................................................... 32
Certificate installation ...................................................................................................... 32
Internet Explorer 4.01....................................................................................................... 32
Internet Explorer 5.0 and higher....................................................................................... 32
Netscape 4.5 and higher ................................................................................................... 32
Server Startup Process ...................................................................................................................33
Client Startup Process .................................................................................................................... 34
UTILITY PROGRAMS .......................................................................................................................35
CDATDisp ..................................................................................................................................... 35
CDUpdate ...................................................................................................................................... 35
Designer .........................................................................................................................................35
QSCopy ......................................................................................................................................... 36
QSTest ...........................................................................................................................................36
QS TOOLS - VERSION 6.60.0 ........................................................................................................... 36
iii REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
Table of Contents
CHAPTER2
PROCESS CONTROL & STATUS
INTRODUCTION ................................................................................................................................ 43
QS PROCESSES .................................................................................................................................. 44
PROCESS ARGUMENTS ................................................................................................................... 45
Archive Arguments ........................................................................................................................ 45
SET .......................................................................................................................................... 45
SHOW ..................................................................................................................................... 45
BRelay Arguments ........................................................................................................................46
SET .......................................................................................................................................... 46
SHOW ..................................................................................................................................... 46
CDATS Arguments ....................................................................................................................... 47
SET .......................................................................................................................................... 47
SHOW ..................................................................................................................................... 47
CDSS Arguments ..........................................................................................................................47
SET .......................................................................................................................................... 47
SHOW ..................................................................................................................................... 47
HIS-HL7 (Inbound) Arguments ....................................................................................................48
SET .......................................................................................................................................... 48
HIS-HL7O (Outbound) Arguments ............................................................................................... 48
SHOW ..................................................................................................................................... 48
SET .......................................................................................................................................... 48
LAS Arguments ............................................................................................................................. 49
SET .......................................................................................................................................... 49
SHOW ..................................................................................................................................... 49
LOGS Arguments .......................................................................................................................... 49
SET .......................................................................................................................................... 49
SHOW ..................................................................................................................................... 49
PDATS Arguments ........................................................................................................................ 49
SET .......................................................................................................................................... 49
SHOW ..................................................................................................................................... 49
PDSS Arguments ........................................................................................................................... 50
SET .......................................................................................................................................... 50
SHOW ..................................................................................................................................... 50
PFILS Arguments .......................................................................................................................... 51
SET .......................................................................................................................................... 51
SHOW ..................................................................................................................................... 51
PMS Arguments ............................................................................................................................52
SET .......................................................................................................................................... 52
System Modes .................................................................................................................. 52
Per Acquire....................................................................................................................... 52
Per Bed ............................................................................................................................. 53
Beds with Serial Fetal Monitor Acquire........................................................................... 53
Per Bed/Acquire ............................................................................................................... 53
SHOW ..................................................................................................................................... 53
REF2002033-023 iv RevisionA
QuantitativeSentinel®ServiceManual
Table of Contents
PtD Arguments .............................................................................................................................. 54
SET .......................................................................................................................................... 54
QPM Arguments ............................................................................................................................54
CYCLE .................................................................................................................................... 54
SET .......................................................................................................................................... 54
SHOW ..................................................................................................................................... 54
QSConnect Arguments .................................................................................................................. 55
SHOW ..................................................................................................................................... 55
SET .......................................................................................................................................... 55
SPP Arguments ..............................................................................................................................55
SHOW ..................................................................................................................................... 55
SET .......................................................................................................................................... 55
CHAPTER3
NETWORK ARCHITECTURE
OVERVIEW ........................................................................................................................................ 57
FETAL MONITOR COMMUNICATION: DIGI & EQUINOX ........................................................ 57
SERIAL COMMUNICATION: DIGI EQUIPMENT .........................................................................58
Cable Specifications ...................................................................................................................... 59
Copper room-to-concentrator .................................................................................................. 59
Copper concentrator-to-concentrator/concentrator-to-host adapter card ................................ 59
Fiber optic concentrator-to-concentrator/concentrator-to-host adapter card ..........................59
SERIAL COMMUNICATION: EQUINOX EQUIPMENT ............................................................... 59
IP COMMUNICATION: LAN ............................................................................................................60
Cable Specifications ...................................................................................................................... 61
IP COMMUNICATION: WAN ISSUES ............................................................................................ 62
IP COMMUNICATION: NETWORK TRAFFIC ............................................................................... 62
DIALUP ACCESS TO THE QS .......................................................................................................... 63
THE QS AND THE HOSPITAL NETWORK ENVIRONMENT ...................................................... 63
INTERFACES ...................................................................................................................................... 63
UNITY ISSUES ...................................................................................................................................64
NT ISSUES .......................................................................................................................................... 64
vREF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
Table of Contents
CHAPTER4
SOFTWARE CONSIDERATIONS
OVERVIEW ........................................................................................................................................ 67
SOFTWARE INSTALLATION ..........................................................................................................67
Prerequisites ................................................................................................................................... 68
Assumptions ..................................................................................................................................70
Installation Procedure .................................................................................................................... 71
SOFTWARE (VERSION) UPGRADES ............................................................................................. 73
Upgrade Process ............................................................................................................................73
Release Notes .......................................................................................................................... 73
Additional costs ....................................................................................................................... 73
Installation ...............................................................................................................................73
Personnel requirements .................................................................................................... 73
System down-time............................................................................................................ 73
Upgrading sites not under warranty (without a valid SSA) .................................................... 74
Upgrading sites under warranty (with a valid SSA) ............................................................... 74
Upgrade Preparation Checklist ...................................................................................................... 75
CHAPTER5
PREVENTIVE MAINTENANCE
OVERVIEW ........................................................................................................................................ 79
GE RECOMMENDATIONS ............................................................................................................... 79
CHAPTER6
DATA BACKUP
SOURCE OF BACKUP TOOLS .........................................................................................................81
RESPONSIBILITY .............................................................................................................................. 81
IMPORTANT CONSIDERATIONS ................................................................................................... 81
AppendixA
GLOSSARY - NETWORK TERMS
AppendixB
SAMPLE NETWORK DIAGRAMS
Overview ............................................................................................................................................B-1
List of Diagrams ................................................................................................................................. B-1
REF2002033-023 vi RevisionA
QuantitativeSentinel®ServiceManual
Table of Contents
AppendixC
FETAL MONITOR SET-UP
List of Fetal Monitors .........................................................................................................................C-1
Corometrics® 115 .......................................................................................................................C-2
Corometrics® 116 .......................................................................................................................C-4
Corometrics® 118 .......................................................................................................................C-5
Corometrics® 120 Series ............................................................................................................. C-6
Corometrics® 145 .......................................................................................................................C-6
Corometrics® 150 .......................................................................................................................C-6
Corometrics® 151 .......................................................................................................................C-7
Corometrics® 170 Series ............................................................................................................. C-8
Agilent / Hewlett Packard Series 50 (1350, 1351, 1353) ............................................................ C-9
Hewlett Packard 8040 ................................................................................................................ C-10
AppendixD
UNITY PARAMETERS
List of Supported Devices ..................................................................................................................D-1
Allied Health Care Bear 1000 .....................................................................................................D-2
Baxter Vigilance ..........................................................................................................................D-3
Bird VIP .......................................................................................................................................D-4
Datex Capnomac ..........................................................................................................................D-5
Dräger Babylog 8000 ...................................................................................................................D-6
Dräger Cato ..................................................................................................................................D-7
Dräger Evita .................................................................................................................................D-8
Dräger Evita 2 ............................................................................................................................D-10
Dräger Evita 2 Dura ...................................................................................................................D-12
Dräger Evita 4 ............................................................................................................................D-14
Dräger Julian ..............................................................................................................................D-16
Dräger PM8060 .........................................................................................................................D-17
Engstrom Elsa ............................................................................................................................D-18
Hamilton Veolar ........................................................................................................................D-19
Hellige SMU EVO .....................................................................................................................D-20
Nellcor Puritan Bennet Adult Star 950 / 1500 / 2000 ................................................................D-22
Nellcor Puritan Bennet Infant Star ............................................................................................D-23
Nellcor Puritan Bennet Infant Star 500 .....................................................................................D-23
Nellcor Puritan Bennet Infant Star 950 .....................................................................................D-24
Nellcor Puritan Bennet pb7200 .................................................................................................D-25
Sechrist 600APM .......................................................................................................................D-26
Siemens SC 9000 .......................................................................................................................D-27
Servo 300 ...................................................................................................................................D-28
Siemens Servo 900 ....................................................................................................................D-29
vii REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
Pageintentionallyleftblank.
AppendixE
QS & OTHER DOCUMENTS
QS DOCUMENTATION ................................................................................................................... E-1
WINDOWS NT & WINDOWS 2000 ................................................................................................ E-1
NETWORKING ................................................................................................................................. E-1
REF2002033-023 viii RevisionA
QuantitativeSentinel®ServiceManual
ListofFigures
FigureTitle PageNumber
QS Context Diagram.................................................................................................................. 5
Major Patient Data Interactions within the QS ..........................................................................6
Ancillary QS Processes.............................................................................................................. 7
Single Server Disk Configuration - Windows NT ...................................................................16
Single Server Disk Configuration - Windows 2000.................................................................17
Dual Server - Disk Configuration ............................................................................................18
Archive Data Flow ...................................................................................................................21
Printer Configuration for Batch and Scheduled Printing .........................................................27
OB Link Fetal Strip Display ....................................................................................................29
QS Server Startup Process .......................................................................................................33
QS Client Startup Process ........................................................................................................34
Network Commands Dialog.....................................................................................................43
Digi Serial Connections ........................................................................................................... 58
Hubs Versus Switches ..............................................................................................................60
HL7 Solar Lab Access Configuration.................................................................................... B-2
Intensive Care Configuration - Single Unit ...........................................................................B-3
Intensive Care Configuration - Multiple Units ...................................................................... B-4
Surveillance Configuration - Single Unit...............................................................................B-5
Surveillance Configuration with Equinox Concentrator - Multiple Units............................. B-6
Surveillance Configuration - Wide Area Network (WAN) ....................................................B-7
Surveillance Configuration (WAN) - Primary & Remote Sites............................................. B-8
Surveillance Configuration WAN-Ring .................................................................................B-9
Corometrics® 116 Set-up.......................................................................................................C-4
Corometrics® 118 Set-up.......................................................................................................C-5
ix REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
Pageintentionallyleftblank.
REF2002033-023 x RevisionA
QuantitativeSentinel®ServiceManual
ListofTables
TableTile PageNumber
Table of Revision History ............................................................................................A
Drive Letter Assignments - Windows NT ..................................................................17
Drive Letter Assignments - Windows 2000 ...............................................................18
QS Component File Name Examples .........................................................................19
Content of T6600l14.EXE ..........................................................................................36
Network Commands Dialog - Component Descriptions ............................................44
Client Workstation Requirements ...............................................................................68
Server Workstation Requirements ..............................................................................69
Network Requirements ...............................................................................................70
Tools Version Applicability ........................................................................................70
Installation Command Parameters ..............................................................................71
Example Upgrade Preparation Checklist ....................................................................75
Corometrics 115 Dip Switch Settings - Switch SW1 ...............................................C-2
Corometrics 115 Dip Switch Settings - Switch SW2 ...............................................C-2
Corometrics 115 Dip Switch Settings - Switch SW3 ...............................................C-3
Corometrics® 151 RS-232 Port Configuration Settings ..........................................C-7
Corometrics® 170 Series Service Codes ..................................................................C-9
Parametric Data - Allied Health Care Bear 1000 ..................................................... D-2
Parametric Data - Baxter Vigilance ......................................................................... D-3
Parametric Data - Bird VIP ...................................................................................... D-4
Parametric Data - Datex Capnomac ......................................................................... D-5
Parametric Data - Dräger Babylog 8000 .................................................................. D-6
Parametric Data - Dräger Cato ................................................................................. D-7
Parametric Data - Dräger Evita ................................................................................ D-8
Parametric Data - Dräger Evita 2 ........................................................................... D-10
Parametric Data - Dräger Evita 2 Dura .................................................................. D-12
Parametric Data - Dräger Evita 4 ........................................................................... D-14
Parametric Data - Dräger Julian ............................................................................. D-16
Parametric Data - Dräger PM8060 ........................................................................ D-17
Parametric Data - Engstrom Elsa ........................................................................... D-18
Parametric Data - Hamilton Veolar ....................................................................... D-19
Parametric Data - Hellige SMU EVO .................................................................... D-20
Parametric Data - Nellcor Puritan Bennet Adult Star 950 / 1500 / 2000 ............... D-22
xi REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
ListofTables
TableTile PageNumber
Parametric Data - Nellcor Puritan Bennet Infant Star ........................................... D-23
Parametric Data - Nellcor Puritan Bennet Infant Star 500 .................................... D-23
Parametric Data - Nellcor Puritan Bennet Infant Star 950 .................................... D-24
Parametric Data - Nellcor Puritan Bennet pb7200 ................................................ D-25
Parametric Data - Sechrist 600APM ...................................................................... D-26
Parametric Data - Siemens SC 9000 ...................................................................... D-27
Parametric Data - Servo 300 .................................................................................. D-28
Parametric Data - Siemens Servo 900 ................................................................... D-29
REF2002033-023 xii RevisionA
QuantitativeSentinel®ServiceManual

PREFACE

INTRODUCTIONTOTHEQUANTITATIVESENTINEL(QS)
The QS Clinical Information System (CIS) is designed to automate record keeping in medical facilities such as intensive care units (ICUs), operating rooms (ORs), obstetrical/gynecological (OB/GYN) units, and units operating on the general floor. The QS Designer enables individual medical organizations to easily configure their systems to meet specific data management requirements without the assistance of experienced medical programmers. Use of the QS Designer should be limited to the institution’s assigned System Manager(s).
UserInterface
Microsoft’s Windows® operating system provides the user interface for the QS. This interface allows the use of function keys, icons, and menus to facilitate user direction of system operations. Scrollable windows provide access to the various screen displays and user dialogs necessary for data entry, storage, and retrieval. User interaction with the QS may be accomplished through a variety of devices such as keyboards, mice, and trackballs.
InterfaceCustomization
System Managers may customize the operation of the QS to meet the specialized needs of different clinical users. This is accomplished through the definition of Views that exhibit unique display formats, specialized collections of charts and forms, etc. View definition also allows the System Manager to provide specific forms of navigation (toolbars, menus, tab control navigators, and functions keys) through the QS that are specifically tailored to meet the needs of individual user groups. Users who have a wide range of responsibilities may be assigned multiple views; this will allow selection of the view best suited for the clinical environment in which they are functioning at any point in time. Views may be defined for environments such as operatingrooms, intensivecareunits, laboranddeliveryunits, neonatalintensivecareunits, etc. As user experience and expertise grow, you should solicit their inputs about special clinical needs (new or modified charts, forms, function key assignments, etc.) so that you may better refine the operational capabilities of currently defined view(s) and create new ones as the need presents itself.
SupportedInterfaces
The QS employs Microsoft and IBM supported software architectural standards, an IBM-compatible microcomputer platform, and standard off-the-shelf network hardware and software products. Adherence to industry standards allows the QS to easily connect to and acquire data from existing hospital information systems (HIS) and laboratory information systems (LIS).
USERBACKGROUND
The intended users of this manual are facility staff members who have been tasked with maintaining the operation of the QS.
xiii REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
Preface-DISCLAIMERS

DISCLAIMERS

Disclaimers have been stated below to clarify the intent of this manual’s content and the manner of its presentation. These statements address system operational considerations, design changes, reproduction rights, and the use of patient data as defined in the paragraphs that follow.
DataCollection
The QS is not intended to replace the patient information obtained from patient monitoring equipment with which it is interfaced; rather, it should be employed as a supplemental device that allows the clinical staff to enter, store, retrieve, and view data in a more efficient yet flexible manner.
DesignChanges
Due to design changes associated with continuing product improvements, information in this manual is subject to change. GE Medical Systems InformationTechnologies(hereafter referred to as GE) reserves the right to change software design at any time and any such changes could affect the contents of this manual. GE assumes no responsibility for any errors or inconsistencies appearing in this manual that result from product design changes and upgrades.
PatientCare
Operation of the QS should neither circumvent nor take precedence over required patient care, nor should it impede the human intervention of attending nurses, physicians or other medical personnel in a manner that would have a negative impact on patient health.
ReferencestoPersons,Places,andInstitutions
References to persons, places, and institutions used within this manual are solely intended to facilitate user comprehension of the QS’s use and functions. Extreme care has been taken to use fictitious names and related information in the examples and illustrations provided herein. Any similarity of this data to persons either living or dead and to either current or previously existing medical institutions should be regarded as coincidental.
ReproductionRights
No part of this manual may be reproduced, stored in a retrieval system, or transmitted in any form or by any means - electronic, mechanical, photographic, etc. - without the prior written permission of GE. All inquiries regarding this manual and/or the Quantitative Sentinel System should be directed to GE.
REF2002033-023 xiv RevisionA
QuantitativeSentinel®ServiceManual
SAFETYSUMMARY-WARNINGS,CAUTIONS,ANDNOTES
SAFETYSUMMARY
WARNINGS,CAUTIONS,ANDNOTES
Warnings, cautions, and notesappear throughout this manual as preventive instructions designed to (1) ensure the safety of individuals using or in close proximity to the QS, and (2) safeguard the integrity and condition of the equipment and software employed by the system. These preventive instructions are presented and defined below. This manual should be (1) mandatory reading for all QS System Managers, (2) placed in a convenient location to facilitate its use as a reference, and (3) employed as orientation material for prospective QS System Managers. This section of the manual also summarizes documentation symbols found within this manual.
GeneralDefinitions
The significance of warnings, cautionsand notesis generically discussed below. Considerations that generally apply throughout this manual are summarized in a subsequent paragraph.
WARNINGS ...............provide the user with instructions intended to prevent the occurrence of
mishaps that could result in either injury or loss of life. Warni n g s will always precede the instructions that possess the potential for human injury.
CAUTIONS ................ provide the user with instructions intended to prevent the occurrence of
mishaps that could result in damage to system equipment/software. Cau- tionswill always precede the instructions that possess the potential for equipment damage.
NOTES ........................ provide the user with instructions intended to prevent inappropriate
actions that will result in neither human injury nor equipment damage. The cost associated with failure to observe a procedural note will typi­cally be in wasted time and effort. Noteswill always precede the instruc­tions that possess the potential for procedural error.
xv REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
SAFETYSUMMARY-WARNINGS,CAUTIONS,ANDNOTES
QSSafetySummary
Warnings and cautions that are generally applicable to the various configurations of the QS, as exemplified in this manual, are summarized as follows:
PotentialElectrical/Mechanical/PhysicalHazards
WARNINGS
CONDUCTIVE HAZARD – Do not use adapters or make plug modifications to equipment power cords.
ELECTRICAL SHOCK HAZARD – Do not operate equipment when moisture or liquids are present on any equipment surface.
FIRE HAZARD – Do not operate electrical/electronic devices such as computer workstations, power supplies, etc. within enclosed spaces. Sufficient ventilation must be maintained if these devices are to operate properly, realize their advertised service lives, and not overheat or catch fire.
FIRE HAZARD – Adequate cooling of electrical/electronic devices such as computer workstations, power supplies, etc. require unrestricted air flow to operate properly, realize their advertised service lives, and not overheat or catch fire. Cooling vents and fan openings should be periodically inspected for signs of debris buildup (lint, dust, etc.) and cleaned/vacuumed whenever buildup is observed.
EXPLOSIVE HAZARD – Do not operate equipment in the presence of flammable anesthetics or inside an oxygenated environment.
INFECTION HAZARD – Do not omit QS equipment from established cleaning/disinfecting procedures appropriate for the environments at your facility. Failure to do so could expose patients, staff members, etc. to unnecessary risk of infection.
PHYSICAL HAZARD – Do not modify physical placement/connection of QS equipment. Improper stowage could result in physical instability and possible injury to user/patient.
CAUTION
CONDENSATION HAZARD – Do not operate equipment recently subjected to environmental variations in temperature and humidity. The potential for accumulation of internal condensation could result in equipment damage.
REF2002033-023 xvi RevisionA
QuantitativeSentinel®ServiceManual
SAFETYSUMMARY-WARNINGS,CAUTIONS,ANDNOTES
Internet/IntranetConsiderations
WARNING
DATA ACCURACY – Users should always verify clinical data retrieved from (provided by) internet/intranet sites accessed via the QS URL capability. The content/operation of the various displays (e.g. pages) is the responsibility of the authors/owners of the individual internet/intranet sites.
GE neither guarantees nor assumes any responsibility for the content of the displays provided by individual sites or the accuracy of the information that they provide.
Surveillance/MonitoringConcerns
CAUTIONS
DATA INTERPRETATION – Users should be aware of the operational characteristics of QSFetalSurveillanceAlerts (Hi/LoNotifications & Spectra). Users should familiarize themselves with the audio/visual indications associated with the alerts feature employed at their site prior to use – refer to the FHRNotificationsGuidelines or SpectraAlerts- Overview information sheets contained within this manual. Failure to review this material could result in misinterpretation of fetal (maternal) conditions.
MONITOR DIFFERENCES – Users should be aware of fetal monitor characteristics as they are interpreted for display by the QS. In general, thicklinesonthepaperstrip correspond to ‘red’ lines on the QS strip; while, thinlinesonthepaperstripcorrespond to ‘black’ lines on the QS strip. Users at institutions using fetal monitors from different manufacturers should be aware of this QS operational characteristic.
TIME SYNCHRONIZATION – Users and members of the Biomedical Engineering staff should be aware that the time on the monitor must be synchronized with the time on the QS. Time synchronization between all devices and QS workstations (servers and clients) is critical. Anomalies will result if synchronization is not maintained. The user may see anomalies such as:
• Charting irregularities with the recorded time of clinical data entry (modify time).
• Fetal strips that restart when workstation displays are refreshed.
• PDATS (QS patient data server) exhibits storage errors.
• Monitored data is not stored when special procedures (non-invasive bloodpressure and cardiacoutput) are performed.
xvii REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
SAFETYSUMMARY-WARNINGS,CAUTIONS,ANDNOTES
ErroneousDataEntry/Calculations
NOTES
DATA COMPUTATION – The QS may compute data values based upon data entered by the clinical practitioner and the formula provided by the QS System Manager. Failure to ensure (1) accurate data entry and (2) correct formula definition could result in the generation of inaccurate computations.
DATA ENTRY – Be sure that the desired patient is selected before performing data entry via charts, chalkboards, etc. Failure to make the desired patient the focal point of data operations could result in the data being placed into another patient file.
DRUG COMPUTATIONS – Clinical users should ensure that correct data values are entered for the QS Compute function. Failure to comply with this requirement could result in an incorrect recommendation of drug rate/dose.
FILE MERGING – Although the QS patient merge mechanism is a relatively simple process, the clinical user should pay close attention to (1) patient selection and (2) data sources for each of the indicated data items. Failure to comply with this direction could result in an output file containing data from inappropriate sources (patients).
MULTIPLE PATIENTS – Clinical users should be aware that multiple patients can be assigned to the same bed if (1) a patient location dialog box (used for admission, discharge, and transfer functions) is open, and (2) another user or process (such as an ADT interface) makes an assignment to the same bed prior to that dialog box being closed. Failure to observe/correct this situation result in data being placed into the wrong patient file. For this reason, you should verify patient location (via the QS roster display) after a transfer, admission, or discharge. If multiple patients are listed for a bed, you should either (1) relocate the incorrectly placed patient or (2) merge the patient files if the situation resulted from a single patient having been assigned an erroneous ID.
PATIENT IDENTIFICATION – Be sure that the patient who previously occupied a specific bed has been discharged (placed in a unit Hold bed) before recording/monitoring data on the next patient placed in that bed. Failure to conform to this requirement could result in data being placed into the wrong patient file.
TYPOGRAPHICAL ERRORS – Although the QS may be configured to ensure that numeric data (pulse, BP, temperature, etc.) is within a specified range of acceptability, users may make typographical errors when entering data. Failure to verify your manually entered data could result in the storage of incorrect data.
REF2002033-023 xviii RevisionA
SAFETYSUMMARY-WARNINGS,CAUTIONS,ANDNOTES
SecurityConsiderations
SYSTEM SECURITY – The QS provides the capability to define the degree of user access to QS workstations via the use of IDs and passwords. It also allows the assignment of READ/WRITE privileges to determine who may access/record patient data on a per item basis. Failure to properly configure the QS security feature could result in unauthorized personnel gaining entry into the QS and ultimately viewing/recording patient data.
QuantitativeSentinel®ServiceManual
NOTE
xix REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
Pageintentionallyleftblank.
REF2002033-023 xx RevisionA
QuantitativeSentinel®ServiceManual
Chapter1
QSSystemOverview
QSDESCRIPTION
The QS system is a software application that operates on industry standard, off-the-shelf software and computer/network hardware. It is a form of application software commonly referred to as a clinicaldata managementsystem or clinicalinformationsystem.The primary focus of this type of software is to provide a data management tool that allows medical institutions to define electronic charts and forms similar to their paper counterparts, to manually enter or automatically acquire, display, store and retrieve patient and clinical practice information.

Capabilities

The primary or general purpose of the QS is to provide automated patient data entry. It accomplishes this by:
1. Allowing creation and use of electronic charts and forms for entering, storing, retrieving, and viewing patient/facility related data (e.g. charts, forms, graphs, chalkboards, user reference manuals, medication administration records).
2. Interfacing with other hospital information systems and medical devices for select, automatic data acquisition, viewing and storage with the electronic patient record.
3. Providing visual notification of when acquired fetal monitor heart rate values exceed the user defined limits for high and low fetal heart rate and poor signal quality.
4. Providing Spectra Alerts capabilities for fetal monitoring (surveillance).
5. Recording acquired fetal monitor data with patient record.
6. Providing automatic computations of physiological indices.
7. Providing calculations from user defined formulas.
8. Providing the ability to record, with the patient record, fluid input and output information that is defined by the user.
9. Providing the ability to export patient data to a relational database for research, reporting and quality assurance purposes.
10. Providing the ability to archive files to a secondary or a tertiary storage medium.
11. Providing the ability to print.
IntendedUsersoftheQS
Intended users nurses, nurse managers, physicians as well as other licensed care providers and trained/ site authorized personnel with system configuration and maintenance responsibilities
1REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSFeatures
UserEnvironment
The QS is intended for use in a hospital or other clinical setting.
PatientApplicability
Access to the patient population is restricted to only those patients within units configured for use with the QS.
Users should note that:
• The QS is not connected directly to any patient;
• The QS is not intended to replace the patient information obtained from patient monitoring equipment with which it is interfaced.
• Use of the QS should not circumvent or take precedence over required patient care.
HIPAAConformance
GE Medical Systems is aware that complying with the Health Insurance Portability and Accessibility Act (HIPAA) is a top priority as you work to meet transaction, security and privacy regulations. Because these new regulations are an important step forward in protecting patient’s privacy and improving efficiency within the healthcare industry, GE is actively engaged in providing information to help you identify and resolve many of the patient care and business issues you may face as you implement actions to comply with HIPAA.
You are encouraged to access the Internet URL listed below for the most recent information about our commitment to HIPAA:
http://www.gemedicalsystems.com/it_solutions/hipaa/statement.html
QSFEATURES
The following paragraphs describe available QS features. Please note that some features are optional and only available if specifically purchased.
ManualPatientDataRecording
User will generally enter data via electronic charts, forms, and/or chalkboards using a computer keyboard. Although default charts, chalkboards and forms are provided for the QS, the QS Designer tool provides appropriately trained site personnel to create their own or modify duplicates of the default items to better suit the needs and requirements of their specific facility.
Clinically-related charts and forms may be combined into an appropriately labeled display group to allow users to access the complete complement of charts suitable for the clinical tasks for which they are responsible.
Charts
An electronic version of the traditional paper charts that clinicians once used to record patient information. QS charts appear on the computer workstation display monitor and generally take the form of tabular charts and flowsheets. Generally used to record recurrent data such as temperature, blood pressure, etc., QS charts provide the maximum amount of patient information within a given display.
REF2002033-023 2 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSFeatures
Forms
Forms are generally used to record data that does not vary with time. Demographic information such as patient name, sex, date of birth, etc. is well suited for collection/display by QS forms.
Chalkboard
Similar to the white-boards used within individual hospital units to display patient (bed) status, attending physician, lab results and other hospital defined information. The QS chalkboard offers the advantage of being periodically updated with the latest data within the patient record.
MAR(MedicationAdministrationRecord)
The MAR allows transcription of medication and fluid orders into the QS using dedicated displays and predefined order templates. Currently, there are four displays associated with the MAR - a MAR display, an I&O Summary display, an Interventions display, and an Order Summary display.
AutomatedPatientDataRecording
Patient data may be automatically acquired from other hospital information systems and/or devices that are interfaced with the QS system. The acquired data is automatically entered and saved with the appropriate patient file(s) and may be subsequently retrieved for viewing within QS charts, forms and chalkboards. Automated data recording combined with manual data entry allows the QS to maintain a comprehensive patient record.
HospitalInformationSystems(HISs)
Automated information transfer (receipt and transmission) is possible if the QS is networked with laboratory, ADT (admit, discharge and transfer), or other information systems. User specified data is acquired from the respective system(s) and is generally unidirectional in that it travels from the HIS system to the QS database. In some configurations, equipped with the HL7 Outbound feature and/or Spacelabs Ultraview Gateway, the QS will serve as either the source of information or a request for information. The QS interface conforms to the HL7 standard - an application level specification for electronic data exchange in healthcare environments.
Devices
The QS is able to acquire data from physiologic monitors and bedside devices equipped with the ability to send data to another system (e.g. via RS-232 connection). Data flow is essentially unidirectional from the device to the QS (except for configurations making use of the Lab Access Server or Unity Time Synchronization). The QS provides no controls to the interfaced monitor or device. Device interfaces are consistent with the data transmission protocol established by the device manufacturer. These protocols are governed by industry standards for data transmission. The acquired data is in the form of parametric data (e.g. blood pressure values) or waveform data. Acquired data recorded within the electronic patient record is available for historical review as well as real-time surveillance capability (fetal monitor waveform data only).
3REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSFeatures
FetalHeartRate(FHR)Notifications
Sites may choose to use either of two available forms of fetal surveillance.
One, FHR Notifications provides both visual and audible indications that a monitored fetal heart rate (FHR) is either above (high) or below (low) site/user defined limits or missing (poor signal quality). These indicators are based upon parameters acquired directly from the interfaced monitor.
The other, Spectra Alerts analyzes FHR and uterine activity (UA) using a set of sophisticated internal algorithms to determine the type and level of alert appropriate for the current fetal state. When appropriate, the QS will generate both visual and audible alerts appropriate for the evaluated fetal state.
PrintingandFaxing
Patient information (e.g. tabular charts, flowsheets and forms) as well as system configuration data (used to define the QS operation as well as item, chart, and form definitions) may be printed either on receipt of a user initiated demand or in accordance with a predefined printing schedule. The printed output may be sent to any properly printer or fax machine (optional) configured to work with the QS.
IndexCalculator
The index calculator permits users to enter formulas and perform mathematical and scientific calculations.

Compute

Compute consists of preset formulas that permit the user to perform nutrition, and drug related calculations. The formulas are based on known, published formulas.
On-lineHelp
On-line help allows users to access information about a particular QS operation or feature. This is similar to the Help feature in common software applications like Microsoft Word.

Security

Password, login requirements, validation requirements and assigned service categories are defined by the site's System Manager(s).

Export

This feature permits the export of ASCII formatted patient data into a relational database (MS Access) for quality assurance, reporting and research purposes. Operation of the relational database is separate from the QS system.

Archive

Archive permits patient data (files) to be permanently saved to an alternative storage medium (currently CD-R).
REF2002033-023 4 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSArchitecture
QSARCHITECTURE
Figure 1 shows the QS in the context of a typical hospital system. Healthcare providers interact with the user interface to review and modify patient data and system configuration data. ADT, Lab, and bedside physiological monitors send data to the QS which incorporates it into the electronic patient data record. OB Link is a web-based solution to deliver and display fetal trace data and other patient data to remote client web browsers through the Windows Internet Information Server (IIS).
QSUsers
(ClinicalStaff)
HealthInformationSystems
(ADT/ClinicalData)
LabSystems
MATERNAL/FETALMONIT O R
Bedside(Physiological)
Monitors
QS
ClinicalInformationSystem
SD
TFT450
ArchiveCD-R
Birthlogs
&
DataReports
Printer
Fax
ZERO
SILENCE
GRAPH
DISPLAY
NBP
POWER
ALL
ALARM
GO/STO P
ON/OFF
GO/STOP
SOLAR8000
m
PDUTXHWWH
OBLinkWorkstation
SolarLabAccess
(RemoteLocation)
Figure 1: QS Context Diagram
5REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSArchitecture
The Solar Lab Access (SLA) interface allows for laboratory results to be sent to GEMS Solar 8000 or Dash 3000 monitors on the Unity network for display. Patient data can be stored on long-term storage media for future retrieval, and may be exported to a third party database for cross-patient analysis. Patient and system configuration data can be sent to printers either on demand or through performance of scheduled print jobs.
Figure 2 shows the major patient data interactions in the QS. Patient data can be charted or reviewed via the primary user interface process, the QS Presentation Manager (QPM). QPM can present patient data in different formats. The Fetal Monitoring Surveillance (FMS) displays fetal wave data and allows users to annotate that data. The Chart interface presents patient data in a tabular chart. The Forms interface presents data in a graphical format. The QS Chalkboard (QCB) interface is an electronic version of chalkboards often found in hospitals at unit central stations, displaying site defined patient data for each unit bed. The Chalkboard Data Services Server (CDSS) manages data that can be accessed via the chalkboard. The Medication Administration Record (MAR) provides the ability to order and chart medications, intake and output fluids.Patient data can also be received from external systems by the system interface process for the Hospital Information System (HIS Inbound) and Patient Monitoring System (PMS).
ADT/Lab Systems
Charting
Systems
Solar
Monitors
Monitors
Web
Browsers
SYSTEM
INTERFACES
HIS
Inbound/
Outbound
LAS
PMS
QSWEB
Internet Info rmation Server(IIS)
Patient
Files
FMS&
Patient
DataCache
PDATS
FMS Charts Forms MAR QCB
QSWeb
PMS
PFILS
CDATS
CDSS
QPM
Configuration
Data
QSServer/Tools
Processes
Designer
Roster
QPM
Queriesabout
patientsorgate
status
PDSS
QS
Processes
QPM& HIS
(ADT)
CCOW
Context
Manager
Se ntillion
Contextor
3rdParty
Ap plications
Figure 2: Major Patient Data Interactions within the QS
REF2002033-023 6 RevisionA
CCOW
UserIn terfa ce
USERS
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSArchitecture
Patient data can be sent to external systems via:
1. The QS Web server (OB Link\QSWeb) - allows fetal monitor data and other charted patient data to be sent via remote access, intranet or internet for display in a secure web browser on QS or non-QS workstations. The browser interface is read-only.
2. The Lab Access Server (LAS) - makes lab data available to Solar 8000 monitors.
3. The HIS Outbound Interface - sends configurable messages containing patient data either automatically or by user request using the HL7 standard.
Once data has been received by one of the interfaces, it is sent to a Patient File (PFIL) server for storage in the file being managed for that patient. Most data is also cached in memory for quick access by a Patient Data (PDAT) server.
The PDSS process keeps track of and manages the storage of patient data in memory and on the server's disk drive.
CDATS provides configuration data to all QS processes
Figure 3 depicts the ancillary QS processes which are vital to the operation of the QS, but which are not primarily responsible for the receipt and management of patient data. The centralized logging server (LOGS) writes system status and error messages to log files to assist in the maintenance of the QS system. The Scheduled Print Program (SPP) supports the printing of patient and configuration data via a scheduled batch job.
QS
Processes
PDATS,
PFILS,&
QPM
Patient
Files
HIS,
PDATS&
PDSS
LOGS
SPP
Archive
PtD
StorageMedia
Figure 3: Ancillary QS Processes
LogFiles
Printers
LongTerm
3rdParty Relational Database
7REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-UserInterfaceFacilities
The Archive server stores data from patient files to long term storage media. The Patient Data Daemon (PtD) supports on demand or scheduled requests to automatically record data, transfer patients, export patient data, backup patient files, and purge patients from the QS.
A more detailed description of the various QS processes follows in the next chapter.
SPP (Scheduled Print Program) supports scheduled print jobs. The schedules are entered via the QPM user interface, and are stored in the configuration data. SPP can be configured for up to 128 print jobs for different days of the week and starting times. Print requests are made via the QPM user interface utilizing standard windows print queues.
PtD (Patient Data Daemon) supports on demand or scheduled requests to automatically record data, transfer patients, export patient data, backup patient files, and purge patients from the QS. PtD jobs are scheduled using the QPM user interface.
USERINTERFACEFACILITIES
QPM (QMI Presentation Manager) provides the major user interface for the QS. QPM interfaces with PDATS & PMS to support the reviewing or recording of patient data. QPM interfaces to PDSS to support ADT services. QPM may be run on any QS workstation, but is not usually run on the same machine as the critical QS servers in order to improve performance. QPM can present data in five formats. These formats are described in the following paragraphs.
The Chart interface presents patient data in a flowsheet format which mirrors the traditional paper model in content and layout. The characteristics of QS charts are defined in the configuration data, and can be created and modified by the QS user.
The Forms interface is an alternative to the chart interface, providing a more graphical presentation of patient data. QS customers can create and modify forms using the Forms Designer.
The Fetal Monitoring Surveillance (FMS) format displays fetal monitor strip chart data and allows users to annotate the acquired data.
QCB (QS ChalkBoard) provides a bed-centric view of patients in the QS, unlike the Charts and Forms formats which provide a patient-centric view. QCB displays data for multiple patients simultaneously, updating dynamically as data changes without requiring the user to take any action to request a refresh. In normal operations QCB relies on CDSS to provide the information to be displayed on the chalkboard. If CDSS is not operational, QCB can receive the information it needs directly from PDATS and PDSS. For besides displaying patient data, QCB also supports modification of patient data and limited ADT services. QS customers can create their own chalkboard templates using the QCB Designer.
MAR (Medication Administration Record) provides the ability to order, record and view medication, infusion, intake and output fluid, and intervention orders for a patient. There is a mechanism to pre­configure the orders using the Designer. QPM allows the clinician to view, modify and activate orders for a patient. The chart interface for displaying medications (MAR) and fluids (I&O) allows for in-cell editing. MAR has an additional display (Order Summary) which displays all orders for a given patient.
The Windows version of QPM provides a dialog which allows the user to retrieve archived patient data. Search criteria can be used to locate a patient for restoration into the QS. The search criteria include patient id, patient name, CD volume name, date archived, and three optional user defined items. Data can be restored from CD placed in the CD-ROM drive of the workstation running QPM, or from the staging area on the server if the patient file has not yet been written to CD. The patient will be restored into a hold bed of the configured restore unit unless the user chooses some other unit prior to initiating the restore. If a patient id is currently being served in the QS, the user can specify an alternate patient id for the patient to be restored.
REF2002033-023 8 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSProcesses
QSPROCESSES
Operation of the QS is enhanced/augmented through the use of ‘mini-programs’ that perform specific activities. Each of these processes is identified and described by the following paragraphs.

Archive

Archive stores data from patient files to long term storage media, currently CD-R. Data can be archived periodically or on demand. Archive maintains a database with information about every successful patient archive, which is used to support the subsequent retrieval of data from the long-term storage media.
The Archive database contains the following of information:
•Patient ID
•Patient Name
• Uncompressed Patient File Name
• Compressed Patient File Name
• Compressed Patient File Size
• Volume Name of the Compact Disk
• Checksum for the Patient File
• Last Value of up to Three User-Configurable Items
Archived patient files can be restored from CD-R on any QS workstation with a CD drive. The restore interface is available in the QPM program.
Before archiving the patient data, the patient files are compressed. The compressed file is written to two CD-R discs. Both discs get the same volume name.
Data files: The Archive and Restore functions use an Access 2000 database to store information about patients that have been archived. The path to this database is note that in NT configurations, the drive specification remains
Log files: The log files for Archive can be found in of detail files -
ArchAdmi.xx and Archive.xx. ArchAdmi.xx details the administrative activities affecting
\qs\logs\archive. These files consist of two types
the process (e.g. starting, stopping, parameter changes) while
D:\qs\archive\NTArchive. Please
E:.
Archive.xx details the activities and/or
errors relating to the Archive process.

BRelay

The BRelay (Broadcast Relay) process is used to allow broadcasts to span the network. The QS system uses broadcasts and multicasts to relay information to the clients. It is common practice for routers and switches to filter out broadcasts. If a client is on a segment separated from the server via a router that filters out broadcasts, it will not work without the aid of Brelay. You should have one BRelay per segment, per IP sub-network.
Data files: none
Log files: The logs for BRelay can be found in
which details process information.
9REF2002033-023
\qs\logs\brelay. These files consist of a BRelay log
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSProcesses

CDATS

The CDATS (Configuration Data Server) program runs only once in a QS environment. This program is responsible for managing and distributing the configuration information to and from other QS processes such as PDSS, PFILS, CDSS, LOGS, etc.
CDATS contains the data dictionary that describes the patient data.
This configuration information is used to tailor the QS to the needs of a hospital site. Almost every QS process reads configuration data at startup, therefore CDATS is a critical part of the QS.
Configuration data is modified via the Designer program.
During system upgrades, the standalone CDUpdate utility is used to modify the configuration data to conform to the format used by the new QS version. CDATS runs a verification once a day.
Data files: The configuration files (site tables) are found in the
\qs\site directory on the machine
running the CDATS process.
Log files: The CDATS log files are found in
•
CDATS.xx files (where xx is a number from 00 to 09) that detail the process function or errors
•
CDATAdmi.xx files that detail the administrative activities
•
CDATUpda.xx files which detail modifications to the configuration
•
CDATVeri.x files which contain information about the verification process
\qs\logs\cdats. These files consist of the following:

CDSS

The CDSS (Chalkboard Data Services Server) program can only be running on one workstation or server in a QS environment. This program is responsible for maintaining information about patient data items to appear on the electronic chalkboard and 'posting' those items to the chalkboard. This program usually runs on the primary QS server along with PDSS and LOGS.
CDSS keeps a cache of data for every patient in a non-hold bed, plus every patient in a hold bed selected in QPM. It only caches data items that have been specified on the As data is charted, CDSS updates its cache and sends that chalkboard data onto the chalkboards. When the relationship between a patient and a bed changes CDSS receives that information from PDSS and passes it onto the chalkboards. CDSS also has the capability of providing data to the chalkboard when the chalkboard asks for it, and for correcting the CDSS cache and its clients chalkboards during a verify. There is only one CDSS in a given QS system. If the CDSS process isn't functioning, PDATS and PDSS send information directly to the chalkboard. As data is updated it will always be displayed on the chalkboard, but if CDSS is unavailable, any initial data values will be displayed as chalkboard until CDSS becomes available and executes its verify pass.
{{DS_PATIENTDATA}} chart.
??? on the
This process (like PDSS) runs a verification process every four hours. The times for this verification vary from site to site because the base-hour varies. You can locate the base-hour and the next scheduled verify by performing a process show.
Data files: The CDSS data files are found in
cdsrcvr.v0 - primary and cdsrcvr.b0 - backup) used to regenerate the roster when the system or the
(
\qs\data. These files consist of two 'recovery' files
process is restarted.
Log files: The log files are found in
\qs\logs\cdss. These files consist of a CDSS - the detail process
logs, VERIFY - the CDSS verify detail logs, and ADMIN - the admin thread log for this process.
REF2002033-023 10 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSProcesses
HIS
HIS (Hospital Information System) controls the interchange of data between the QS and Hospital Information Systems. Acquisition of data from external sources is handled by the HIS Inbound Interface. Distribution of patient data to external sinks is handled by the HIS Outbound Interface.
The HIS Inbound Interface receives messages from external computer systems which contain ADT (admit, discharge, transfer) information, or lab results. The inbound interface will accept messages formatted using the HL7 Standard (versions 2.1 and 2.2) as well as custom, non-HL7 message protocols. The messages are parsed and stored in the patient data record. The interface to the external system may be RS-232 or TCPIP.
The HIS Outbound Interface generates messages containing patient data and forwards them to external systems via a network connection using the TCP/IP protocol suite. Message content is configurable using message template charts. Generation of outbound messages can be triggered automatically when a patient is transferred to a 'Hold' bed in a unit that has been specified in a configurable list or manually at the users request. Outbound messages are formatted using either version 2.1 or 2.2 of the HL7 standard.
In general, each type of HIS interface, inbound or outbound, must be run as a separate HIS process on a separate workstation. If no HIS interfaces are established, then HIS is not executed.
Data files: none
Log files: This program's log files can be found in
\qs\logs\his_xxx (where xxx is the extension for
the type of system interface, usually HL7). These files consist of the following detail:
HIS_xxx log which details the HIS process
•
•
<acquire> log which details specifics about the acquire
•
<acquire> data log which details data tracing for the specific acquire
<acquire> represents the name specified in the Manage Configuration - System - Acquire definition
(i.e. if the acquire name is ADT, the logs will be called
ADT.00 - ADT.10).
LAS
LAS (Lab Access Server) provides lab data to Solar monitors on the Unity network. Only one LAS process is run per Unity LAN.
LAS keeps a list of registered monitors, their associated TCP/IP address and port, along with what patient was associated with the monitor the last time the monitor registered with LAS. LAS receives requests from Solar monitors for registration, ADT Data, Lab Directory, Lab Data, and Microbiology/ Blood Bank data. It also receives notifications from HIS about new lab data for a specified patient.
Data files: none
Log files: The logs for LAS can be found in
process information and a log for the defined acquire. The log file will consist of an acquire name with an extension of
.00 - .10.
\qs\logs\las. They consist of a LAS log which details
11 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSProcesses

LOGS

The LOGS program can only be running on one workstation in a QS environment. This program is responsible for logging information from the other processes running. It is usually found on the primary server (QSServer) running with PDSS and CDSS but is not limited to such. If the LOGS process is not alive or reachable, then the message will be written to
CAUTION
Log files should never be opened (with editors such as Notepad, Word, etc.). If it is necessary to inspect the content of any log file, users should copy the file(s) of interest and rename it (them). The duplicated file(s) may then be opened without risk. Failure to comply with this caution could cause the associated processes (and the QS) to malfunction.
NOTE
All log files in a QS environment follow the same name extension convention. Files with the
.10 will always indicate the oldest files. The logs are always in a
subdirectory of
\qs\logs on the primary QS drive on the machine that runs
the program.
.00 extension will always be the most recent and
qserror.00 on the local hard disk.
Data files: none
Log files: This program's log files can be found in the
to eleven files named
QSLOG.00 - QSLOG.10.
\qs\logs\logs subdirectory. There may be up

PDATS

The PDATS (Patient Data Server) program runs multiple times in a QS environment. It is usually found on all client machines; mobiles and print servers are avoided if possible. This program is the patient cache server. When a patient is being accessed, for either reading or writing, the patient data is loaded into a cache (RAM) on a workstation for faster access. Each patient is handled by a PDATS slot, which is essentially a thread that provides service for that patient.
PDATS is the primary way that most QS programs query and store patient data. When PDATS receives data to be stored, it gives that data to PFILS so that the data will be stored in the file. Likewise, when a PDATS slot is being loaded, it requests patient data from PFILS.
PDATS also handles computed items and is responsible for item classes as they relate to results reporting. There may be many PDATS processes running in a QS system, although only one PDATS process should be on any given workstation. If a PDATS dies or is unavailable, PDSS will cause a different PDATS workstation to provide service for the patient(s) to be cached.
Data files: none
Log files: This program's log files can be found in
PDATS log. This log contains all cache-slot 'load' and 'unload' transactions.
\qs\logs\pdats. These files consist of only a
REF2002033-023 12 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSProcesses

PDSS

The PDSS (Patient Data Services Server) program can only be running on one workstation in a QS environment. This program is responsible for maintaining information about resource availability on the various workstations and patient data resources. As an example, this program keeps track of the number of PDATS slots available, in use, and who is loaded in these slots, as well as the patient file storage location.
PDSS accepts inputs from HIS and QPM to admit patients to the QS, transfer them to different units and rooms, and other high-level management functions. PDSS provides demographic information to QS processes requesting directory information. PDSS also manages the gate status, which inhibits most QS processes from starting until the essential QS processes are ready to provide service.
This program usually runs on the primary QS server along with CDSS and LOGS. This program runs a verification process every few hours. The times for this verification vary from site to site because the basehour varies. You can locate the basehour and the next scheduled verify by performing a process show.
If PDSS is not active, then system services are degraded. Users cannot log in and new QS processes cannot start up. However, processes that already know which PDATS/PFILS are providing service for their patients can continue to function.
Data files: This program's data files are found in of two recovery files (
pdsrcvr.v4 - primary and pdsrcvr.b4 - backup), used to regenerate the roster
\qs\data for versions 4.05 and above. They consist
when the system or the process is restarted.
Log files: The log files are found in
VERIFY - the pdss verify detail logs and ADMIN - the admin thread log for this process.
logs,
\qs\logs\pdss. These files consist of a PDSS - the detail process

PFILS

The PFILS (Patient File Server) program can be running multiple times in a QS environment. This program is responsible for the management of the files in which the patient files are stored. PFILS performs all read and write transactions to these files, as well as file manipulation (renaming, purging, etc.).
Data for each patient is stored in a separate file. There must always be a primary copy of this file, which has the extension of copy of the patient file will be maintained with the extension of which checks the validity of patient files. There must be at least one PFILS in a QS system. There may be more than one PFILS, but if so, a given patient will be served by only one of those servers. If PFILS is unavailable, then patient data cannot be saved.
Data files: This program's data files are found in process. The drive may vary but is usually data files and have the naming convention of for secondary files.
.v01. If the system is configured for redundant PFILS, then a secondary
.s01. PFILS has a verify capability
\qs\pfils on the machine running the PFILS
D:\ (E:\ on NT systems). The data files are the actual patient
<patient-id>.v01 for primary files and <patient-id>.s01
Log files: This program's log files are found in
\qs\logs\pfils. These files consist of only a PFILS
log. This log contains all information about patient file manipulation and verification.
13 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSProcesses
PMS
The PMS (Patient Monitoring Subsystem) program may be run multiple times in a QS environment. This program is responsible for acquiring monitor data (adult or fetal), and storing it in the patient's file and/or transmitting it for display on the workstations. PMS can auto-detect per-port-fetal-monitors from Corometrics (115, 116, 118, 120 series, 145, 150, 151, 155, 170 series and 556), Hewlett Packard* (135x, 8040A and 8041A), Oxford** (Sonicaid Team and Team Duo), AMS** (FetaScan 1400 and 1500) and Kranzbühler** (FetaCare).
PMS maintains a 30-minute cache of parameter data, a 50-minute cache of fetal data, and broadcasts fetal monitor data to all requesting clients. PMS receives annotations from FMS and provides data for monitor charts to QPM. If notification is enabled, PMS will analyze fetal heart rate (FHR) data, notify QPM/FMS of Hi, Lo, and Penlift states, and receive notification acknowledgment from FMS. PMS also supports Spectra Alerts. PMS may run on more than one server or workstation. The PMS process starts several threads for each configured acquire while the acquire monitors data that is to be supported by PMS on assigned workstation. If no acquires have been configured for a given PMS on a given workstation, PMS will terminate execution.
Hewlett Packard’s medical division is now called Agilent Technologies.
*
**Support for Oxford Sonicaid, AMS and Kranzbühler monitors from QS version 5.05.
Data files: The NOTIFICATION_SETTINGS.DAT file is found in \qs\data on the workstation
running this process. This file contains the Fetal Notification settings for each bed in a QS environment. It does not apply in an ICU environment.
Log files: PMS log files can be found in
•
PMS log which details the PMS process
•
<acquire> log which details specifics about the acquire task
•
<acquire>-data log which details data tracing for this specific acquire task
•
<acquire>-trace log which contains the tracing files for the acquire task.
The
<acquire> represents the name specifies in the Manage Configuration - System - Acquire
definition (e.g. if the acquire name is SERIALFM, the logs will be called
SERIALFM.10).
\qs\logs\pms. These files consist of the following:
SERIALFM.00 -
PtD
The PtD (Patient Daemon) process is responsible for on demand or scheduled requests to automatically record data, transfer patients, export patient data, backup patient files and purge patients from a QS system. This process can be found running multiple times in a QS environment.
Data files: The data files for PtD can be found in keep track of which patients, charts and jobs have completed.
Log files: The log files for PtD are found in details the PtD process and a detail log for each PtD job defined on the system. These log files have the same name as the job definition - up to 32 characters and with detail specifics about the activity of each configured, enabled PtD job.
\qs\logs\pdss. They consist of several .dat files that
\qs\logs\ptd. These files consist of a PtD log which
.00 - .10 extensions. They
REF2002033-023 14 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
QPM
QS Program Manager (QPM) is the user interface program and is used to interact with the system. This program runs on all interactive workstations being used for patient data retrieval or review.
Data files: none

Log files: none

SPP
SPP (Scheduled Print Process) runs on any workstation in a QS environment which manages a printer that a site wishes to run scheduled print jobs automatically from the QS. From QS version 5.05.0, SPP supports scheduled batch printing i.e. printing a collection of documents at a specified time or interval.
Data files: The data files consist of three
.dat files found in \qs\spp on the workstation running the
SPP process. These files keep track of which patients, charts and jobs have completed and aid in the recovery process should SPP fail.
Log files: The log files for SPP are found in
\qs\logs\spp. These files consist only of the SPP log
which details information about the SPP schedule.
SYSTEMFUNCTIONS
This section of the manual consists of additional information about several parts/functions of the QS system. This information is intended to provide a better understanding of the QS. Information is grouped by function, rather than by QS process.
Logfiles
All processes in the QS system maintain their own log on the local harddrive. The log messages are written to a log file in extensions
00 - 10. The file with extension .00 is the newest.
When the line count of the current log file exceeds it's maximum (2000 lines by default), the log file with extension
.10 is deleted, the existing logs renumbered with the next higher number, and a new log
file with the extension admin command.
Messages have the following format:
\qs\logs\<process name>. A set of up to 11 log files are maintained, with
.00 is started. This so called cycling of the log file can also be requested with an
10/11 10:08:08 QSClient1:QPM > My log message date time workstation:process>log message
If the LOGS process is not available, a process will attempt to write locally to \qs\logs\qserror.00.
When a new process is started, it will cause the contents of is running and
If a process can not log to its current log file (
qserror.00 is not too big.
.00), a log file with the extension .99 will be created. The
qserror.00 to be added into qslog.00 if LOGS
existence of this log file will block further logging by the process. Therefore, log files with the extension
The LOGS process additionally maintains the central log file (
.99 should be deleted. While the .99 file exists, the process will log to QSError.00.
qslog.xx) and the user action log (ua.xx).
The central log file contains important messages from various QS processes.
The user action log logs user activity on the system like selecting a patient, displaying a form, etc.
15 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
Disk2
QSSystemOverview-SystemFunctions
Abnormal log messages can often be recognized by:
• exclamation marks in the message
• the words: unexpected, error, time-out
• the same message repeated over and over in the logs
When a process is terminated abnormally, it writes error information to
errorinf.$$$. Errorinf files with
less than 1024 characters will be written to the central log file, otherwise a message is logged that the error information was too large to log.
StorageConfiguration
In every QS system, patient data is stored in duplicate on the server's hard-drives. Optionally, one copy of the data may be written to a second server (backup server) instead of the primary server's second disk(set).
SingleServerSystems-WindowsNT
A common disk configuration for the primary QS server in a Windows NT configuration is shown in Figure 4.
The first partition set consists of 3 partitions implemented on a RAID 5 array of 3 identical physical disks.
With the RAID 5 array, 3 disks with n GB storage capacity yield a total usable disk space of 2n GB. This RAID array is implemented at the hardware level, not the Windows NT level, by using an array controller.
Disk 1 holds the system partition holds the QS software and the PFILS partition database files.
C: with the Windows NT system files, the QS partition D: which
E: that holds the QS patient files and the MS Access
QSServer
C:SYSTEM
D:QS
E:PFILS
Disk1
(manually)
Pfils
F:
G:
Figure 4: Single Server Disk Configuration - Windows NT
The second part of the storage space consists of a single disk with at least 2n GB storage capacity. This disk holds copies of the QS and the PFILS partitions in the RAID5 array as partitions
G:, respectively. The QS program files and configuration data is copied to the F: partition during
manufacturing of the system.
Maintaining the copy of the patient files is the responsibility of the PFILS process. As soon as an item of data is entered and the user moves to the next input field on a form or chart, PFILS writes the data to both copies of the patient file.
F: and
REF2002033-023 16 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
The Windows NT drive letter assignments are summarized in Table 1.:
Table 1: Drive Letter Assignments - Windows NT
DriveLetter Purpose FileSystem
AFloppydisk FAT
CBootandSystempartition NTFS
DQSpartition NTFS
E Patientfiles(PFILS)partition NTFS
FQSBackuppartition NTFS
GPatientfilesbackuppartition(PFIL-
BACK)
H CD-drive CDFS
NTFS
SingleServerSystems-Windows2000
A common disk configuration for the primary QS server in a Windows 2000 configuration is shown in Figure 5.
QSServer
C:SYSTEM
D:QS
PFILS
Figure 5: Single Server Disk Configuration - Windows 2000
The first partition set consists of 2 partitions implemented on a RAID 5 array of 2 identical physical disks.
With the RAID 5 array, 2 disks with n GB storage capacity yield a total usable disk space of 2n GB. This RAID array is implemented at the hardware level, not the Windows level, by using an array controller.
The single disk 1 holds the system partition partition
D: holds the QS software and PFILS (that holds the QS patient files and the MS Access
C: with the Windows 2000 system files. The QS
database files).
17 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
The Windows NT drive letter assignments are summarized in Table 2.:
Table 2: Drive Letter Assignments - Windows 2000
DriveLetter Purpose FileSystem
AFloppydisk FAT
CBootandSystempartition NTFS
DQSpartition
Patientfiles(PFILS)partition
E CD-drive NTFS
NTFS
DualServerSystems(WindowsNTOnly)
In systems with a backup server, Disk 1 of the backup server acts as the receiver for the data from the primary server's Figure 6. For both servers, the two
The data on the QS partition ( the copy is configurable and is by default once every 60 minutes.
As in the single-server system, maintaining the copy of the patient files is the responsibility of the PFILS process. As soon as an item of data is entered and the user moves to the next input field on a form or chart, PFILS writes the data to both copies of the patient file.
QSServer
C:SYSTEM
D:QS
E:PFILS
D: and E: partitions. The configuration for this type of system is depicted in
C: partitions are identical.
D:) is periodically copied by the QSCopy program. The frequency of
QSCOPY
PFILS
F:
G:
BKServer
C:SYSTEM
D:QS
E:PFILS
F:
G:
Disk1Disk2
Figure 6: Dual Server - Disk Configuration
REF2002033-023 18 RevisionA
Disk1Disk2
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
FileNamingConvention
The application files are stored in compressed format and are named in the following format:
•
RxxxxLnn.exe for release files, where xxxx is the version and nn is the build number of the
release
RxxxxPmm.exe for patch files, where mm is the patch number
•
•
SxxxxLnn.zip for string files, where xxxx is the version and nn is the build number of the
release
HxxxxLnn-ddd.zip for help files, where xxxx is the version and nn is the build number of the
• release and ddd is the type of database (e.g. QKS, CIS)
WxxxxLnn.exe for OBLink files, where xxxx is the version and nn is the build number of the
• release
UxxxxLnn.zip for OBLink help files, where xxxx is the version and nn is the build number of
• the release
Strings and help file zip files have the format changed with a patch, the names change to
The OB Link executable release file has the form
The OB Link help zip file has the form:
SxxxxLnn and HxxxxLnn. If strings and/or help files are
SxxxxPmm and HxxxxPmm, respectively.
WxxxxLnn, the patch would be WxxxxPmm.
UxxxxLnn, whereas a patched version would be UxxxxPmm.
Examples of the file names associated with various QS Components are summarized in Table 3.
Table 3: QS Component File Name Examples
QSComponent FileName
Release R5050L38.EXE
NTpatch R5050P03.EXE
Strings S5050L38.zip
Stringspatch S5050P03.zip
Help H5050L38.zip
Helppatch H5050P03.zip
OBLinkrelease W5050L38.exe
OBLinkhelp U5050L38.zip
19 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
QSDirectoryStructure
The QS directory is the place where most of the QS-relevant files are stored. Every server and workstation in a QS system has a QS directory. Workstations have a subset of the QS directories shown here.
D:\QS\Archive
Holds the patient files that are waiting to be archived. They are copied here by the PtD process.
D:\QS\Archive\Image
The working directory when archive CDs are being created.
D:\QS\Data
This directory holds the strings files. Together with the site tables, these determine the language in which the QS is presented to the user.
D:\QS\Exe
Here you will find all the QS executables, DLLs and utilities, such as Cdatdisp. For a primary QS server, the contents of this directory is copied from the Update directory, every time the server starts.
D:\QS\HL7Out
This directory contains the recovery files and end of job reports related to HL7 Outbound processing.
D:\QS\Logs
Logs holds all the log files for the processes running on the local machine. On the QSServer, logs also keeps the main QS log file (
QSLog) and the user activity log file (UALog).
D:\QS\MSAccess
The directory where the Microsoft Access database files are stored.
D:\QS\Pfils
The directory where the patient files are stored.
D:\QS\Release\NT
This directory contains the application and configuration files for the servers (QSServer.bat) and
the clients (
QSClient.bat). The clients copy strings, help, release and patch files from here on
startup.
D:\QS\Site
The site tables are stored in this directory. Together, the site tables form the configuration database. Although the database consists of a number of separate files, it is not possible to replace files one-by-one. The files form a relational database and if single database files are replaced, references in the database may be lost and the database will become unusable.
REF2002033-023 20 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
D:\QS\SPP
This directory contains the recovery files and end of job reports related to SPP.
D:\QS\Tools
In the tools directory, all the startup batch files and utilities are found that have no place in the Exe directory or in one of the subdirectories of Release. It also holds templates for
QSServer.BAT, QSClient.BAT and QSClient.CMD.
D:\QS\Web
This directory contains the executables, Active Server Pages and help files for the OB Link web site. This directory is only present on QS servers in a surveillance system with the OB Link option.
ArchiveandRestore
Long-term storage of patient data in the QS is achieved by writing patient files to CD-ROM. The patient data can later be restored via a user menu selection within the QPM program.
Thearchivingprocess
Figure 7 provides an overview of the archiving process:
PatientFileswith
PtD StagingArea
nnnextension
Archive
Access
Database
CD-RDrive1 CD-RDrive2
Figure 7: Archive Data Flow
PtD will periodically copy patient data that is ready for archival into an area on a hard drive known as the staging area. The Archive server will wake up once an interval (default of 60 minutes) to determine if there is data ready for processing. If files are found with extensions between
999, they are assumed to be patient data files. These files are verified and compressed. If sufficient
data has accumulated in the staging area (default 600 MB compressed data) or sufficient time has elapsed since the previous archival to CD (default 90 days), the data will be copied to a pair of CD­R disks.
000 -
There will be only one Archive server running at a given QS site. Archive is run on the main server so that it can take advantage of the file protection available on the server's disk.
Since the Archive process often executes on a server far from any consistent user observation, Archive will send popup messages to logged-on QS users for important events. Important errors are sent to all QS users while success or maintenance messages are sent only to system staff. The following popup messages may be generated:
21 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
All users:
• Insufficient disk space to perform archive
• Error writing to CD-R Device x
• CD Volume x, written to CD-R Device y failed verification!
• No blank disks found while attempting to write CD.
System staff only:
• CD-R Device x: No disk. Please insert new, blank disk.
• Used data disk. Please insert new, blank disk.
• Damaged disk. Please insert new, blank disk
• CD-R Device x: Unknown disk. Please insert new, blank disk.
• CD successfully written and validated to CD-R Device x, Volume name: y
Thearchivedatabase
Archive and restore use an Access database to store information about patients that have been archived. This database is located in data is archived.
\qs\archive\NTArchive.mdb. The database will grow larger as
Never delete, overwrite, rename, or open the database (unless directed by QS Technical Support) or you could corrupt the data that has been archived to disk.
The Access Database is used to maintain a directory of all archived patients, and information about each patient file that would aid in efficiently restoring a patient file regardless of how long ago that patient was archived. This information includes but is not limited to the volume (disk) they were archived to, patient name, patient ID, the date the file was archived, the media to which the patient file was copied and the status of the patient file.
The database file will grow as data is added into it. According to Microsoft, the maximum size of an Access database using the Microsoft Jet engine is 2 gigabytes. If the average patient record in this database is 1KB (it's probably less), you would be able to fit approximately 2,000,000 of these records in the database.
In order to connect to the database, Archive and Restore use a DSN-less connection. This means that you do not have to go into the control panel and set up a data source name (DSN) for the connection to work. The QS will take care of the connection for you. However, a copy of the appropriate ODBC driver (MDAC) must be installed on each computer for the queries to function.
Patientfilesizeconsiderations
If a patient file is too large to archive because of available memory constraints or the CD-R storage media limitation of 600MB, the renamed with a
BIG-nnn extension. Thus, the file will never be able to be Archived or Restored. If a
site wishes to restore the file, they will need to manually copy the file from the staging area to the PFILPATH and rename the file to a .
QSSERVER PDSS SET RESTORE=<PatientID>@QSSERVER
ID number of the patient).
.000 file will remain in the staging area indefinitely and be
V01 extension. They then need to issue the command, QSMAN
in order to restore the file (<PatientID> is the
REF2002033-023 22 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
HowArchiveinitializesdisks
When Archive encounters a blank disk, it initializes the CD before writing to it. Disk initialization occurs automatically, requiring no action by the user.
Each pair of CDs will be assigned the following volume name:
PP is the configurable prefix that can be set in the Designer. QS is the default DDD is day of the year (January 1st is 001 and December 31st is 365 in most years) YYYY is the year (2002) NN is a count that goes up if more than one batch of CDs is created in a day. This starts at 01.
PPDDDYYYYNN
WhathappenswhenoneoftheCD-Rdrivesisnotoperational
Archive is able to work with just one CD-R(W) drive. Archive always makes two CDs for a given batch of data. Should one drive fail, the first data copy (image) will be written to the first available functioning drive. Once the CDR disk is replaced, Archive will write the second copy of data to the same drive.
CD-Rlifeexpectancy
CD/CD-R life varies according to type and manufacturing method. Manufacturers claim 75 years (cyanine dye, used in green discs), 100 years (phthalocyanine dye, used in gold discs), or even 200 years (advanced phthalocyanine dye, used in platinum discs) once the disc has been written. The shelf life of an unrecorded disc has been estimated at between five and ten years.
Exposing the disc to excessive heat, humidity, or to direct sunlight will greatly reduce the lifetime. In general, CD-R media is far less tolerant of environmental conditions than pressed CDs, and should be treated with greater care. A scratch in the top surface (label side) will render a CD-R unusable. CDs should be stored in a cool, dark, dry place.
CD-RW (CD Re-Writable) disks are an entirely different media and in no way compatible with CD-R media or devices. CD-RW disks have an entirely different composition.
OtherimportantthingstoknowaboutArchive
1. Each compressed patient file must be smaller than 600 MB as the available space on a CD
is limited to 600 MB and the first release does not have the ability to straddle one patient file across multiple disks. If files are encountered that are too big, the file will be renamed
BIG-nnn extension.
with a
2. The time and days that PtD backup jobs occur should be carefully considered. It would
be best to have the patient files readytobecompressed when other processes are NOT running verifies and when very few users are on the system. Then, theoretically, when Archive initializes (every hour), it will go through its compression process and have less impact on the system performance.
3. A CD-R can not be burned if less than 1.5 MB of compressed patient data exist
4. Archive will always attempt to write as much data as is in the staging area to CD-R
regardless of the current MB_DATA setting, up to 600MB. For instance, if the MB_DATA setting is 200, when 200MB of compressed data has accumulated in the staging area, archive will attempt to copy this data to CD-R. However, if there are no blanks in the drives, archive will not be able to write, but will continue to accumulate and compress data. If, when there are finally blanks available, 500MB of data has accumulated
23 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
in the staging area, archive will write all that data to a pair of duplicate CD-R's, not just 200MB. If 700MB of data has accumulated, the oldest 600 MB will be archived and the remaining (most recent 100MB) will be left in the staging area until archive is triggered again, either manually by
SET ARCHIVE, by TIME_SPAN or MB_DATA.
5. On termination, Archive closes all files and de-allocates memory. Archive can not be
terminated while it is in the middle of writing to CD-R, because the Nero interface software will hang. Therefore, if a termination admin command (stop, cycle, cycle with reboot) is received, Archive will delay termination until the current archival process is complete. When an Archive
STOP/CYCLE is issued and Archival has already begun, it can
take up to 4 hours to stop Archive.
FilesusedbyArchive
Inthestagingarea:
ptid.nnn - the patient file copied in by PtD ptidmmddyyyysssssssss.tmp - the working file during preprocessing ptidmmddyyyysssssssss.gz - the compressed file ready to be written to CD ptid.BAD-nnn - patient files that failed verification ptid.BIG-nnn - patient files that are greater than 600 MB when compressed, and thus too big to
fit on the media
NTArchive.mdb - the Access database file error.out - a temporary file that only exists during interval processing. Contains any redirected
errors from the Stingray compression software
Intheimagedirectory:
Used by Windows 2000 Configurations Only (Nero)
QSDDDYYYYNN.REC - lists all patients that will be stored in the archive QSDDDYYYYNN.NRG - the image file as the archive is being created QSDDDYYYYNN.1 - the image file as it is being copied to the 1st CD QSDDDYYYYNN.2 - the image file as it is being copied to the 2nd CD QSDDDYYYYNN.DONE - the recovery file after both disks have been created
NOTE
Windows 2000 versions of Archive will also archive any existing
CDATS.zip (backup) files to the CDS.
Used by Both Configurations
VOLPARAM.INI - parameters used by CD writing software QSDDDYYYYNN.TXT - comma-delimited ASCII DB entries for the patients in a given
volume
REF2002033-023 24 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
Used by Windows NT Configurations Only (SmartStorage)
QSDDDYYYYNN.CDI - the image that will be written to CD for the volume name to the left of
the dot
QSDDDYYYYNN.LAY - specification for files to be included in the image and their ultimate
destination on the CD
PRETXT, PRECDI, PRELAY - initial versions of the files listed above QSDDDYYYYNN.LVT - transient file created and destroyed by Smart Storage in the creation
.PRECDI/.CDI image file
on the
QSDDDYYYYNN.DAT - transient file created and destroyed by Smart Storage in the creation
.PRECDI/.CDI image file
on the
ArchiveAdminCommands
For a list of administrative commands that can be issued to control Archive, see “Archive Arguments” on page 45
Example output from qsman qsserver archive show
Sending SHOW to ARCHIVE on QSSERVER Archive GA R5042L16 1999 running at QSSERVER Terse Up since: 10/11/1999 18:01:13 Current time: 10/11/1999 21:09:52 Staging Area \\QSSERVER\Archive\: Data ready for archival: 256 MB/42 files MB free: 701 Target Drive 1: Data or ot her used disk. P lease r eplace with blan k disk. Drive S tatus Date: 10/11/99 21:04:05 Target Drive 2: Data or ot her used disk. P lease r eplace with blan k disk. Drive S tatus Date: 10/11/99 21:04:05 Current Settings: 60 Minute Interval; 1X Write Speed 90 Day Time Span; 600 MB Data Threshold Next archival to disk starts in 75 days or 344 MB Archive status: Last Archive: An unspecified error was returned by the last attempted archive. Last archive error: Could not inventory CD-R Device 2: Drive may be empty. Last completed volume: BZ270199902 126 MB/100 files on 09/27/1999 Admin: 2 @ 10/11/1999 21:09:52; Processing SHOW Archive: 4 @ 10/11/1999 21:03:33; Waiting for next interval in 60 minutes
QPMRestore
The Restore Patient QS Action will launch an appropriate dialog if the corresponding licence has been purchased. This dialog will not be displayed unless you have the Archive license and the currently logged on user has the Restore user privilege.
The search criteria in the upper left-hand corner of the dialog are used to search for patients that match all of the specified criteria. Patient Id, Patient Name, CD-ROM and Date Archived are always displayed. There are 3 user configurable items (in this case
Gravida) that are only displayed if they are configured.
25 REF2002033-023
Delivery Date, PT-AGE, and
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
After the user has specified all of the search criteria that they are interested in, they press the Search button. This will populate the bottom half of the screen with the patients that meet the selection criteria. Below the list of patients, one can see the number of patients that matched the search criteria. The columns can be sorted by clicking on the title name for the column. The columns contain:
Patient Id - the Patient id of the file that was archived
•
•
Patient Name - the latest charted value for patient name. If no patient name was charted, this
will say
No Name
• User Configurable Items - The values that were charted for user configurable items 1, 2, and 3.
The title shown is the name of the item that is currently configured for that user configurable item.
CD-ROM - The volume name of the CD where the data has been written. If blank, the data is
• in the staging area.
Date Archived - when the data was written to CD
•
•
File name - the filename of the patient file on the disk. This is the compressed file name.
•
File Size - the size of the patient file
To restore a patient, either double-click the entry or highlight and press the Restore button. The following things may happen once you initiate a restore:
• If it cannot communicate with the Archive server and the data is in the staging directory but not yet on CD, Archive will give you an error message that it can't find the staging area.
• If the data is on a CD and Archive cannot find that CD in the drive of the machine running Restore, it will prompt you to put that CD into the drive.
The patient data file will be copied to the
\qs\restore directory on the client workstation where the
file will be uncompressed and verified. The patient file will then be copied to PFILS and a restore command will be issued to PDSS.
If the patient id is already active in the QS, you will be prompted to specify a different patient id. This has the same effect of doing a change id on the file that you are restoring into the QS. The patient already in the QS is unaffected by this.
The patient file will go into the unit specified in the upper right hand corner of the Restore dialog screen.
The restored patient will become the selected patient in the QPM that is running the restore dialog.
ProblemsrestoringduetoCDdrivedirty/CD-Rmediaproblems
Scratches on the CD-R media or dirt on either the CD-R media or the lens in the CD drive can cause problems when trying to restore files. Several steps can be taken to remedy this situation.
First, make sure the CD-R media is clean. Any foreign matter large enough to see on the bottom side of the CD-R must be removed. CD-R manufacturers recommend cleaning the CD-R with a soft, dry cloth. Do not use any solvents.
If the CD-R has light surface scratches on the bottom side, in some cases they may be polished out. There are commercially available polishes designed for use on CDs. Follow the instructions included with the product. These will only repair the lightest scratches.
If the CD-R itself is not he problem, it is possible that the laser lens in the CD drive has accumulated dust or dirt.
REF2002033-023 26 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions

Printing

Batchprinting
As indicated by Figure 8, the QS supports batch printing, which allows printing of multiple objects (such as charts and forms) with one request. This capability is useful for daily shift prints, discharge prints, transfer prints, and physician rounds prints. Under the Clinical Print tab of the Designer there is a choice called to the appropriate user views. Each element in the batch has a range of time of data to be printed (i.e. 8 hrs, 12 hrs, 24 hrs, all data, etc.). The user invokes the batch through one of the navigators. A batch print dialog will appear and the user must provide an range of time), select a print queue and press the the printer associated with the selected queue.
Batch Print. These are defined by the System Manager and added
Anchor Date and Time (end of the
OK button. The batch will send all print jobs for to
PrintJobs
QSClient
Queue----
PrintServer
Queue----
ICUNurseStationPrinter
Share----
\\PrintServer\ICUNurseStationPrinter
PrintServer
\\
Workstation
ICUNurseStationPrinter
\
PrintJobs
PrintDeviceatthe
ICUNurseStation
Figure 8: Printer Configuration for Batch and Scheduled Printing
Scheduledprinting
As illustrated by Figure 8, printing may be scheduled to automatically print at a predefined day and time. Under the Clinical-Print tab in Designer you will find a System Manager can create scheduled print jobs to run on specified workstations and print to specified printers. This functionality is useful for physician rounds print jobs, shift print jobs, and daily medical records print jobs.
Scheduled Print selection. The
27 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
SPP essentially replaces the user for the purposes of a batch print. Therefore, as part of the scheduled print job definition the System Manager must minimally specify the following:
• Scheduled Run Time.
• Data Range End Time (Anchor Time).
• Whether the data Range End Time is before, the same as, or after the Scheduled Run Time.
• Which Batch jobs to Print.
• The Patient Selection Criteria (i.e. which patient population to print).
• The workstation on which it will be run.
• The printer where the output shall print.
• The print-template used for the end of job report. If this template has a region, it will be filled in with the report from the report-file created by SPP.
The printer selection field on the dialog uses a drop down list to display all the printers in the QS Printer Configuration. It also supports free text entry. The System Manager must select the printer name from the drop down list.
The text files (other than logs) created by the SPP process(es) are located in the
\QS\SPP directory.
The files are:
JobRecovery.dat - This is the job and patient recovery file. It lists the SPP job being run and the list of patients selected.
PtRecovery.dat - This shows the status recovery file. It lists the current patient, the last run batch id and the last run element.
RetryCount.dat - This is the retry count file. It contains the current retry count.
SPPReport.txt - This is the end of job report that is written while SPP is running a job.
OBLink
OB Link (QS Web server interface) is a web-based solution to deliver and display fetal trace data, fetal alerts and other charted patient data to remote client web browsers through the Internet Information Server. For a sample OB Link screen, see Figure 9.
The OB Link web application uses Active Server Page (ASP) technology to embed the patient data in web pages using HTML format. A URL (Uniform Resource Locator) will initiate the transmission of fetal heart rate data from the QS web server (ISAPI DLL) to the Java applet running in the client browser.
REF2002033-023 28 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
The QS must be at version 5.05 or higher to run OB Link.
Figure 9: OB Link Fetal Strip Display
QSWeb
The new QSWeb.DLL component is loaded by the IIS (Internet Information Server) program
InetInfo.Exe) that resides on the C: drive. QSWeb.DLL is configured as an ISAPI filter to the IIS
( program and is loaded during startup of IIS. QSWeb interfaces with the other QS processes to generate the web pages for the OB Link web site.
This feature has been developed to run on the main QS server but can optionally be run on a QS Load Share server server.
−however, QSServer must be running on the workstation functioning as the QS
29 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
InternetInformationServer(IISfromMicrosoft)
This is also known as the Microsoft's IIS program. It is a Windows service that can be controlled
Settings -> Control Panel -> Services icon.
via
NOTE
It is important to note that the QS processes (specifically CDATS) need to be brought up first.
The IIS process need to be set up for manual start from the
Settings -> Control Panel -> Services icon.
Additional information about IIS may be obtained at the following URL:
http://www.microsoft.com/windows2000/server/evaluation/features/web.asp
Logfiles
The new QSWeb.DLL component is loaded by the IIS program (Internet Information Server /
InetInfo.Exe) that resides on the the proper subdirectories on
C: drive. When QSWeb.DLL attempts to log messages it looks for
C:\QS\LOGS but the logs subdirectories really reside in D:\QS\LOGS in a
production environment.
A new optional parameter called process, it will look for the subdirectory. Setting the
LOGSPATH variable to LOGSPATH=D:\QS\LOGS will allow QSWeb.DLL to
LOGSPA TH will be supported. During the QS initialization
LOGSPATH environment variable and use its value as the log file
locate the logs subdirectories.
The log files for OB Link can be found in the
\QS\LOGS\QSWeb subdirectory. The QSWeb.DLL loaded
by IIS (Internet Information Server) will write to this file.
IIS, which loads the QSWeb DLL, logs to
YYMMDD is the current date.
C:\WinNT\System32\Logfiles\W3SVC1\inYYMMDD.log where
StringsFiles
The new QSWeb.DLL component is loaded by the IIS program (InetInfo.Exe) that resides on the
same drive as the QS (normally files from
C:\QS\DATA but the string files really reside in D:\QS\DATA in a production environment.
D:). When QSWeb.DLL is initialized, it attempts to load the string
Use the be set to
REF2002033-023 30 RevisionA
DATAPATH= environment variable so that the QSWeb.DLL can find the strings files It needs to
DATAPATH=D:\QS\DATA.
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
OBLinkwebfiles
A self-extracting archive file EG6600L14.EXE contains the OB Link web files.
A new subdirectory
The
WXxXxLxx.exe file is a self-extracting zip file containing files for the \QS\Web\Data, \QS\Web\Class
\QS\Web\Images subdirectories and must therefore be executed from the \QS\Web directory.
and
The site Help files are contained in the zip file
\QS\Web\HELP subdirectory.
\QS\Web will contain all the web-related files for the OB Link web application.
UXxXxLxx.zip and is to be extracted to the
The subdirectory content is as follows:
• Data - Active Server Pages (ASP) files
• Class - Java class directory
• Help - Web-based help files
• Images - Images (and JavaScript) directory
Stripchartappletandscreensizeapplet
In Netscape, resizing the browser window does not resize the applet until you refresh. This is a property of the Netscape browser, and not related to our applet.
When used across international boundaries, the date/time on the strip will be the date/time at the server, but the months will use the client's translations.
When Daylight Saving Time (DST) switches (April and October in the USA), the times on the strip chart will not switch. If you start the applet in Daylight Saving Time, all times will appear as DST, whether the actual switch occurs before or after.
Although the strip chart looks real, it is not. It does not contain the event marks or annotations from the original.
Rips in the strip chart indicate periods when the data was not available. One possible reason could be the fetal monitor is/was off.
On some older browsers, the VCR controls may be replaced by a scroll bar.
The applets log diagnostic information to the Java console. In Netscape Communicator, the console under
Communicator -> Tools -> Java Console. In IE, it is under View -> Java Console.
After a patient ID change, the applet will stop collecting data. Return to the patient select screen and grab the correct patient.
31 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
Browsersetup
In order to use OB Link, both Cookies and JavaScript must be enabled. JavaScript (also known as Microsoft Virtual Machine) may need to be downloaded/installed from the Microsoft web-site.
Under Internet Explorer (4.01 SP2 and subsequent), HTTP 1.1 protocol must NOT be enabled. To disable, do the following:
From the menu, under
Select the
Scroll down to
Advanced tab.
HTTP 1.1 Settings and uncheck Use HTTP 1.1.
View, select Internet Options.
If this option is enabled, the Java applet may lock up and binary data may appear in the browser window. If this happens, disable the setting and restart the browser.
Certificateinstallation
To avoid the dialogs informing the user that the site is not trusted, the Certificate Authority must be installed at the client as a Trusted Root Authority. Follow the link from the first OB Link page, then use the following instructions, depending on the client browser.
NOTE
Certificate installation must be performed by a user logged on as an Administrator.
InternetExplorer4.01
When the File Download dialog appears, select Open this file from it s curren t lo cation, then press the
OK button. On the New Site Certificate dialog, ensure Enable Certificate is checked. You may leave
all of the others checked, but at the very least, Then click
Yes on the following dialog to add the authority to your browser.
Network server authentication must be checked.
InternetExplorer5.0andhigher
When the File Download dialog appears, select Open this file from it s curren t lo cation, then press the
OK button. On the Certificate dialog, press the Install Certificate... button to invoke the Certificate Manager Import Wizard following store Authorities
. Press the Browse button next to Certif icate store and select Trusted Ro ot Certification
. Press OK, press Next, and then Finish. On the Root Certificate Store dialog, press Yes to
dialog. Press the Next> button and select Place all certificates into the
add the authority to your browser. Press
Netscape4.5andhigher
Walk through the New Certificate Authority dialogs. When prompted to select the certificate's
purpose, check off enter a
Nickname, enter GE (this is really up to you, but should be something meaningful in case
the certificate needs to be retrieved).
REF2002033-023 32 RevisionA
Accept this Certificate Authority for Certifying network sites. When prompted to
OK.
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
ServerStartupProcess
Figure 10 illustrates the server startup process. In short, the QSServer service calls a number of batch files, resulting in the consecutive startup of all configured QS processes.
START
QSServerService
\qs\tools\StartQS.bat
SET
Environmental
Variables
StartQS.bat
callseither
QSServer.bat(WinNT)or
GEMSITCIS.bat(Win2K)
CDATS
LOGS
PDATS
PFILS
PDSS
(opensSTARTUPgate)
CDSS
PtD
PMS
ARCHIVE
QSUptime
Figure 10: QS Server Startup Process
33 REF2002033-023
QSServerStartup
Complete
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-SystemFunctions
ClientStartupProcess
Figure 11 illustrates the client workstation startup process. In short, the QSServer service calls a number of batch files, resulting in the consecutive startup of all configured QS processes.
START
StartClient.bat
DELETE
\qs\exe\*.*
DOWNLOAD
Release&PatchFiles
&Tools
EXPLODE
Release&PatchFiles
into\qs\exe
and
Toolsinto\qs\tools
NO
Version.bat,QSClient.bat,
GET
Strings,&HelpFiles
Unzip
Strings&HelpFiles
DoPatchFilesExistFor
CurrentRelease?
YES
CALL
QSClient.bat
END
StartClient.bat
Figure 11: QS Client Startup Process
REF2002033-023 34 RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-UTILITYPROGRAMS
UTILITYPROGRAMS
QS utility programs are essentially software tools that allow System Managers to quickly and efficiently perform support tasks that maintain an optimal QS operational state. These utility programs are identified below and described in the subsequent paragraphs.
CDATDisp CDUpdate Designer
QSCopy QSTest

CDATDisp

This utility is designed to output the formatted values of selected CDAT tables to a file. This utility may differ with each version of the QS. The utility requires input of a file name that will contain the formatted dump and the CDAT table(s) to dump. It allows inspection of a site's current configuration without having to run the QS Designer. CDATDISP.EXE is found in
\qs\exe and is part of the release.

CDUpdate

This utility is different for each version of the QS, because its purpose is to update the CDAT information as needed for a particular version of the QS. The most that can be said in terms of a general design is that CDUPDATE writes questions to the screen, and based on the user's response, opens and modifies CDAT tables. This tool is used to update a site from one QS version to the next.
This utility also allows setting of the site's licenses, setting the IP addresses of workstations and servers and setting the maximum number of users that can connect to the OB Link web site at a time. CDUpdate will only run on the QSServer (location of the site tables). If the QSServer has an IP address different from the address that is configured in the site tables, CDUpdate can still be run with the standalone parameter:
cdupdate standalone
The CDUpdate.exe program is located within the \qs\exe directory.

Designer

The Designer is the main QS configuration tool. It is a Windows-based graphical user interface that allows System Managers to modify the site's configuration to suit the institution's particular needs. Depending on the QS licenses bought (e.g. MAR, Customize).
If the QS system is down, the Designer can still be started on the computer where the site tables reside by making the following entry at a command prompt:
designer standalone nocdats opengate node=qsserver (or current server name in the site tables)
The Designer.exe program is located within the \qs\exe directory.
35 REF2002033-023
RevisionA
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSTOOLS-VERSION6.60.0

QSCopy

QSCopy is the utility that is responsible for copying configuration data from a QSServer to a backup server. By default, QSCopy will copy the configuration data once per hour to a computer called BKSERVER. The default copy interval and target computer name can be changed by specifying these two parameters on the command line:
QSCopy <target> <interval>
where <interval> is the copy interval in seconds (default is 3600), target is the computer name of the
server the data is copied to.
The QSCopy.bat utility is located within the
\qs\tools directory.

QSTest

This utility tests the communications to the PDSS, PFILS and PDATS processes running on a system. It has one optional run time parameter
logfile. With out logfile specified output will give one screen of
information per process and will clear the screen between processes. With logfile specified, the output will stream up the screen. With logfile specified, the output can be redirected to a file or printer for review.
QSTOOLS-VERSION6.60.0
Table 4 is an alphabetical list of files (tools) with a brief description of their intended use. These files are provided within a self-extracting file titled
*.CMD files are the property of GEMS-IT. The majority of the *.EXE files were provided by the Windows
NT/2000 Server Resource Kit.e:
Table 4: Content of T6600l14.EXE
FILENAME WHEREUSED INTENDEDPURPOSE
AddFTPUser.bat NT4/W2kserver CreatestheQSFTPaccount.
ALLACLS.bat NT4/W2kserver ThisfileusesXCACLS.EXEtosettheNTpermis-
T6600L14.EXE . All *.BAT, *.TPL, registrymodificationfiles and
sionsondrivesD:,E:,F:,andG:(forNT4)andD: (forW2k)tothepermissionsspecifiedforproduc- tionssystems.
ATRLS_CV.zip NT4Server
AuditTrail.bat NT4/W2kserver
BEEP.exe Any UsedtocreateanaudiblebeepthroughthePCsys-
BKServer.tpl NT4Server BKServer.battemplatefile.
ChangeQSClientService.exe Client,Loadshare UsedtosettheQSClientServicetostartinthecon-
CHOICE.exe Any Usedtocreatemenuselectionsinbatchfiles.(i.e.
REF2002033-023 36 RevisionA
Te ln et softwareusedforremotesupport.Requires licensepurchaseforinstall.
UsedtomaintainauditlogsonD:orE:toavoid usingtoomuchspace.
temspeaker.
textoftheQSaccount.Thispermitsaccessto QSServerresourcesviaNetBiosfiletransfer.
Status.bat)
QuantitativeSentinel®ServiceManual
QSSystemOverview-QSTOOLS-VERSION6.60.0
Table 4: Content of T6600l14.EXE
FILENAME WHEREUSED INTENDEDPURPOSE
ClientCFG.bat Client Usedtoextractregistryinformationtoafilefortrou-
bleshooting.
Con2prt.exe Client,Loadshare UsedinPrinter.battoconnecttosharesonanother
computeronthenetwork.
ConfigServer.bat NT4Server ConfigurestheserverforusewiththeQS.Creates
directorystructure,setsenvironmentvariablesand loadsregistrysettings(seeQSServerRegistry.txt), installsTel n et ,createsandconfiguresuser accounts,createsnetworkshares,installstime syncservice,setsNTfileanddirectorypermissions viaALLACLS.bat,copiesTools.batandQSI- Cons.tpltotheD:\qs\release\ntdirectory,creates desktopshortcuts(QSShutdown,QSStatusand
CommandPrompt).Thisfilewillrequiretheuserto specify,viathecommandline,thetablestoinstall
onthesystematthetimeofexecution.Thespeci- fiedtables(filename.zip)willbeunzippedtothe
D:\qs\sitedirectory.
Cshell.bat Any UsedtocontrolerrorhandlingforeachQSprocess
(Stop,cycle,systemreboot,etc.).
cygwinb19.dll Any ProvidesUnixtoolcompatibilityforNT
DumpEL.exe Any UsedtoretrievetheNTEventViewerlogfroma
machinefortroubleshootingpurposes.
FixKill.bat NT4/W2kClient Corrects the registry setting for the debugger –
kill.exe; called by Tools.bat
Fonts.bat Any Automates loading of QS fonts on any machine that
will run QPM or Designer
Freedisk.exe
NT4/W2k Server
Used in various batch files to check for minimum free hard drive space.
GetQS.txt NT4/W2k Client,
Loadshare
Used by the FTP program to automate retrieval of files from a QSSERVER. Specifies the username
and password to connect as and directory where QS files are retrieved. Called out in StartClient.bat
GetQSexe.txt NT4/W2k Client,
Loadshare
Used by the FTP program to automate retrieval of files from a QSSERVER. Specifies the server to
connect to, username and password to connect as and directory where executable files are retrieved. Called out in StartClient.bat
GetUpTime.bat NT4/W2k Server Creates a zip file containing logs for uptime statis-
tics
Grep.exe Any Used to search text/log files for specific strings of
text.
Gunzip.exe Any Zip utility
37 REF2002033-023
RevisionA
Quantitative Sentinel® Service Manual
QSSystemOverview-QSTOOLS-VERSION6.60.0
Table 4: Content of T6600l14.EXE
FILENAME WHEREUSED INTENDEDPURPOSE
Gzip.exe Any Same as Gunzip.exe
Head.exe Any Used to retrieve the first few lines from a text/log file
and display it on the screen.
Hidden.exe Any Used to hide the task bar program button from
users.
IfMember.exe Any Checks a user name for group membership.
InstallOBlink.bat NT4 Server/
Loadshare
InstallQS.bat Client
Used to prepare the system for OBLink installation. Not for use on Win2k systems.
Uses command line variables to install the QS con­figuration. Sets the auto-logon user and password.
InstallVNCSetupISS.txt Any
Installation script for WinVNC. Used by installation batch file.
Instsrv.exe Any
Used configuration batch files to install a specified service. (i.e. QSSERVER service)
InstallVNC.bat Any
Used to automatically install WinVNC. Requires SP4 or higher.
Kill.exe Any Used to stop processes.
KillTree.exe NT/W2k Server Executable targeted for the cluster server to kill a
QS server process and its parent. This is only to be used with QS process started with CSHELL.
Logfile.bat Any Used to capture state of system processes and log
files – outputs to various files.
Loaddskf.exe Any Utility for loading a floppy image from a file saved
with Savedskf.exe
MakeBackup.bat NT4 Server Convert a QS server to a BK server
MakePrimary.bat NT4 Server Convert a BK server to a QS server
NewSID.exe Any Executed on a system after applying a “Ghost”
image to the hard drive. Generates a unique Secu­rity Identifier for the machine.
Now.exe Any
Displays Date and Time. Used in batch files to log this information.
NTFonts.txt Any Installs Fonts
NTPrivs.exe Any Used by InstallQS.bat and ConfigServer.bat to
modify user privileges
OBLINK.VBS W2K Server/
Loadshare
Used to install configure IIS to support OBLINK on
Win2k Servers
OS2Fonts.txt Any Installs QS OS/2 Fonts on an NT workstation
REF 2002033-023 38 Revision A
Quantitative Sentinel® Service Manual
QSSystemOverview-QSTOOLS-VERSION6.60.0
Table 4: Content of T6600l14.EXE
FILENAME WHEREUSED INTENDEDPURPOSE
Pathman.exe Any Add / Delete path variables
Printkey.exe Client Used to print the display when the Print Screen key
is pressed.
QMIUse.bat Any Used to map a drive to a share on another
machine. Command line variables are required.
QSAtJobs.tpl NT4/W2k Server Renamed to QSAtJobs.bat and called by Config-
Server.bat and MakePrimary.Bat to setup sched­uled jobs to run at specific times.
QSBackup.bat NT4/W2k Server Scheduled to run as an “AT” job by QSAtJobs.bat to
backup specific files to a specified backup drive and/or Backup server every 8 hours.
QSChange.bat NT4/W2k Client Used to change QSUPDATE and QSBASEPORT
environment variable registry settings.
QSClient.tpl NT4/W2k Client This file is customized on a per site basis for start-
ing process on specified or generic clients. QSCli­ent.bat resides in D:\qs\release\nt on the server.
QSCopy.bat NT4/W2k Server Called from QSSERVER.bat to copy backup files to
the BKSERVER or other specified location every 3600 seconds.
QSIcons.bat NT4/W2k Client Called by QSClient.bat to configure the shortcuts in
the Program menu. It will remove older shortcuts if they are found.
QSLocalAccount.bat NT4/W2k Server Used by InstallShield on Win2k server for setting
privileges.
QSServer.tpl NT4/W2k Server Template file that can be renamed to
QSSERVER.bat for starting of the QS processes. Resides in D:\qs\release\nt on the server.
QSServerRegistry.txt NT4 Server
Contains registry settings required for QS opera­tion. Called by regini.exe in ConfigServer.bat
QSTimeServ.bat Client, Loadshare Creates a new TimeServ.ini file based on the value
of QSUPDATE; places in %WinDir%, stops the time service, updates the registry and starts the service again. Will run automatically, upon reboot, if the
QSUPDATE variable changes.
Qstop.bat Any Used to stop QS processes on any machine on the
QS network. Requires CDATS to function.
Qsuser.txt Client, Loadshare Contains a registry setting that sets the auto-logon
user to QSUSER. Called by regini.exe in various batch files. May also be run from the command line
with regini.exe to reset the auto-logon user back to QSUSER (not needed on Win2K)
39 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
Page intentionally left blank.
Table 4: Content of T6600l14.EXE
FILENAME WHEREUSED INTENDEDPURPOSE
QSWkly.bat NT4/W2k Server Scheduled to run as an “AT” job by QSAtJobs.bat to
backup specific files to a specified backup drive and/or Backup server on a weekly basis.
Rclient.exe Any Used primarily by Tech Support for remote com-
mand line abilities. Runs as a service. See
Rsetup.exefor installation information.
Rconmode.exe Any Enables you to change the screen buffer size and
the window size of the current console. The syntax is:
rconmode bufferx,buffery,windowx,windowy
Where:
bufferx is the screen buffer width in characters. buffery is the screen buffer height in characters. windowx is the window width in characters. windowy is the window height in characters. For example, the following command changes the
screen buffer size to 80 x 500 and the window size to 80 x 50:
rconmode 80,500,80,50
Rconmsg.dll Any Rconsole file
RconStat.exe Any Lists all current remote console connections
Rconsvc.exe Any Used to control services on a remote machine.
Rcruncmd.exe Any Used to run programs /executables on a remote
machine.
Reg.exe Any Registry query and modification tool.
RegDmp.Exe Any Utility for dumping specified registry information to a
file.
Regini.exe Any
Used to process text files that contain registry set­tings. Inserts the contents of the text file in to the
registry.
RoboCopy.exe Any Used to synchronize files between networked com-
puters.
Rsetup.exe Any
Locally or remotely install Remote Console service. (rsetup <computername>)
SaveDskf.exe Any Used to create exact duplicate floppy image files
that can be loaded to other floppies using LOADDSKF.EXE.
REF 2002033-023 40 Revision A
Quantitative Sentinel® Service Manual
QSSystemOverview-QSTOOLS-VERSION6.60.0
Table 4: Content of T6600l14.EXE
FILENAME WHEREUSED INTENDEDPURPOSE
SC.Exe Any Utility to obtain detailed information about Windows
NT services
SetNetBIOSTransfer.BAT Any Calls ChangeQSClientService.Exe to modify the
QSClient Service to use the QS account and new password; Sets METHOD=NET.
Shortcut.exe Any
Used to create shortcut links to programs. Called by ConfigServer.bat and QSIcons.bat
Shutdown.exe Any Used to shutdown or reboot the local or remote win-
dows computer
Sleep.exe Any
Used to delay batch file progression. Stops pro­gression by specified number of seconds.
Srvany.exe Any Used to start QS processes via a specified service.
SrvMgr.exe Any Used to remotely manage services and shares.
StartClient.bat Client, Loadshare Called by the QSClient service to configure and
load the QS client software.
Startdes.bat Client, Loadshare Used to start the designer after other necessary QS
process have completed.
StartQPM.bat Client, Loadshare Used to start QPM after other necessary QS pro-
cesses have completed
StartQS.bat NT4/W2k Server
Called by the QSSERVER service to set/verify the system configuration and start QS processes via QSSERVER.bat. If run on a Cluster server it will stop QS processes, via Killtree.exe, that may be
running before attempting to start them again.
Status.bat Server
Used to display a menu of processes. Menu selec­tions will cause the status of the process to be dis­played on the screen.
StopQS.bat Any Attempts to stop all possible QS processes on the
machine it is run on. Similar to Qstop.bat which only stop processes found running.
Stub.exe Any
QS Icon file associated with QS programs. Changes the default icon to that of the QS Icon. Called out in ConfigServer.bat and QSIcons.bat for
use by shortcut.exe
Tail.exe Any
Used to display the last few lines of a text/log file. Dynamically displays entries to the file as they are
appended.
Timeserv.client Client, Loadshare Template file used with Timeserv.exe for synchro-
nizing the computer clock with the QS server. Edit this file to change the time source / connection method used by the computer.
41 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
QSSystemOverview-QSTOOLS-VERSION6.60.0
Table 4: Content of T6600l14.EXE
FILENAME WHEREUSED INTENDEDPURPOSE
TimeServ.dll Required for function of TimeServ.exe
TimeServ.exe Any Installed as a service by ConfigServer.bat, Con-
figWS.bat and InstallQS.bat. Synchronizes the computer clock with an outside source on a sched­uled basis.
TimeServ.server NT4/W2k Server
Tlist.exe Any Used to show a list of running programs on a com-
Tools.bat Client, Loadshare
Unzip.exe Any Used to un-compress files that have been com-
Unzipsfx.exe Any Unzip tool
Vnc333r9.zip Any Compressed file containing the WinVNC program
VNCset.reg Any Registry settings for auto VNC install via
Xcacls.exe Any Used to edit or view NTFS permissions.
Template file used with Timeserv.exe for synchro­nizing the computer clock with an outside source. Edit this file to change the time source / connection
method used by the computer.
puter.
Automatically installs/re-installs the tools version. Uses the version specified in Version.bat or hard coded version if not set by Version.bat. Creates flag file when complete. NOTE: New tools are copied to the workstation only when the release file is not found in \qs\exe.
pressed using Zip.exe
that may be setup on a computer to provide remote desktop viewing.
INSTVNC.BAT
Zip.exe Any Used to compress the size of a file or files. Reduces
storage space required and accelerates uploading/ downloading of files.
REF 2002033-023 42 Revision A
Quantitative Sentinel® Service Manual
Chapter 2
ProcessControl&Status

INTRODUCTION

The dialog pictured in Figure 12 is used to issue administrative (operational) commands to QS processes. These processes allow users to view specificprocessstatus and setprocessoperationalparameters. The as-delivered configuration of the QS makes this dialog available via the Network menu Commands option; however, QS System Managers at configurable sites may use QS Designer to assign the Network Commands action to any navigator element.The various control elements of this dialog are summarized in Tabl e 5.
Figure 12: Network Commands Dialog
The operation of the dialog’s command buttons is consistent with other QS dialogs in that use of the OK command button initiates performance of the currently specified process commands (as indicated by the entries within the data fields and radio button status). The C from the workstation display without initiating any further actions. Selection of the H provides access to information about this dialog and the processes that it controls.
43 REF 2002033-023
ancel command button removes the dialog
elp command button
Revision A
Quantitative Sentinel® Service Manual
ProcessControl&Status-QSPROCESSES
Table 5: Network Commands Dialog - Component Descriptions
Control/Element Description
Workstation Allows you to specify which workstations that the dialog will be accessing/con-
Process Allows you to select the specific process of interest. Each of the process
Command Allows you to select one of four radio buttons to indicate the preferred action to
Arguments QS process commands may be be defined in greater detail through appropri-
trolling. You may select any workstation configured as part of the QS, the cur­rent (local) workstation or all workstations as the focus of the action or status check being requested.
options is described in the paragraphs that follow this table.
be performed - Set, Show, Stop, and Cycle.
Set - Allows you to change the operational parameters of the selected process
on the specified workstation(s).
Show - Allows you to view status (statistics) of the selected process on the
specified workstation(s).
Stop - Causes the selected process to cease operation. In general, this option
should not be used unless directed by a member of QS Customer Sup­port. Questions should be directed to the QS Help number listed within this document. The use of arguments is not appropriate for this command.
Cycle - Allows you to stop and restart the selected process. It is generally used
after the QS configuration has been modified by a QS System Manager. If you are unfamiliar with the cycling of processes, please contact QS Cus­tomer Support for directions.
Note: The cycle command will only work if the QS is operating under CShell. Otherwise, the process will stop and not restart.
ate entries in the Argument field.
Arguments appropriate for the various QS processes are described within the process descriptions that follow this table.
QSPROCESSES
The following processes may be controlled using the Network Commands dialog.
ARCHIVE LAS PTD
BRELAY LOGS QPM
CDATS PDATS QS Connect
CDSS PDSS SPP
HIS-HL7 PFILS
HIS-HL7O PMS
REF 2002033-023 44 Revision A
Quantitative Sentinel® Service Manual
ProcessControl&Status-PROCESSARGUMENTS
PROCESSARGUMENTS
Users may specify operational parameters (referred to as arguments) that control the performance of either a set or show command. Since arguments vary from process to process, each command available for use with each QS process is described within the following appropriately labeled paragraphs. Users may also view the arguments available for each command by entering Help into the argument field with either the Set or the Show command.
Please note that arguments are not used in conjunction with the Stop command.
ArchiveArguments
If a termination admin command (stop, cycle, cycle with reboot) is received, Archive will delay termination until the current archival process is complete.
SET
VERBOSE=TRUE causes ARCHIVE to log and show INFORMATIONAL messages. VERBOSE=FALSE causes ARCHIVE to ignore INFORMATIONAL messages. ARCHIVE causes the immediate archival of data to CD-R unless the server is in a HOLD state. HOLD prevents patient file preparation and archival until a RESUME command is received or the
Archive server is rebooted.
INTERVAL=mm sets the minutes between periodic passes for file preparation and potential archival. mm
must be from 1-1440. If =mm is not specified, an interval will be triggered without writing to CD-R, unless TIME_SPAN or MB_DATA criteria are met.
MB_DATA=bb sets the megabytes of data in the staging area that will trigger archival to long term
storage media. bb must be from 2-600.
TIME_SPAN=dd sets the number of days since the last archive that will trigger archival to long term
storage media. dd must be from 1-365.
RESUME permits Archive to process data when the next interval expires.
SHOW
STATUS presents the standard server screen STATUS=SUMMARY provides a translatable (internationalizable) summary of the Archive status. This
information can be requested on demand by user via QPM. QPM simply sends this admin command to Archive and puts the resulting text in a message box.
45 REF 2002033-023
Revision A
ProcessControl&Status-PROCESSARGUMENTS
BRelayArguments
SET
CHALKBOARD=FALSE causes Chalkboard messages NOT to be broadcast. FETALWAVE=TRUE causes FetalWave messages to be broadcast. FETALWAVE=FALSE causes FetalWave messages NOT to be broadcast. GATEKEEP=TRUE causes Gatekeeper messages to be broadcast. GATEKEEP=FALSE causes Gatekeeper messages NOT to be broadcast. HEARTBEAT=TRUE causes Heartbeat messages to be broadcast. HEARTBEAT=FALSE causes Heartbeat messages NOT to be broadcast. LOCATOR=TRUE causes Locator messages to be broadcast. LOCATOR=FALSE causes Locator messages NOT to be broadcast. NOTIFY=TRUE causes Notification messages to be broadcast. NOTIFY=FALSE causes Notification messages NOT to be broadcast. TIME=TRUE causes Time Synchronization messages to be broadcast. TIME=FALSE causes Time Synchronization messages NOT to be broadcast. WATCHDOG=TRUE causes WatchDog messages to be broadcast. WATCHDOG=FALSE causes WatchDog messages NOT to be broadcast. ALLMSG=TRUE causes all received messages to be broadcast. ALLMSG=FALSE causes all received messages NOT to be broadcast. RESETCOUNT resets the Process Status screen counts. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging.
Quantitative Sentinel® Service Manual
SHOW
STATS shows the current QS statistics. STATUS shows operational information about BRELAY. This is the default SHOW option.
REF 2002033-023 46 Revision A
ProcessControl&Status-PROCESSARGUMENTS
CDATSArguments
SET
BACKUP=[Filename] will BACKUP to current working CDAT tables and place them in a compressed
file with the given filename in the CDATBACK directory.
BASEHOUR=HH sets the starting hour for verify passes hour. HH must be a value from 0 to 23. INTERVAL=MM sets the minutes between periodic verify passes. MM must be 60, 120, 180, 240, 360,
480, 720 or 1440.
LOCK=TRUE creates a CDAT.LCK file and holds all updates LOCK=FALSE deletes the CDAT.LCK and allows CDAT updates to be resumed MODIFY=HOLD holds all CDAT updates MODIFY=RESUME allows CDAT updates to be resumed NEWLOGS closes the current log files and opens new ones. RESTORE=[filename] restores a compressed file of CDAT tables from the CDATBACK directory and
places them in use.
UPDATE forces a save of the current CDAT tables by copying .000 to .001, .001 to .002, etc. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging. VERIFY initiates verification of the CDAT tables.
Quantitative Sentinel® Service Manual
SHOW
INFO displays the path of the CDAT tables, and summary information on each CDAT table version. STATS displays the current CDATS metrics and QS statistics. STATUS shows operational information about STATUS.
CDSSArguments
SET
BASEHOUR=x sets hour of the day that the verify interval is started on. The valid range for 'x' is 0 to 23. INTERVAL=x sets the minutes between periodic verify passes. The valid entries are 60, 120, 180, 240,
360, 480, 720 or 1440.
SETSELECTPT=PtId signifies that a patient has been selected by a QPM. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging. VERIFY[=PtId] initiates an immediate verify pass. The patient to verify may optionally be specified.
SHOW
ACTIVE shows the active CDSClient workstations. DUMPCACHE[=PtId] shows Cached data. If no patient id is given, the patients cached will be displayed.
If a patient id is given, the items stored for that patient are displayed.
STATS returns the current QS statistics. STATUS shows operational information about CDS.
47 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
ProcessControl&Status-PROCESSARGUMENTS
HIS-HL7(Inbound)Arguments
SET
ADT=TRUE enables ADT processing. ADT=FALSE disables ADT processing. FLUSH=TRUE disables all HL7 processing. Use with EXTREME CAUTION!!! A number of
transactions to FLUSH may be specified instead of TRUE.
FLUSH=FALSE re-enables HL7 processing. LAB=TRUE enables LAB processing. LAB=FALSE disables LAB processing. NEWLOG closes the current log file and opens a new one. ORDER=TRUE enables Order processing. ORDER=FALSE disables Order processing. TRACE=TRUE enables ComPort tracing on the HL7 Lower Level Protocol. TRACE=FALSE disables ComPort tracing. TXACT=TRUE enables transaction logging. TXACT=FALSE disables transaction logging. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging.
HIS-HL7O(Outbound)Arguments
SHOW
STATS will display the current metrics and QS statistics. STATUS shows operational information about STATUS.
SET
NEWLOG closes the current log file and opens a new one. ROUTER=TRUE enables Results to be transmitted. ROUTER=FALSE disables Results to be transmitted. SERVER=TRUE enables Outbound requests. SERVER=FALSE disables Outbound requests. TXACT=TRUE enables transaction logging. TXACT=FALSE disables transaction logging. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging.
REF 2002033-023 48 Revision A
LASArguments
SET
DATA[=ALL | ADT | LABDIR | LABDATA | LABNOTE | RWHAT] enables data logging on the type of data
selected. If none of the optional data types is specified, ALL is logged.
[NO]DEBUGMODE enables or disables debug data logging. NODATA[=ALL | ADT | LABDIR | LABDATA | LABNOTE | RWHAT] disables data logging on the type of data
selected. If none of the optional data types is specified, ALL is logged.
VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging.
SHOW
MLIST[=IP_ADDRESS] returns the current entries in the monitor list. The IP address of the monitor to list
may optionally be specified.
STATS returns the current QS statistics. STATUS shows operational information about CDS.
Quantitative Sentinel® Service Manual
ProcessControl&Status-PROCESSARGUMENTS
LOGSArguments
SET
NEWLOGS closes the current log file and opens a new one. NEWSTATS closes the current stat file and opens a new one.
SHOW
STATSreturns the current QS statistics. STATUS shows operational information about LOGS.
PDATSArguments
SET
METRICS=NN sets the per slot performance metrics interval to the specified value (in minutes). NN must
have a value between 1 and 1440, inclusive.
RESET METRICS resets (zeros) the total performance metrics. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging.
SHOW
PATIENT=PTID shows detailed information on the specified patient(s). Wildcard characters of '*' and '?'
may be used in the PTID.
SLOTS[=start-stop] shows the patients in the specified slots. STATS shows the current PDATS metrics and QS statistics. STATUS shows operational information about PDATS. TABLES shows the CDAT tables in use.
49 REF 2002033-023
Revision A
ProcessControl&Status-PROCESSARGUMENTS
PDSSArguments
SET
BASEHOUR=HH sets the starting hour for verify passes hour. HH must be a value from 0 to 23. INTERVAL=MM sets the minutes between periodic verify passes. MM must be 60, 120, 180, 240, 360,
480, 720 or 1440.
LOAD=PtId[@Workstation] loads the specified patient in PDATS. The workstation to load the patient at
may optionally be specified.
NEWLOGS closes the current log files and opens new ones. PURGE=PtId deletes the specified patient from the system!!! RESTORE=PtId@Workstation restores the specified patient. The patient's data must reside in the PFILS
directory on the specified workstation.
UNLOAD=PtId unloads (drops) the specified patient from PDATS. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging. VERIFY[=PtId] initiates an immediate verify pass. The patient to verify may optionally be specified. If '*'
is specified, a verify on ALL patients will be initiated.
Quantitative Sentinel® Service Manual
SHOW
BEDMAP shows the patient id for each occupied bed. PATIENTS WHERE CRITERIA=VALUE[, CRITERIA=VALUE][, FULL] shows roster information for selected
patients. One or more selection criteria may be specified. Criteria are logically ORed. Valid criteria are: ATTEND, BED, GROUP, ID, INFO, NAME, PDATS, PFILS, SERVICE, UNIT. Selected information for each patient will be shown unless FULL is specified.
PATIENTS ALL[ FULL] shows roster information for all patients. Selected information for each patient
will be shown unless FULL is specified.
PDATS shows MAX, USED, and FREE slots for each PDATS. PFILS shows the number of patients served and disk space available for each PFILS. PTDELTA=ID shows the current PtDelta values for the given Patient ID. STATS will return the current QS statistics. STATUS shows operational information about PDSS. TABLES shows the CDAT tables in use.
REF 2002033-023 50 Revision A
ProcessControl&Status-PROCESSARGUMENTS
PFILSArguments
SET
BASEHOUR=x sets hour of the day that the verify interval is started on. The valid range for 'x' is 0 to 23. BCACHE=# sets the number of backup file handles to be cached. The range must be between 10 and
1024 inclusive.
COPY=PTID>FILENAME causes PFILS to copy the patient record to the specified file. DROP=PTID causes PFILS to end serving the patient PTID. May be suffixed with the modifier /
BINARY to force a binary (non-text) return code. May be suffixed with the modifier / RENAME to cause PFILS to end serving the patient PTID and rename the data file, or with the modifier /DELETE to cause PFILS to end serving the patient PTID and delete the data file.
INTERVAL=x sets the minutes between periodic verify passes. The valid entries are 60, 120, 180, 240,
360, 480, 720 or 1440.
PCACHE=# sets the number of primary file handles to be cached. The range must be between 60 and
6144 inclusive.
REENUMERATE removes patients from the Work List that there are not any files for them. Initiates
service for patients that are not in the Work List.
SERVE=PTID causes PFILS to begin serving the patient PTID. May be suffixed with the modifier /
BINARY to force a binary (non-text) return code. May be suffixed with the modifier / CREATE to cause PFILS to create the data file and begin serving the patient PTID.
VERBOSE=TRUE causes PFILS to log and show INFORMATIONAL messages. VERBOSE=FALSE causes PFILS to ignore INFORMATIONAL messages. VERIFY[=PtId] initiates an immediate verify pass. The patient to verify may optionally be specified. ZEROASTATS resets the total Append Statistics to zero. ZEROCSTATS resets the Cache Hit/Miss Counts to zero.
Quantitative Sentinel® Service Manual
SHOW
ASTATS returns the current append performance statistics. CSTATS returns the current cache performance statistics. HSTATS returns the current work list hashing distribution statistics. MSTATS returns the current Merge statistics. PATIENT=PTID[/BINARY] returns a list of detailed information on the given patient.The wildcard
characters of '*' and '?' may be used in the PTID. BINARY will cause PFILS to respond to the SHOW command in an internal format useful only to PFILSC.
SLOTS=[start-stop] returns a list of patients in the Work List in the range of slots given. STATUS returns the current Process Status. This is the default SHOW option. STATS returns the current QS statistics.
51 REF 2002033-023
Revision A
PMSArguments
SET
System Modes
/[NO]CHECKSKEW enables/disables checking for skewing on monitor timestamps. /[NO]MISSEDSTORE enables/disables missed storage interval processing. /[NO]STOREALARMS enables/disables storing data when the monitor is in alarm. /[NO]VERBOSE enables/disables informational message logging.
For the following stored procedure parameters, x can have any of the following values: ALL, NONE, ECG, VITALSIGNS, TEMPERATURE, OXYGENATION, VENTILATOR, CARDIACCALCS, FIXED, FETALMONITORINGA + sign can be used to combine the options. The default value is ALL.
/STPROCABG=x sets what PMS item types to store when the Arterial Blood Gas stored procedure is
stored.
/STPROCCO=x sets what PMS item types to store when the Cardiac Output stored procedure or
Cardiac Calculations are stored.
/STPROCPC=x sets what PMS item types to store when Pulmonary Cardiac Calculations are stored. /STPROCNBP=x sets what PMS item types to store when the NIBP stored procedure is stored. /STPROCWP=x sets what PMS item types to store when the Wedge Pressure stored procedure is
stored.
SYNC ? shows a summary of Unity Time Sync commands and parameters SYNC=[0, 1, or 2] 0 disables Unity time master synchronization. 1 enables Unity time master
synchronization. 2 performs a one-time immediate time sync with the Unity network.
SYNCTIME=[0000..2359] sets the time of day at which the server synchronizes its time with the Unity
network.
SYNC_QUOTA=[0..255] sets the maximum number of times per day synchronization takes place. SYNC_DRIFT=[1..255] sets the maximum time difference allowed between QSServer and Unity
network time master before synchronization takes place.
Quantitative Sentinel® Service Manual
ProcessControl&Status-PROCESSARGUMENTS
Note
Per Acquire
/ACQUIRE=NameSelects the Acquire task that you wish to control. /NEWLOGCycles the current message log file for the selected Acquire task. /[NO]DATAEnables/disables data logging on the selected Acquire task. /[NO]TRACEEnables/disables ComPort tracing on the selected Acquire task.
REF 2002033-023 52 Revision A
Quantitative Sentinel® Service Manual
ProcessControl&Status-PROCESSARGUMENTS
Per Bed
/BED=Name selects the Bed that you wish to control. /ACK acknowledges a notification on the selected Bed. /[NO]DATA enables/disables data logging on the selected Bed. /[NO]NOTIFY enables/disables notifications on the selected Bed. /HI=LIMIT, DURATION, RECOVERY, RESET changes Hi settings on the selected Bed.LIMIT range is
30 to 240 bpm and Hi must be at least 10 greater than Lo. DURATION/RECOVERY range is 1-600 seconds, RESET range is 1 to 3600 seconds.
/LO=LIMIT, DURATION, RECOVERY, RESET changes Lo settings on the selected Bed.LIMIT range is
30 to 240 bpm and Hi must be at least 10 greater than Lo. DURATION/RECOVERY range is 0-120 seconds. RESET range is 1 to 3600 seconds.
/PEN=DURATION, RECOVERY, RESET changes Penlift settings on the selected Bed.LIMIT range is
30 to 240 bpm and Hi must be at least 10 greater than Lo. DURATION/RECOVERY range is 1-300 seconds. RESET range is 1 to 3600 seconds.
/TACHY=VALUE changes Tachycardia MHR setting on the selected Bed. /BRADY=VALUE changes Bradycardia MHR setting on the selected Bed. /[NO]NOTIFY enables/disables notifications on the selected Bed. /[NO]MATERNAL enables/disables maternal-only mode on the selected Bed.
Beds with Serial Fetal Monitor Acquire
/[NO]TRACE enables/disables ComPort tracing on the selected Bed. TRACE may be enabled for
only one FM Serial bed per workstation at any time.
/CLOSEFMPORT closes the serial port to the bed's monitor.
Per Bed/Acquire
/BEDACQUIRE=BedName,AcquireName specifies the Bed-Acquire you want to control. /[NO]DATA enables/disables data logging on the selected Bed-Acquire. TENERRORS=mm sets PMS to cycle if ten store errors occur in mm minutes. The default is to set
mm to zero which disables cycling on store errors.
SHOW
(no parameters) gives standard info. /ACQUIRE=Name selects the Acquire task(s) that you wish to check by specifying the name of the
acquire task (e.g. SerialFM). If no acquire tasks are specified, status for all tasks will be displayed.
/BED=Name selects the Bed(s) that you wish to check by specifying the bed name(s). If no bed names
are specified, status on all beds will be displayed./BED=Name displays status for ALL acquires for the bed.)
/BEDACQUIRE=BedName,AcquireName selects the particular bed/acquire combination that you wish to
check.
/DATA=Name displays cached parameter data for the specified bed. /STATS displays QS statistics.
53 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
ProcessControl&Status-PROCESSARGUMENTS
PtDArguments
SET
Supports the following: Help, Interval, InvalidNumber, NewLog and Verbose. Only one command may be specified at a time.
ASCII Export only
INVALIDNUMBER=TEXT invalid number is exported as text string. INVALIDNUMBER=NULL invalid number is exported as null value. INTERVAL[=minutes] wakes up PtD and optionally changes the schedule interval to the specified
minutes.
NEWLOG closes the current log file and opens a new one. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging.
QPMArguments
CYCLE
(no parameters) cycles the QPM program. REBOOT restarts the workstation
SET
/[NO]VERBOSE enables/disables informational message logging.
SHOW
(no parameters) gives standard info. STATS provides statistics info. BEDMAP provides a list of the current Bed/Patient map. ALL provides both info and statistics.
REF 2002033-023 54 Revision A
QSConnectArguments
SHOW
STATS returns the current QS statistics. STATUS shows operational information about QSConnect.
SET
NEWLOGS closes the current log files and open new ones. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging. CONNECT=ConnectName/SetCommand passes the SetCommand to the specified ConnectName
Valid SetCommands are:
START initiates the specified ConnectName. STOP terminates the specified ConnectName. PAUSE temporarily suspends the specified ConnectName. RESUME restarts the paused ConnectName. DATA=ON initiates data logging on the connect. DATA=OFF terminates data logging on the connect. TRACE=ON initiates trace logging on the connect. TRACE=OFF terminates trace logging on the connect. FLUSH=TRUE enables data collection by the connect. FLUSH=FALSE disables data collection by the connect. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging.
Quantitative Sentinel® Service Manual
Page intentionally left blank.
SPPArguments
SHOW
STATS returns the current QS statistics. STATUS shows operational information about SPP.
SET
NEWLOGS closes current log files and opens new ones. VERBOSE=TRUE enables informational message logging. VERBOSE=FALSE disables informational message logging. START initiates the next job running if it is scheduled to run today
REF 2002033-023 55 Revision A
Quantitative Sentinel® Service Manual
Page intentionally left blank.
REF 2002033-023 56 Revision A
Quantitative Sentinel® Service Manual
Chapter 3
NetworkArchitecture

OVERVIEW

The QS uses networks for two basic types of communication. First is the communication amongst the QS server and its clients. Second is the collection of patient monitor data by the QS Patient Monitoring System (PMS) server.
At a high level, the QS server and its clients connect using the Internet Protocol (IP). This can operate over a variety of lower level protocols and physical media. In a Local Area Network (LAN), this is nearly always Ethernet but can be token ring as well. Such LANs can be joined to form Wide Area Networks (WANs) using various connections such as ISDN and T1 lines.
Many types of patient monitors exist, and they transmit patient data in many different forms. Thus, the QS PMS process that collects these data may have varied inputs. Fetal monitors typically feed the PMS process through serial connections either to a Digi adapter in the server, or to an Equinox box which then passes the data on to the server over the Ethernet using IP. Other monitors reach the PMS server using IP by connecting directly to the Ethernet.
Since IP on Ethernet is so prevalent, it is possible to put much of the QS’s communication onto a single network. For instance, it is theoretically possible to run the QS client-server communication and some of the PMS monitor-data collection over a hospital’s existing Ethernet, along with any other resident applications.
However, clinical performance requirements often dictate that the QS be put on its own Ethernet, isolated from the existing Hospital network. Further, monitor data running on IP over Ethernet is nearly always on its own GE Medical Systems Unity LAN, separating the QS client-server communication from PMS data collection. Fortunately, intelligent (switching) Ethernet hardware can minimize collisions by directing frames only to the correct LAN segments and by limiting broadcasts’ collision domains with virtual LANs (VLANs). This allows the separation of the aforementioned QS client-server communication, PMS monitor data collection, and other hospital applications, despite their use of the same networking hardware.
FETALMONITORCOMMUNICATION:DIGI&EQUINOX
Many fetal monitors can send data out over serial connections. Sometimes intermediate hardware is needed (as in the case of Sacs for certain Hewlett-Packard monitors) but basically the basic approach is the same for all. Wired serial connections are run from the monitors to a concentrator, whether a Digi or an Equinox. The concentrator gathers the output from multiple monitors and relays it on the QS’s PMS process. A Digi concentrator delivers it over a dedicated Digi line to the Digi adapter card in the PMS server. An Equinox concentrator packages the serial monitor data into IP and passes them over Ethernet to the PMS process. Details of each appear in the following sections.
57 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
NetworkArchitecture-SERIALCOMMUNICATION:DIGIEQUIPMENT
SERIALCOMMUNICATION:DIGIEQUIPMENT
The QS’s PMS process collects data from fetal monitors via serial input. The Digi C/X system provides multiple serial ports on the PC where the PMS process resides. As many as 128 serial connections (and thus fetal monitors) can be multiplexed to a single Digi adapter. This is accomplished by connecting Digi concentrators (also called extenders), each with sixteen serial ports, to the Digi adapter. The Digi adapter’s two ports will support a total of up to eight Digi extenders. These extenders can all be daisy chained to one port, or split in any amounts between the two ports. Figure 13 shows possible Digi connections.
fetal monitors
PC w/Digi card
Digi
concentrator
serial-fiber transceiver
RS-232 copper, 250 foot max from fetal monitor to Digi concentrator
RS-422 copper, 1000 foot cumulative max from Digi adapter port to last concentrator on line
fiber optic cable, 1.2 mile max be tween any two transceivers
Digi concentrator, up to 8 total, in any combination, attached to the two Digi adapter ports
fetal monitor, up to 16 per Digi concentrator (max 128 monitors if all 8 possible concentrators are used)
Figure 13: Digi Serial Connections
Two types of media may be used in the Digi serial network: fiber optic and copper cable. Over copper, the fetal monitor passes data via EIA-232 asynchronous serial communication to the Digi concentrator. Thus only copper cable is used to wire rooms to concentrators.
Also over copper, the concentrators connect to one another and to the Digi adapter card by way of high speed EIA-422 synchronous serial connections. However, any number of fiber segments may be inserted anywhere within any of these copper EIA-422 connections when enclosed by a pair of fiber transceivers. Thus copper and fiber may be used to wire concentrators to each other and to the Digi adapter. Because any single fiber segment can be up to 1.2 miles long, its use will allow the serial connections to span much longer distances than will the 1000 foot cumulative span of the copper cable supporting EIA 422.
Cable specifications follow, however it is important to note that CAT5 unshielded twisted pair (UTP) cable may not be used for the serial fetal monitoring network. The serial concentrator vendor has specified a cable type and GE must adhere to this specification due to ISO 9001 guidelines and FDA policy.
REF 2002033-023 58 Revision A
Quantitative Sentinel® Service Manual
NetworkArchitecture-SERIALCOMMUNICATION:EQUINOXEQUIPMENT
CableSpecifications
Cable requirements for commonly employed network configurations are provided in the following paragraphs.
Copperroom-to-concentrator
Copper for RS-232, shielded, untwisted cable with foil and drain wire, 22 AWG installed in compliance with local codes. There is a 250 foot distance limitation from fetal monitor to serial concentrator .
Copperconcentrator-to-concentrator/concentrator-to-hostadaptercard
Copper for RS-422, STP 4-pair, foil with drain wire, 24 AWG installed in compliance with local codes. There is a 1000 foot (cumulative) from the host adapter to the last serial concentrator on the line.
Fiberopticconcentrator-to-concentrator/concentrator-to-hostadaptercard
Fiber Optic, Multimode 62.5mm/125mm, duplex configuration. 1.2 miles distance limitation.
NOTE
The 1000’ cumulative distance from the host adapter to the last serial concentrator still pertains when fiber is employed. The length of fiber is merely not considered in the overall measurement,
The most important characteristics of this system that need to be considered during the quote phase are:
• 16 ports (beds) per serial concentrator
• Two separate lines on the Digi controller card (typically installed in the main or load share server)
• Any combination among the two lines of the adapter up to 8 extenders
Physical location will effect the amount of equipment needed and its layout. For example, if there are 4 beds in Unit A and 5 beds in Unit B a site may need two extenders (although there are fewer than 16 beds) due to physical separation of the units and the location of serial cable terminations.
SERIALCOMMUNICATION:EQUINOXEQUIPMENT
As stated before, the QS’s PMS process collects data from the fetal monitors via serial input. The Equinox ESP-16 is a 16 port terminal server which will allow data streams from 16 fetal monitors to be directed back to the PMS process via its 10/100BaseT Ethernet port. Multiple serial concentrators may be used as needed.
The cabling requirements for the serial side (between the Equinox and the fetal monitors) of the Equinox are the same as those listed above for the Digi concentrator usage. Though there is a difference in the pin-outs, the cable which needs to be pulled is the same. The Ethernet side of the Equinox box is a standard 10/100BaseT half-duplex connection. Once the Equinox is connected to the Ethernet, distance and data rate is limited only be the Ethernet infrastructure.
−with the added capability of CAT5 cable
59 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
Switch
NetworkArchitecture-IPCOMMUNICATION:LAN
IPCOMMUNICATION:LAN
This section will concentrate on Ethernet as it is our most commonly installed LAN type.
The first decision that will drive the remaining network equipment requirements is whether to install a 10Mb or 100Mb Ethernet network. Network performance is tied directly to the amount and availability of bandwidth (the amount of data that can be transmitted per unit of time). In short, more is better thus the 100Mb Ethernet is preferred. Today there is little cost difference between 10 and 100Mb components so the decision is not a difficult one.
Generally, all network components purchased are either 10Mb, or all are 100Mb, but there are exceptions. Nearly all network interface cards in the computers supplied by GE are auto-sensing and can connect at either speed. Other network components also have the ability to mix media speeds. For example, the Bay Networks BayStack 350 series switch can have up to twenty-four 10/100Mb auto-sensing ports which allow both 10 and 100Mb Ethernet clients to attach to it.
Hubs and switches are used to connect the various network cables together. Hubs listen on all ports and repeat any data that arrive on a given port as output on all other ports. Switches do the same except that they repeat the incoming data as output ONLY on the proper destination port, as shown in Figure 14. Thus switches allow more network traffic because their intelligent delivery of data confines much traffic to smaller segments, minimizing collisions. Much of the data heard by the switch will not be repeated at all because it will be sent out only from the same port where the destination machine is connected.
sender
receiver
Hub
Data leave the hub on all but the sender's
port.
sender
receiver
Data leave the switch only on the
receiver's port.
Figure 14: Hubs Versus Switches
Hub and switch requirements will also be driven by the number of purchased QS network connections as well as physical network layout. If a site has purchased a total of twelve Ethernet connections for the QS, a single 12-port hub may not be sufficient due to network cables being pulled to two separate wiring closets. In this instance two hubs would be required.
Also, it is possible to join more network connections than the number of ports in the largest hub. The quote template includes stackable hubs that may be combined to form one large virtual hub when many network connections run to a single central location. This can be done with UTP cable but most hubs have fiber optic ports to allow such hub-to-hub connections.
REF 2002033-023 60 Revision A
Quantitative Sentinel® Service Manual
NetworkArchitecture-IPCOMMUNICATION:LAN
While this may be sufficient for small installations, large numbers of machines in a single logical hub can create excessive collisions. For this reason it often makes sense to link hubs from different areas to the server’s central location by connecting them to a switch. As with hub-to-hub connections, this can typically be done using fiber optic or UTP cable. The switch can then simultaneously compartment the various segments’ traffic while allowing all to reach to the server. Other reasons for using a switch are:
• Ethernet clients terminating to one of several wiring closets (e.g. multiple units):
• A mix of media (i.e. UTP and fiber)
• Customer desired network performance
• Switching used to isolate the QS when utilizing a house network
The currently preferred switch has space for 4 media adapters. The available adapters are 2-port 100Mb UTP, 2-port 100Mb fiber, 4-port 10Mb fiber and an 8-port 10Mb UTP and an expansion module allowing connection to another switch. These modules may be installed in any combination. Each connection to the switch will require a port of the appropriate speed and medium type. The server(s) may plug directly into the switch in lieu of an additional hub.
CableSpecifications
Cable requirements for commonly employed LAN configurations are provided as follows:
Ethernet cabling specifications and limitations:
• Plenum rated CAT5 unshielded twisted pair (UTP) 4-pair, 24 AWG
• 330’ from component to component
Fiber specifications and limitations:
• Multimode 62.5µm/125µm, duplex configuration
• 1.2 miles distance limit
61 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
NetworkArchitecture-IPCOMMUNICATION:WANISSUES
IPCOMMUNICATION:WANISSUES
The previous topics are applicable to the QS network being installed in a single site. There are additional considerations when implementing a QS network at several, physically separate sites. These instances are referred to as wide area network (WAN) implementations.
A WAN is generally considered to be a network that covers a wide geographical area and operates at speeds generally lower than those of a local area network (LAN). The QS has been successfully implemented over a number of connection types, including ISDN, T1, T3, ATM, etc. GE has no preference with regard to WAN connection type, but we do have some general guidelines concerning number of workstations per connection type.
• ISDN should be utilized for single workstation connectivity.
• T1 may be utilized for up to 10 workstations.
• Any remote site with greater than 10 workstations should be connected using T3, ATM, or some other high-speed WAN connection.
The factors that determined these general rules are discussed further in the Network Traffic Statistics section of this guide.
With any WAN implementation, the customer is responsible for installation, configuration and support of supplied WAN components ensuring end-to-end connectivity. GE does not have the technical support resources, knowledge base, or tools to provide support of this nature.
GE will work with the customer to select WAN hardware and software that meets the requirements of the QS network as part of network-related Project Management consultation.
IPCOMMUNICATION:NETWORKTRAFFIC
On average, the QS software places a 5-15% load on a local 10Mb Ethernet network. During the running of certain processes such as printing, PtD jobs (patient data export and archiving), chalkboard verification functions, and fetal data review of high risk patients (long-term monitored patients), the network can experience bursts of 40-60%.
th
A T1 line speed is 1.544 Mbps (about 1/6 network, the average bandwidth utilization of the software can exceed the entire capacity of a T1 line. Consequently, if a hospital has more than 10 workstations connecting to the server over a WAN, a single T1 line is not sufficient.
Several alternatives are available. If possible, connection via fiber is the most efficient. If a fiber solution is not viable, options include multiple T1 lines (1 line per 10 workstations) and a load balancing router (a router that bonds T1 lines together and switches from one line to the next when the a T1 line reaches capacity), or other high speed networks such as T3, ATM or frame relay.
The figures above are estimates. Recommendations are based on the assumption that the QS system is isolated from the house network and/or is running on a dedicated T1 line(s).
the speed of Ethernet). When using the QS across a wide area
REF 2002033-023 62 Revision A
Quantitative Sentinel® Service Manual
NetworkArchitecture-DIALUPACCESSTOTHEQS
DIALUPACCESSTOTHEQS
The QS requires dialup access allowing GE to service, troubleshoot, and maintain the system. Access is accomplished using a remote access service (RAS) dialup connection. The main use of this connection is for system upgrades and system support calls.
System upgrades occur anywhere between two and six times a year including major and minor releases as well as patches. The connection is used to download the new software, application files, and/or tools releases to the server upon which it is distributed to the clients automatically.
System support calls are the result of the site contacting GE technical support with any manner of system problem. Technical support will utilize the dialup connection to troubleshoot, diagnose, and repair system errors.
While the majority of our customers have the support modem active at all times, there have been occasions when, due to security concerns, we have been asked to use alternative methods for access. The most common method of introducing additional security is having the modem powered off and requiring the technical support engineer to call a 24-hour hospital help desk for modem activation. There are other methods which are acceptable but it is important that the technical support department is contacted as to verify the technical aspects as well as the non-business hours feasibility.
THEQSANDTHEHOSPITALNETWORKENVIRONMENT
Because of the amount of broadcast data associated with the patient monitoring functionality of the QS, and the need for available bandwidth to transmit critical patient information, it is highly recommended that the QS network segment is physically or virtually isolated from any existing hospital “house” network. Segmentation also aids in troubleshooting and problem isolation for both the QS and the house network. Having the networks isolated eliminates one potential source of error for both GE Technical Support and a hospitals IS staff.
There are three methods of network isolation most commonly used with QS implementations. Physical segmentation has new, dedicated cable installed for exclusive use of the QS. This is the most common and easy to implement manner of isolation. A router may be installed to isolate the QS segment from the house network. Finally, in a switched environment, the QS may be placed on its own VLAN.

INTERFACES

The QS is capable of receiving data from HL7 compliant hospital information systems (HIS) lab, and pharmacy systems. There are two ways the connection between systems can be made.
The first, and most common, is a TCP/IP network connection. Basically, a router is placed between the QS network segment and the hospital network and a route is established allowing the traffic to pass to the QS server. The router is required for network isolation which will be covered further.
The second connection method is a serial connection. In this method, a serial connection is run directly to a COM port on the machine running the data acquisition process.
There are several QS processes that are related to the implementation of an interface to a HIS. The HISS process is started on typically a QS server or load sharing server. This process accepts and stores data from the ADT and/or Lab systems. LAS (Lab Access Server) is the QS process that supplies ADT information and Lab data to Solar monitors. PMS is the process that acquires physiological data from various sources and an acquire task is needed to gather HIS or LAS data.
63 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
NetworkArchitecture-UNITYISSUES
UNITYISSUES
The GE Medical Systems Unity network is a link for efficient sharing of clinical information between cardiology, patient monitoring (non-fetal or maternal/fetal), hospital information and laboratory equipment.
A second network interface card is installed into the QS machine (and its backup, if one exists) which gathers patient data. This card is assigned an IP address in the Unity network range as supplied by GE Medical Systems. This card is then connected to one of the Unity (real time network) hubs. Information is then made available to the QS from GE Medical Systems monitors as well as non-GE Medical Systems bedside devices connected to the network. Non-GE Medical Systems devices are connected using Octanet, Octacomm or UnityNetworkInterfaceDevice solutions.
InterfaceDevices
The Octacomm and UnityNetworkIDdevices are self-contained, network-able, multi-port data interface devices that have the ability to interface external, standalone, patient-connected devices to the GE Medical Systems Unity network.
Octanet
Essentially, the QS will interface to the Octanet in the same manner as an Octacomm or Unity Network ID device. The difference is the Octanet interfaces peripheral bedside devices through a Solar monitor as compared to the interface devices that are connected to the same network as the adult monitors. When interfacing to Octanet, the QS will receive what the adult monitor transmits, which is not necessarily all parameters which the peripheral bedside device is transmitting.
The type of bedside peripheral devices include, but are not limited to, ventilators, IV pumps, NBP, SpO2, urimeters, other manufacturer’s monitors, or any device that produces RS-232 serial output. Device ID Cable Adapters (DIDCA) are used to interface and identify various devices to the Unity Network ID, Octacomm, and Octanet.
NTISSUES
• User Accounts and Security
The QS uses two accounts for system functionality: QS and QSuser. The QS account is a member of the Administrative group on the local machine and is used for support purposes. The QSUser account is a member of the Users group and has no special privileges. By default, the system will automatically login the QSUser account and start the QS application. This behavior can be changed so as not to automatically login and not to auto-start the QS application if the site wishes to implement workstations differently.
• Workgroup versus Domain
The standard QS system uses the workgroup model. If a site wishes to integrate the QS workstations into an existing domain, the site may do so after the system is installed. The site will be responsible for managing the domain and must maintain the Domain Controller/Backup Domain controller on servers other than the QS system servers.
rd
•3
Party Applications
3rd party applications may be installed on the QS clients. The installation and support of these applications is the sole responsibility of the hospital staff. GE will not provide technical support for installation and/or use of such applications.
REF 2002033-023 64 Revision A
Quantitative Sentinel® Service Manual
Network Architecture - NT ISSUES
• Static IP Addresses and DHCP
While the QS can be implemented in a network that utilizes DHCP, the IP addresses assigned to the QS workstations need to be static. The QS workstations are identified within the application by their IP address.
65 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
Page intentionally left blank.
REF 2002033-023 66 Revision A
Quantitative Sentinel® Service Manual
Chapter 4
Software
Considerations

OVERVIEW

Events such as workstation replacement or repair will make it necessary for support personnel to either install or upgrade the QS configuration on one or more client workstations. The following paragraphs describe both of these processes.
This chapter also lists the minimum requirements for upgrading to QS Version 6.60.0.
Please note that changing server configurations, workstation names, etc. or other integral parameters of the QS (as installed at your site) is a serious undertaking. Generally, tasks of this nature should not be attempted without discussion with either a member of your facility’s IT staff or a QS Customer Support representative.

SOFTWARE INSTALLATION

The install program contained on the QS® Client CD (part number 2008342-002) provides a quick and efficient method of performing the following QS client workstation configuration tasks:
• Verification of all inputs
• Creation of necessary directory structure
• Placement of tools files into their proper location on the target machine
• Creation of QS accounts - QS, QSUSER (if needed)
• Creation of Start menu items
• Addition of registry entries to support the QS
• Addition of the Time Service
• Addition of the WINVNC server
• Establishment of autologon parameters
67 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE INSTALLATION

Prerequisites

Requirements for QS 6.60.0 client workstations, server workstations and network configurations are provided by Table 6, Table 7, and Table 8, respectively.
Table 6: Client Workstation Requirements
CATEGORY REQUIREMENT
General Requirements • Must be capable of operating with Microsoft Windows NT 4 or Microsoft
Windows 2000 Professional
• Must be capable of running Quantitative Sentinel (QS) Version 6.60.0
• Must be capable of operating on a TCP/IP-based network - network requirements are provided in Table 8
• Operating System partition must be 1 GByte or greater
• Space allocated for QS configuration and data storage must be 4 GBytes or greater
• Video system (monitor) must support a resolution of 1024x 768 dpi and be capable of displaying 16 bit colors
• Taskbar property Always on Top must be disabled
Additional Requirements for Perinatal Installations
Required Components for NEW (QS6.60.0) Installations
Required Components for Sites Upgrading to QS6.60.0
• Must be capable of emitting audible alert tones
• Must not shutdown the patient data display (i.e. the power-save mode must be capable of being disabled)
• Must support use of Internet Explorer Version 6.0 or later
• Must support use of Adobe Acrobat Version 4.0 or later
• Intel Pentium III (or compatible) Microprocessor operating at 1.0 GHertz or greater
• Microsoft Windows 2000 Professional with Service Pack 3 or Microsoft Windows NT 4 with Service Pack 6
• 256 MBytes of RAM or greater
• 4.0 GByte Storage Subsystem or greater
• 17 inch (or greater) Display Monitor with a refresh rate of 72 Hertz
• Keyboard
• Windows-compatible Mouse or Trackball
• CD-ROM Drive
• Intel Pentium III (or compatible) Microprocessor operating at 400 MHertz or greater
• Microsoft Windows 2000 Professional with Service Pack 2 or 3, or Microsoft Windows NT 4 with either Service Pack 4 or 6
• 96 MBytes of RAM or greater
• 2.0 GByte Storage Subsystem or greater
• 15 inch (or greater) Display Monitor with a refresh rate of 60 Hertz or greater
• Keyboard
• Windows-compatible Mouse or Trackball
• CD-ROM Drive
Additional Considerations • All hardware should appear on the Microsoft Compatibility List
appropriate for the installed operating system.
REF 2002033-023 68 Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE INSTALLATION
Table 7: Server Workstation Requirements
CATEGORY REQUIREMENT
General Requirements • Must be capable of operating with Microsoft Windows NT 4 or Microsoft
Windows 2000 Server
• Must be capable of running Quantitative Sentinel (QS) Version 6.60.0
• Must be capable of operating on a TCP/IP-based network - network requirements are provided in Table 8
• Operating System partition must be 2 GByte or greater
• QS configuration and data storage partition must be 4 GBytes or greater
Required Components for NEW (QS6.60.0) Installations
Required Components for Sites Upgrading to QS6.60.0
• Intel Pentium III (or compatible) Microprocessor operating at 1.0 GHertz or greater
• 768 MBytes of RAM or greater
• 18 GByte RAID-5 Storage Subsystem or greater with either a hot-spare or backup drive
• Windows-compatible pointing device (mouse or trackball)
• 1024x768 Display Monitor capable of 256 colors or greater
• Uninterruptible power supply or battery backup
• Keyboard
• CD-ROM Drive
• 3.5 inch floppy drive
• Clustered-server configuration or warm backup server
• Intel Pentium III (or compatible) Microprocessor operating at 500 MHertz or greater
• 384 MBytes of RAM or greater
• 9.0 GByte SCSI Storage Subsystem (RAID-5 or Monolithic)**
• Windows-compatible pointing device (mouse or trackball)
• 1024x768 Display Monitor capable of 256 colors or greater
• Uninterruptible power supply or battery backup
• Keyboard
• CD-ROM Drive
• 3.5 inch floppy drive
Additional Considerations • All hardware should appear on the Microsoft Compatibility List
appropriate for the installed operating system.
** On NT4 QS Servers with C:; D:; E:; F:; and G: drives, the QS drive (D:) used for configuration
information must have a storage capacity of 1 GByte or greater.
69 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE INSTALLATION
The QS requires a functional and reliable network system. Customers are responsible for providing and maintaining the network operation and performance characteristics at an acceptable level (see Tabl e 8).
Table 8: Network Requirements
CATEGORY REQUIREMENT
General Requirements • Must be capable of transmitting and receiving TCP/IP messages
between clients and servers
• Cable length must conform to network hardware manufacturer’s specifications
• Wireless transmission distance must conform to network hardware manufacturer’s specifications
Hardware Components • Network components must conform to IEEE-802 standards
• Components installed in client and server workstations must be supported by Microsoft - appear in the Hardware Compatibility List available on the Microsoft web site - http://www.microsoft.com/hcl
Workstations • Client to server communications must ensure TCP/IP communication
with low latency times (<10 millisecond average) and sufficient bandwidth (average utilization < 20%)
• Server components must be capable of transmitting at 100 MBps or greater
• Client components must be capable of transmitting at 10 MBps or greater
Network Drawings • Detailed network drawings (reflecting the as built configuration) must be
made available to GEMS IT
Server WorkstationTable 9 summarizes QS Tools applicability to specific QS versions and the specific CDs upon which each version of QS Tools may be found.
Table 9: Tools Version Applicability
CD-ROM Revision Tools Version QS Version Status
2008342-002 A 1.04 5.06.1 Active
2008342-002 B 1.05 6.00.0 Obsolete
2008342-002 C 1.05 6.00.0 Active

Assumptions

The Installqs program assumes that the Primary QS server is named QSSERVER and that it is reachable using TCP/IP. If the server name is not QSSERVER, then the variable QSUPDATE must be changed on every client to the name of the server that has the QS files for downloading. If the client cannot reach the server because it is in another IP domain, then the LMHOSTS and Hosts files must be modified to point to the correct TCP/IP address for the Primary QS Server.
Information on changing environmental variables and modifying the LMHosts and Hosts files may be found in the Windows documentation provided by Microsoft.
REF 2002033-023 70 Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE INSTALLATION

Installation Procedure

To complete the client workstation software installation process, perform the following steps.
1. Insert the QS Client CD into the CD-ROM drive of the workstation being configured.
2. Access a command prompt and change the directory to match that of the CD-ROM drive.
3. Start the automated installation process using the following command structure.
Installqs D: Y QSUSER
The command shown above reflects the use of normal parameters. Each parameter is sepa­rated from the others by a single-space. Each command element may be modified in accor-
dance with the information in Table 10.
Table 10: Installation Command Parameters
Parameter Description
Ta r get Drive (D: in the example)
Local Accounts (Y - normal selection)
Autologon / Autostart (QSUSER - normal selection)
This paragraph designates the drive to which the QS software will be copied (loaded). The acceptable range of inputs is from C: to Z:. This component MUST consist of a drive letter and a colon - example C:, D:, E:, etc.
Acceptable inputs are either Y or N.
•Enter Y (yes) if accounts are to be created on this client workstation.
•Enter N (no) if this workstation will be part of a domain structure where there is no need for accounts on this workstation.
Acceptable inputs are QSUSER, ALL, and NONE.
• QSUSER will autologon to the system at boot-time and start QPM.
• ALL will not autologon at boot-time, but will start QPM for any user who logs into the workstation.
• NONE will not autologon to the workstation at boot-time and will not start QPM for users who log into the workstation.
4. After the installation (configuration) process has been completed, remove the QS Client CD from the workstation drive.
5. Close the Command Prompt window.
NOTE
QSUSER is automatically added to the Power Users group as part of the
installation process. If the workstation is configured with Windows 2000, proceed directly to step 7. If the workstation is configured with Windows NT then Step 6 needs to be performed.
6. If the workstation is configured with the Windows NT operating system, you must remove QSUSER from the Power Users group through the use of the
Manager
7. Click the
capability.
<RMB> over an unoccupied area of the displayed desktop and select the Properties
Administrative Tools > User
menu option.
71 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE INSTALLATION
8. Select the Settings tab and make sure that the following options are set as indicated:
• Desktop Area - set for a resolution of 1024 x 768
• Color Palette - 65536 Colors (16 bit)
9. Reboot the client workstation.
NOTE
The <RMB> refers to the right mouse button for a pointing device configured for right-handed users generally used to access menu options.
10. Click the
<RMB> over the task bar and select the Properties menu option and make sure that
the following options are set as indicated:
• Auto hide enabled (check mark visible)
• Always on top disabled (no check mark)
11. Acknowledge all messages (including the welcome message) during reboot.
NOTE
If the client workstation is configured with the Windows 2000 Professional operating system, you will need to perform step 12 to ensure that all of the fonts installed during start-up are activated.
12. After the QPM program is running, perform a manual system shutdown and then reboot the workstation.
REF 2002033-023 72 Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE (VERSION) UPGRADES

SOFTWARE (VERSION) UPGRADES

The QS is periodically modified to correct operational anomalies and incorporate new feature sets in an attempt to best serve the needs of our customers. These modifications are automatically installed as part of a new installation; however, previously installed QS configurations will need to be upgraded in order for the features/capabilities of a particular QS release to be available.

Upgrade Process

Upgrades are provided free of charge to all customers either still under warranty or in possession of an active (unexpired) softwareserviceagreement (SSA). Customers that are neither under warranty nor in possession of a valid service agreement may still obtain upgrades; however they will need to initiate the process by contacting a QS sales representative.
Release Notes
The various features and fixes associated with a new QS upgrade are described in version specific releasenotes that are delivered by mail and/or email to primary customer contacts at each facility. These release notes are generally delivered once the associated QS release has become available.
Additional costs
Generally, there are no additional costs associated with a QS upgrade for customers possessing a valid warranty or SSA. However, should an upgrade require any of the following items/services, the associated costs will be the responsibility of the customer.
1. Procurement and installation of new hardware.
2. Training to address use of the new features.
3. Project management, corrective actions or services requiring a GE representative to travel to the customer facility.
Installation
The installation of a QS upgrade is generally performed remotely by GE personnel via a dedicated remote connection.
Personnel requirements
The normal upgrade process is performed almost entirely by a GE employee. However, a staff member at the facility being upgraded will be required to load the upgrade CD-R disc into the QS server workstation.
System down-time
The upgrade process involves suspension of QS system operations in order to perform system­cycling (rebooting) and other necessary procedures. Customers should be prepared for a period of disruption approaching eight (8) hours. Actual length of the disruption is determined by many factors such as the size and complexity of the installed QS configuration. Please be aware of the fact that GE Customer Support personnel will make every effort to minimize the duration of system non-availability.
73 REF 2002033-023
Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE (VERSION) UPGRADES
Upgrading sites not under warranty (without a valid SSA)
Customers without either a warranty or valid SSA should contact a QS sales representative at the following number to obtain information about obtaining the desired QS upgrade.
QS Sales ............................ 1-866-664-8677 option/extension 9
Upgrading sites under warranty (with a valid SSA)
The process that these customers should use to obtain a QS upgrade is described as follows:
1. Customer initiates a call to QS Customer Support (see listing) to request an upgrade.
2. QS Customer Support verifies that the customer either has a valid service agreement or is still under warranty.
3. If in possession of a valid warranty or SSA - QS Customer Support logs the request into the call log and an UpgradePreparationChecklist(see Table 11), which must be com- pleted prior to scheduling of the upgrade, is faxed to the customer.
4. The Customer completes and returns the checklist to QS Customer Support.
5. QS Customer Support contacts the customer soon after the completed checklist is received and reviewed to schedule the upgrade.
6. QS Customer Support ships an upgrade CD-R disc to the customer.
7. QS Customer Support orders documentation appropriate for the requested upgrade and has it shipped to the customer.
8. QS Customer Support performs the upgrade on the previously scheduled date.
REF 2002033-023 74 Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE (VERSION) UPGRADES

Upgrade Preparation Checklist

Table 11 exemplifies the upgrade preparation checklist normally provided by QS Customer Support.
NOTE
Please contact QS Customer Support should your facility desire to upgrade your current QS configuration. Do not use the example checklist that follows as its content may no longer be appropriate.
Table 11: Example Upgrade Preparation Checklist
COMPLETED
(Yes or No)
Contact Information
1. Do you have a GEMS-IT Software Services Agreement (SSA) signed?
2. Who are the Points of Contact for upgrade – including email, phone, pagers, and fax numbers:
• System Manager
• Clinical Perinatal Director
• IS Director involved in this upgrade (if
different from System Manager)
3. Do you want CD upgrade information shipped prior to upgrade
4. Should Documentation Manuals to be shipped to same POC & Address as upgrade CD?
Readiness Assessment (OS/2 vs NT, Clients vs Servers, Domain Environment)
5. What is your current QS version?
6. Is site using any OS/2 clients or servers for ANY processes below:
STEP COMMENTS
IfNo, please contact your sales rep to sign the SSA
before you are eligible for the upgrade
You should coordinate with each of them to ensure they
are aware of upgrade & know what, if anything, is
needed of them before or during the upgrade process
If Yes, provide name and address if different than cur­rently identified key contact
IfNo, provide name, address, phone, & email address
If you are on version prior to 5.06, this upgrade may be a
2 step upgrade process if you are not purchasing new
servers (see step #11 below)
• Printing 1. Ifyes, then you must convert all PLDs, Forms and
• Archiving
• Faxing
• Chalkboards Ifyes, then same process as Printing
75 REF 2002033-023
Charts from OS/2 to NT in order to print;
2. Will you have this conversion completed prior to your scheduled upgrade?
3. What is the scheduled date for this conversion to occur __________________________
Ifyes, are you using WORM drives?
1.
2. Have you ordered QS ACT services for converting platters to CD?
3. When do you plan to send your optical platters to GE
Ifyes, then same process as Printing
Revision A
Quantitative Sentinel® Service Manual
Software Considerations - SOFTWARE (VERSION) UPGRADES
Table 11: Example Upgrade Preparation Checklist
COMPLETED
(Yes or No)
STEP COMMENTS
• Spectra-Tel (Previous Version of Physician's Remote Access)
7. Are you using Old Style Fluids? Ifyes, then you will ultimately need to convert to New
8. If you are not sure about your OS/2 status, please take the steps outlined to the right and do not proceed with this Checklist until these steps are completed.
9. Per OS/2 questions above (step 8), if you have confirmed that you have no servers and/or clients running OS/2, then are your servers and clients on NT Service Pack 4 or above?
10.Do you have a Backup and Loadshare Server Complete the Server & Workstation Validation
Ifyes, then hospital needs to purchase OB Link
Style fluids by reentering all data.
NOTE: You can proceed with the overall upgrade
without completing this segment; however, you will not
be able to print any fluid information after upgrade
conversion.
1. Test each of the processes noted above (step 6) after turning off your OS/2 server and clients. If all your processes above work satisfactorily, then you are ready for the upgrade.
2. Contact Customer Support to confirm as necessary.
Ifno, you need to make arrangements with your IT department to have NT Service Pack 4 or above.
NOTE: GE strongly recommends Service Pack 6a.
Checklist for Steps 10 through 14 to ensure you have
appropriate server and client workstation hardware configurations to support QS 6.xx.x.
11.Are you ordering new servers?
12.Do you have suffient RAM for each Server? See Table 7
13.Are you ordering new client workstations? If yes, then any new workstations provided by GE will
14.Do you have suffient RAM for each client workstation? See Table 6.
15.Is your site on a Domain?
Ifyes, then you do not need to contact Customer
Support to schedule your upgrade. Our manufacturing
operations will deliver your existing site tables with the
upgrade incorporated.
Ifno, you need to upgrade the amount of RAM in all
servers.
NOTE: If the site purchases additional RAM from GE, then the QSIC or GE Service representative can install the RAM in the server. Otherwise, the site is responsible for installing the RAM.
come with Windows 2000 Professional loaded.
NOTE: Windows 2000 workstations can coexist with Windows NT workstations on the same network. However, you will not be able to use the new workstations until their configuration is upgraded to QS
6.xx.x.
Ifno, you need to upgrade the amount of RAM in ALL
client workstations
If your QS system is running on the Hospital domain and
you have made changes to the original QS setup, then
your upgrade performance may be more complicated
REF 2002033-023 76 Revision A
Loading...
Buy Points How it Works FAQ Contact Us Questions and Suggestions Privacy Policy Cookie Policy Terms of Use