System, Nuance Configuration CSTD US20-S1K.805.01 US15-112.843.01

ACUSON S2000
Configuration
System
Nuance Configuration
This document is valid for:

ACUSON S2000 Ultrasound Systems
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ACUSON S2000 US15-112.843.01.01.02 Page 2 of 42 © Siemens, 2012

03.12 Ultrasound Restricted
Table of Contents 3
1 Nuance Configuration 4
1.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.1.1 Prerequisites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.2 Configuration Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.2.1 Nuance Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.2.2 Verify that Nuance License is Enabled. . . . . . . . . . . . . . . . . . . . . . 7
1.2.3 Set Up Nuance Transfer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
1.2.4 Nuance Configuration Verification . . . . . . . . . . . . . . . . . . . . . . . . 11
1.3 Creating Nuance Custom Fields . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
1.4 Advanced: Creating Custom Measurement Labels (Keys). . . . . . . . . . . . . . . 20
1.5 Removing Custom Key Substitutions File . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
1.6 Check for Missing Custom Fields. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
1.7 Nuance Transfer Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
1.7.1 Missing Accession Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
2 Changes to Previous Version 40
2.1 Changes to Previous Revision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
3 List of Hazard IDs 41
© Siemens, 2012 US15-112.843.01.01.02 Page 3 of 42 ACUSON S2000

Restricted 03.12 Ultrasound
4 1 Nuance Configuration
1.1 Overview
ACUSON S2000TM system VB21A software provides settings for configuring the ultra‐
sound system to transfer measured results to the Nuance, PowerScribe 360 server. The
Nuance data transfer feature is a licensed feature.
The Nuance export feature is configured on the Basic System, System Config page. The
user will be able to specify a server, site, username and password. This information will
be used when connecting to a Nuance server. When the connection is established the
Accession number is the unique identifier used to place all the measurements in the cor‐
rect exam. At the conclusion of an exam measurements are sent one at a time to the Nu‐
ance server. Successful completion or failure reasons are displayed in the syngo status
field. The Job Queue Form will allow the user to resend or delete items.
1.1.1 Prerequisites
Before visiting the customer who purchases the Nuance feature, contact the customer
Nuance server administrator to request:
1. Nuance Server IP Address - IP address of the Nuance device

2. User name - user name required to log in to the Nuance device
3. Password - the password required to log in to the Nuance device
4. Nuance Site Name - a name to identify a data repository

Nuance Configuration 1 5
1.2 Configuration Procedure
1.2.1 Nuance Setup

1. Select the System Config icon or press the System Config key. The system displays
the System Config window.
Fig. 1: Nuance Configuration

2. Select Service from the System Config menu. The system displays the Service Op‐
tions pane.
Fig. 2: Service Window
(1) Service Button

(2) Service Options Pane
(3) Local Service Button

3. Click Local Service... from the Service Options pane. The system displays the Authen‐
tication window.
Fig. 3: Service Software Authentication Window
4. Enter the Service Key, then click OK. The system displays the Service Software home
window.
5. Navigate to Service > Licensing.
1.2.2 Verify that Nuance License is Enabled

1. Click Configuration on the Service home window.
2. Navigate to Service > Licensing.

3. View the General Licensing settings.

Fig. 4: Configuration > Licensing > General Licensing Settings
a) Select Use Local License File if it is not already selected.

4. Click License Details.

5. Verify that the Nuance License (US_S2K_NUANCE) is listed and the license is current.
Fig. 5: Nuance License
1.2.3 Set Up Nuance Transfer

1. Exit out of the Service section.

2. Navigate to System Config > Basic System.

Fig. 6: Nuance Configuration
3. In the Nuance section of the Basic System window, enter the following information
in the fields. Refer to the graphic above for fields.
- 1. Enter IP address in Server Address, for example, http://192.168.253.102/
RadPortal.
- 2. Enter User Name in User Name, for example, admin.
- 3. Enter Password in Password.
- 4. Enter Site Name in Site, for example, University.
- 5. Click Save.

1.2.4 Nuance Configuration Verification

In this section, the steps to verify that Nuance has been set up correctly, and can be ac‐
cessed are described.
1. Log in the Service home page.

2. Click Utilities.
3. Select Escape to OS from the Source drop-down menu.
4. Select NT Commend Interpreter from the Command drop-down menu.
5. Type explorer in the Parameters field, then clock Go. The Windows Explorer win‐
dow will display.
6. In the Windows Address bar, type the IP address of the Nuance RadPortal that is being
used for Nuance Setup.
Fig. 7: Nuance Server Address

7. If the address is valid and the connection is working, the RadPortal Sign-In window
will be displayed. Enter the username and password that is being used for Nuance Set‐
up.
Fig. 8: Nuance Server Login

8. If the username and password are correct, the portal will be displayed, and Nuance
server setup has been done correctly.
Fig. 9: Nuance Portal Window
9. The Nuance Portal access has been verified. Sign out by clicking Sign out in the upper
right corner of the window, then close the Explorer window.

1.3 Creating Nuance Custom Fields

The ACUSON S2000 system exports data to Nuance as key/value pairs: a unique key (la‐
bel) that identifies a particular measurement that was made, and the value of that meas‐
urement. The key must match the Name of a Nuance Custom Field, or the measurement
will not be exported. This requires the customer to define Nuance Custom Fields for each
of the measurements they wish to receive and use in their Nuance reports. Here is a proc‐
ess for doing that:
1. Schedule a test patient on the HIS/RIS server (with Accession number) for a study to
be configured for export to Nuance.
2. Update the worklist on the ACUSON S2000 system and register the test study from
the Scheduler database.
3. Perform measurements for that study, following the normal protocol. Do not end the
study.
4. Insert a USB memory stick into a port on the ACUSON S2000 system control panel.
5. Start the ReportDriver tool by pressing Ctrl+Alt+M+D (there is no need to select Appli‐
cation, Repeat Count and Mode).

6. Click the "Save Nuance Key/Values" button.

Fig. 10: Save Nuance Key/Values

7. Browse to the USB memory stick, and save the "MeasurementDataKeyValues.csv" file.
Rename the file, as desired.
Fig. 11: MeasurementDataKeyValues.csv
8. Remove the USB memory stick and insert it into another computer.

9. Open the "MeasurementDataKeyValues.csv" file. (It will open in Microsoft Excel by de‐
fault.)
Fig. 12: MeasurementDataKeyValues Excel Sheet
10. The first column in the file contains the "keys", or labels that uniquely identify each
measurement made. The second column contains the corresponding values.
The key names are comprised of a series of parts separated by underscores ("_"). Each
part corresponds to some aspect of the measurement. When all the parts are assem‐

bled together, the key is unique to a report. The following pictures illustrate how the
keys can be correlated to report fields:
Fig. 13: Key Name Examples

11. For each of the keys in the first column, define a Custom Field in PowerScribe360. The
"Name" of the custom field must match the key exactly. The "Description" of the cus‐
tom field can be whatever is desired.
Fig. 14: Custom Field
12. Add these new custom fields as AutoText in the PowerScribe360 reports.
13. Update the study schedule in PowerScribe360 to include the test study.
14. End the study on the ACUSON S2000 system. The report data will be exported to Pow‐
erScribe360. Bring up the report for the test study in PowerScribe360 to view the da‐
ta.
 Repeat this procedure if it is necessary to map more studies to the Nuance server.

1.4 Advanced: Creating Custom Measurement Labels (Keys)

Some customers want to rename the "keys" (labels) that identify each measurement, to
suit their preferred way of organizing and defining Nuance Custom Fields. This section
describes how to configure the ACUSON S2000 system to create custom labels.
Internally to the ACUSON S2000 system, each measurement has a unique identifier (key)
that begins with "MCR_" (Measurements, Calculations and Reports). These keys often ex‐
ceed the 80-character limit for a Nuance Custom Field Name. Therefore, when exporting
measurements for Nuance, the keys are shortened according to some simple substitution
rules. These rules are defined in a system configuration file. It is a .CSV (comma separated
value) file, which can be conveniently read and written by Microsoft Excel. The first col‐
umn contains a pattern to look for in a key, and the second column contains a value to
substitute for that pattern. For example:

Fig. 15: Patterns and Substitutions
These default substitutions result in conversion from "MCR" labels to Nuance labels like
this:
MCR_LEFT_CAROTID_BULB_CV_DISTANCE_VASCULAR_MEAN
becomes
LT_CRTD_BULB_CV_DISTANCE_VASC_MEAN
and
MCR_LEFT_PROXIMAL_COMMON_CAROTID_ARTERY_CV_DISTANCE_VASCULAR[0]
becomes

LT_PROX_CMN_CRTD_ART_CV_DISTANCE_VASC[0]
If it is desired to have the ACUSON S2000 system export measurements to Nuance using
keys other than the defaults, create and install a custom "key substitutions" .CSV file.
1. Schedule a test patient on the HIS/RIS server (with Accession number) for a study that
is to be configured for export to Nuance.
2. Update the worklist on the ACUSON S2000 system and register the test study from
the Scheduler database.
3. Perform measurements for that study, following normal protocol. Do not end the
study.
4. Insert a USB memory stick into a port on the ACUSON S2000 system control panel.
5. Start the ReportDriver tool by pressing Ctl+Alt+M+D (do not need to select Applica‐
tion, Repeat Count and Mode).

6. Click the "Save MCR Key/Values" button.

Fig. 16: Save MCR Key/Values

Rename the file if desired.
8. Remove the USB memory stick and insert it into another computer.
9. Open the "MeasurementDataKeyValues.csv" file. (It will open in Microsoft Excel by de‐
fault.) The first column in the file contains the internal ACUSON S2000 system keys

that uniquely identify each measurement made. The second column contains the cor‐
responding values.
Fig. 18: MeasurementDataKeyValues Excel Sheet

10. Create a new file in Excel by clicking the "New" (empty page) button the toolbar.
Fig. 19: Create new Excel File

11. Switch back to the "MeasurementDataKeyValues.csv" and select the first column by
clicking on the column header.
Fig. 20: Select Column Header
12. Copy the column by pressing Ctrl+C.

13. Switch back to the new (empty) file, select the first empty cell in column A, and press
Ctrl-V to paste the original MCR keys into that column.
Fig. 21: Paste Column in New Excel Sheet

14. In column B, enter new labels that will be substituted for the original ones from col‐
umn A. Here is an example:
Fig. 22: Label Substitution Example
n Each line should have something in both column A and column B. Don't leave any
lines with only a label in column A. Remove the entire line if there will be no substitu‐
tion for that label.
n There should be no blank lines between the first and last line of the file.
n Numbers inside brackets indicate a specific measurement out of possible multiple
 n
ones for that type. [0] is the first, [1] is the second, and so on.
To export only the first measurement made of a given type, provide a substitution for
only the [0] instance of that key and remove the others from your new key substitu‐
tions file. This results in only the label ending in "[0]" to be matched and exported.
n To export all the measurements of a given type, provide a single substitution line, re‐
moving the "[x]" from the end of the key in column A. This will result in all instances
of the measurement being matched and exported.

15. When all the key substitutions have been defined, select File -> Save As… from the
Excel menu, and save the file in .CSV format to the USB memory stick. A suggested
name is KeySubstitutions.csv, but it can be named any name as desired..
 Always save the file in .CSV format. Do NOT save in Excel format.
Fig. 23: Save File in .CSV Format
16. Remove the USB memory stick from the computer, and insert it in the ACUSON S2000
system control panel.

17. In the Report Driver, click the Install KeySubstitutions button.

Fig. 24: Install Key Substitutions

18. Browse to the USB memory stick, select the custom KeySubstitutions.csv file created,
and click Open.
Fig. 25: Open KeySubstitutions.csv File
The custom keys will now be used when generating Nuance export data.
The system stores only one KeySubstitutions file. Installing a new KeySubstitutions.csv
 file will overwrite the previous one. If custom key substitions are created one exam type
at a time, append all substitutions for all exam types into a single .csv file prior to instal‐
ling it.

19. Click the Save Nuance Key/Values button.

Fig. 26: Save Nuance Key/Values

Rename the file if desired.
IMPORTANT: If the ReportDriver window closes after clicking "Open", there is a problem
 with the custom KeySubstitutions.csv file. Go back to step 14, pay careful attention to
the notes, and look for any errors. If problems continue, remove the custom key substi‐
tution file as described in the following section to revert to the system defaults.
Proceed with Step 8 in to map the ACUSON S2000 system measurement data to Power‐
Scribe360 custom fields.
The custom KeySubstitutions.csv file will be included in the UltrasoundSpecific backup/
restore package.

1.5 Removing Custom Key Substitutions File

To revert to the system default key substitutions, remove the custom file from the system
as follows:
1. Start the ReportDriver tool by pressing Ctrl+Alt+M+D, and click the Remove KeySub‐
stitutions button.
Fig. 28: Remove Key Substitutions

1.6 Check for Missing Custom Fields

If a particular custom field did not export to the Nuance Server, check for this log file from
C:\Syngo\log\NuanceExportMissingCustomFields.txt.
This log file is overwritten for each Nuance export. Once the missing custom fields have
been identified, the missing Nuance key/value pairs need to be added to the Nuance serv‐
er. Contact Nuance server administrator to update the key/value pairs.

1.7 Nuance Transfer Troubleshooting

The completion or failure of the patient measurement exam which is transferred to Nu‐
ance server at End Exam can be monitored from Patient Browser -> Transfer -> S2000 to
Nuance data transfer Status….
Fig. 29: Nuance Data Transfer Status

Fig. 30: Nuance Job Status Display
1. Look through the Job Status column and any unsuccessful transfer message from Nu‐
ance server will be displayed in this window.
2. Check for the Nuance server connection by following steps.
3. If Nuance configuration is correct, retry the transfer again by highlighting the jobs and
click Retry All.
4. If the problem requires a Nuance server administrator to fix, contact the Nuance serv‐
er administrator for any server related failures.
1.7.1 Missing Accession Number

The following conditions must be satisfied for an Accession Number to be available.
1. US_S2K_NUANCE Nuance export license is available on the system.

2. Nuance Configuration section on the Basic System, System Config window is com‐
pleted.

If the user attempts to register a patient from Patient Registration dialog without entering
an Accession number the following dialog will display.
Fig. 31: Accession Number Dialog Box
If the user selects Enter Accession Number, the Accession Number dialog is dismissed,
the user is left in the Patient Registration Dialog.
If the user selects Continue without Accession Number, patient registration is comple‐
ted with no Accession number.
If the user attempts to implicitly register the unknown patient via static image print/store,
clip store, 3D bookmark store, 3D volume store, or by entering Stress Echo, the following
dialog displays after the patient is registered:
Fig. 32: Patient Accession Number Needed

40 2 Changes to Previous Version
2.1 Changes to Previous Revision

Change(s) Description
Rev. 01 Initial Release

List of Hazard IDs 3 41
There are no Hazard IDs in this document.

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Print No.: US15-112.843.01.01.02 | Replaces: n.a.

Doc. Gen. Date: 03.12 | Language: English
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ACUSON S2000

This document is valid for:

ACUSON S2000 US15-112.843.01.01.02 Page 2 of 42 © Siemens, 2012

2 Changes to Previous Version 40

2.1 Changes to Previous Revision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

3 List of Hazard IDs 41

© Siemens, 2012 US15-112.843.01.01.02 Page 3 of 42 ACUSON S2000

1. Nuance Server IP Address - IP address of the Nuance device

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1.2 Configuration Procedure

1.2.1 Nuance Setup

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(1) Service Button

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1.2.2 Verify that Nuance License is Enabled

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3. View the General Licensing settings.

a) Select Use Local License File if it is not already selected.

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1.2.3 Set Up Nuance Transfer

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2. Navigate to System Config > Basic System.

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1.2.4 Nuance Configuration Verification

1. Log in the Service home page.

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1.3 Creating Nuance Custom Fields

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6. Click the "Save Nuance Key/Values" button.

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1.4 Advanced: Creating Custom Measurement Labels (Keys)

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Fig. 15: Patterns and Substitutions

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6. Click the "Save MCR Key/Values" button.

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12. Copy the column by pressing Ctrl+C.

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© Siemens, 2012 US15-112.843.01.01.02 Page 29 of 42 ACUSON S2000

Fig. 23: Save File in .CSV Format

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17. In the Report Driver, click the Install KeySubstitutions button.

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19. Click the Save Nuance Key/Values button.

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ACUSON S2000 US15-112.843.01.01.02 Page 34 of 42 © Siemens, 2012