Instructions to Setup GxAlert

Step 1 - Log into the GeneXpert Computer

If you plan to install a modem or OpenVPN make sure you login to Windows using an Administrator-
level account. This will not be necessary for day-to-day GeneXpert operations, just this once to setup
the GxAlert uploads.

Step 2 - Install 3G Modem

If you are installing a modem to access the internet do that now.

Step 3 - Verify Internet Access

Test that the machine can access the internet by opening a browser and visiting:
https://admin.gxalert.com. Some 3G Modems may restrict access to most sites, but this site should
be available and come up in your browser.

Step 4 - If necessary, install and configure OpenVPN (see Appendix A)

The LIS connector on Cepheid’s GeneXpert Dx software transmits results to the specified server IP address
in plain text. To protect patient privacy this transmission should be encrypted. If your program is using
secure routers (with managed VPN) or GxConnect to transmit results to GxAlert then you may probably
skip this step.

Step 5 – Install GxConnect (see Appendix B)

This will configure the GeneXpert software, collect initial install information, and securely report all results
(including status=incomplete) to the GxAlert server. If 2 green icons and results are uploading then you
know install was success.

Step 6 – Verify Host Communication Settings (see Appendix C)

The GxConnect installer will configure the Host Communication settings for you. If the GxConnect shows
a green device icon and says “Device Found” then the settings are correct. For you first few installs, or if
there is any problem with GxConnect (either icon is red), then you must manually configure the Host
Communication settings.

Need Help? Contact Support

Online: http://support.gxalert.com
Email: support@gxalert.com
Phone: +1.413.489.1421

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Appendix A – Install and Configure OpenVPN
1. Open the OpenVPN folder from the thumb drive.

2. The OpenVPN Installer Files look like this:

3. Run the “Set-Up OpenVPN.exe” file as an administrator

In Windows XP, if you logged in as an administrator then you're all set, just double-click on the
“Set-Up OpenVPN.exe” file to run it. In more recent versions of windows (Windows 7), right-click
on the “Set-Up OpenVPN.exe” file and choose Run-As Administrator.

The OpenVPN installer will open like this:

Click the NEXT button to proceed.

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Click I AGREE to accept the Open Source License.

Click NEXT to accept the default components.

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Click INSTALL to accept the default location and begin installation.

You may see a frightening warning from Microsoft during installation. This warning is due to the
fact that that Open Source developers are not paying Microsoft to sign off on their software. We
are using open source software because it's free and not licensed by a corporation. You may safely
ignore this warning if you see it.

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Click CONTINUE ANYWAY to continue with the installation.

Click NEXT to finish the installation.

You probably don't need to view the Readme for OpenVPN, so unclick the checkbox and then
click the FINISH Button.

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4. Copy the four files from the CONFIG folder in your installer files (either your memory stick
or the files you downloaded from GxAlert) to the config folder now found in directory at
"C:\Program Files\OpenVPN\config"

There are several ways to copy files in

windows. One easy way is to open the
Config folder from your install files,
select all the files, right-click and
choose COPY

Then open "C:\Program Files\OpenVPN\config", right-click, and choose PASTE. If prompted, click
OVERWRITE/REPLACE files with the ones you're copying.

If you open the "C:\Program Files\OpenVPN\config" folder after copying it will look like this. Note
the dates of the first four files are all the same. (which means you copied them correctly)

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5. Set OpenVPN to automatically run as a service

OpenVPN is now correctly installed

with the proper Security certificate
for your country. Now we must
set it up to run in the background
automatically every time windows
starts.

From the Installer files (you

downloaded or have on memory
stick) double-click the file “MMC-
Services.msc”. This will open the
services for your computer.

Scroll down to the OpenVPN

Service, right-click it, and choose
PROPERTIES.

This will pop up properties for the

OpenVPN Service like this:

Set the Startup Type to Automatic

and click OK. Next time the
machine starts, the OpenVPN service
will automatically run.

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Appendix B – Install GxConnect
Open the GxConnect folder on your flash drive, then double-click on SETUP. If an error message comes
up about running it or unblocking it, click yes to run or unblock the application. If the installer detects an
update online, it will download the latest update and run that.

When the application runs, you will see the following setup screen.

Fill in the fields:

- Country (Mozambique)
- Name this site (name of lab or facility, and which GeneXpert if multiple, e.g. CTRL-1)
- Router Number (on bottom of router, e.g. MC60413816) or SIM card number.
- Lab Contact (person in lab to contact if connectivity problem with GeneXpert)
- Installer (your name, email and phone – so you can receive success messages)

Click Finish

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Understanding Icons and Messages from GxConnect
After running setup for GxConnect, the application will open and check for two things:

1. That the GxAlert Secure Server is accessible over the internet.

2. That the Device – GeneXpert Dx software is accessible and the host communications settings were
correctly configured for automatic upload of results.

Ideally, you want to see both icons green (successful connection to server as well as successful
configuration of device and the test results will start uploading). Once you have both icons green, you
should receive an SMS Text and email sent to the mobile phone and email address specified for the
Installer during the setup screen.

In some cases, you may run into a problem and one or both icons will turn red.

If the Device icon turns red you MUST use make sure you manually setup the Host Communications
settings (See Appendix C). GxConnect will send this error to our programmer for analysis and correction.
You may exit the GxConnect in this case.

If, at any time, the Secure Server icon turns red, it means GxConnect cannot reach the GxAlert server via
the internet. Most common causes of this are an unplugged modem, a disconnected modem (click
CONNECT on modem software), or the server is offline.

Check in the GeneXpert Dx software to see if “host is connected”… if that’s true then you’re still OK and
results will be uploaded via the LIS connector.

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Appendix C –Host Communications Settings
Start the GeneXpert Software and log in with a GeneXpert Admin-level account.

If it asks to Archive Database or Perform Data Management functions,

simply Click NO.

From the main Setup Menu, choose System Configuration and then select the 5th (far-right) tab called
Host Communication Settings.

Fill in the communication settings as follows:

• Check the checkbox to Enable Host Communication

• For Host ID enter: [Your Facility/Device Name, e.g. “Zankli Lab”]
• UnCheck the checkbox Automatic Host Query After Sample ID Scan
• UnCheck the checkbox Automatic Test Order Download
• UnCheck the checkbox Automatic Result Upload
• UnCheck the checkbox Use Instrument Specimen ID
• Select Protocol: HL7
• Select Run Host As: Server
• For Server IP Address enter: 11.12.0.1 (for Mozambique)
(If not using OpenVPN or other problem, use IP 96.127.33.204)
• For Port # enter: 3012 (for Mozambique)

11.12.0.1
3012

When all settings are complete as above, click the EDIT button to the right of
the Host Test Code called MTB-RIF Assay G4 Version 5.

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• Check the checkbox to Enable this test for upload
• For Assay Host Test Code enter: MTB-RIF
• Copy the values for each Result Name to the values for each Result Test Code listed for the test.
When you are finished with this task, you should be looking at a two-column table with identical values in
the left and right cells of each row as seen above.

Click OK when complete to close the dialog box.

Click OK to close the Host Communications Settings box.

In the GeneXpert main

icon navigation, select
CHECK STATUS. This
will show
messages in the bottom
pane. If the
internet and
OpenVPN are
working and you
correctly specified the IP
number in the steps
above, then it should
display Host is
connected at....

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Finally, to test uploading of results, choose VIEW RESULTS from the GeneXpert icon navigation near the
top, then select UPLOAD TEST from the bottom menu. This will display all of the tests that have been
performed by this GeneXpert machine.

Click the checkbox of the first test to select it and then click the UPLOAD button. This will send the test
to GxAlert. The upload status should change to “Uploading” (or “Re-Uploading”) for a few seconds and the
to “Uploaded” if it was successful.

If successful, go back to Host Communications Settings and check the box next to Automatic Result
Upload. This will now automatically upload all past and current results in real time, without the need to
manually push them. Click OK to close the dialog box.

You can confirm this automatic upload is working, by clicking Check Status and looking in the "Messages"
panel for "Host is connected" (which means the GeneXpert is correctly talking to the server). Then go back
to View Results and Upload Test. You should see a streaming list of tests changing status to "Uploading"
and then "Uploaded". The GeneXpert will continue to send all past results in its database. It is okay to
disconnect the modem or shut down the GeneXpert software; the GeneXpert will simply continue sending
results the next time there is connectivity. This will happen in the background and the lab tech/user does
not need to start/stop or push any buttons.

If, when closing down the GeneXpert software, it is in the middle of sending a test result to GxAlert, a
dialog box appears warning "The GeneXpert is still sending test results. Close anyway?" You may close
the software at no harm to the test result; it will simply attempt to send the result again the next time
there is connectivity. Upon the very first connection to GxAlert, it can take an hour or more (depending on
bandwidth and connection strength) to upload all the past results.

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