Connex Data Management System - Welch Allyn€¦ · The Data Catcher application acts as a gateway between select Welch Allyn devices and external information hosts that wish to receive

Connex® Data Management System

Administrative guide Connex 2.0 SP2

ii Welch Allyn Connex

© 2009 Welch Allyn. All rights are reserved. No one is permitted to reproduce or duplicate, in any form, this manual or any part thereof without written permission from Welch Allyn.

Welch Allyn assumes no responsibility for any injury to anyone, or for any illegal or improper use of the product, that may result from failure to use this product in accordance with the instructions, precautions, warnings, or statement of intended use published in this manual.

Welch Allyn, Connex, and Spot Vital Signs are registered trademarks of Welch Allyn.

Wireshark is a registered trademark of the Wireshark Foundation.

Software in this product is copyrighted by Welch Allyn or its vendors. All rights are reserved. The software is protected by United States of America copyright laws and international treaty provisions applicable worldwide. Under such laws, the licensee is entitled to use the copy of the software incorporated with this instrument as intended in the operation of the product in which it is embedded. The software may not be copied, decompiled, reverse-engineered, disassembled or otherwise reduced to human-perceivable form. This is not a sale of the software or any copy of the software; all right, title and ownership of the software remain with Welch Allyn or its vendors.

Welch Allyn Technical Support

DIR 80015565 Ver. A, 2009-08

www.welchallyn.com

USA 800 289 2501

Canada 800 289 2501

Welch Allyn4341 State Street RoadSkaneateles Falls, NY 13153 USA

Welch Allyn LtdNavan Business ParkDublin Road, NavanCounty Meath, Republic of Ireland

http://www.welchallyn.com

iii

Contents1 - Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

About this guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Reference documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Contacting Welch Allyn Tech Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

2 - Connex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Introduction and architecture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Software components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Getting started . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Connecting to Connex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14EMR HL7 messages. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Backing up Connex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

3 - Connex clients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Introduction to workflows. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Connex workstations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

4 - Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Troubleshooting rejected messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27Stopping and restarting Tomcat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Troubleshooting vitals transfer from a vital-signs device connected to a Connex workstation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34Troubleshooting vitals transfer from Spot LXi (wireless radio or hardwired Ethernet adapter) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Appendix: LXi configuration worksheet . . . . . . . . . . . . . . . . . . . . . . . 45

iv Contents Welch Allyn Connex

1

1

Introduction

About this guideThis guide is written for network administrators and others with a background in information technology. The guide provides an overview of the tasks needed to manage the Welch Allyn Connex® Data Management System.

For more information on Connex, consult the Connex directions for use.

For more information on other Welch Allyn products mentioned in this guide — for example, Spot Vital Signs®, Spot Vital Signs LXi, and Vital Signs Monitor (VSM) — see separate instructions for the specific product.

Reference documentsThis document references the following support documentation. Check-marks identify the documents that pertain to your facility’s implementation.

Contacting Welch Allyn Tech Support For further assistance, contact Welch Allyn Connex support (see page ii).

Part number Description

20011139 Connex Directions for Use

SM2907 Connex IT Specifications

705310 Spot Vital Signs LXi Directions for Use

4500-921 Spot Vital Signs LXi Wireless Radio Accessory Directions for Use

20011394 Spot Vital Signs LXi Wireless Radio Configuration Utility Directions for Use

4200-87E Spot Vital Signs Directions for Use

810-2250-01 VSM 300 Directions for Use, Masimo

810-2252-01 VSM 300 Directions for Use, Nellcor

2 Introduction Welch Allyn Connex

2

3

Connex

Introduction and architectureWelch Allyn Connex is a software system that enables users to collect patient data from various Welch Allyn devices, enter data manually, review data, and send data to a hospital information system.

The following charts provide a logical diagram of the Connex system.

Figure 1. Connex system diagram

Note For the latest information and an in-depth discussion of any topic, consult the Connex directions for use.

Connex server

Data Catcher/DCP

HIS

Hospitalinformation

system

Vitalsdevice

Barcodescanner

Vitalsdevice

Barcodescanner

Vitalsdevice

Barcodescanner

Vitalsdevice

Barcodescanner

Vitalsdevice

Barcodescanner

Vitalsdevice

Barcodescanner

Vitalsdevice

Barcodescanner

Wireless orwired

networking

Wireless orwired

networking

Outboundvitals

ADT

Connexclients

Workstation 1

Workstation 2

Workstation 3

Workstation 4

......

4 Connex Welch Allyn Connex

Figure 2. Connex server diagram

Figure 3. Connex server details

Connex server

DatabaseTomcat server

Java Virtual Machine

Operating system

Oracle

Windows Server 2003

SynapseHIS

Hospitalinformation system

Connex database data

Connex client

Connex server

Database

HIS

Synapse

Oracle

Reportsi-net Crystal-Clear

HL7 link

HL7 task

Hospital information systemHTTP

Outboundvitals

ADT

Administrative guide Connex 5

Figure 4. Connex workstation diagram

Software componentsA number of software applications make up the Connex system.

Java Virtual MachineA Java Virtual Machine (JVM) is a set of computer software programs and data structures that use a virtual machine model to execute other computer programs and scripts.

TomcatTomcat provides the web interface for Connex.

OracleThe Oracle database stores vital-signs data and auditing information for Connex.

ConnexThe Connex application provides electronic documentation of vital-signs data from a variety of Welch Allyn devices (Spot, Spot LXi, VSM 300 Series and VSM 52000) through a range of workflow options. Connex also provides a user interface for patient data entry and for review of data (tabular and graphical data) when the EMR is not available.

DCPThe DCP Server application provides the Device Connection Protocol (DCP) for determining where Welch Allyn services reside. Since DCP Server runs as a Windows service, it always runs and is available, even if no users are logged in to the system.

Internet Explorer

Microsoft Windows XP/2000

Vitals

device

Barcode

scanner

USB

driver

Connection toConnex server

Keyboardwedge

USB

US

B

USB

RS232


Because DCP relies on UDP network broadcasts, it is assumed that one DCP Server will be installed per device subnet. If DCP broadcasts (UDP port 44435) are forwarded by the infrastructure’s network routers, then potentially only one DCP Server is required.

Data CatcherThe Data Catcher application acts as a gateway between select Welch Allyn devices and external information hosts that wish to receive data from those devices. Data Catcher acts both as a device server, collecting information from multiple clients connected concurrently, and as a client, connecting to external information hosts and forwarding data.

The Data Catcher application provides a conduit for networked devices to communicate with the Connex application. The Data Catcher solution also offers a service installation wrapper that enables the Data Catcher console application to run transparently in the background of a server machine.

Getting startedConnex provides administrative tools to help you manage data. Follow these instructions to enable all tools. You need to do this once.

To enable all administrative tools

1. Open your web browser.

2. Go to this URL: http://connexip/WADev/createStoredProcedures.jsp

Your Connex IP address is:__________________________________

A screen similar to the following appears, which means all tools were enabled.

Figure 5. Enable administrative tools


Connecting to ConnexConnecting to the Connex user interface is similar to using any other web page.

To connect to Connex


2. Go to this URL: http://connexip/Consult (connexip is your Connex IP address recorded on page 6).

A screen similar to the following appears.

Figure 6. Logon page

3. Enter the user name and password of a valid user. During the installation procedure, an Admin user was created with the following credentials:

User name: __________________________________

Password: __________________________________

4. Click LOGIN. A default home page appears.

The home page is different depending on the type of user that logs in.

Users with administrator rights see the following screen.

Note Internet Explorer version 6 is recommended.


Figure 7. Administrator home page

The home page for a Clinician or Technician has different menu options.

Figure 8. Clinician/Technician home page

Current logged-in userMenu items


Users

Types of usersThe following table lists the types of users and their capabilities.

Table 1. User roles and functions

For information on setting up alerts, consult the Connex directions for use.

Creating a new userAnyone accessing the Connex user interface needs a user name and password.

You can create a new user through the Connex user interface. You can also create multiple new users at once by saving user information to a subdirectory on the Connex server.

To create a new user through the Connex user interface

1. Click SYSTEM MANAGER.

2. Click User Manager.

3. Click Add New User.

Figure 9. System Manager/User Manager

Roles Available functions

Technician Capture VitalsPatient SearchImport Vitals

Clinician Capture VitalsPatient SearchImport Vitals Alert(s) Setup for PatientsRemove Vitals

Administrator System Manager Alert(s) Setup for Alerts by Location System-wide Alerts


The new user information screen appears.

4. Fill in user information. Fields with a red dot are mandatory. The following image provides instructions on how to fill in mandatory fields.

Figure 10. New user information

5. Click SAVE to save the new user.

Select “Account is active.”Enter user name.Enter password twice. Password cannot contain the user name.

Type the first name and last name of the user.

Fields with a red dot are mandatory.

Highlight the locations. Select multiple locations by holding down the Ctrl key.

Save

Select WelchAllyn from the drop-down menu.

Select the role for this user. Multiple roles can be selected but is not recommended.


To create multiple new users at once

1. Create a text file that contains user information in the following format:

Last Name|First Name|Middle Name|Sex|DOB|Phone Number|Address|Barcode ID|Location|User Name

Example: Smith|Jane|Lois|Female|04161986|3153967809|1 Main St.|jsmith|1D|janesmith

If multiple default locations are desired, enter the same user multiple times with only the location being different:

Smith|Jane|Lois|Female|04161986|3153967809|1 Main St.|jsmith|1D|janesmith

Smith|Jane|Lois|Female|04161986|3153967809|1 Main St.|jsmith|4L|janesmith

2. Give the file a unique file name and a .txt extension. The name of the file must not match the name of a file already in the PROCESSED subdirectory of the Save Copy Folder.

3. Save the file to the TOPROCESS subdirectory of the Save Copy Folder. Once processed, the file is automatically moved to the PROCESSED subdirectory of the Save Copy Folder.

The default password for a new user is connex123! and must be changed upon first login.

Modifying a userIn the Connex user interface, you can make changes to user information.

To modify a user



3. Enter search criteria to find the user. (For more information on searching, see “Searching for users” on page 12.)

Figure 11. Modify a user (first screen)

4. Click GO to start the search.

5. Click the user who needs to be modified.



Figure 12. Modify a user (second screen)

6. Modify the user information.

7. Click SAVE.

Searching for users

To search for users



3. Enter the desired search criteria.

Figure 13. Search for users

• Selecting Active User(s) restricts the search to users who have an active account. (A user’s account is active when the “Account is active” check box is selected.)

• Leaving all fields blank displays all users.

4. Click GO to start the search.


Creating a report of all usersYou can create a report that lists all users. This report can be saved in PDF format.

To create a report of all users



3. Ensure that all search fields are blank.

4. Click GO.

Connex lists all users.

5. Click the printer icon.

Figure 14. Create a user report

Connex displays the report in a separate window.

6. Click Save to save the report as a PDF file.

Deleting usersTo delete users, you must inactivate their accounts and then delete all inactive accounts from the Connex database.

Before doing this task, back up your Connex database. For instructions on how to back up your database, see “Backing up Connex” on page 21.

To delete users

1. Inactivate each user that you want to delete.

a. Click SYSTEM MANAGER.

b. Click User Manager.

c. Enter search criteria to find the user.

d. Click GO to start the search.

e. Click the user that you want to inactivate.

User information appears.

f. Deselect Account is active.

g. Click SAVE.

h. Repeat these steps for each user.


2. Delete all inactive users.

a. Go to this URL: http://connexip/WADev/CleanData.jsp (connexip is your Connex IP address recorded on page 6).


Figure 15. Delete all inactive users

b. Click Purge inactive providers.

Patients

Readmitting a discharged patient in ConnexWhen patients are discharged, their accounts are no longer visible in Connex. As a result, messages for discharged patients cannot be transferred from Connex to the EMR. To transfer a discharged patient’s messages to the EMR, you must readmit the patient in Connex.

Follow these instructions to readmit the patient in Connex and then return the patient to discharged status.


Note You do not need to readmit the patient in the EMR.


To readmit a discharged patient in Connex


2. Go to this URL: http://connexip/WADev/patientData.jsp (connexip is your Connex IP address recorded on page 6).


Figure 16. Readmit a discharged patient in Connex

3. Under Change Patient Visibility, enter the Patient MRN# (medical record number).

4. Select Add.

5. Click Process.

Messages for this patient can now be sent to the EMR.

To discharge the patient in Connex

1. Select Remove.

2. Click Process.


Deleting discharged patientsYou can delete patients who were discharged within a specified date range, which can help you manage the size of the Connex database. This task deletes all information for these patients.


To delete discharged patients


2. Go to this URL: http://connexip/WADev/CleanData.jsp (connexip is your Connex IP address recorded on page 6).


Figure 17. Delete discharged patients

3. Click to fill in From date and To date.

4. Click Remove patients.


EMR HL7 messages

Viewing messagesThe Exchange Transactions screen provides information about each message sent between Connex and an ADT and HL7 system. You can view all messages or apply filters.

To view Exchange Transactions and apply a filter

1. In the Connex user interface, click SYSTEM MANAGER.

2. Click Exchange Transactions.

3. (Optional) To change the filter:

a. Click CRITERIA.

Figure 18. Filter criteria

The Criteria dialog box appears.

b. Enter the criteria for the messages you want to view.

Clicking the word next to TYPE or STATUS displays a drop-down list. Clicking the words PATIENT ID also displays a drop-down list.


Figure 19. Criteria dialog box

The TYPE list contains all message types that have been sent to or from Connex.

The STATUS list contains the following options:

The PATIENT ID list contains other ID options.

c. Click OK.

Connex displays messages that match your criteria.

4. Double-click a message to view its contents.

ALL Show all status types

EDITED Show only those messages that have been manually edited

RECEIVED Show only those messages that have been received by the Synapse HL7 processor

PROCESSED Show only those messages that were processed successfully

REJECTED Show only those messages that were rejected

Drop-down list


Editing and resending messages to the EMRThe following instructions enable you to edit any message and resend it to the EMR.

To edit and resend a message


2. Go to this URL: http://connexip/WADev/patientData.jsp (connexip is your Connex IP address recorded on page 6).


Figure 20. Edit and resend a message

3. Under Reprocess Message, enter the Message Number.

4. Select the source of the message from the drop-down list.

5. Click Edit.

The message appears.

6. Edit the message.

7. Click Save.

8. Click Process to resend the message to the EMR.


Deleting processed messagesYou can delete messages that were processed within a specified date range, which can help you manage the size of the Connex database.


To delete processed messages


2. Go to this URL: http://connexip/WADev/CleanData.jsp (connexip is your Connex IP address recorded on page 6).


Figure 21. Delete processed messages

3. Click to fill in From date and To date.

4. Click Remove HL7.


Backing up ConnexBack up Connex on a regular basis by following your facility’s IT guidelines and policies for backing up patient data.

To create a backup manually

1. Stop Tomcat.

a. From the Windows taskbar, select Start > Control Panel > Administrative

Tools > Services.

b. On the Services screen, scroll down to WA-Tomcat and highlight it.

c. Click Stop on the left side of the screen.

2. Copy these directories:

C:\Tomcat

C:\oracle\product\10.1.0\oradata\orcl\

Store the directories in an alternate location.

3. Delete the C:\Tomcat\work directory.

a. Open Windows Explorer.

b. Navigate to the Tomcat directory, usually C:\Tomcat.

c. Right-click the Work folder and choose Delete.

4. Start Tomcat.


Tools > Services.


c. Click Start on the left side of the screen.

You can automate this process by using a backup utility that has the ability to start and stop services.

If the Connex server needs to be restored, contact Welch Allyn Technical Support (see page ii).

Note When you restart Tomcat, the Work directory is automatically rebuilt.


3

23

Connex clients

Introduction to workflowsThe Connex system can capture vital signs from a number of Welch Allyn devices used in a variety of workflows.

Device operation is covered in the directions for use (DFU) for the particular device (refer to “Reference documents” on page 1 for a list of device DFUs).

The following summarizes the characteristics of each workflow.

Wireless Spot LXi This workflow supports Spot LXi with wireless radio and barcode scanner. Users send readings directly from Spot LXi to the Connex application. No workstation or Connex client user interface is needed. Typically Spot LXi is mobile and running on battery power.

The user performs the following steps:

1. Uses the barcode scanner to scan the Clinician ID at the beginning of patient rounds (optional).

2. Uses the barcode scanner to scan the Patient ID.

3. Takes vitals (within 15 seconds due to SureBP).

4. Adds Pain, Respiration, Height, and Weight (all are optional).

5. Sends the reading to Connex. (The radio turns on and sends. Connex sends the reading to the EMR after ID confirmation. If the radio is unable to connect to Connex, Spot LXi saves the reading until the next send attempt.)

6. Repeats for all patients.

7. Plugs the device into AC power to recharge it.

8. Powers off Spot LXi. (By doing so, the user removes the Clinician ID from Spot LXi.)

Hardwired LXi with Ethernet AdapterThis workflow supports Spot LXi with barcode scanner and third-party Serial-Ethernet adapter. Users send readings directly from Spot LXi to the Connex application. No workstation or Connex client user interface is needed. Typically Spot LXi is permanently installed at patient bedside and plugged into AC power.

24 Connex clients Welch Allyn Connex


1. Uses the barcode scanner to scan the Clinician ID for each patient (optional). (Typically clinicians change for each patient.)




5. Sends the reading. (Connex sends the reading to the EMR after ID confirmation.)

Batch Spot Check VitalsThis workflow supports Spot LXi with barcode scanner. The Spot LXi and barcode scanner are used to capture multiple patients’ vital signs (up to 50 readings). The user then connects Spot LXi to a Connex workstation via USB or serial cable and uploads all readings at once. Typically Spot LXi is mobile and running on battery power.

The user typically performs the following steps:

1. Uses the barcode scanner to scan the Clinician ID at the beginning of patient rounds (optional).




5. Saves the reading. (Device reading count increments.)


7. Connects Spot LXi to a Connex workstation via USB or serial cable.

8. Imports all readings with a single click in Connex.

9. Plugs the device into AC power to recharge it.

10. Powers off Spot LXi. (By doing so, the user logs off Connex.)

Computer-Based VitalsThis workflow supports these devices: Spot, Spot LXi, VSM 300 Series and VSM 52000. The hospital integrates any of these devices with a mobile computing cart, typically with a barcode scanner.


1. Logs in to Connex at the beginning of patient rounds.


Alternately, the user can select the patient in Connex, either from the patient list (populated through the ADT system) or by using the Patient Search function.

The Capture Vitals screen appears.

3. Takes vitals. (Blood pressure can be started from the PC or the device.)

Administrative guide Connex clients 25

4. While readings are being captured, adds Pain, Respiration, Height, Weight, and Glucose (all are optional), as well as important modifiers, such as body position (lying, sitting, standing), and oxygen flowrate.

5. Saves the reading. (The Patient Summary screen appears. Connex sends the reading immediately to the EMR.)


7. Logs off Connex.

Vital-Signs MonitoringThis workflow supports these devices: VSM 300 Series and VSM 52000. The device monitors a single patient (up to 99 cycles). The user then connects the device to a Connex workstation and uploads the readings.


1. Uses the device at patient bedside like a typical vital-signs monitor, using timed intervals and alarms.

2. Connects the device to a Connex workstation.

3. Selects the patient.

4. Selects which readings to import to the EMR (selects all readings or picks by reading and date/time). Readings that are not imported can be printed.

The selected readings are imported, and then all readings are deleted from the vital-signs device. The device resets for the next patient.

TriageThis workflow supports these devices: Spot, Spot LXi, VSM 300 Series and VSM 52000. The device is permanently attached to a Connex workstation via USB/RS232. A barcode scanner may also be attached to the workstation.


1. Logs in to Connex.


Alternately, the user can select the patient in Connex, either from the patient list (populated through the ADT system) or by using the Patient Search function.

The Capture Vitals screen appears.

3. Takes vitals. (Blood pressure can be started from the PC or the device.)

4. While readings are being captured, adds Pain, Respiration, Height, Weight, and Glucose (all are optional), as well as important modifiers, such as body position (lying, sitting, standing), and oxygen flowrate.

5. Saves the reading. (The Patient Summary screen appears. Connex sends the reading immediately to the EMR.)


7. Logs off Connex.

26 Connex clients Welch Allyn Connex

Connex workstationsWithin the user interface-supported workflows, client workstations can be used to capture vital signs or review patient data. The user interface for the Connex client is covered in detail in the Connex directions for use.

The following shows a client workstation set up to capture vital signs.

Figure 22. Connex workstation diagram

Internet Explorer

Microsoft Windows XP/2000

Vitals

device

Barcode

scanner

USB

driver

Connection toConnex server

Keyboardwedge

USB

US

B

USB

RS232

4

27

Troubleshooting

Troubleshooting rejected messagesRejected messages are common. Not every rejected message indicates a problem; however, these messages should be viewed periodically.

Connex provides two ways to view rejected messages: the Rejected Outbound Messages List and the Exchange Transactions screen.

The Rejected Outbound Messages List enables you to quickly view rejected messages and determine whether a message was rejected because the patient was discharged before the message was sent to the EMR.

The Exchange Transactions screen provides detailed information about errors and enables you to fix errors and resend messages to the EMR.

Rejected Outbound Messages List To view the Rejected Outbound Messages List


2. Go to this URL: http://connexip/messages (connexip is your Connex IP address recorded on page 6).

The Rejected Outbound Messages List appears.

Figure 23. Rejected Outbound Messages List

28 Troubleshooting Welch Allyn Connex

3. (Optional) Filter messages by selecting a location from the drop-down list or by entering text in the Search box.

Red text indicates the message pertains to a discharged patient.

You can readmit a discharged patient in order to transfer messages to the EMR. For more information, see “Readmitting a discharged patient in Connex” on page 14.

Exchange TransactionsTo view rejected messages via the Exchange Transactions screen, follow the instructions in “Viewing messages” on page 17. In the Criteria dialog box, change the status to REJECTED.

Possible causes of rejected messages

On the Exchange Transactions screen, the Comments column provides an error code for each rejected message.

Explanations of error codes are listed below. These explanations are instrumental in troubleshooting messaging issues between Connex and an ADT/EMR system.

MSH error codes

Example:

MSH|^~\&|CONNEX|WELCH ALLYN|MEDITECH|ECMC|200805191225||ORU^R01|20080519122524140|P|2.3||||||||

Table 2. MSH error code explanation

PID error codes

Example:

PID|||M000007122^^^CVS^MR||FOLEY,NICK^^||19560204|M|||^^^^|||||||V00000015795||

Error Cause Solution

MSH-2 Encoding Characters must be provided Enter encoding characters, for example, “^-/&”

MSH-3 Sending Application must be provided Enter sending application, for example, “CONNEX”

MSH-4 Sending Facility must be provided Enter sending facility, for example, “WELCH ALLYN”

MSH-5 Receiving Application must equal XXXX Enter receiving application, for example, “MEDITECH”

MSH-6 Receiving Facility must be present Enter receiving facility, for example, “ECMC” or appropriate hospital/facility name

MSH-7 Date/Time of Message must be provided Enter date/time of message, for example, “200805191225”

MSH-9 Message Type must be provided Enter message type, for example, “ORU^R01”

MSH-10 Message Control ID must be provided Enter message control ID, for example, “20080519122524140”

MSH-11 HL7 Processing ID must equal P Can occur following a switch from test to production environment. Ensure that the field contains “P”

MSH-12 Version ID must equal 2.3 Ensure that this field contains “2.3”

Administrative guide Troubleshooting 29

Table 3. PID error code explanation

PV1 error codes

Example:

PV1||I|9Z3^925Â|||||||||||||||||||||||||||||||||||||||||20080130165400-0400|20080225165400-0400|

Table 4. PV1 error code explanation

OBR error codes

Example:

OBR|1|||CVS^CONNEX VITAL SIGNS^L|||20080519122800-0400|||LAGOSTIN^LAGOSTIN^^|||||||||||||||||||||

Table 5. OBR error code explanation


PID-3 Cannot Reconcile Patient (PID-3). Record not found in database

Ensure that this field corresponds with a PID for a patient currently admitted in the Connex database

PID-3 Missing Required Field PID-3 Enter a PID for a patient currently admitted in the Connex database

PID-5 Patient Last Name is required Enter the appropriate patient’s name in this field


PV1-3 Cannot reconcile Patient Location (PV1-3/0) Ensure that this field contains a value corresponding with a valid location registered in Connex

PV1-7 Cannot reconcile Attending Physician Enter appropriate physician information

PV1-8 Cannot reconcile Referring Physician Enter appropriate physician information

PV1-9 Cannot reconcile Consulting Physician Enter appropriate physician information

PV1-19 Cannot reconcile Patient Visit Enter appropriate patient visit number

PV1-44 Invalid date format in PV1-44 Enter an appropriate start date/time in this field

PV1-45 Discharge Date/Time is required for A11/A03 message

Enter a discharge date/time in this field to process the message

PV1-45 Discharged Patient cannot be updated Check that the patient being updated is currently admitted in the Connex database


OBR-3 Filler Order Number must be provided Enter a valid filler order number

OBR-4 Universal Service Identifier is required Enter universal service identifier, for example, “CVS^CONNEX VITAL SIGNS^L”

OBR-16 Ordering Physician is required Enter a valid Clinician ID in OBR-16

OBR-16 Cannot reconcile Ordering Physician The Clinician ID is invalid. Enter a valid Clinician ID


OBX error codes

Example:

OBX|1|NM|SYS^BLOOD PRESSURE SYSTOLIC^L|1|151|MM(HG)|25-260||||F|||20080519122800-0400|20070903439|êcmcêcmc^|

Table 6. OBX error code explanation

Examples of rejected messages

This section provides two examples of rejected messages. Each example includes an assessment of the error code.

In the following image, error code PID-3 is highlighted.

Figure 24. PID-3 error

Based on the “PID error code explanation” on page 29, this error means the patient is not in the Connex system.


OBX-14 Observation Date/Time is required Ensure that this field contains a date/time stamp in the proper format

OBX-16 Responsible Observer Ensure that this field contains a valid ID for the clinician taking the vitals

Message contents

Error code and comments


In the next example, error PV1-3 is highlighted.

Figure 25. Message Contents Type A31

Based on the “PV1 error code explanation” on page 29, this error means the patient’s location is not in Connex.

Editing and resending a rejected message

From Exchange Transactions, you can edit a rejected message and resend it to the EMR.

To edit and resend a rejected message

1. On the Exchange Transactions screen, click the message to highlight it.

2. Click EDIT.

Figure 26. Edit a rejected message

3. In the Message Editor dialog box, edit the message.


Figure 27. Message Editor

4. Click SAVE.

5. On the Exchange Transactions screen, click the pencil icon next to “Source” to resend the message to the EMR.

Figure 28. Resend a rejected message

Stopping and restarting TomcatTomcat is the web server and interface that ties many of the pieces of the Connex system together. Tomcat runs as a service. During troubleshooting, the service may need to be stopped and restarted.

To stop and restart the Tomcat service

1. Stop WA-Tomcat service.


Tools > Services.


Note The pencil icon next to a message means the message was edited. Clicking this icon does nothing.


c. Click Stop.

Figure 29. Tomcat service

2. Delete the Tomcat Work directory.

a. Open Windows Explorer.

b. Navigate to the Tomcat directory, usually C:\Tomcat.

c. Right-click the Work folder and choose Delete.

Figure 30. Tomcat Work directory

Note When you restart Tomcat, the Work directory is automatically rebuilt.


3. Restart WA-Tomcat service.


Tools > Services.


c. Click Start.

Troubleshooting vitals transfer from a vital-signs device connected to a Connex workstation

Follow these troubleshooting steps if vitals cannot be transferred from a vital-signs device to a Connex workstation via a wired connection (USB or serial).

For general device operation and troubleshooting information, refer to the device directions for use.

Symptom — “Device Disconnected” message in Connex clientFigure 31. Device connected states

Possible solutions:

• Ensure that the vital-signs device is plugged in and turned on. If the device is running on batteries, ensure that the batteries have sufficient charge to operate the device.

• Ensure that the connectivity (USB or serial) cable is attached to the device and the computer, and the cable is undamaged.

• Verify that no other browser windows are open. If Connex has already established a connection to the device through one window, subsequent windows will show the device disconnected. Users may see this especially if they minimize the window between uses. To fix, close the extra windows and train users to look for an already open window.

• Log out of Connex, unplug and reattach the connectivity (USB or serial) cable, and restart the Connex client.

• Verify that the vital-signs device is configured properly to send vital-signs data, per the vital-signs device directions for use.

• Verify that the device drivers are set up properly. Refer to the Connex Client Software Installation Instructions on the Connex Client CD.

• Use a cable from a known working setup.

• Use a vital-signs device from a known working setup.

Displays when a device is connected and communicating with Connex software.

Displays when a device is disconnected or not communicating with Connex software.


Symptom — Network connectivity issues: workstation to serverThe Connex client constantly monitors network connectivity to the server. If the network connection is interrupted for any reason, Connex disables data entry and displays the following screen.

Figure 32. Network error

Use standard network troubleshooting procedures to correct connectivity problems between Connex workstations and the Connex server.

You can disable this message on all Connex workstations by editing the preference file on the server.

To disable the message on all Connex workstations

1. Open C:\Tomcat\wellogic\Consult-WA_3_10_7_021907-SNAPSHOT\WEB-INF\classes\properties\Preference_Application.xml.

2. In the section shown below, change the “hasNetworkCheck” value to false.

<Preference name=“hasNetworkCheck”>

<Value>false</Value>

</Preference>

<Preference name=“refreshTime”>

<Value>3000</Value>

</Preference>

<Preference name=“statusMessage”>

<Value>The computer has lost its connection to the local network.+ The application will resume once connection to the network has been reestablished. </Value>

</Preference>


3. Save the changes to the preference file.

4. Issue a prefaway.

a. From the Connex login page, go to this URL: http://connexip/Consult/prefaway?task=deleteDeploymentPrefs (connexip is your Connex IP address recorded on page 6).

b. Wait for the screen to go completely white. (This may take up to 40 minutes.)

5. Stop and restart Tomcat according to “Stopping and restarting Tomcat” on page 32.

Symptom — Browser issues: pop-up blocker in Internet ExplorerBy default, Internet Explorer blocks most pop-up windows. This feature can prohibit the proper operation of Connex.

To disable pop-up blocker

1. Open Internet Explorer.

2. Choose Tools > Internet Options.

3. Select the Privacy tab.

4. Click Settings in the Pop-up Blocker section of the window.

5. Enter the IP address or hostname of the Connex server in the field labeled “Address of website to allow.”

6. Click Add.

7. Click Close.

8. Click OK to close the Internet Options dialog box.

9. Close the browser.

Symptom — Browser issues: ActiveX controlsIf ActiveX controls are not set up properly, the following error message appears in the Internet Explorer window.

Figure 33. ActiveX error

ActiveX error message


To enable ActiveX to run properly on a Connex workstation

1. Open Internet Explorer.

2. Choose Tools > Internet Options.

3. Select the Security tab.

4. Click the Trusted sites icon.

5. Click Sites.

6. Deselect “Require server verification (https:) for all sites in this zone.”

7. Add the Connex server to the list of trusted sites by entering “http://” followed by the Connex server IP address.

8. Click Add.

9. Click Close.

10. On the Security tab under Trusted sites, click Custom level.

The Security Settings dialog box appears.

11. Scroll down to the ActiveX controls and plug-ins section.

12. Select Enable for each of these settings:

• “Initialize and script ActiveX controls not marked as safe for scripting”

• “Run ActiveX controls and plug-ins”

• “Script ActiveX controls marked safe for scripting”

13. Click OK. If asked “Are you sure you want to change the settings for this zone?” click Yes.

14. Click OK to close the Internet Options dialog box.

15. Close the browser.

Troubleshooting vitals transfer from Spot LXi (wireless radio or hardwired Ethernet adapter)

Symptom — Data not received by ConnexPossible solutions:

• Verify that the Spot LXi, network interface device (wireless radio or Ethernet adapter, including null modems) and barcode scanner are configured and cabled properly. For details, refer to the Spot LXi documentation (see “Reference documents” on page 1).

• Ensure that the device is plugged in and turned on. If the device is running on batteries, ensure that the batteries have sufficient charge to operate the device.

• Verify that barcodes were read and assigned properly to Clinician ID and Patient ID.

• Verify that Temperature is not in Monitoring Mode. Temperatures read in Monitoring Mode cannot be transferred to Connex.


• Verify that the device setup in the Internal Configuration Mode matches the below list and the correct port assignments are made for the barcode scanner and network interface device:

• 802.11 b radio only (part number 4500-920): Verify radio functionality by observing the LED lights on the radio. If the barcode scanner lights up, the radio is getting power. Note: The radio turns on only when sending data or when Spot LXi is in the Internal Configuration Mode.

Table 7. Wireless radio status LEDs

Information System On

Barcode Patient ID On

Barcode Clinician ID On

Weight Scale Off

Wireless Module DPAC

Printer Off

LED LED color Function

Power Off Bridge is not receiving power.

Red Bridge failed its Power On Self Test (POST) and is not configured forwireless communication.

Amber Bridge passed its POST but is not configured for wireless communication.

Green Bridge passed its POST and is configured for wireless communication.

Link Off Bridge is not receiving power.

Red Bridge is searching for an access point.

Green Wireless network and MAC have associated with an access point.

Comm Off No power or no wireless TCP session is established and no physical serialconnection is detected.

Red No wireless TCP session is established; a physical connection is detected.

Blinking Red A physical serial connection was detected and there is serial traffic presenton that connection, but no wireless TCP session is established.

Amber A wireless TCP connection is established but no physical serial connectionis detected (i.e., no serial cable is attached to the Bridge).

Blinking Green A wireless TCP session is established, a physical serial connection isdetected, and the Bridge is transmitting or receiving data across the wiredserial port.

Green A wireless TCP session is established, a physical serial connection isdetected, but there is no active data movement across the wired serial port.


• Ping the wireless radio or Ethernet adapter:

a. At any Connex workstation, select Start > Run.

b. Type CMD in the text box and click OK. The computer displays a DOS prompt.

c. Type PING XXX.XXX.X.X (XXX.XXX.X.X is the IP address of the network interface device) and press Enter.

Observe the ping results. Errors mean there is a problem with the network interface device configuration or the network routing from the workstation to the device.

Figure 34. Wireless radio ping results

Symptom — Request time outPossible solutions:

• Recheck the IP address.

• Check the configuration of the wireless radio and/or the access point.

• Check the cable and null modem connections for tightness and correctness.

• Bad radio.

Symptom — Destination net unreachablePossible solutions:




• Bad radio.

Symptom — Lost packetsPossible solutions:





• Bad radio.

Symptom — Network connectivity issues: wireless signal strength (802.11 b radio only)

The 802.11 b radio (part number 4500-920) communicates radio signal strength to the Spot LXi for troubleshooting purposes. You can use this feature to determine areas within the hospital with weak wireless AP coverage.

To determine signal strength

1. Press to power off Spot LXi.

2. Press and hold and simultaneously for 5 seconds. This powers on the device in the Internal Configuration Mode.

3. Use to choose External Devices and press . The External Devices Menu appears.

4. Use to choose Wireless Module and press . Use to select DPAC and press .

5. Observe the wireless radio signal strength indicator.

Figure 35. Signal strength indication

6. Use to choose Exit and press .

7. Press to turn off the device and press again to power on.

Use the wireless vendor’s recommended methods to remediate areas with weak signal strength.

Sufficient signal strength Insufficient signal strength


Symptom — Network connectivity issues: connected portsFrom the Connex server, issue the command:

netstat –na

This command lists all ports that the server is listening on. The command is useful to verify that the ports that are needed are created on the server and are being advertised.

An output similar to the following appears.

Figure 36. Netstat command (top half of screen)

Figure 37. Netstat command (bottom half of screen)

If the above ports are not listed, the LXi units cannot connect.

If the server and the LXi devices are not on the same Class C subnet mask, UDP port 44435 must be allowed to pass through the network or VLAN to reach the Connex server, which is not a typical configuration.

WiresharkWireshark is a public-domain network packet capture utility. As such, it is freeware and very useful in problem determination. You can use Wireshark to determine why Spot LXi units are not connecting to Connex, when all else is believed to be correctly configured.

DCP application is correctly configured to listen on the TCP Port 281

UDP Port 44435


Using Wireshark to capture network data

Before following these steps, ensure Wireshark is installed and functioning on the Connex system.

To capture network data

1. From the Windows taskbar, select Start > All Programs > Wireshark > Wireshark.


Figure 38. Wireshark

2. Choose Capture > Options.

The following dialog box appears.

Figure 39. Wireshark capture options

3. Select the desired interface.

4. Click Start.

Wireshark starts data capture and displays all captured traffic.


The data that is most interesting is if DCP is getting the discovery packets from the LXi system. To suppress all of the unwanted traffic, a filter must be applied.

The following image shows a capture with a filter configured.

Figure 40. One-way filter

This trace shows the LXi device communicating with the DHCP server. You will notice that port 44435 is not used.


A successful capture showing the UDP discovery is shown below.

Figure 41. Data capture

In the above example, the LXi (10.28.12.216) unit sends a broadcast to port 44435 on the network. The DCP application replies back to the LXi unit with the IP address and TCP port of the Connex (10.28.12.25 port 281) server, then subsequent communications are done via TCP.

Filter to and from the device

UDP discovery from LXi

Response back from DCP with Connex IP and TCP port number

TCP communication between LXi and Connex

45

Appendix: LXi configuration worksheetTo configure a Spot LXi device to communicate with Connex, you need to set the following operating parameters in the device Internal Configuration Menu:

• Date/Time

• Manual Parameters

• External Devices

• Save Readings

You can use this sheet to document your facility’s settings for later reference.

For instructions on how to change these settings, refer to the Spot LXi directions for use.

Date/Time settings

Parameter Your setting Description

Date Format mm/dd/yyyydd/mm/yyyy

Displays the date in one of the following styles:• mm/dd/yyyy example: July 16, 2005 = 07/16/2005• dd/mm/yyyy example: 16 July 2005 = 16/07/2005

Date Set the current date Changes the date on the Display Window and in patient readings. Note: It is important to accurately set the date on the LXi, since this is the date used to record values.

Time Format 12-hour24-hour

Displays the time in one of the following styles:• 12-hour example: 5:00 PM• 24-hour example: 17:00

Time Set the current time Changes the time on the Display Window. Note: It is important to accurately set the time on the LXi, since this is the time used to record values.

46 Appendix: LXi configuration worksheet Welch Allyn Connex

Manual Parameters settings

External Devices settings


Height OnOff

Height Units in (inches)cm (centimeters)

Height Default Changes the default patient height displayed in the Navigation Window.

Weight OnOff

Weight Units lb (pounds)kg (kilograms)

Weight Default Changes the default patient weight displayed in the Navigation Window.

Respiration OnOff

Pain Level OnOff


Information System OnOff

You must enable this option to send patient readings wired or wirelessly.

Barcode Patient ID OnOff

You must enable this option to send patient readings wirelessly.

Barcode Clinician ID OnOff

Required for Send YesNo

You must enable this option to require the sign-in of the clinician. Only visible when Barcode Clinician ID is on.

Clear on Send/Save YesNo

You must enable this option to clear the Clinician ID after sending or saving the measurements. Disable to keep Clinician ID until power down. Only visible when Barcode Clinician ID is on.

Weight Scale OnOff

Spot LXi can connect to a scale, and the weight will appear on the display window. Note: Disables manual entry of weight.

Wireless Module NoneDPAC

You must enable DPAC to send patient readings wirelessly (through optional wireless radio) or wired (through optional Ethernet adapter).

Printer OnOff

Administrative guide Appendix: LXi configuration worksheet 47

Save Readings settings


Save Mode Manual Automatic

If automatic, Spot LXi saves readings at a preselected time interval. For either option, Spot LXi automatically saves the measured parameters into memory before automatically powering off when not used for 30 minutes.

Auto Save Interval Changes the amount of time before automatically saving the current patient reading. Only available if Automatic Save Mode is enabled.

Reading Full Action Auto OverwriteAsk OverwriteDo Not Overwrite

Spot LXi can save 50 patient readings in memory. Upon reaching reading 51, the device may automatically overwrite reading 1, ask the user if he/she wants to overwrite reading 1, or disable the ability to take another reading until at least one reading is erased.

48 Appendix: LXi configuration worksheet Welch Allyn Connex

Connex Data Management System - Welch Allyn€¦ · The Data Catcher application acts as a gateway between select Welch Allyn devices and external information hosts that wish to receive

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