laurel bridge waypoint user manual · o hl7 orm and adt o http restful messages • data inputs o...

Waypoint User Manual ©2018 Laurel Bridge Software, Inc. All Rights Reserved v1.1.0

Laurel Bridge Waypoint User Manual

Orchestrating Medical Imaging Workflow

Laurel Bridge Software, Inc.

302-453-0222

www.laurelbridge.com

Document Version:1.1.0

Document Number: LBDC-0000xx-xxxxxx

Last Saved: 4/30/2018 4:41:00 PM


Table of Contents 1. Waypoint Server Basics ........................................................................................................... 1

1.1. Overview ...................................................................................................................................................... 1

1.2. Use Cases ..................................................................................................................................................... 2

1.3. Theory of Operation ..................................................................................................................................... 6

1.3.1. DICOM Service Class Providers ............................................................................................. 6

1.3.2. HL7 Receiver.......................................................................................................................... 7

1.3.3. DICOM Service Class User ................................................................................................... 13

1.3.4. HL7 Sender .......................................................................................................................... 13

1.4. User Interface ............................................................................................................................................. 14

1.4.1. Waypoint Cllient.................................................................................................................. 14

1.4.2. DICOM Options ................................................................................................................... 15

1.4.3. HL7 Options ......................................................................................................................... 19

1.4.4. Web Options ....................................................................................................................... 22

1.4.5. Data Views .......................................................................................................................... 22

1.5. Web User Interface .................................................................................................................................... 23

2. Installation ............................................................................................................................. 29

2.1. Minimum System Specification .................................................................................................................. 29

2.2. Prerequisites .............................................................................................................................................. 29

2.3. Installing SQL Server 2012 Express x64 with Tools .................................................................................... 29

2.4. Installing SQL Server 2014 Express x64 with Tools .................................................................................... 30

2.5. Main Install ................................................................................................................................................. 30

3. Getting Started ...................................................................................................................... 36

3.1. Overview .................................................................................................................................................... 36

3.1.1. WaypointClient ................................................................................................................... 36

3.2. Installing a License ..................................................................................................................................... 41

3.2.1. Activating a license over the internet ................................................................................. 41

4. Configuration ......................................................................................................................... 41

4.1. DICOM Sources .......................................................................................................................................... 41

4.2. DICOM Destinations ................................................................................................................................... 41

4.3. HL7 Sources ................................................................................................................................................ 42

4.4. HL7 Destinations ........................................................................................................................................ 42

4.5. Web Sources .............................................................................................................................................. 42


4.6. Web Destinations ....................................................................................................................................... 43

5. System Settings ...................................................................................................................... 43

6. Notifications .......................................................................................................................... 44

6.1. Prefetch Trigger Notification ...................................................................................................................... 44

7. Enabling Input and Output .................................................................................................... 45

8. User Interface Details ............................................................................................................ 45

Waypoint Server FAQ .......................................................................................... 46

References ........................................................................................................... 47

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1. Waypoint Server Basics

1.1. Overview

Waypoint acts as a repository for radiology orders. Minimally, MWL Orders contain the

following data:

• Patient Identifier

o Patient ID (a.k.a. MRN medical record number)

o Patient Name

• Patient Demographics

o Date and Time of Birth

o Patient Sex

o Patient Address

o Patient Account Number

• Scheduled Procedure Step Sequence

o Scheduled Station AE Title

o Scheduled Procedure Step Start Date

o Scheduled Procedure Step Start Time

o Modality

o Scheduled Performing Physician

o Scheduled Procedure Step Description

• Study Instance UID

• Study Date

• Study Time

• Accession Number

• Requested Procedure Description

The purpose of Waypoint is to provide services to allow clients on the network to create, query

and update the worklist items. The design and analysis provided by this document, focuses on,

but is not restricted to, the following protocols:

• DICOM DIMSE Messages

o Modality Worklist Information Model - FIND

o Unified Procedure Step

o Modality Performed Procedure Step

• HL7 ORM, ORU and ADT messages

• HTTP RESTful services

• FHIR (HL7 Fast Healthcare Interoperability Resources)

The DICOM standard specifies the Unified Procedure Step to acquire worklist data. Unified

Procedure Step is implemented with the DIMSE N-CREATE service. In addition, the DICOM

standard specifies the Unified Procedure Step as a RESTful service. The DICOM standard also

specifies the Modality Performed Procedure Step which is a DIMSE N-CREATE service. The

Modality Performed Procedure Step allows the modality to N-GET and N-SET data from the

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worklist item. Finally, and possibly the most common way to acquire worklist data is from the

HL7 ORM message. Waypoint will support each of these protocols.

This document describes Waypoint in phases as follows:

• Modality Work List Server

o Windows Service

o Installer

o DCF 3.4

o HL7 Library

o Web Interface

o Active Directory, LDAP, and Standalone security credentials, i.e. username and

password

o HTTP RESTful Interface

o Persistent Storage: SQL Express

o Audit Logging

• Configuration

o Persistent Storage: SQL Express

o DICOM DIMSE Messages

o HL7 ORM and ADT

o HTTP RESTful Messages

• Data Inputs

o HL7 Messages

o HTTP RESTful Web Messages

o DIMSE Messages

o IOCM messages

• Data Outputs

o MWL SCU

o HL7 Messages

1.2. Use Cases

Use Cases are a UML modeling tool to specify the subject, i.e. Waypoint, the actors that

communicate with the subject, and the interactions between the two. This analysis helps identify

the boundary interfaces between the actors and the system. Actors are humans, as well as

external systems that exchange signals and data with the subject. A use case is the specification

of a set of actions performed by a system, which yields an observable result that is, typically, of

value for one or more actors or other stakeholders of the system. For this system, the Actors are:

• Hospital Admissions

• Referring Physician

• Performing Physician

• Modality

• Clinician

• MWL SCU (e.g. Navigator)

• PACS/Image Store

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• HIS/RIS

• Service IT

• Software Developers

Waypoint can be used in conjunction with other Laurel Bridge products. These products share

many of the same Use Cases listed above. PowerTools is used to test the boundary interfaces

defined by the use cases. Compass, Navigator and Exodus can benefit from the services

provided by Waypoint.

• Power Tools

o Query Client

o Store Server

o HL7 Sender

o HL7 Receiver

o MWL Server Console

• Compass

• Navigator

• Exodus

• Mercury

Hospital Admissions Use Cases Hospital Admissions has the following Use Cases:

• Query for a Patient Record

• Create New Patient Record

A Patient Record contains the following data:

• Patient’s Name

• Patient ID (a.k.a. MRN medical record number)

• Patient’s Birth Date

• Patient’s Sex

The Patient’s Name and Patient ID are qualified together as the Patient Identification. We

cannot assume that the Patient ID alone is a primary key. Patient’s Birth Date and Patient’s Sex

are qualified as patient demographics. Waypoint will generate a unique primary key for each

patient record that is stored.

Implementation must support a way to resolve conflicting Patient ID’s. For example add an

Organization Code to the patient record that is paired with the Patient ID.

Referring Physician Use Cases Referring Physician has the following Use Cases:

• Submit New Order

• Cancel Existing Order

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• Update Existing Order

An Order contains the following data:

• Patient Identifier

o Patient ID

o Patient Name

o Date and Time of Birth

o Patient Sex

o Patient Address

o Patient Account Number

• Scheduled Procedure Steps

o Scheduled Station AE Title

o Scheduled Procedure Step Start Date

o Scheduled Procedure Step Start Time

o Modality

o Scheduled Performing Physician


• Accession Number

• Study Instance UID

• Requested Procedure Description

This use case is the triggering event to create a new patient order. DICOM defines the Unified

Procedure Step SOP Class for creating and updating orders. Also, DICOM offers the Modality

Performed Procedure Step (MPPS) to update orders. However, the most common message to

create a patient order is the HL7 ORM^O01. The first field in the Common Orders segment is

Order Control ORC|1. This defines whether to interpret the message as a new order, update, or

cancel.

0119: Order control codes

VALUE Scheduled Status

NW 1 – New Order Created

OK 2 – Scheduled at a modality

IP 3 – In-Progress

CA 4 - Cancel order/service request

CM 5 – Order is completed

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Performing Physician/Clinician Use Cases The Performing Physician has the following Use Cases:

• Query for today’s orders

• Assign Orders to Modalities

• Initiate Modality to Create Study/Series/Images

These use cases are focused on querying Waypoint for new orders that are being scheduled to

begin processing. This necessitates that each order has a state to distinguish new orders from, in

process, complete, cancelled, etc… This ties into Modality Use Cases that will update the state

of the worklist item.

Modality Use Cases The Modality has the following Use Cases:

• Query Worklist to Prefetch today’s orders

• Send Modality Performed Procedure Step (MPPS) to MWL SCP

• Update state of worklist item from scheduled, processing, complete, failed, etc…

A Modality Performed Procedure Step has the following data:

• Patient’s Name

• Patient ID

• Patient’s Birth Date

• Patient’s Sex

• Referenced Patient Sequence

o Referenced SOP Class UID

o Reference SOP Instance UID

• Scheduled Step Attribute Sequence

o Study Instance UID

o Accession Number


• Performed Procedure Step Start Date

• Performed Procedure Step Start Time

The Modality is the actor that accepts a worklist order and is responsible to notify Waypoint with

any changes to the status.

MWL Query Use Cases As noted earlier, Waypoint does not yield results that are directly observed by the Radiologist.

However, viewing stations are often coupled with a prefetch engine, such as Navigator, that may

incorporate an MWL query to resolve the list of relevant prior exams. The MWL query searches

for worklist items by matching patient demographics and scheduled procedures to retrieve the

Study Instance UID from prior exams. Those studies are copied to a viewing station by

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requesting a C-MOVE from the store server to the viewing station. To accomplish this,

Waypoint is coupled with one or many Store Servers. The coupling between Waypoint and

Store Server is loose, meaning the Store Server is a separate device, commonly known as a

VNA, (Vendor Neutral Archive). Historically, a PACS implemented both the Modality Worklist

(MWL) and the Store Query/Retrieve Servers. The Store Server is a Boundary interface to

Waypoint. A software tool that includes an MWL query client has the following use cases:

• Query for exams for a date range, e.g. today’s exams

• Query for relevant priors for a given patient

• Query for a patient ID to retrieve additional data, such as the Issuer of Patient ID

1.3. Theory of Operation

The primary scope of Waypoint is to provide the Workflow Management category SOP Classes

as defined in DICOM PS3.2 2017 – Conformance. See Appendix D in this document for the

Waypoint DICOM Conformance claim. In addition to DICOM, Waypoint offers additional

features that are compliant with HL7 and IHE to provide features for external interfaces that are

not DICOM based. The Use Cases in the previous section and Appendix C System Architecture,

define actors that are DICOM devices, as well as actors that populate and query worklist data

using HL7 and HTTP RESTful protocols. Finally, a simple CSV file is supported to import and

export worklist data

At the heart of Waypoint is a SQL Server database that maintains the persistent data for the

worklist items. Appendix C section 6 shows the schema for the SQL database. The system

settings, configuration, Application Program Interfaces (APIs), User Interfaces (UI), and security

are all tied to populating and querying the SQL database. Clients of Waypoint fall into 3

categories:

1. DICOM SCU

2. HTTP Client (includes DICOM RESTful Services)

3. HL7 Sender

To support these clients, Waypoint has system requirements for DICOM server, HTTP server,

and HL7 server that provide the following:

• Starting and stopping the server

• Configuring the server

• Monitoring the server

• Sending notifications from the server

1.3.1. DICOM Service Class Providers

The DICOM Service Class Providers implemented by Waypoint are:

• Verification

• Modality Performed Procedure Step

• Modality Performed Procedure Step Retrieve

• Modality Performed Procedure Step Notification

• Modality Worklist Information Model – FIND

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• Unified Procedure Step – Push

• Unified Procedure Step – Watch

• Unified Procedure Step – Pull

• Unified Procedure Step – Event

1.3.2. HL7 Receiver

The Waypoint HL7 Receiver parses HL7 messages to insert, update or query work items in the

SQL database. Each HL7 message has a message type in a message header field, typically field

MSH|9. Handling of HL7 messages must be flexible and extensible to support the workflow of

the hospital information systems (HIS/RIS). For Waypoint to process the HL7 message, the

message type must have a corresponding configuration file to map the fields in the message to

columns in the database tables.

The primary data stream for worklist data is HL7 messages that are broadcast from the Hospital

Information System and Radiology Information Systems (HIS/RIS). It is very common to use

the HL7 ORM^O01 message to create and update worklist orders. Note, in most cases there is a

direct correlation between a field in the HL7 message and the DICOM tag, however, some fields

require additional processing to use the value from the HL7 message as input to create the

DICOM item.

Patient name, mixed case vs all upper case Patient name, number of subcomponents in field, 2 vs 6 Schedule status, CM message came 2 minutes before Ordered message NW does not have Scheduled Location CM does not have ScheduledProcedureStepStartDate NW does not have RequestedProcedureComments CM does not have StudyDate CM does not have ReferenceSopInstanceUID

1. Messages for the same procedure can arrive in any order. The Scheduled Status will maintain a logical progression and cannot go backwards:

a. New b. Scheduled c. In-progress d. Complete or Cancelled

2. An order can be cancelled any time before it is complete 3. A Complete order cannot be cancelled, but a Cancelled order can complete

for example, if we receive CM before Ordered, it will stay in the Completed state 4. An empty value will not replace an existing value, for example the new order message specifies:

a. Scheduled Status (New) b. Scheduled Station AE Title c. Scheduled Procedure Step Start Date d. Modality e. Institution Name f. Scheduled Performing Physician g. Requested Procedure ID h. Requested Procedure Description i. Study Instance UID

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j. Study Date k. Accession Number l. Scheduled Procedure Step ID m. Referenced SOP Class UID n. Referenced SOP Instance UID

5. The Completed order message, whether it arrived before or after the New Message, specifies:

a. Scheduled Status (Complete) b. Scheduled Location c. Requested Procedure Comments

In the config file, the HL7Tag has syntax to support custom parsing of the HL7 message to

generate the value that is stored in the database. In the simplest form, the HL7Tag specifies a

Segment name, a vertical bar (‘|’) and an index number indicating the specific field within the

segment, e.g. PID|5 for the Patient Name. There is also the ability to concatenate a string

constant with the value from the HL7 message. For example, it is common to concatenate a

DICOM UID prefix to the Accession number to generate the Study Instance UID, e.g.

"1.2.840.114089." + ZDS|1.1.2. Finally, a sequence of alternate fields can be examined looking

for the first field that has a non-empty value. For example, many sites use PID|3 for the Patient

ID, (a.k.a. MRN), however PID|2 is available for the alternate Patient ID. Setting the HL7Tag to

the following means use PID|3 if it is not empty, otherwise use PID|2. If both are empty set the

value of Patient ID to UNKNOWN:

HL7Tag = PID|3 ?? PID|2 ?? “UNKNOWN”

The following is an example of the config file used to parse the HL7 ORM^O01 message:

# Laurel Bridge Waypoint is a service that maintains the patient

demographics, procedure steps, and related meta-data for radiology

orders.

# This conforms to the Workflow Management Category in the DICOM

standard.

# The persistence of the data is stored in SQL Express in the two

tables: Patients and Worklists. The schema for the tables

# are defined in separate SQL script files that create or alter the

table in the database. The Waypoint service provides the

# ability to upate and query the patient and worklist data through a

variety of protocols including:

# DICOM, HL7, and HTTP RESTful

#

# The purpose of this config file is to define rules that are

applied to the above protocols to populate and maintain the

persistent data.

# The CFG group name is the column name in the database table. The

attributes define how to parse the message for the given protocol.

[ DICOM System ]

ModalityWorklist = enabled

UnifiedProcedureStep = enabled

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Port = 11115

[ HL7 Receiver ]

MessageType = ADT^A04

MessageType = ORM^O01

Port = 11119

SendAck = true

SendAr = false

EnableTlsSsl = true

TlsSslCertificateFilename =

Password =

[ MWLPeer ]

[ MWLPeer/1 ]

host = localhost

port = 11114

aetitle = MwlServer

copylocal = true

[ Patients ]

Prefix = OtherPatientIds.Patients.

# Patient Name

[ Patients/PatientName ]

DicomTag = (0010,0010)

HL7Tag = PID|5

# Patients Birth Date

[ Patients/PatientBirthDate ]

DicomTag = (0010,0030)

HL7Tag = PID|7

# Patients Sex

[ Patients/PatientSex ]

DicomTag = (0010,0040)

HL7Tag = PID|8

# Additional Patient History

[ Patients/AdditionalPatientHistory ]

DicomTag = (0010,21B0)

HL7Tag =

[ Patients/Custom1 ]

DicomTag =

HL7Tag =


DicomTag =

HL7Tag =

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DicomTag =

HL7Tag =


DicomTag =

HL7Tag =


DicomTag =

HL7Tag =

[ OtherPatientIds ]

Prefix = OtherPatientIds.

[ OtherPatientIds/Pid ]

DicomTag = (0010,0020)

HL7Tag = PID|3 ?? PID|2

[OtherPatientIds/Ipid ]

DicomTag = (0010,0021)

HL7Tag = MSH|4

[ WorklistOrders ]

# Scheduled Station AE

[ WorklistOrders/ScheduledStationAeTitle ]

DicomTag = (0040,0100.0040,0001)

HL7Tag = OBR|20

# Scheduled Location

[ WorklistOrders/ScheduledLocation ]

DicomTag = (0040,0100.0040,0011)

HL7Tag = OBR|20.4

# Scheduled Start Date

[ WorklistOrders/ScheduledProcedureStepStartDate ]

DicomTag = (0040,0100.0040,0002)

HL7Tag = OBR|7 ?? OBR|36

# Scheduled Start Time

[ WorklistOrders/ScheduledProcedureStepStartTime ]

DicomTag = (0040,0100.0040,0003)


# Modality

[ WorklistOrders/Modality ]

DicomTag = (0040,0100.0008,0060)

HL7Tag = OBR|21.1 ?? "SC"

# Instituion Name

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[ WorklistOrders/InstitutionName ]

DicomTag = (0008,0080)

HL7Tag = OBR|20.4

# Scheduled Performing Physician

[ WorklistOrders/ScheduledPerformingPhysician ]

DicomTag = (0040,0100.0040,0006)

HL7Tag = MSH|6 ?? "Physician scheduled for " + PID|5

# Requested Procedure Code Value

[ WorklistOrders/RequestedProcedureCodeValue ]

DicomTag = (0032,1064.0008,0100)

HL7Tag =

# Requested Procedure Code Meaning

[ WorklistOrders/RequestedProcedureCodeMeaning ]

DicomTag = (0032,1064.0008,0008)

HL7Tag = OBR|4.1

# Requested Procedure Code Cpt

[ WorklistOrders/RequestedProcedureCodeCpt ]

DicomTag = (0032,1064.0008,0102)

HL7Tag =

# Scheduled Procedure Description

[ WorklistOrders/ScheduledProcedureDescription ]

DicomTag = (0040,0100.0040,0007)

HL7Tag = OBR|4.1.5

# Study Instance UID

[ WorklistOrders/StudyInstanceUid ]

DicomTag = (0020,000D)

HL7Tag = "1.2.840.114089." + ZDS|1.1.2 ?? "1.2.840.114089." + OBR|2

# Study Date

[ WorklistOrders/StudyDate ]

DicomTag = (0008,0020)


# Study Time

[ WorklistOrders/StudyTime ]

DicomTag = (0008,0030)


# Accession Number

[ WorklistOrders/AccessionNumber ]

DicomTag = (0008,0050)

HL7Tag = ZDS|1.1.2 ?? OBR|2

# Requested Procedure Description

[ WorklistOrders/RequestedProcedureDescription ]

DicomTag = (0032,1060)

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HL7Tag = OBR|4

# Scheduled Station (Unknown)

[ WorklistOrders/ScheduledStation ]

DicomTag = (0040,0100.0040,0010)

# Scheduled Status

[ WorklistOrders/ScheduledStatus ]

DicomTag = (0040,0100.0040,0020)

HL7Tag = ORC|5

# Referenced SOP Class UID

[ WorklistOrders/ReferencedSopClassUid ]


HL7Tag = "1.2.840.114089." + ZDS|1.1.2 ?? "1.2.840.114089." + OBR|2

# Referenced SOP Instance UID

[ WorklistOrders/ReferencedSopInstanceUid ]


HL7Tag = "1.2.840.114089." + ZDS|1.1.2 ?? "1.2.840.114089." + OBR|2

[ WorklistOrders/Custom1 ]

DicomTag =

HL7Tag =


DicomTag =

HL7Tag =


DicomTag =

HL7Tag =


DicomTag =

HL7Tag =


DicomTag =

HL7Tag =

[ Visits ]

Prefix = Visits.

# Visit Status Id

[ Visits/VisitStatusId ]

DicomTag = (0038,0008)

HL7Tag =

# Referring Physician's Name

[ Visits/ReferringPhysiciansName ]

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DicomTag = (0008,0090)

HL7Tag = OBR|16

[ Visits/Custom1 ]

DicomTag =

HL7Tag =

[ Visits/Custom2 ]

DicomTag =

HL7Tag =

[ Visits/Custom3 ]

DicomTag =

HL7Tag =

[ Visits/Custom4 ]

DicomTag =

HL7Tag =

[ Visits/Custom5 ]

DicomTag =

HL7Tag =

1.3.3. DICOM Service Class User

Waypoint supports federated access to external Modality Worklist Servers on the hospital

network. Meaning, Waypoint can be configured with multiple destination worklist servers.

When Waypoint receives a query message for which no results exist in the local database, it will

multi-plex the request to the MWL Service Class Providers that are configured as DICOM

Destinations.

1.3.4. HL7 Sender

Waypoint supports Notification triggers that send HL7 messages to a configured destination.

Therefore, Waypoint will contain an HL7 Sender to handle HL7 Notification events. See section

6.1 Prefetch Notification Triggers for further information.

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1.4. User Interface

1.4.1. Waypoint Cllient

Figure 1.4-1 Splash Screen

Figure 1.4-2 Waypoint Client

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1.4.2. DICOM Options

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1.4.3. HL7 Options

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1.4.4. Web Options

1.4.5. Data Views

Waypoint stores data and calculates metrics to monitor the activities being performed. Most

importantly, the SQL Server Database will maintain tables for Patients and Worklists. Each

row in the Patients table will have a unique, auto-incrementing integer ID followed by all patient

identification and demographics fields identified in DICOM Part 3 section C.2.2 Patient

Identification Module. Each row in the Worklists table will have a unique, auto-incrementing

integer ID followed by all attributes identified in DICOM Part 3 sections 10.6 Request Attributes

Macro, C.4.10 Scheduled Procedure Step Module and C.30.4 Unified Procedure Step

Relationship Module. In both tables, a field will have a NULL value if the message used to

create the record did not specify that information.

In addition, the following data will be maintained:

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• Log messages for info, debug, warning, error and exception conditions

• Audit Logs

• HL7 messages, keep the original HL7 messages in text files that were processed to create

MWL entries in the database

• Active DICOM associations

• Active HL7 connections

• Active HTTP RESTful connections

The following metrics will be calculated and displayed on the dashboard user interface:

• Number of current DICOM connections

• Number of current HL7 connections

• Number of DICOM queries since last data purge

• Number of DICOM aborted connections since last data purge

• Number of errors logged since last data purge

• Days since last data purge

• Days since last database backup

• Memory in use

• Hard Disk space available

Note, when any metric data triggers a notification event, an email message is sent to a list of

users. See section 5 for a description of Email Properties for notifications. See section 7 for

more information about data inputs and outputs.

1.5. Web User Interface

The Web User Interface is accessed through any common web browser from a personal

computer, tablet, or smart phone. The default port is 10400 and it can be changed from the

DICOM Options > System tab on the Waypoint Client user interface. The home screen for the

web user interface is a dashboard as shown:

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The Orders graph shows cumulative status of the orders that have been received by Waypoint.

The orders are most commonly received as HL7 ORM messages, however, orders can also be

created and updated using DICOM UPS, MPPS and DICOM Web RESTful.

The remaining menu items: Patients, Orders, Connections and Users require a login to access.

The default login user is “Administrator” with password “LaurelBridge1234”. This can be

changed from the Users screen. There is also support for accessing the site’s Active Directory

for user login authentication.

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The Patients screen shows a grid of the Patients stored in Waypoint. There is a filtering system

to allow you to fully7 control viewing only a specified list of patients. The Patients screen is

shown below:

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Notice the Add Patient button that allows you to create new patients, as shown:

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The Orders screen shows a grid of the orders stored in Waypoint. There is a filtering system to

allow you to fully control viewing only a specified set of orders. The Orders screen is shown

below:

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Notice on the Orders screen is a button to Add Order. This allows you to search for, edit existing

orders, or create new orders, as shown:

Waypoint Web Users

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2. Installation

2.1. Minimum System Specification

- Intel i5, 4GB+ RAM, 500GB+ HD 7200+ RPM,

- Windows 10, Windows Server 2008 R2, or Windows Server 2012 R2

- SQL Server 2008 R2 x64, SQL Server 2012 x64, or SQL Server 2014 x64.

SQL Express edition may be used in most installations.

The full SQL version must be used for failover cluster configurations.

Depending on your workflow your system requirements may differ. For example, a workflow

with large study counts and/or large image sizes may require improvements to the CPU,

memory, disk, network card, etc.

2.2. Prerequisites

Laurel Bridge Waypoint utilizes several components known as prerequisites that must be

installed for the application to work. The following prerequisites must be installed prior to

installing Waypoint:

- Microsoft .NET Framework 4.6.2 - Microsoft SQL Server - Microsoft SQL Management Studio

IIS Express 8.0 x64 is an optional prerequisite and can be installed before or after Waypoint

installation. The IIS Express installer is included in the Waypoint zip file. You must install IIS

Express 8.0 x64 in order to use Waypoint web features.

2.3. Installing SQL Server 2012 Express x64 with Tools

These are instructions for installing SQL Server Express in its most basic configuration for use

by Waypoint. These instructions are valid for Windows 7, Windows 8.1, Windows Server 2008

R2 and Windows Server 2012. The installation procedure may differ if an older version of SQL

Server is installed, if the full version of SQL Server is preferred, or if SQL Server authentication

mode must be enabled.

1. Log in to Windows as a user with administrative privileges. 2. Run the SQL Server 2012Express x64 with tools (SQLEXPRWT_x64_ENU.exe) installer. 3. On the Setup screen select New installation or add features to an existing installation. 4. On the License Terms screen Accept the license, click the Next> button. 5. On the Product Updates screen choose whether to check for updates based on your corporate

policy. 6. On the Feature Selection screen make sure all of the checkboxes are checked for all of the

Instance Features. Make sure that the Management Tools checkboxes are checked, click the Next> Button.

7. On the Instance Configuration screen the defaults should be correct. The named instance should be SQLExpress. Allow it to install in the default location, which should be C:\Program Files\Microsoft SQL Server\

8. On the Server Configuration screen the defaults should be fine for the Service Accounts tab and the Collation tab defaults.

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9. On the Database Engine Configuration screen on the Account Provisioning tab, select Windows Authentication Mode. The Current user (who must have Administrative Privileges) should be in the list under Specify SQL Server Administrators. If it is not, click the button to Add Current User. Leave the defaults on the other two tabs.

a. You must also add the '‘NT AUTHORITY\SYSTEM’ user. Click the Add… button and type System into the text box then click the Check Names button to add to the list and click OK. You should now see ‘NT AUTHORITY\SYSTEM (SYSTEM)’ in the list of SQL Administrators. Click the Next> button.

10. Installation should complete in several minutes.

2.4. Installing SQL Server 2014 Express x64 with Tools

These are instructions for installing SQL Server Express in its most basic configuration for use

by Waypoint. These instructions are valid for Windows 7, Windows 8.1, Windows Server 2008

R2 and Windows Server 2012. The installation procedure may differ if an older version of SQL

Server is installed, if the full version of SQL Server is preferred, or if SQL Server authentication

mode must be enabled.

1. Log in to Windows as a user with administrative privileges. 2. Run the SQL Server 2014Express x64 with tools (SQLEXPRWT_x64_ENU.exe) installer. 3. On the Setup screen select New installation or add features to an existing installation. 4. On the License Terms screen Accept the license, click the Next> button. 5. On the Microsoft Update screen choose whether to check for updates based on your corporate

policy. 6. On the Feature Selection screen make sure all of the checkboxes are checked for all of the

Instance Features. Make sure that the Management Tools checkboxes are checked, click the Next> Button.

7. On the Instance Configuration screen the defaults should be correct. The named instance should be SQLExpress. Allow it to install in the default location, which should be C:\Program Files\Microsoft SQL Server\

8. On the Server Configuration screen the defaults should be fine for the Service Accounts tab and the Collation tab defaults.

9. On the Database Engine Configuration screen on the Account Provisioning tab, select Windows Authentication Mode. The Current user (who must have Administrative Privileges) should be in the list under Specify SQL Server Administrators. If it is not, click the button to Add Current User. Leave the defaults on the other two tabs.

a. You must also add the ‘NT AUTHORITY\SYSTEM’ user. Click the Add… button and type System into the text box then click the Check Names button to add to the list and click OK. You should now see ‘NT AUTHORITY\SYSTEM (SYSTEM)’ in the list of SQL Administrators. Click the Next> button.

10. Installation should complete in several minutes.

2.5. Main Install

After installing the prerequisites, the Waypoint installer (Waypoint.msi) can be run. For

machines with an older version installed, this installer will upgrade any previous installation

while maintaining any current configuration settings.

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You must have Windows Administrator privileges in order to install Waypoint correctly.

After launching the Waypoint installer by double-clicking Waypoint.msi, the user is greeted with

the Welcome screen:

Press the ‘Next >’ button.

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The user is then greeted with the License Agreement screen:

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Select the ‘I Agree’ radio button and then press the ‘Next >’ button. The user is then greeted with

the Installation Location screen:

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Specify an installation location (the default location is typically the best choice) and then press

the ‘Next >’ button. The user is then greeted with an installation progress screen:

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After installation completes, the user is then greeted with the Installation Complete screen:

Press ‘Close’ to complete the installation. The computer should be rebooted after installation.

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3. Getting Started

3.1. Overview

The Waypoint application is comprised by the following:

• WaypointService is a Microsoft Windows Service that is the control and data model

• WaypointClient is a Microsoft Windows Forms application that is used to configure the

WaypointService

• WaypointRestService is the application entity that works with IIS to provide the Web

user interface and support for HTTP RESTful queries

3.1.1. WaypointClient

The default installation for WaypointClient is

C:\Program Files\Laurel Bridge Software\Waypoint\WaypointClient.exe

A link to this file is automatically added to the Start Menu as Laurel Bridge Waypoint.

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The menu bar gives you control to start and stop services for: Incoming DICOM messages,

Incoming Web RESTful messages, and Incoming HL7 Messages. Being a DICOM Modality

Waypoint Broker, you configure Waypoint to accept and store HL7 messages. The data stored

from the HL7 messages is used to populate the data for DICOM MWL queries coming from

modalities, viewing stations, and study prefetch engines.

The Edit menu item contains an entry for HL7 Options. This opens and editor to allow you to

create and configure HL7 Sources. The primary configuration parameter is the Listen Port that

defines the TCP port that Waypoint uses to accept HL7 messages from the HL7 source. The

next step is to edit the MWL Mappings. The MWL Mappings define the parsing rules for

extracting data from an HL7 message for each field that supplies the data for a DICOM MWL

query.

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The MWL Mappings editor allows you to fully control how the HL7 message is used to populate

the data that is stored for the worklist entry. Please see section 1.4.7 HL7 Receiver for more

information about HL7 configuraiton. Here is the MWL Mapping screen.

Notice the Test button at the bottom of the screen. This allows you to iteratively update the

configuration and immediately test it with one of your HL7 messages. First copy a sample HL7

message to the system clipboard using any common editor like Notepad. On the Test dialog,

paste the HL7 message the click the OK button. The Test Result column on the above screen

will be updated with the results from parsing the message.

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Clicking Paste copies the system clipboard to the display. Clicking OK runs the test and updates

the Test Results column:

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3.2. Installing a License

Describe steps for installing a license

3.2.1. Activating a license over the internet

Describe steps for activating a license

Waypoint runs as a Windows Service that hosts DICOM, HL7 and Web servers. Waypoint also

communicates as a client to other servers on the network. There are server specific

configurations for Sources, Destinations, and Notifications. System Setting are defined in

section 5. Notifications are defined in section 6.

4. Configuration

4.1. DICOM Sources

DICOM Sources define the Service Class Users (SCU) that are permitted to communicate with

Waypoint. Each source has the following list of properties, including the Default source that is

required to exist, though it may be disabled:

• Description

• Permissions (check boxes)

o Create

o Delete

o Modify

o Query

o Subscribe

• Called AE Title

• Source Enabled

• Calling AE Title

• Host/IP

• Store Commit Enabled

• Logging (on or off)

• Settings (edit DIMSE and PDU properties)

4.2. DICOM Destinations

DICOM Destinations are peer Modality Worklist Servers on the network that Waypoint will

forward MWL C-FIND queries to when entries are not found in the local database:

• Description

• Calling AE Title (Fixed, Source Calling, or Source Called)

• Host/IP (Default option)

• Destination Enabled

• Called AE Title (Fixed, Source Called)

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• Host/IP

• Port

• Verification Test Button

• Settings (edit DIMSE and PDU properties)

4.3. HL7 Sources

HL7 Sources define the HL7 network source that are permitted to communicate with Waypoint.

For example, the HIS/RIS that sends ORM and ADT messages to Waypoint. Each source has

the following list of properties, including the Default source that is required to exist, though it

may be disabled:

• Description

• Source Enabled

• Start When Incoming HL7 Started

• Host/IP or Allow Any

• Connection Idle Timeout

• HL7 ACKs Enabled

• Logging (on/off)

• Site Name

• Listen Port

• Inbound IP

• Use TLS

4.4. HL7 Destinations

HL7 Destinations define the HL7 network devices that Waypoint communicates with using HL7

messages. This is discussed in Section 6 Notifications. Each destination has the following list of

properties, including the Default source that is required to exist, though it may be disabled:

• Description


• Host/IP

• Port

• Test Button


• Site Name

• Use TLS

• Max Attempts

• Retry Delay

• Wait for Acknowledgement

• ACK Timeout

4.5. Web Sources

Waypoint implements multiple web controllers:

1. WaypointController implements the HTTP methods for the Web User Interface.

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2. WorkitemsController implements the HTTP methods for the Unified Procedure Step

RESTful Service (UPS-RS).

Each web source has the following list of properties, including the Default source that is required

to exist, though it may be disabled:

• Description

• Source Enabled

• Host/IP or Allow Any

• Connection Idle Timeout


4.6. Web Destinations

Waypoint supports ability to issue RESTful queries to Web Destinations. Each Web Destination

has the following list of properties, including the Default source that is required to exist, though

it may be disabled:

• Description


• Host/IP

• Port

• Test Button


• Use TLS

• Max Attempts

• Retry Delay

5. System Settings

The systems settings for Waypoint include:

• Application Logging

o Directory

o Filename

o Max File Size

o Number of Files

o Log Verbosity

• DICOM Incoming

o Enabled at Startup

o Max Connections

o Listen Port

o Enable TLS Listener

▪ TLS Listen Port

▪ Timeout

▪ Auth Timeout

o TLS Certificate Configuration

▪ TLS Certificate

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▪ Password

o Web Interface

▪ IIS Location

▪ Hostnames

▪ HTTP Port

▪ HTTPS Port

o Audit Logging

▪ Enabled

▪ Host/IP

▪ Transport

▪ Port

▪ Site ID

▪ Use TLS

▪ Ignore Certificate Name Mismatch Errors

▪ Allow Self-Signed Certificates

▪ Message Types to Log

• Application Start/Stop

• Software Configuration (Input/Output Start/Stop)

• DICOM Instance Network Transfer

• DICOM Instance Import/Export

• User/Security Alerts

o Web User Administration

▪ LDAP / Active Directory

• LDAP Enabled

• Domain Name

• Admin Role CN

• User Role CN

• View Role CN

▪ User Timeout

▪ Administrator Password Reset

▪ Import Users

▪ Export Users

6. Notifications

Describe Notifications, i.e. email triggers for error conditions

6.1. Prefetch Trigger Notification

One of the use cases for Waypoint is MWL queries to prefetch prior exams 1 or 2 days before a

scheduled exam is performed. Mammo exams are often ordered a year in advanced. Waypoint

provides the ability to send out a notification at some configured time before the exam is

scheduled to trigger the prefetch engine, e.g. Navigator, to request relevant prior studies to be

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copied to the viewing station. The notification is a HL7 SIU message containing patient

demographics and patient order information for the schedule exam.

7. Enabling Input and Output

8. User Interface Details

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Waypoint Server FAQ

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References

• Modality Worklist SCP

o Workflow Application Entity Specification (part 2 section B4.2.2)

o Unified Procedure Step (part 4 annex CC)

o Unified Procedure Step (part 3 section 7.11.1)

• HL7 Receiver (part 2 section C.8.1.3)

o ORM^O01

o ADT^A04

• Power Tool Applications:

o HL7 Sender to forward HL7 messages

o MWL Query SCU to communicate with peer Worklist Server

o Store Query SCU to communicate with Store Server

• DICOM Model of the Real World (part 3 section 7.1)

o Figure 7-3. Model of the Real World for the Purpose of Modality-IS Interface

• SQL Training

o https://www.red-gate.com/simple-talk/sql/t-sql-programming/sql-server-

functions-the-basics/

• FHIR

o Populating FHIR Resources (part 17 section HHH.4.2.2)

o QIDO RESTful service (part 18 section 6.7)

• UPS-RS Open Event Channel (part 18 section 6.9.10

o RFC6455 – details on WebSocket protocol.

o Smart Websocket Client (Chrome Extension app)

▪ https://chrome.google.com/webstore/detail/smart-websocket-

client/omalebghpgejjiaoknljcfmglgbpocdp?utm_source=chrome-app-

launcher-info-dialog

• IHE Radiolog7 (RAD) Technical Framework Vol 2 – Transactions

o IHE RAD TF-2

▪ http://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_TF_

Vol2.pdf

• DICOM Standard o http://www.dicomstandard.org

https://www.red-gate.com/simple-talk/sql/t-sql-programming/sql-server-functions-the-basics/

https://www.red-gate.com/simple-talk/sql/t-sql-programming/sql-server-functions-the-basics/

https://chrome.google.com/webstore/detail/smart-websocket-client/omalebghpgejjiaoknljcfmglgbpocdp?utm_source=chrome-app-launcher-info-dialog



http://www.dicomstandard.org/