UM-0001 User`s Manual, The AFHCAN Cart v4
Contents
1. UM 0001 User s Manual The AFHCAN Cart V4 Version 3 1 3 Introduction to Peripheral Devices The model V4 AFHCAN Cart 1s equipped with a computer system CPU monitor keyboard mouse network cable and wireless network antenna It also includes three peripheral devices a media reader a scanner and a digital camera 1 3 1 Standard Equipment The items described below are included as standard features of the model V4 AFHCAN Cart 1 3 1 1 Multimedia Reader The media reader allows digital images or documents to be read into a case from the various media cards such as those used in digital cameras This functionality 1s activated via the Digital Camera button in the software The media reader is located in the right rear area of the top drawer 1 3 1 2 Scanner The scanner allows documents or photographs to be scanned in and added to a case The scanner 1s controlled by the AFHCAN software so 1t 1s not necessary to use the buttons located on the front panel of the scanner in fact the buttons are disabled in the AFHCAN application The scanner function is activated by the Scanner button in the software The scanner is located on the left side of the top drawer 1 3 1 3 Digital Camera A digital camera is included with the Cart It is housed in a docking station in the front right compartment in the bottom drawer Cabling for the USB connection and DC power for charging the battery are permanently installed in the bottom drawer Images2. ET1928L uses RF energy only for its internal function Therefore its RF emissions are very low and are not likely to cause any interference in nearby electronic equipment UM 0001 User s Manual The AFHCAN Cart V4 Version 3 1 6 General Specifications and Operating Limits 1 6 1 Device Labeling Table 1 shows the labels used on the Cart and the meaning of each label refer to Figure 6 and Figure 7 for locations Table 1 Labeling used on the Cart Label Meaning Identifies the Cart s main power switch Placing the rocker switch into the ON position I applies System Power power to the computer and all attached peripheral devices ON Each peripheral device can then be turned on using its own power switch OFF Placing the rocker switch into the OFF position O removes power from the computer attached peripheral devices and any other components on the Cart Alaska Federal Health Care Access Network a division of l Alaska Native Tribal Indicates the Cart s manufacturer Health Consortium www afhcan org Telehealth Workstation Model V4 Indicates device name model number and serial number Serial Indicates device s overall rating with regard to protection IPXO from ingress of dust and moisture not protected Power Input 120VAC 60Hz 10A Indicates device input power characteristics Identifies the rating and type of externally accessible fuses Two fuses are located on the back of the power switch Power
3. Switch Fuses where the AC power cable connects to the assembly one 10A 250V Fast Acting for each leg of the power connection but not ground The fuses are Bussman GDB fast acting glass tube 5 x 20 mm Identifies a general purpose USB port that allows additional USB peripheral devices to be connected Audio Identifies a 1 8 inch stereo headphone jack for audio Out output Microphone Identifies a 1 8 inch microphone input 17 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Label Hand Switch Composite Video In S Video In VGA Out S Video Out 1 6 2 Operating Limits Meaning Identifies a 1 4 inch jack for connecting the hand switch Identifies a composite video input port that allows a video signal from an additional device to be brought into a case Identifies an S Video input port that allows a video signal from an additional device to be brought into a case Identifies a VGA output port which allows a second monitor or overhead projector to be connected to the Cart Anything that is being displayed on the Cart s touchscreen monitor will be displayed simultaneously on the second device Not applicable to the standard V4 Cart Used only when a Spectrim Pro video capture card is installed which includes an S Video Out signal Tables 2 and 3 list the environmental limits for the AFHCAN V4 Cart Table 2 Operating limits Parameter Temperature Humidity non condensing Pressure Table 3 Non
4. a database or by entering new patient information into the database e describe the patient s condition and history using a variety of forms tailored to various medical specialties e use the peripheral devices attached to the Cart to obtain images and data and save this information into a case e decide what to do with the case send the case to another provider or group of providers place the case on hold so you can come back later and add information send the case to electronic archives where it can be saved for future reference and viewed by other providers as needed discard the current changes made during this session with the case The AFHCAN client software that runs on a Cart is called the tConsult Cart software The software is very intuitive to operate 1 1 2 2 tConsult Servers To achieve full functionality each Cart in an AFHCAN system must be connected to a network server running AFHCAN tConsult Server software The server stores information about all the Carts that are connected to that server Servers also store the information about all the patients and all the cases that the server has handled Usually a server connects to a number of Carts in a particular geographic region All users with Carts connected to a given server can send cases to each other Servers can also be connected to other servers This allows users with Carts in one region to send cases to users with Carts at a distant location If a C
5. appear reminding you to place the digital camera in the drawer 3 The software will automatically shut itself down and display a message that says It is now safe to turn off your computer It is now safe to turn the Cart off 4 Once the message above is displayed simply turn the System Power switch to OFF 0 21 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 22 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Section 3 Routine Maintenance 4 1 Care and Cleaning Routine maintenance is limited to cleaning of external surfaces In general the surfaces of the Cart can be wiped down with a cloth slightly dampened with a mild detergent or dilute disinfectant solution The monitor screen surface and scanner top can be cleaned with a soft cloth lightly moistened with a suitable glass cleaner It is recommended that routine cleaning be performed once a month or more often if local conditions warrant 4 2 Elementary Troubleshooting On the whole the Cart 1s robust The computer automatically reboots to the AFHCAN software after any power outage Note It is always best to initiate Cart shutdown from within the AFHCAN software This ensures no data is lost The first step in troubleshooting consists of verifying that power is available e ensure the Cart is plugged into a working wall outlet e ensure the power cable is connected to the box housing the main power switch e ensure the main power switch is on
6. are read in from the digital camera s memory via the Digital Camera button in the software The digital camera is a primary tool for dermatology general trauma or other visible medical situations 1 3 2 External Connections There are nine external connection points on the V4 AFHCAN Cart e USB e Audio Out e Microphone e Hand Switch e Composite Video In e S Video In e VGA Out e S Video Out e Foot Switch 12 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 1 3 2 1 USB Port The USB port allows any USB device to be connected to the Cart However in order for the device to function with the AFHCAN tConsult Software the software must include the programming and drivers needed to control and communicate with the device The following functionality is built into the tConsult Software e A thumb drive or external hard drive can be connected and can be used with the following software features when used with the Digital Camera function the tConsult Software will interrogate the attached USB device and read the following types of files into a case jpg bmp png mpg wmv avi mov mp3 wma pdf doc and t1f when viewing an image in a case the thumb drive can be used for saving a copy of the image Right click on the image and select Save As A window will open allowing you to browse to the thumb drive Notes 1 Be aware of HIPAA requirements when copying images 2 The system prevents users fr
7. operating limits Parameter Temperature Humidity non condensing Pressure Range 50 F to 95 F 10 C to 35 C 30 to 70 227 mmHg to 760 mmHg 303 hPa to 1 013 hPa Range 4 F to 120 F 16 C to 49 C 30 to 85 227 mmHg to 760 mmHg 303 hPa to 1 013 hPa 18 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Section 2 Operation 2 1 Basic Operating Procedures The following is an introduction to Cart operation suited to a basic functional checkout 2 1 1 Guidelines on Placement and Setup Find a location for the Cart where there is room for both the user and the patient to be seated nearby Make sure there 1s a power outlet available as well as a network cable connection point 1f wireless access is not being used Warning Be sure to lock the wheels when the Cart is in the desired position Push the locking levers down by gently stepping on the tip of the lever ia Push to unlock Figure 8 Wheel locks 2 1 2 Applying Power Turn the SYSTEM POWER switch to ON D This makes power available to all devices installed on the Cart Note With just a few exceptions the standard practice 1s to leave most peripheral devices switched on at all times with power to individual devices being controlled by the Cart s System Power switch This includes the monitor and scanner The digital camera is normally left off when in the docking station Once the System Power switch 1s turned on the computer
8. R Oa a ROEA 20 21 Operating the Digtal Camera iseni a E A 20 2 k0 Operaine the Media Reade ia 21 ZN SNUSE DOWD ebosca ronn ias 21 Section 3 Routine VISION anes wiseisccsscsascsiecissccccssssssiariesdosasiadsssssancevectensededssescosasendessasseccveotes 23 AA A adicta 23 42 Elementary rOUDIGSHOOUIN meadows els 23 Appendix A Technical Description eessocssssseecccccsssseecccccsssssccecocosssseececcoosssssseeecossssssseesssssoo 25 Device Classi ICALOIS ld 25 Additional Infra ION paein aea a aan 25 Critical Components and Power Distribution ooooocnnnnnnncnanananaannnnanannannnnnnnnn nono n o non nono nono non nnnn nono 25 List of Illustrations Figure Title Page U NEAFHCAN Care froni VOW is 5 Z V AFHCAN Carl Side VEW Session ar e E 6 gt NEE PE CIN Care Dat kee E A EE 7 A VAAFHCAN Cart el 8 5 V4 AFHCAN Cart computer and power DayS oooooooooonncoccnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnoss 9 6 Main power switch front and back views oooooooococcncncnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnoos 10 E Extemalconnecion pots earne 11 A A A IRS 19 List of Tables Table Title Page Wanne and ca non VINDOIS a vi E Labels sd on the Car srine a S 17 A OPTADO S ee AE E EAEE EE AA EA EA E 18 3 Nomoperaina iS cdas 18 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Preface About this Document This document introduces the AFHCAN Cart model V4 for clinical users Only the baseline configu
9. User s Manual The AFHCAN Cart V4 Document ID UM 0001 Version 3 A AFHCAN Telehealth Solutions a UM 0001 User s Manual The AFHCAN Cart V4 Version 3 The names of any providers and patients used in illustrations or examples in this document are fictitious and were developed in accordance with AFHCAN s deidentification procedures Every effort has been made to ensure this manual is a high quality product Check AFHCAN s website www afhcan org for updates or additional information Please let us know if you have any suggestions for improvement using one of the following means of contact AFHCAN Product Development Team 4000 Ambassador Drive Anchorage AK 99508 Phone 888 449 4435 toll free Fax 907 729 2269 Email customersupport anthc org Copyright 2010 Alaska Native Tribal Health Consortium ANTHC All rights reserved No part of this publication may be reproduced stored in a retrieval system or transmitted in any form or by any means including photocopying electronic mechanical recording or otherwise without the prior written permission of Alaska Native Tribal Health Consortium UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Table of Contents Section Title Page Prelat ii a ocaso V About this DOC SING E A A IA y Wanin sand Caution gt DOS NENA vi FOr MOO O deta dla eo nina eis vi section L Introductio ccinn ots eee cseoes dees eee hoes E eel es a cch tokio ees 1 1 1 In
10. art has temporarily lost network connectivity to a server it is said to be running in Off Line mode Much of a Cart s functionality for creating a case is still available but the case cannot be sent to another provider until network connectivity is restored Operations that depend on connection to a network are not active when a Cart is running off line The temporarily inactive functions are grayed out when displayed in the software 1 1 2 3 Communication Services The communications between a Cart and a server as well as the communications between one server and another can take place over a variety of communication services There are many From a technical standpoint Carts communicate only with servers not with each other Servers forward the information in the form of a case to the appropriate provider when he or she logs in at a Cart or workstation running AFHCAN software UM 0001 User s Manual The AFHCAN Cart V4 Version 3 ways these communications services can be set up including satellite systems microwave systems terrestrial based local area and wide area networks telephone lines etc These services operate behind the scenes and a full description of these services 1s beyond the scope of this manual 1 1 2 4 AFHCAN Workstations An AFHCAN workstation is any computer running AFHCAN tConsult Cart software As mentioned earlier the AFHCAN tConsult Cart software runs on the computer in the AFHCAN Cart and controls all aspec
11. be enabled in the Client Setup Utility so the functionality is available in the Add To Case screen 14 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 in general the Spectrim Lite video capture card can only handle one s video source at a time the default input for a video otoscope if one is mounted on a Cart is the s video input wired internally to a Y cable itis necessary to turn off any other video sources e g the otoscope when connecting an external video source to the S Video In connector 1 3 2 7 VGA Out The VGA Out connector allows the computer s monitor output to be displayed on an external device such as an overhead projector The monitor on the Cart receives its signal from an internal DVI card The signal going to the monitor on the Cart is separate from the VGA Out signal so both display devices can be used at the same time 1 3 2 8 S Video Out The S Video Out connection applies only when a Spectrim Pro video capture card is installed It is not used on the baseline V4 Cart If the optional Spectrim Pro video capture card is installed the S Video Out provides a parallel output of the active video device either composite or S video for display on other monitors or overhead projectors or for use with S video recording devices 1 3 2 9 Foot Switch The foot switch jack is located in the upper left corner of the power bay It is wired in parallel with the hand switch and any additional trigger switche
12. e ensure the power switches of the various devices are ON as needed e g the monitor In addition check any cable connections which are in view or readily accessible without removing any protective shrouds or covers 23 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 24 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Appendix A Technical Description Device Classifications The footswitch is classified as IP X8 meaning it can be used while subject to complete immersion in water All other parts of the AFHCAN cart are classified IP X0 no protection from ingress of dust or moisture The AFHCAN V4 Cart is rated as Class I equipment It is not suitable for use in the presence of a flammable anesthetic mixture with air or with oxygen or with nitrous oxide The normal mode of operation is continuous Additional Information AFHCAN will make available on request circuit diagrams component parts lists descriptions and calibration instructions that will assist the user s qualified technical personnel to repair those parts that are designated by AFHCAN as repairable Critical Components and Power Distribution A diagram showing the power distribution for critical components is included as an attachment immediately following the last page of this manual 25 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 26
13. e symbol or arning l i E i label may result in personal injury and or serious equipment damage l Failure to comply with the information associated with the symbol or Caution label may result in equipment damage Note Draws the reader s attention to something that might be important for successful operation of the referenced item For More Information This document describes the equipment to a level of detail that will meet most user s needs in the context of clinical use For more information contact AFHCAN Customer Support AFHCAN Customer Support Phone 888 449 4435 Fax 907 729 2269 email customersupport anthc org vi UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Section 1 Introduction 1 1 Introduction to the AFHCAN Cart The AFHCAN Cart is a tool for communicating medical information obtained during a patient encounter from one healthcare provider to another Additional information may be generated by customer purchased medical devices connected to the Cart Outputs from the devices feed directly into the Cart s computer which temporarily stores and assembles the information into a case The case can then be transmitted over any conventional communications network including telephone lines satellite links or other available systems Because the information remains in its original form the receiving provider sees exactly what the sending provider sees with little or no loss of detail The system is an effic
14. e trigger switch and the foot switch discussed later can activate the capture 1 3 2 5 Composite Video In The Composite Video In connection allows an external composite video source to be connected to the video capture card With the Spectrim Lite standard in the baseline V4 build the Composite Video In connector is wired in parallel via a Y cable with internal wiring for permanently attached composite video devices such as a dental camera The following points pertain to the Spectrim Lite video capture card asuitable button must be enabled in the Client Setup Utility so the functionality is available in the Add To Case screen in general the Spectrim Lite video capture card can only handle one composite video source at a time the default input for a dental camera if one is mounted on a Cart is the composite video input wired internally to a Y cable itis necessary to turn off any other video sources e g the dental camera when connecting an external video source to the Composite Video In connector 1 3 2 6 S Video In The S Video In connection allows an external s video source to be connected to the video capture card With the Spectrim Lite standard in the baseline V4 build the S Video In connector is wired in parallel via a Y cable with internal wiring for permanently attached s video devices such as an otoscope The following points pertain to the Spectrim Lite video capture card asuitable button must
15. ections between any points must be approved and certified at both the sending and receiving sites e all activity within a case and on the network 1s tracked as a unique event e custody of a case is systematically transferred so that only one person can open and add to a case at any given time UM 0001 User s Manual The AFHCAN Cart V4 Version 3 1 2 Main Components of the AFHCAN Cart Figures through 7 show the main features of the baseline V4 AFHCAN Cart Please be aware that your Cart may have additional devices attached Refer to the user manuals for those devices for more information Antenna for wireless network Top shelf Touchscreen monitor Main power switch Equipment bins paper Handswitch video capture trays are an option Keyboard Mouse Top drawer scanner media reader Middle drawer supplies Bottom drawer digital camera Computer bay Power bay Footswitch video capture Figure 1 V4 AFHCAN Cart front view Note The terms main power switch and system power are used interchangeably throughout this manual UM 0001 User s Manual The AFHCAN Cart V4 Version 3 A Maximum shelf load 25 pounds Media expansion panel Wheel lock Computer bay Power bay Figure 2 V4 AFHCAN Cart side views UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Rubber cover over cable management access hole Enclosure for Cart s Stowage tab for main power switch power cord Wiring
16. een Note After about ten minutes of not communicating with the system the camera will automatically return to 1t s previous status off and recharging 2 1 6 Operating the Media Reader To use the media reader proceed as follows 1 Place a suitable media card with an image file stored on it into the correct slot in the media reader Note For the purposes of initial familiarization and operational checkout you can use the SD memory card from the digital camera Take a photograph then remove the SD memory card by sliding the battery cover on the bottom of the camera open and pressing down on the SD card to unlatch it 2 From the Add To Case screen select the Digital Camera button Thumbnail images of all photographs on the card will appear at the left of the screen The appearance of thumbnails successfully tests the media reader 3 To discard the image or images from the case click the Back button A window will pop up advising you that images will be lost Click Yes to confirm the operation and return to the Add To Case screen 2 1 7 Shutting Down Close the software and turn off the Cart as follows 1 Press the Log Out button in the upper right corner of the software A window will pop asking you to verify your intent to log out Click Yes This returns you to the AFHCAN shell 2 From the AFHCAN shell press Shutdown A window will pop asking you to verify your intent to shut down the computer Click Yes A message will
17. ge appears in the middle of the screen The presence of a thumbnail image indicates a successful scanner test To discard the image or images click the Back button A window will pop up advising you that images will be lost Click Yes to confirm the operation and return to the Add To Case screen 2 1 5 Operating the Digital Camera To operate the Kodak V1233 digital camera proceed as follows l Remove the digital camera from the cradle press the camera power button to turn it on and press the shutter button to take a photograph Press the power button to turn the camera off Place the camera in the docking station Press the bar at the front of the docking station This allows the camera to communicate with the computer This must be done before the next step Note Pressing the Digital Camera button in the software before activating the digital camera as described in step 4 results in an error message explaining the correct sequence Press Cancel and resume with step 4 From the Add To Case screen select the Digital Camera button Thumbnail images of all photographs on the camera will appear at the left of the screen The appearance of thumbnails successfully tests the camera 20 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 6 To discard the image or images click the Back button A window will pop up advising you that images will be lost Click Yes to confirm the operation and return to the Add To Case scr
18. ient reliable and secure means for exchanging medical data This technology is often used for obtaining a telemedical consult but it can support other functions such as patient referrals and scheduling Depending on the types of user purchased devices attached to the Cart the medical information in a case could be in any of the following forms e digital images originating from a digital camera video otoscope dental camera or other video device e textual information or documents the AFHCAN tConsult Cart software includes built in forms for assessment data patient histories etc administrators can design forms for their organizations using tConsult Web comments or instructions can be added to a case other documents or images can be added as attachments e patient identification information patient information can be entered directly into a database of patient information patient information can be imported from an electronic medical records system patient information is available to all providers in the local network e scanned images or documents originating from a scanner e data displays and reports originating from an ECG digital spirometer tympanometer audiometer vital signs monitor e video video clips can be incorporated into a case originating from a digital camera Carts equipped with a video camera can engage in live video teleconferencing this capability is separate from the tCo
19. manently saved to the telemedicine server and is then available to be sent to another provider over the communications network e the AFHCAN system works with the communications network to ensure all images and other components of the case arrive safely at the destination e AFHCAN software at the receiving end assembles all the information in the case and then lets the receiving provider know a case is available for review e the receiving provider can then open and review the case at his or her convenience e g between appointments The store and forward strategy does very well at handling large quantities of digital information such as images or video clips Store and forward can also be used in conjunction with live voice or video communications as a way to provide background information prior to a live session 1 1 2 The AFHCAN System The AFHCAN Cart functions as one part of a communications network In the path from one provider to another there are a number of other parts each contributing to the process These components are described in the following sections UM 0001 User s Manual The AFHCAN Cart V4 Version 3 1 1 2 1 AFHCAN tConsult Cart Software The heart of the AFHCAN telemedicine system is the AFHCAN tConsult Software AFHCAN designs the software that runs on the computer in the AFHCAN Cart The software allows the user to perform the following tasks e identify the patient either by selecting an existing patient from
20. nsult Cart software used to develop a case e audio originating from a digital stethoscope UM 0001 User s Manual The AFHCAN Cart V4 Version 3 1 1 1 Store and Forward Telemedicine The AFHCAN Cart uses a store and forward strategy for transmitting telemedicine cases In contrast to live video or live voice communications store and forward allows information to be gathered saved transmitted and subsequently reviewed as a package a case The following are some of the problems that can be encountered when obtaining a medical consult using live voice communications e the sending provider and the consulting provider must both be available at the same time e the communications system or network must be up and running with adequate bandwidth e live communications are limited to audio and video e video feeds are prone to lag time and loss of detail In remote areas that depend on satellite networks communications can be subject to a variety of technical limitations and interruptions It can also be a problem scheduling a live consult between providers with busy schedules The store and forward strategy overcomes these problems The following steps outline the basic sequence e a provider sees a patient and gathers information into the Cart using various peripheral devices forms and other resources e the information being gathered 1s assembled into a case which 1s specific to that patient and that particular visit e the case is per
21. o Out The Audio Out jack allows users to listen to audio from the computer on headphones Connecting a 1 8 inch plug into the jack cuts out the audio feed to the built in speakers in the monitor Good headphones will have improved audio quality over the monitor speakers or they can be used for 13 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 private listening The audio can originate with video sessions VTC camera installed video clips from the digital camera or audio clips brought into a case 1 3 2 3 Microphone The Microphone jack allows a microphone input to be connected to the computer This applies primarily to video sessions when a VTC camera is installed When a 1 8 inch plug is inserted into the Microphone jack it cuts the signal from the microphone installed with the VTC camera At the time of this writing it 1s not possible to record an audio clip directly into a case 1 3 2 4 Hand Switch The Hand Switch jack allows still images from a video device to be captured into a case An input from the hand switch triggers the Spectrim Lite video capture card or Spectrim Pro video capture card if installed to capture the available video feed as a still image Note Some devices that can be attached to a Cart have their own trigger switch For example the Evolution M Series Dental Camera has a trigger switch on the handpiece When that device is installed it is wired in parallel with the hand switch The hand switch th
22. om viewing the C and D drives 3 Right clicking on an image also accesses advanced image editing e Digital cameras can be connected to the USB port provided they conform to one of the following standards the camera functions as removable media similar to a thumb drive the camera conforms to the Windows Image Acquisition WIA standard Note For details on how to connect a particular camera to a computer refer to the manufacturer s user manual e The Midmark digital spirometer can be connected to the USB port and used with the Digital Spirometer function All software and drivers needed to support this device are included in the tConsult Cart software e Any USB device that generates a video signal a webcam for example can be connected but the following steps are necessary to make it work the drivers for the device must be installed the Video Source button must be activated via the Client Setup Utility Pushing the Video Source button brings up a menu where you can select the driver for the video device If drivers for more than one video device have been installed it will necessary to know the name filename of the driver associated with the device in order to use it Ifa PTZ VTC camera is installed on the Cart this feature allows you to capture still images into a case from the video stream the camera produces It is not possible to capture a live video feed into a case using this feature 1 3 2 2 Audi
23. ractice HIPAA regulations the policies and procedures of your facility your own clinical training experience and judgment 1 5 Warnings and Cautions Please observe the following points e AX Warning Follow all warnings and cautions in the manufacturer s literature for any devices attached to the Cart as applicable e Warning Do not expose the Cart or any of its peripherals to water aside from a slightly dampened cloth for cleaning The footswitch 1s rated IP X8 meaning it is protected during use from ingress of water at moisture levels up to and including complete immersion e AX Warning Do not remove any of the protective covers or wiring shrouds during normal operation e Warning Once the Cart is positioned push the locking levers down on the wheel locks front wheels only to prevent the Cart from accidentally moving during use e Warning Do not connect items which are not specified as compatible with this system Doing so may compromise safe use of the equipment e A Caution Asa computer based system the Cart should not be subjected to unusually strong electromagnetic fields such as might occur with large HVAC motors or MRI machines e A Caution Asa computer based system the Cart can generate small amounts of electromagnetic energy much of which is shielded by the sheet metal surrounding the computer The Model 1928L user guide for the touchscreen monitor includes the following statement The
24. ration is covered Supplemental technical details are provided in Appendix A The V4 Cart comes with the following devices as a baseline configuration e power system including main power switch with fused hot and common lines isolation transformer with on off switch and circuit breaker six outlet and four outlet power strips with circuit breakers e computer system including HP rp5700 computer Flashbus Spectrim Lite video capture card Spectrim Pro is an option memory 1 GB DIMM DVI D Adapter firewire USB 2 PCI host adapter wireless network card two USB hubs monitor keyboard and mouse e scanner e digital camera e wireless antenna e multimedia reader The V4 Cart is a functional system in its out of the box configuration A variety of additional peripheral devices can be connected to the Cart to expand its functionality Information about those devices is beyond the scope of this manual This manual focuses on the hardware aspects of the AFHCAN Cart For information regarding operation refer to the current software user s manual or on line help system UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Warning and Caution Symbols The following symbols and labels are used throughout this manual to alert readers to information which is important to safety equipment integrity or successful operation Symbol Label Meaning A Warni Failure to comply with the information associated with th
25. s from other devices such as the Evolution M Series Dental Camera An input from any one of these devices will trigger the Spectrim Lite or Spectrim Pro video capture card to capture a still image from an incoming video feed into a case The footswitch is rated IP X8 indicating it is suitable for use in environments where it may be subject to complete immersion All other parts of the AFHCAN Cart are not rated with regard to protection from ingress of dust or moisture 1 4 Clinical Considerations The following are some points worth considering when incorporating an AFHCAN Cart into a clinical setting e in general the AFHCAN Cart is designed to support screening level medical examinations and consults e the Cart is designed to supplement and enhance existing channels of communication itis good to have a working relationship with a provider in place before sending cases to that provider for a consult never hesitate to use voice communications as a way to follow up on cases or as a way to make sure the needed information is collected 15 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 e alittle practice and experience goes a long way in developing your skills as a user the more experience people have in using the Cart the easier it is to use we encourage new users to take advantage of training opportunities provided by AFHCAN e your use of the Cart must always remain within the bounds of good clinical p
26. shroud Stowage bracket for Cat 5 cable Figure 3 V4 AFHCAN Cart back UM 0001 User s Manual The AFHCAN Cart V4 Version 3 Cable bin USB hub Multimedia reader Scanner Top Drawer Mot PRES A Tee ofa Compartments available for storing supplies Middle Drawer Electronics Cable management compartment raceway power outlet DC adapters USB hub Compartments available for Digital camera specific model may vary based on availability storing supplies or add on peripheral devices Bottom Drawer Figure 4 V4 AFHCAN Cart drawers UM 0001 User s Manual The AFHCAN Cart V4 Version 3 AC outlet Computer strip Power nen Circuit breaker Circuit breaker Isolation transformer CD DVD reader Computer power switch normally left on Figure 5 V4 AFHCAN Cart computer and power bays UM 0001 User s Manual The AFHCAN Cart V4 Version 3 x _ Fuseholder with fuses Figure 6 Main power switch front and back views 10 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 A Ne Composite Video In Media expansion panel Footswitch jack upper front area Media expansion panel Media expansion panel middle front area lower rear area Figure 7 External connection points Aside from the footswitch which is rated IP X8 the AFHCAN Cart is rated IP X0 with regard to protection from ingress of dust or moisture 1 e no protection 11
27. troduction to the ARCANO hae i te apogee la a alg l 1 1 1 Store and Forward Telemedicine cccccccccecceccoccesccsccsccsccecsscceccsccescascascascesceccs 2 RL Tic AB HCAN SYS Mt tiara 2 1 1 2 1 AFHCAN tConsult Cart SOW A e e do O o 3 1 1 2 2 Network Servers rr a laos isis ii drianda 3 11 23 COMA AAA A a dis 3 1 24 ARCANOS OA e ah eo 4 IM O A A 4 LENO I NCUW OF Ke ECU e a a a tales e ado 4 1 2 Main Components Of the AVEC AN Cata ibi 5 13 Introduction to Penpheral Devices O aa 12 Lor Standard Equipment E eee ee 12 1 3 1 1 Multimedia Reader lr cla 2 A IN II A 12 Ba ko Dieta CAMA A A ONNE 12 V3 2 Eta ICAA o a ld 12 EA USB PO AA a ET CRS TERA NY E 13 EPA A suena NEEE series a este ETE AE ENEE A EA 13 aia VACIO PAC 14 EA A E O A A A A INTO 14 ELSA Video e 14 AO O dale a ALO 14 ESE A E A A A OIT 15 AS A A oace se ae eran i grace NEEE ste moe en eens 15 E BU WLC A a AN 15 LAMA CASO ICL ON a e de 15 LS Warniies and CAOS A AS 16 1 6 General Specifications and Operating Limits 0ooonnnnnnnnnnnnnnnnnnnnnnnannnnnnnnnnnnnnnnnnnnnnr rro nono nn nono 17 EL Device Labelin o 17 EE O A E E A 18 Section 2 Opera toa a aa aa a aea araa a aeaa a aoaaa Ri 19 Dal Basic Op ratine Procedi ES nd 19 2 1 1 Guidelines on Placement and SetuP iirinn aat e a a i aeaii 19 212 APPIN ROWE dat da 19 ZU OS Orme into the SOWAT creir a A A A AR 19 UM 0001 User s Manual The AFHCAN Cart V4 Version 3 2 1 4 Operatino the SCANNET oriire aana
28. ts of the Cart s operation The AFHCAN tConsult Cart software can also be loaded on ordinary personal computers or laptops allowing those computers to create send and receive cases When a healthcare provider originates a case the AFHCAN Cart is the primary tool for collecting the medical information The receiving provider normally would not need to add new medical data but would only need to view the images and data provided The receiving provider can respond to the case by adding comments instructions or questions and can then send the case back to the originating provider or forward it to another provider Of course there is nothing to prevent someone from receiving and reviewing a case using an AFHCAN Cart The software is the same The only difference between an AFHCAN Cart and other workstations is the availability of peripheral medical devices 1 1 2 5 tConsult Web AFHCAN developed the tConsult Web interface as a way to view cases from any computer with network or Internet access The consulting provider can add comments or other information to the case and return it to the originating provider or forward it to a different provider There is some limited capability for creating cases using tConsult Web as well 1 1 2 6 Network Security The AFHCAN software takes many steps to ensure the integrity and privacy of all data e all data is encrypted e authorized users are approved by an administrator and given passwords e conn
29. will boot up to the AFHCAN shell The shell allows you to either open the AFHCAN software or shut down the system To move to the login screen touch the Telemedicine button or click on it with the mouse 2 1 3 Logging Into the Software At the login screen enter a username and password Contact your system administrator or AFHCAN for assistance Note that the password 1s case sensitive Press the Login button UM 0001 User s Manual The AFHCAN Cart V4 Version 3 On successful log in the Start screen will be displayed the name of the screen is in the upper left corner 2 1 4 Operating the Scanner To operate the scanner proceed as follows l 2 From the Start screen select Create a New Case At the next window select Real Case or Test Case Test cases use fictitious patients and are used for training Test patients are safe for testing and training because they are never confused with real patient information This takes you to the Add To Case screen Note If the devices below are only going to be functionally checked out it is not necessary to select a patient or enter patient data From the Add To Case screen select the Scanner button This takes you to the Scanner screen From the Scanner screen select the Black and White Gray Scale or Color button The scanner will automatically scan whatever is on the scanner table and create a thumbnail image that appears at the left on the screen A larger version of the ima
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