Introduction and Architecture
With the satellite system an existing custo diagnostic environment is extended with a further server - the satellite server - which is installed e.g. on a mobile equipment cart. The client installed on the trolley can either connect to the master server (network mode) or to the locally installed satellite server (satellite mode). In case evaluations are generated in satellite mode, they are transmitted to the master server. Since this is a pure server-to-server communication, neither user interaction nor direct database/file system access is required, as it was in previous versions. For synchronization it is sufficient that the satellite server can establish a network connection - operation of the custo diagnostic client is not required. It is recommended to check in advance if a satellite functionality is necessary or a reliable WiFi network exists.
Which data is synchronized between master server and satellite server is configurable, so that a variety of application scenarios can be mapped (home visit notebook, mobile equipment cart in the clinic, branch system)
In many cases, the Satellite Workstation should not always work with the Satellite Server, but in network mode also with the Master Server directly. In order to make the selection user-friendly for the user, the so-called "custo diagnostic starter" was developed, with which different connection options can be displayed and selected. Since this is a full-screen application, it is suitable for systems that are not used for other applications. You can find more information about the custo diagnostic starter on the following page: custo diagnostic starter.
Preparation / required information
For a later installation you need
- Determination of deployment scenarios and data synchronization
- License for master server / satellite server
- Supervisor Password for Master Server
Deployment scenarios and data synchronization
Prior to installation / configuration, the essential cornerstones of the deployment scenario / data synchronization must be defined. The exact configuration depends on the customer's requirements. At this point, we provide decision guidance on the crucial issues. Even if the actual configuration of the synchronization options will be done later, the discussion with the user or the definition of the desired scenario should be done at the beginning, and is therefore already presented here. Later on, only the transfer of the specification into the system takes place.
The following synchronization options are available - you will find a decision basis for their activation below:
- Tenants: All Tenants of the master system are downloaded and the corresponding links (users, patients, etc.) are set. Should be used if the master system runs with clients.
- Doctors: The doctors of the master system are downloaded and the corresponding links are set (users, patients, evaluations). If this feature is used on the master system, it should be synchronized as well.
- Devices: The devices are downloaded and the corresponding links to the waiting room list entries are set. If this feature is used on the master system, it should be synchronized as well.
- Patients: The patients and their attributes are synchronized.
- Orders: The orders are synchronized, In this case, the related patients are synchronized automatically, even the general patient sync is not activated.
- Users: The users are also synchronized, including their passwords.
- Configuration: The client configuration is synchronized. (see below)
- Job status: If the status of a job changes, the master system is informed.
- Upload evaluations: The evaluations are uploaded and created in the master system. If the patient does not exist in the master system, he will be created (including his doctor). Nothing else is created (orders, devices, etc.)!
- Delete evaluation after uploading: The delete flag is set at the evaluation after uploading. Deleted evaluations are no longer synchronized with the master system.
- Print jobs on server
- Log files of the client system
Synchronization of patient master data
Basically, the question must be answered whether patient data should/must be available on the satellite system. In many cases it is sufficient to record ECGs in the satellite mode (as so-called "Quick ECG"), to annotate them and to assign them to the corresponding patient after synchronization in the master system. The disadvantage is the step of "assigning" in the master system. But the workflow is otherwise very simple, since this can be started directly, e.g. via appropriate command line parameters. Furthermore, in GDT-based systems the patient may not be available in the custo diagnostic system (house call) and the result cannot be transferred back via GDT. Even in large practice groups it is often desired not to keep all patient names on a system that leaves the practice.
Also in the hospital it has to be checked if it makes sense to synchronize all patient data on the satellite: If you work with a job workflow, the patient data is always synchronized with a job (even if the general patient synchronization is switched off), if the system is rather used as a backup system for network failures, you are very flexible with the immediate ECG and later assignment, because many scenarios can be mapped with one workflow (master server not accessible, patient data unknown, complete failure of the infrastructure).
Synchronization of orders, clients, doctors, devices
As a rule, this information should always be synchronized - even if this information is apparently not affected. The reason is that evaluations always have a number of references to this information. If this information is not available in the satellite system, or if it deviates due to manual configuration, it can lead to inconsistencies.
Delete evaluations after uploading
This setting is recommended from a technical perspective. In principle, it is a sensible approach to keep as little data as possible on a mobile system. Furthermore, deleting avoids conflict situations in the data. If, for example, an evaluation is processed and synchronized on the satellite, which has already been evaluated in the central system, the data status in the central system is overwritten and lost. It is therefore recommended to delete the evaluations from the satellite.
Server export
As a rule, exports should also be performed by the master server within a satellite system.
Download configuration
A central configuration - or downloading the configuration from the master server - means that the workstation configuration is initially identical, regardless of whether the client is started in satellite or network mode. This simplifies the configuration because it only has to be done once.
Possible application scenarios
Szenario | Options to be set | Remarks |
|---|---|---|
"Quick ECG" as a backup system (network failure) and situations where patient data is not available. |
| Work flow:
The disadvantage is the step of "assigning" in the master system. However, the workflow is otherwise very simple, as this can be started directly, for example, via appropriate command line parameters. Furthermore, in GDT-based systems the patient may not be available in the custo diagnostic system (house call) and the result cannot be transferred back via GDT. Even in large practice groups it is often desired not to keep all patient names on a system that leaves the practice. As there is no patient data on the system, no registration is necessary. |
Workflow |
| Configures a very simple system that only pulls patients from the central system and synchronizes the evaluations again when a connection is established. Useful, for example, for so-called "home visit" laptops, where a family doctor typically visits patients at home, or drives to a home to measure blood pressure and perform lung function, or reads the LZ ECG directly. If "Delete after upload" is activated, the laptop is also "cleaned" and no longer contains any important data. |
Simple mobile workflow |
| Configures a system that "only" synchronizes the waiting room list entries with the patients. All evaluations and order statuses are highly synchronized. If you activate "Delete after upload" the satellite is always clean after synchronization In this configuration the satellite must / can be configured independently from the central system Dummy ECG evaluations can also be generated and highly synchronized |
Guided mobile workflow without clients |
| Extends the "ECG recorder replacement" to users and their configurations, so the satellites can be configured centrally and the settings are rolled out to the satellites when they synchronize |
Complete mobile system |
| Extends the workflow to include synchronization of all patients. The satellite then has the complete patient database after synchronization. This means that work can be carried out with or without orders, and the assignment to the central system is retained. |
Branch practice / Second practice |
| In this mode, all evaluations are uploaded from the "store system" / "secondary practice" to the main system without the user having to worry about them. The branch systems are independent of the main system and are not interested in their patients, users or configuration. If findings are updated in the "Branch System", they are also synchronized and the main system has the latest status of all its branches Replaces then the dial-up crutch and other handicraft solutions |
Export and printing
In a networked environment, the master server is equipped with a number of interfaces. The satellite system supports the server export, i.e. it marks the data transferred to the master server in such a way that after successful synchronization the data is also exported from the master server. In principle, this procedure should be aimed at, because it allows the existing interfaces to be used and there is no need to discuss further interface configuration with other parties.
When printing in satellite mode, the problem arises that there is often no network available to enable printing from the satellite system. For situations without network, a local printer would have to be used. Against this background custo diagnostic in satellite mode also supports automatic printing from the master server at a later time. If the master server is configured (CSC → printer - server printer) the user can select an appropriate printer when finishing an evaluation on the satellite. The printout is then generated by the master server as soon as the synchronization has been completed.
Identical or individual satellite system configuration
If you operate several satellite systems on one master server, you can decide whether all satellite systems can be configured identically with regard to the aforementioned data synchronization options or whether all systems can be configured differently. To keep the administrative effort low, an identical configuration is recommended.
With an identical configuration, you can perform the data synchronization options centrally on the server.
An individual satellite system configuration can be done in the CSC of the satellite server. (When starting the CSC, the corresponding URL or server can be set).
Licenses
With the order number 50711 you will receive all licenses necessary for the operation of an additional satellite.
These are for the master server:
- Support of a further satellite
- 2 additional network workstation licenses. (One license is used for synchronization, another if a user is using the "network mode". These licenses are automatically permanently assigned to the workstation).
For the satellite server is included:
- License for operating a server
- License for operation as Sat-Client
2 network workstation licenses. (This allows simultaneous use of custo diagnostic manager and Custo Service Center). These licenses are automatically assigned to the workstation.
Installation and configuration
Installation of a custo diagnostic server on the satellite PC / server
Install the custo diagnostic server on the satellite PC like a normal server installation. (Usually a mariaDB is used).
After installing the licenses you should be able to see the license option as follows:
Install a custo diagnostic client on the satellite PC in the usual way.
Note: Each satellite must have a unique workstation name. Therefore do not overwrite the workstation name with an identical name in the CustoCfg.ini if there are several satellites.
Installing the satellite options on the master server
After importing the licenses you should see the number of licensed satellite systems on the master server:
Configuration of the central system
A configuration of the central system is not absolutely necessary. However, default settings for the clients can be made here. Furthermore, the page in the CSC shows when which client last synchronized (4) and you can look at the log files of the client if you are at the server (5).
Button | Name | Function |
|---|---|---|
| 1 | Preconfiguration of the client | If the checkbox at (2) is set, exactly this configuration is set on all clients. If a different configuration should be set manually on a client, it would be overwritten |
| 2 | Force pre-configuration of the client | If this checkbox is set, the settings at (1) apply to all clients |
| 3 | Save Configuration | The settings under (1) and (2) are saved and activated |
| 4 | Satellite licenses: Total and in use | Shows the total number of satellite licenses on the server and the number of registered satellites |
| 5 | Last synchronization | Shows the last time the satellite has reported to the master. If this time is very far in the past, the satellite is probably no longer connected to the network |
| 6 | Refresh | The list of clients is updated. Here you can see when which client has synchronized last. |
| 7 | Deactivate / Activate | Removes the selected satellite. The satellite can then no longer log on and synchronize |
| 8 | Show Logfile Directory | If you have selected a client in the list and press this button, the directory with the log files of this client will open, |
Configuration on the client
Taste Key | Name | Function |
|---|---|---|
| 1 | Register / Re-register | Use this button to register the satellite server with the master server (see below) Important: Configure the synchronization options before you Register your satellite. |
| 2 | Resynchronize | Performs a complete resynchronization |
| 3 | Remove Registration | Deletes the existing connection to the central system |
| 4 | Configurations for satellite system | Sets which entities should be synchronized |
| 5 | Refresh | Updates the list of statuses, here you can see if there are any errors and what is synchronized in the last synchronization step |
Registering the satellite server with the master server and initial synchronization
Use the Register New button to register the satellite with the master server and perform the first synchronization. It is important that the appropriate settings have been made beforehand to determine which data should be synchronized.
Here you can set the time from which the first synchronization for patients and orders should be carried out and from which modification date evaluations should be uploaded.
If you do not need all data on the satellite, but only the orders from this week on, it makes sense to enter a date not far in the past to speed up the first synchronization
Configuration of the status button
The status button then has the following states:
State | Meaning | Tooltip |
|---|---|---|
| There are still 7 evaluations not synchronized and the central server is not available |
|
| There are still 7 evaluations not highly synchronized, but the central server is accessible | |
| There are no evaluations for synchronization, the central server is accessible |
|
| There are no evaluations for synchronization, the central server is not available |
With version 5.5 and above the status Button is shown automatically.
Configuration of the central print job
In order to print from the satellite to the server printer, printing on the server (Drucken am Server) must first be set up in the master system. These settings are then automatically transferred to the satellite system.
In the satellite system only the option "Do Server Printouts on Master" has to be configured, then the print jobs are automatically uploaded during synchronization
Print jobs are marked in the satellite with an evaluation attribute (UploadServerPrintJob).
After successful configuration on the satellite, the server printers set up in the master system can be used in the quit dialog, as described for printing on the server (Drucken am Server).
Configuration of the Central Export
It is possible to use the central export services from the satellite without having to configure them again separately on the satellite. If the configuration is correct, the "Normal" export workflow appears in the end dialog for the user. When exporting from the satellite, the evaluation is uploaded during synchronization and then exported in the next cycle.
To export from the satellite in the central system, at least the following satellite options must be activated:
Upload Evaluation
Perform server export to master
Upload PDF to master (optional if a PDF is to be exported)
The export option "Server" must be active on the Satellite Client
Export of PDF documents
If PDF documents are to be exported, the corresponding settings must be set for each project
PDF export:
Summarized printout
Configured PDF export
In the printout (context PDF export):
The desired print pages
Schedule, Logging
Synchronization time
By default, the system tries to synchronize once a minute (see "Synchronization" in CSC->Tasks/Scheduler), if this does not work, a corresponding status is entered. It may happen that partial synchronizations succeed (e.g. only patients, but no tasks). The synchronization is designed in a way that no inconsistencies can occur.
Evaluations are only sent "en bloc", i.e. no inconsistencies can occur here either. The evaluations are always sent completely.
Logging of the satellite
Client
If you activate the upload of log files, all log files of the client from %PUBLIC%/Roaming/customed will be uploaded to the server. These can then be found under:
c:\diagserverdata\log\$WORKSTATIONNAME$
Server
The server zips its log file once a day as a gzip file. This file is then loaded into the same directory as the log files of the client