chapter 14 custom fields

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Chapter 14

Custom Fields

ObjectivesIn this chapter you will:

• Manage custom fields in the Administrator Portal

• Create custom fields for populating exam data in AutoText.

• Create custom fields for exporting in the HL7 message.

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Introduction to Custom Fields

Custom fields are data items (also called metadata) associated with a particular order. You can use custom fields:

• as merge fields to populate exam data in an AutoText, such as measurements, radiation dosage information, flags, and so on.

• to export an HL7 message to the RIS, such as when a mammography exam requires a follow-up letter to the patient.

Custom fields can be automatically populated with data by an interfaced RIS and/or imaging machine. In addition, radiologists, editors, technologists, and administrators can populate data in custom fields. As an administrator, you can define custom fields for each of your facility’s sites.

Export and Import Custom Fields

If you have existing custom fields in a site, and want to use those custom fields for another site, you can export and import custom fields between sites. Exporting/importing maintains the custom field properties and options. If a procedure code matches in the new import target (Site), the procedure association is maintained as well.

Export Custom FieldsTo export custom fields from a site to a csv file:

1. Click Setup > Sites and select a site from the drop-down list.

2. Click the Custom Fields link and select Export. A bar at the bottom of the window asks if you want to open or save the csv file. By default, the file names of exported custom fields csv files appear as <Site Name>_CustomFieldsExport.csv. For example, University_CustomFieldsExport.csv.

3. Choose either Open or Save. In most systems you will have a Save As option, allowing you to change the file name and its location.

The file is copied to the location you selected and ready to be used for importing by another site.

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The following illustrations show a partial example of an exported custom fields worksheet.


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Import Custom FieldsNote: The following fields are limited to a specific number of characters (shown below). Keep these lengths in mind when creating custom fields so that the export/import process works properly.

Name: 80 Description: 100 Group: 30

Procedure: 100 Choice Value: 896 Choice Label: 30

Export Value: 500

To import custom fields from another site’s csv file:

1. Click Setup > Sites and select a site from the drop-down list.

2. Click the Custom Fields link and select Import.

3. Browse to and select the file you want to import and click Open.

4. Click Next.

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5. From the column mapping dialog box, make sure that the column names match the mapping item in the drop-down list.

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6. Click Next. The conflict action dialog box opens.

7. Select either Update or Skip, based on the descriptions shown.

8. Click Import. After the import, the custom fields import summary dialog box opens.

9. If there are any errors or warnings, click the View link to see a list of the errors/warnings that might need to be addressed.

10. When finished, click Close.

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Creating Custom Fields

You can create a custom field as a free-text field or as a pick list. For example, you could create a free-text field for assigning an exam measurement, while a pick-list field would be appropriate for selecting a significant findings alert. If the custom field is marked as required, it must be populated with a value by the radiologist prior to signing the report.

Create a Free-Text Custom Field

1. In the Administrator Portal, click Setup > Sites.

2. From the drop-down list at the upper right, select a site.

3. In the Custom Fields section, click the Create new item icon to begin creating a custom field.

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4. Type a Name for your custom field (see Practical Examples for Using Custom Fields, beginning on page 346). Maximum field length is 80 characters.

5. Type a Description (optional). Maximum field length is 100 characters.

6. Act (active) is automatically selected, which causes the field to appear in the merge field Custom drop-down listing in the PowerScribe 360 Reporting client application.

7. If applicable, select Exp which causes the data in the field to be exportable in the HL7 message by the Bridge to the RIS.

8. If applicable, select RF which requires that the radiologist populates the field with a value prior to signing a final report.

Note: If the custom field you are creating applies only to specific procedure codes, do not select this check box until you have assigned the specific procedure codes.

9. If applicable, select RA (Resident Approved) which makes the custom field required for resident-approved reports. (Replaces the RP field in previous versions.)

10. To assign the custom field to one or more specific roles in the system, click the Role drop-down list and choose Attending, Resident, Editor, and/or Technologist.

11. If applicable, enter a value in the Default field. This will be the value that appears in the custom field by default.

Tip: If you plan to provide a list of choices for this custom field, you can skip this step and Create a Pick List Custom Field, described in the next topic.

12. Click the Commit changes icon to save the new field.

Create a Pick List Custom Field

1. In the Choices column for one of your custom fields, click Edit. The Custom Field Choices dialog box opens.

2. Click the Create new item icon.

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3. Enter the first Value. The value can be used as a custom merge field in AutoText. Maximum field length is 896 characters.

4. Enter a corresponding Label which will display in a drop-down list of choices for the user to see and select (either by voice or mouse click). Maximum field length is 30 characters.

5. Enter an Export Value. The export value is sent in the OBX5 segment of the HL7 message during the report upload, allowing more flexibility to configure the Value field as a custom merge field in AutoText. (Your RIS may limit what you enter here because the text in the Value field is exported in the HL7 message.) Maximum field length is 500 characters.

6. Set the Active check box as needed.

7. To allow a user to select more than one of these choices when using the custom field, select the Allow multiple selections check box. With this check box selected, the user will see individual check boxes for each custom field choice.

8. Click the Commit changes icon to save the new choice.

9. Repeat steps 2 through 8 for each new choice to add to the pick list.

10. If required, use the up and down arrow indicators in the far right column to reorder your choices. Or, click the Sort Alphabetically link if that option suits your needs.

11. Click Close Window link to return to the Custom Fields section.

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Associate Procedure Codes with a Custom FieldAssociating one or more procedure codes with a custom field ensures that the custom field is available to populate with exam data applicable to the associated procedures. For example, when custom fields are built for carotid ultrasound measurements, those fields are available to populate when carotid ultrasound procedures are performed on patients.

1. After creating a free-text or pick-list custom field as described above, click Add under the Procedures column in the row of the newly created custom field. The Procedure Code Selection dialog box opens.

2. Enter the search parameters for the procedures you want to associate with the custom field using one of the following methods:

• Select a Modality and Anatomy.

• Type a procedure code or procedure description in the Procedure Code/Description field.

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3. Click Search to display the applicable procedures in the All Procedures list.

4. In the All Procedures list on the left, select each procedure you want to associate with the custom field and click Add. The procedures appear in the Selected Procedures list on the right.

To dissociate a procedure code from a custom field, select the procedure code to remove in the Selected Procedures list and click Remove.

5. Click Close Window in the upper right to return to the Custom Fields section.

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Inserting Custom Fields into AutoText

In order to have custom fields populate exam data into an AutoText, create an AutoText containing those custom fields as merge fields.

1. From the client application AutoText Editor screen, place your cursor where you want to insert the custom field. In this example, the cursor is to the right of the Time field.

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2. Click the Merge Fields tab located on the right side of the AutoText Editor window.

3. Select <Custom Fields> from the Type menu.

4. Locate and double-click the Fluoro 1. Time (min) item.

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The field appears in the AutoText.

5. Repeat steps 1 through 4 to insert the same or other custom fields into the AutoText, selecting the appropriate custom field for each item.

Note: When you insert the same custom field into the AutoText multiple times, they are considered linked custom fields. When one instance of the custom field is populated in the report, all instances of that custom field are populated as well.

6. Save and close the AutoText.

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Assigning Values to Custom Fields

Assigning values to custom fields may be very useful for reporting in that it can alleviate the radiologist from having to dictate exam measurements. Editors and technologists can assign values to custom fields on unreported orders using the PowerScribe 360 Reporting client. Radiologists can also use the client to assign values to custom fields during the reporting stage. Alternatively, editors and technologists can use the PowerScribe 360 Reporting Administrator Portal to assign values to custom fields on unreported orders. Administrators can assign values to custom fields at any time using the administrator portal.

Assigning Custom Fields Using the PowerScribe 360 Reporting Client

You can assign custom field values in the client application from either the Explorer screen or the Report Editor screen.

Assigning Custom Fields from the Explorer Screen

1. Search for and select the applicable exam. With the exam highlighted, click the Insert Custom Fields link on the Order Data tab. The Custom Fields dialog box opens.

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2. Click the Value column to assign a value to the custom field. Some custom fields are set up with drop-down lists while others require that you dictate (or type in) a value.

Note: You do not have to assign values to all the custom fields; only for those that pertain to your report.

3. To view only custom fields that relate to your current role in the system (Attending, Resident, Editor, and Technologist), select the Filter by role check box. Selecting this check box allows you to work with only the custom fields in a report that relate to your particular role.

4. When finished populating the custom fields for your report, click OK. The image below shows the populated custom fields in the Order Data tab.

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Assigning Custom Fields from the Report Editor Screen

1. Select Properties from the navigation panel and click the Insert Custom Fields link (or click Insert > Custom Fields from the menu bar). The Custom Fields dialog box opens.

2. Click the Value column to assign a value to the custom field.

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3. When finished populating the custom fields for your report, click OK.

The custom fields appear in the Custom Fields section of Properties in the navigation panel.

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Assigning Custom Fields Using the PowerScribe 360 Reporting Administrator Portal

The portal view differs depending on the role of the user (i.e., whether the user is an editor, technologist or administrator). An administrator can populate or change custom fields at any stage of reporting, even after the report is final.

Assigning Custom Fields as an Editor or Technologist

1. As an editor or technologist logged into the portal, search for the applicable exam under the Explorer tab. Select the Custom Fields tab and click Insert Custom Fields, which opens the Order Custom Fields dialog box.

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3. If applicable, select the Filter by Role check box.

4. When finished populating the custom fields for your report, click Save Changes and Close Window.

Assigning Custom Fields as an Administrator

1. Log in to the portal as an administrator, search for and select the applicable exam under the Explorer tab.

2. Click Actions and select Edit Custom Fields, which opens the Order Custom Fields dialog box.


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4. When finished populating or changing the custom fields, click Save Changes and Close Window.

Attempting to Sign a Report without Assigning Values to Custom Fields

If a custom field is required (which means that the RF and/or RA check boxes were selected when the field was created), the radiologist must assign a value to the custom field prior to signing the report. If the radiologist attempts to sign a report containing an empty, required custom field, the Custom Fields dialog window opens. If the radiologist clicks OK or Cancel without assigning a value to the custom field, a message window opens stating Please fill in the required custom fields for all the accessions of the report.

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Practical Examples for Using Custom Fields

Example 1: Mammography BI-RADSCustom fields can be used for mammography BI-RADS when a hospital requires two separate codes, one to convey the BI-RADS score, and the other to send an HL7 message to the RIS to trigger a follow-up letter to the patient when her score indicates a level of suspicion for the possibility of breast cancer. The BI-RADS value as well as the HL7 follow-up message are selected from pick-list custom fields by the radiologist during reporting and prior to signing the report.

1. Create a new pick-list custom field named BIRADS.

2. Select the Act, Exp, and RF and/or RA check boxes.

3. If required, select one or more Roles from the drop-down list: Attending, Resident, Editor, or Technologist.

4. Under Choices, click the Edit link.

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5. Edit the Choices column to enter each Value, Label, and Export Value as pick list selections.

6. If required, use the up/down arrow icons in the far right column to reorder your choices. (Another reordering option is to click the Sort Alphabetically link.)

7. Click the Close Window link.

8. Under the BIRADS custom field’s Procedures column, click Edit.

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The Procedure Code Selection dialog box opens.

9. Search for and select the applicable mammography procedures.

10. Click Add to copy the procedures to the Selected Procedures column.

11. Click the Close Window link. The procedures you selected are now associated with the BIRADS custom field.

12. Create and save a pick-list custom field named Follow-up Recommendation with the Act, Exp, and RF and/or RA check boxes selected.

13. If required, select one or more Roles from the drop-down list: Attending, Resident, Editor, or Technologist.

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14. Under Choices, click the Edit link.

15. Enter a value, label, and export value (if needed) for each pick-list selection.


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18. Under the Follow-up Recommendation custom field’s Procedures column, click Edit.

19. Repeat steps 9 through 11 above to search for, select and add the applicable mammography procedures to associate them with the Follow-up Recommendation custom field.

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Note: If you want to have the BI-RADS and Follow-up Recommendation text appear in the dictated report, create an AutoText containing those fields as either custom merge fields or pick list fill-in fields (see Creating a Pick List Fill-in Field, beginning on page 267).

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Example 2: Carotid UltrasoundUsing AutoText custom fields that contain exam data, such as carotid ultrasound measurements, can help reduce report turnaround times. Exam data can be added automatically by an imaging machine, or manually by a technologist, so the radiologist does not have to dictate the measurements during reporting.

1. Create and save several free-text custom fields, one per carotid artery measurement, with Act (Active) check box selected.

Tip: Begin the Name of each custom field with the same word (Carotid in this example) followed by a numeric sequence (0.1, 0.2, and so on, in this example). Doing this causes the fields to appear in a logical sequence in the client application Custom Fields drop-down list.

2. Under the custom field’s Procedures column, click Edit.

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The Procedure Code Selection dialog box opens.

3. Search for and select the applicable carotid procedures.

4. Click Add to copy the procedures to the Selected Procedures column.

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5. Using the client application, create a carotid AutoText and insert the custom fields as merge fields.

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6. Assign values to the custom fields for the exam accession number.

7. The following illustration shows the pre-populated carotid custom fields in the AutoText prior to report dictation.

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Example 3: AlertsYou can use a custom field to send an HL7 message to the RIS in order to communicate an alert for a significant finding. For example, if the results of an exam demonstrate acute appendicitis requiring immediate surgery for treatment, a radiologist can send an HL7 red alert message by using a custom field.

1. Create and save a pick-list custom field named Alert with the Act, Exp, and RF and/or RA check boxes selected.

Note: Because we want the Alert custom field to apply to all procedures, do not add any specific Procedures (last column) to this alert.

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2. Click Edit in the Choices column to enter each value, label, and export value as pick list selections.



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The following illustrations show the radiologist selecting a value for the Alert custom field, and the results of selecting that field as it appears in under Properties to the left.

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Creating a Custom Fields Worklist

You can create a worklist to retrieve only those orders and reports containing a custom field that was assigned a particular value, such as a red alert for a significant finding requiring immediate treatment.

1. From the Administrator Portal, select the Setup group and click the System tab.

2. In the Worklists section, click the Create New icon.

3. Enter a Name and a Description (optional) for the worklist.

4. Click the Commit Changes icon.

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5. In the Worklists section on the row where the new worklist was added, click Edit under the Definition column.

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6. The Worklists dialog box opens, showing the name of the worklist and the tree structure to be used to design the query. Click the Composite Expression link on the left side of the window.

7. From the drop-down list on the right, select Simple Expression and click Add.

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8. Select the applicable field name, such as Alert in this example, from the Field drop-down list.

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9. Select the applicable Operator (Equals in this example) from the Operator drop-down list.

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10. Select the applicable Value (Red in this example) from the Values drop-down list.

11. Click Update. The newly created expression now appears on the left side of the window.

12. Click Save and Close.

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Searching Using the Custom Fields Worklist

You can now search using the newly created custom fields worklist to retrieve those orders and reports containing the particular value, such as Red alert in this example.

1. From the Administrator Portal, select the Exams group and click the Explorer tab.

2. In the WL search section, select the applicable worklist from the drop-down list.

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3. Click Search. Any reports containing the Red alert custom field appear in the results grid.

Running the Custom Fields Report

For information on running the Custom Fields management report, see Report Custom Fields, beginning on page 548.

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