• View and edit reports. Press the R key or click the Report menu item to open the report in a new frame. Use the series selection menu to open the report in the current frame. If you have editing privileges, you can edit the report.
• Insert links to annotated key images. Links save the frame layout, image number, window/level/zoom settings, and annotations. You can insert links using the "Link to image" button in the report editor. Any length measurements are automatically placed in the report text.
• Link to related cases. Click "Open > Comparison in this frame" to open a different study next to the report, pull up the desired image and place annotations, then "Link to image." This will let you link to multiple different cases from a single report. The linked images will be displayed next to the report. Alternatively, to switch to a completely different case, open the second case in another window, get the URL ("Share > Get link"), and use "Insert > Link" in the report editor to insert the URL into the first case.
• Set the default layout for a case. Pull up the desired images, annotate, then click "Share > Save bookmark."
• Comparison studies. For follow-up studies, view both cases with their reports side-by-side. You can click on key findings in the old report, find the correlate in the new study, and insert a corresponding link into the new report. First, open the two studies side-by-side. Second, split the frame for each study. Finally, use the series selection menu to pull up the reports next to the image frames for each study.

One or more presenters can control the screen share, and one or more viewers can watch but not control the screen. You can also temporarily disconnect to view the case on your own. You can rejoin the screen share at any point. To join a screen share, you need the 7 digit code. You also need permission to see the cases. If the presenter shows a private case, you will need to log in to see it.

The standard Claripacs server can support about 10 simultaneous screen share users, the shared server can support about 3 simultaneous screen share users, and custom server configurations can support up to 1000 simultaneous screen share users. Each screen share connection requires about 10 Mbps of bandwidth on your end.

Claripacs is fully HIPAA compliant for storing protected health information. This requires signing a business associate agreement with Claripacs and setting up a VPN.

For teaching file use, Claripacs can be configured to automatically perform HIPAA-compliant anonymization of DICOM files. However, you must check to make sure that no patient identifiers are displayed in the image (for example, ultrasound or 3D reconstructed images). If your hospital signs a business associate agreement with Claripacs, then protected health information may be uploaded to the ClariPACS server for purposes of anonymization.

Uploading cases to Claripacs

There are 3 different options:

1. Upload DICOM files on the web. In your PACS system, look for "Send exam," "Save as," "Export," "Download," or a similar option. If you can send the exam to OsiriX or TeraRecon, those programs can also save DICOM files. If the scan is on a CD or DVD, look for a directory that contains .dcm files. Once you have the DICOM files, upload by clicking here.
2. Send directly from PACS, or use the uploader API. Documentation is here (requires administrator login to view).
3. Use our DICOM anonymizer and forwarder (requires administrator login to view). This gives you the convenience of sending cases directly from PACS, without requiring a business associate agreement or VPN. The DICOM anonymizer and forwarder is free Windows software that receives cases from your clinical PACS, then automatically anonymizes the cases on your end before forwarding to Claripacs.

Claripacs supports uncompressed and JPEG-compressed DICOM files. JPEG, PNG, GIF, and TIFF files must be converted to DICOM format before uploading to Claripacs. It's better to use the original DICOM files, because DICOM files contain thousands of grayscale levels (compared to 256 levels in a JPEG file), and also contain useful metadata about each image.

Downloading cases from Claripacs

You have full control and ownership over the data you send to Claripacs. Images can be downloaded at any time in DICOM or PNG format. The entire study can be downloaded as a ZIP file, which includes the DICOM files and HTML report.

If you are terminating your Claripacs account, we will provide FTP access to download all your data. The data includes DICOM files and HTML reports. The DICOM images and the text of the reports can be read by a wide range of different software. However, Claripacs-specific features (such as linking to annotated key images) will not work without the Claripacs software. You can also use Amazon's Import/Export feature to receive the files by mail. For that option, we will give you an access key, and you are responsible for supplying the hard drive, and paying the Amazon fees.

ClariPACS anonymizer

In teaching file mode, when DICOM files are received by Claripacs, all of the DICOM headers are deleted except for the following list. Note that you must manually review each image to ensure that PHI is not present in the images themselves.

0008:0016: SOP Class UID
0008:0050: Accession Number (this is anonymized in the DICOM headers, but it is temporarily stored in the 
           "Diagnosis / notes" field so that you can find your study)
0008:0060: Modality
0008:0070: Manufacturer
0008:1030: Study Description
0008:103E: Series Description
0008:1090: Manufacturer's Model Name

0010:0040: Patient Sex
0010:1010: Patient Age (ages >80 are anonymized)

0018:0050: Slice Thickness
0018:0060: kVp
0018:0080: TR
0018:0081: TE
0018:0083: Nex
0018:0087: Magnet strength
0018:0091: ETL
0018:0095: Pixel bandwidth
0018:1150: Exposure Time
0018:1151: mA
0018:1310: Acquisition matrix
0018:1314: Flip angle

0020:0011: Series Number
0020:0013: Image Number
0020:0032: Image Position
0020:0037: Image Orientation
0020:1041: Slice location

0028:0004: Photometric Interpretation
0028:0030: Pixel spacing
0028:1050: Window Center
0028:1051: Window Width

7FE0:0010: Image data

The following settings can be customized from the "Account info" page, when logged in as an administrator:

• Private versus public PACS. In a private PACS, all cases are private, and you must log in to view them. In a public PACS, cases are private by default. However, you have the option to make cases individually public. When viewing a case, select "Share > Publish case" to make the case publicly viewable, and "Share > Unpublish case" to make it private again. Private cases can be viewed by anyone who is logged in. Public cases can be viewed without logging in.
• Default case browser URL. This allows you to specify which columns to display in the case browser, as well as a default folder and sort options.
• IP address restriction.
• Add users. User types are: View cases only, Create / edit / delete cases, and Administrator.
• Custom logo.

The following settings can be customized by emailing us:

• Anonymization level: Option 1: No anonymization. Option 2: Anonymize everything except accession, UIDs, age (unless >80Y), gender. Option 3: Anonymize everything except age (unless >80Y) and gender.
• Custom user authentication.

Claripacs URL format

The Claripacs viewer can be embedded into another web page. Simply click "Share > Get link" and copy the HTML code. If desired, the viewer can be controlled using Javascript in the parent page.

The Claripacs URL format is open, and lets you integrate with other software. Here are some examples:

Link to a specific image:

http://www.claripacs.com/viewer.php?acc=CL0060&ser=3&img=10

Link to a report:

http://www.claripacs.com/viewer.php?acc=CL0060&ser=report

Change zoom settings. Other optional parameters include: xpos, ypos, zoom, window_level, window_width.

http://www.claripacs.com/viewer.php?acc=CL0060&ser=3&img=10&relative_zoom=1

Hide the menu bar and icons ("mode=simple"):

http://www.claripacs.com/viewer.php?acc=CL0060&ser=3&img=10&mode=simple

Split screen. type is cols or rows. size is in percent. url1 and url2 are URL encoded, and can contain nested split screens.

http://www.claripacs.com/split.php?type=cols&size=70&url1=%2Fviewer.php%3Facc%3DCL0060%26ser%3D3%26img%3D10&url2=%2Fviewer.php%3Facc%3DCL0060%26ser%3Dreport

An alternative simplified interface (conference mode):

http://www.claripacs.com/case/CL0060

If you have a list of Claripacs accession numbers in Excel or Google Drive / Spreadsheet, you can generate links to those cases using the following formula:

=HYPERLINK("http://www.claripacs.com/case/"&A1, "View case")

where A1 is the accession number.

URL shortener:
Redirect to the long URL:

http://www.claripacs.com/a.php?a=mf
http://www.claripacs.com/a.php?a=mf&mode=simple

Return the long URL:

http://www.claripacs.com/a.php?b=mf

Screen share (must use https rather than http):
If you have the screen share code:

https://www.claripacs.com/screen/1234567

To start a new screen share:

https://www.claripacs.com/screen_share.php

Browse cases in a specific folder:

http://www.claripacs.com/browser.php?folder=Interventional%20radiology

Browse cases matching a search term:

http://www.claripacs.com/browser.php?query_terms=liver

Browse cases, hiding the folder list ("hidefolders=true"), showing all results (numresults=-1), and using conference mode links (linktype=2):

http://www.claripacs.com/browser.php?hidefolders=true&numresults=-1&linktype=2

Login, then redirect to another URL. Logging in sets a cookie ("PHPSESSID") that determines access permissions for future requests.

http://www.claripacs.com/login.php?redirect=%2Fbrowser.php

Delete accession (after logging in):

https://www.claripacs.com/post_proc.php?job=delete_accession&acc=CL0060

Information on accession- and MRN-specific logins (for site administrators only).

Embedded Claripacs

To customize the Claripacs viewer interface, click "Share > Get link", and copy the iframe code, which allows you to embed the viewer in another web page. Add an "id" to identify the iframe, and add "&mode=simple" to the URL to hide the menu bar and icons. For example:

<iframe id='fig1' style='height:512px; width:512px; border:none;' scrolling='no'
src='http://www.claripacs.com/a.php?a=mf&mode=simple'></iframe>

If desired, the embedded Claripacs viewer can be controlled using Javascript in the parent page. In order to do this, you must use an http and not https link to Claripacs. First, include "http://www.claripacs.com/js/embedded.js". Then:

Button to switch the left mouse button to "Scroll":

<input type="button" value="Scroll" onclick="change_left_mouse(document.getElementById("fig1").contentWindow, 3);">

Button to switch the left mouse button to "Window/level":

<input type="button" value="W/L" onclick="change_left_mouse(document.getElementById("fig1").contentWindow, 1);">

Button to switch the left mouse button to "Zoom":

<input type="button" value="Zoom" onclick="change_left_mouse(document.getElementById("fig1").contentWindow, 4);">

Button to switch the left mouse button to "Drag":

<input type="button" value="Drag" onclick="change_left_mouse(document.getElementById("fig1").contentWindow, 2);">

Button to toggle hiding/showing the menu bar and icons:

<input type="button" value="Toggle simple mode" onclick="toggle_simple_mode(document.getElementById("fig1").contentWindow);">

Button to switch to full screen:

<input type="button" value="Full screen" onclick="top.location=document.getElementById("fig1").contentWindow.get_url()+
(document.getElementById("fig1").contentWindow.claripacs_display_mode==='simple' ? '&mode=simple' : '');">

Button to screen share the iframe:

<input type="button" value="Screen share this case" 
onclick="top.location='https://www.claripacs.com/screen_share.php?mode=presenter&url='+encodeURIComponent(document.getElementById("fig1").contentWindow.get_url());">

Button to show the report:

<input type="button" value="Show report" onclick="find_viewer(document.getElementById("fig1").contentWindow).show_report_button_pressed()">

Get the current URL of the Claripacs viewer, including image number, annotations, split screen, etc:

<input type="button" value="Get URL" onclick="alert(document.getElementById("fig1").contentWindow.get_url());">

Link to change the content of the iframe. Note that using "read_url_line()" allows you to change the image number or annotations without the screen blinking, which would happen if you simply changed the iframe src.

This is the <a href="javascript:void(0)" 
onclick="document.getElementById('fig1').read_url_line('http://www.claripacs.com/a.php?a=mg&mode=simple')">corpus callosum</a>.

Download Chrome, Firefox, or Internet Explorer. If you are stuck with Internet Explorer 8 or earlier, and are not allowed to update your browser, you will need the Chrome Frame plugin.

For faster scrolling, please increase your browser's cache size. To pre-load 1000 CT images, your cache size should be at least 300 MB, and for 10000 images, your cache size should be at least 3 GB.