Dialysis System

SW 8.09.13
Training module 12 Communication
Ref: Operators Manual SW 8.09.13
- Chapter 1 General Description
- Chapter 14 Communication System
- Chapter 15 Report Environment
Artis Communication System

Application to IT:
Choice of advanced IT technologies enabling:
- Clinical staff to have simple access to
hemodialysis data
- Ensure efficient compatibility with external
clinical software

Important Notice: Important:

This presentation does not relieve any user of Please note that the SW change to
the Artis Dialysis System from his or her duty to 8.09.13 of this presentation does not
carefully read the full text of the Operators change the training of the Artis Dialysis
Manual before using the system. System for the users.

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Artis native IT - Standards and
technologies
RFID1: Radio Frequency IDentification
- The Artis Patient Card embeds the RFID technology
Data are transferred without physical contact
HL7: Health Level 7 > [HL7]
- The Artis dialysis system provides data coded under the HL7 V2.5 standard (XML encoding)
in conformity with standards for interoperability of Health Information Technology.
The Artis dialysis system is compatible to any Clinical Software under HL7 protocol
TCP/IP: Transmission Control Protocol / Internet Protocol
- Artis is compliant with the TCP/IP (Transmission Control Protocol/Internet Protocol)
communication protocol and therefore is compatible with common platforms:
The Artis dialysis system allows to transfer data through Internet
SMTP: Simple Mail Transfer Protocol
- SMTP is an Internet standard for electronic mail transmission across Internet Protocol (IP).
The Artis dialysis system can send out emails

1: Artis Operators Manual SW 8.09.13, Chap. 14

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Artis native IT - Standards and
Technologies
RS232: Recommended Standard 232
- The Artis dialysis system offers RS 232 serial port
It offers an alternative for data acquisition, on top of the Ethernet connection

Ethernet
- The Artis dialysis system offers an Ethernet port
The Artis dialysis system can be connected to an external software application

USB: Universal Serial Bus

- The Artis dialysis system offers a USB port
It offers a much easier serviceability through a standard USB stick

VNC: Virtual Network Computing

- The VNC client is already embedded into Mediartis.Web (see after)
VNC allows to remotely access data and the Artis Graphical User Interface. (read only)

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Artis connectivity panel

The connectivity panel at the rear of the machine is equipped with a large
range of communication ports

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Artis native IT features

The Contact-less Patient card

The Artis dialysis system allows to fully handle the card (format/read/write).
No other devices or software product are needed.

Patient identification

Prescription download to the Artis dialysis system

The contact-less technology makes it fast and secured

The Artis dialysis system reads the prescription from the network or from the
card.

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 Patient Card handling
The 3 operations New Modify Erase Patient Card can
be directly made on the machine (no other device or software
are needed)
How to read: the Patient Card must be brought straight in
front of the reader (located above the EvaClean device).
Download of the prescription is possible:
When the Prescription screen is displayed and until
patient connection
When machine is in standby (not being used)
When the prescription is downloaded from the card to the
Card Artis, a review window is displayed. The operator must verify
reader the adequacy and confirm. The same mandatory parameters
(identified with an exclamation mark symbol) as the manual
prescription must be confirmed before patient connection.
When Exalis is in use, the Patient Card can be configured as
a patient ID Card, allowing to download the patient
prescription from the network without any manual search/ID
typing.

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Artis native IT features

Universal Serial Bus

The Artis dialysis system hosts a USB port on its back-side. This port
allows to:

Use a USB key to copy settings from a machine to another

Retrieve black-box sessions

Perform software upgrades of the Artis dialysis system

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USB key handling
BlackBox
BlackBox records a set of
technical and service parameters:
Treatments parameters
Alarms
Operator actions
Machine processes and phases
Actuators information status

The BlackBox function a Service Level 2 function- is accessible from the Report
screen; it requires a password to enter.
The BlackBox recorder runs automatically and keeps the sessions in its internal memory
(up to 24 sessions). It can be configured in different manner (list of parameters, sampling
time, number of sessions).
The analysis of the BlackBox data requires Mediartis.Tech

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USB key handling

1. In the BlackBox sub-screen

- Press <Close current session> button
- Press <Export BlackBox file> button

2. Press the <Export all> button

It is also possible to transfer single session
by selecting the file with the up/down arrows
and then pressing the <Export> button
3. Press the <Close> button
4. Exit the Service Mode by pressing the
<Exit Service Mode> button in the
Service Overview screen

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Artis native IT features
Exalis connectivity (V1.16)

The Artis dialysis system is natively able to be integrated with Exalis 1.16
The communication protocol between the Artis dialysis system and Exalis
is performed by means of a proprietary protocol that runs on TCP/IP.

Co-working of Artis with Exalis allows:

Automatic data collection (treatment results, alarms and operating phases)

Date management (patient history files, treatment report,..).

Data export from Exalis to 3rd parties according to HL7 protocol

Prescription download

Data storage

Pre/post dialysis recording

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Exalis handling
Exalis is a clinical software application and a data
base expanding the IT potential of Artis.
Exalis provides 4 main functionalities:

1. Download the patient prescription to the machine

In the prescription screen, press the <Patient ID> button
Enter the Patient ID using the keyboard provided
Confirm the ID entry; prescription is automatically downloaded
A Prescription Review sub-screen is displayed, allowing the
operator to verify at one glance the settings and confirm
Download of the prescription is possible only until the patient
connection
2. Record specific PRE and POST bpm (Auto BPM must be
activated during preparation and after disconnection)
3. Store synchronous data (according to a settable sampling
rate) and asynchronous data (alarms and events) at any time
between patient connection and patient disconnection
4. Export data to a third-party clinical SW, though the HL7
protocol

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Mediartis
Mediartis is the Gambro IT offering designed to expand IT
potential of Artis

Mediartis is a suite of software modules aiming at:

Improving the medical use of hemodialysis data to enhance clinical outcomes
Improving the use of resources to enhance operational efficiency
Expanding the added value of the dialysis system

The up-coming slides introduce the Mediartis modules existing today

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Mediartis. Physio
Mediartis.Physio Offline is a quality control tool that presents condensed and
easily accessible reports from an extensive hemodialysis database. Designed
for in-depth analysis of key aspects of dialysis, it effectively supports
physicians in monitoring dialysis quality indicators

Mediartis.Physio main features are:

Data extraction from Exalis
Automatic monitoring of the vascular access (Accesscan module)
Quality control of dialyis delivery
Intra and Inter patient variability assessments

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Mediartis. Physio

Mediartis. Physio is the clinical module of Mediartis software suite to improve

consistent achievement of clinical targets in reducing variability in treatment.

Historical graph of Clinical targets vs achieved values Cross analysis of relevant combination

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Mediartis. Web

Mediartis.Web is a website hosted by the Artis dialysis system (embedded in

Artis software) and accessible by an Internet Explorer client before, during
and after the treatment. The protocol is HTTP on TCP/IP.

Mediartis. Web allows:

Remote access of the Artis Graphic User Interface (read only)
Treatment report (Patient data, Treatment prescription, Treatment results)
Treatment parameters (table or graphs)
Service pages
History of disinfections
History of alarms

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Mediartis.Web

Remote access to Artis

Graphical Interface

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Mediartis.Web

Treatment report

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Mediartis.Web

Treatment parameters

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Mediartis.Web

Disinfection history

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Mediartis.Web

Service pages

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Mails

The Artis dialysis system can send out emails to a pre-defined list of web
addresses using SMTP on TCP/IP.

The mails are sent out by means of Mediartis.Web and can contain
some attachments such as:
Last BlackBox session

Current screenshot of whats displayed on the Artis Graphical User Interface

The software identification that is running on the Artis dialysis system

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Mediartis.Tech
Mediartis.Tech is a software application dedicated for serviceability. A
private log-in permits the technician to access the application as well as
the BlackBox management tool for data download and data analysis.

Mediatis.Tech allows:
BlackBox management

Service-log to access instantaneous data (Troubleshooting)

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Mediartis.Tech

BlackBox Login Page

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Mediartis.Tech

BlackBox Main Page

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Mediartis.Tech

Service log
Multiple Graphs

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Nice to know
Activation of the Card reader and of the Exalis connection is
done in Service 2

Connection to Exalis, as well as Mediartis or any Clinical

Software, requires the network parameters to be preset

In case of Exalis connection, the Patient Card shall be preset

as ID Card only

The <Patient ID> button is displayed in the prescription screen

only if the machine is effectively connected to Exalis

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For the safe and proper use of the devices referenced within, refer to
Warnings, Precautions and the complete Instructions for Use or the
appropriate manual available by contacting customer support.

MediArtis and Exalis are Trademarks of Gambro AB.

Gambro is an indirect subsidiary of Baxter International Inc.
Back up slide:
List of the treatment parameters available for acquisition through the network:

Remaining Time Venous Pressure Acc. Online Bolus Na Equivalent Set UF volume
Accumulated Substitution
Acc UF Volume Arterial Pressure Volume Forecast Na Intake
blood volume (blood
Acc UF Rate pH (optional) Pre-dialyzer pressure volume variation in %) Event
Sodium Conductivity Kt Arterial flow SN Forecast BV Medication
Bicarbonate conductivity QF/QB Venous flow SN Ionic Mass Balance
Temperature QI/QF Stroke volume Ionic effactive dialysance
Fluid Flow Rate TMP Set Diastolic Pressure (BPM) Real blood flow
Actual Substitution Rate Scale weight Systolic Pressure (BPM) Plasma Conductivity
Heparin Pump Speed K concentration Heart Rate (BPM) System Pressure
Accumulated Blood
Volume (accumulated Set Blood Flow (DN and
treated blood vol.) Effective dialysis time Plasma Na Conc SN)

TMP Acc. Heparin Bed Scale patient weight Kt/V

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