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Modalities connects your CT, MRI, ultrasound and X-ray machines to ClinikEHR: Register each imaging machine (or its bridge PC) with a private key. Finished studies with a matching accession attach automatically; anything ambiguous waits below for review.

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Before you start

Without the imaging bridge this page shows a locked card: Modality integration is a Professional feature, with “Connect your CT/MRI/US/X-ray machines: orders reach the modality worklist and finished studies attach themselves to the order for reporting.” A View plans button sits underneath — see Change your plan. You also need whoever looks after the machine’s bridge PC, because half of this task happens there.
Image pixels never leave your building. ClinikEHR stores addresses only, and the viewer reads full-resolution studies from your own on-site archive: “Images never leave the clinic — only these URLs are stored.”

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What you’re looking at

Register modality adds a machine; Refresh re-reads the page. Four sections follow.

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The modality registry

Before you register anything it reads No modalities registered yet. Each row offers New key and Pause (or Resume).

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Studies awaiting review

These arrived without a matching accession. Attach each to the right order so its images show up for reporting. Columns are Received, Modality, Patient / accession, Study and Review, and the healthy state is Nothing waiting — unmatched studies appear here.

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The three settings blocks

Prior-image sources (PACS) — “When a study arrives, the bridge pulls the patient’s priors from these archives for comparison.” Auto-archive to cloud archives matching studies as they attach, with no per-study click. Full-resolution viewer (OHIF) holds the two addresses the report’s Open full viewer button uses.

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Register a machine

1

Select Register modality

The dialog explains what it is about to do: A private key is generated for this machine’s bridge PC — it authenticates every study it forwards.
2

Name it

Name is the only required field — the example is “CT Room 1”. Add the AE title (optional) and Type (optional) if you know them; both help you tell machines apart later. Select Register.
3

Copy the key and configure the bridge PC

The Bridge key for {name} dialog opens. Set the key on the machine’s bridge PC as the X-Modality-Key header, and copy it before you close the dialog.
4

Confirm it is talking

Once the machine forwards its first study, Last seen changes from never to a timestamp.
The bridge key is shown once, at the moment it is generated. If it is lost, use New key on the row to generate a replacement — which immediately stops the old key working, so the machine will forward nothing until the bridge PC is updated. Never write the key down anywhere shared: it authenticates every study that machine sends.

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Attach a study that arrived unmatched

A study with an exact accession match attaches itself. Everything else waits under Studies awaiting review, because guessing which patient an image belongs to is not a thing software should do.
1

Read the row

It shows the modality, the patient name and accession the machine sent, and the study — modality code, image count, series count. A missing name shows as (no name in study), a missing accession as no accession.
2

Select Attach to order

The dialog, Attach study to an order, names the study’s patient and accession. Search by accession, patient or test… is pre-filled with whatever the study carried; nothing matching reads No matching orders awaiting a study.
3

Select the order

Selecting a row attaches immediately — there is no second confirmation. You get Study attached — images are now on the order. Attaching only makes the images viewable; the radiologist still writes the report — see Radiology reports.
Discard removes an unmatched study from the queue with no confirmation dialog. Use it only for genuine junk — a test acquisition, a duplicate — and check the row twice first.

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Connect priors, archiving and the viewer

1

Add a PACS source

Add source takes a Name, an AE Title, a Host and a Port (104 by default) — the archive priors are pulled from. It must be reachable from your own on-site archive. Its status badge toggles Active / Paused when you select it.
2

Set an auto-archive policy

Switch Auto-archive to cloud on, choose which Modalities to auto-archive (none selected means all of them) and a Minimum images threshold to Skip trivial studies below this image count. Select Save auto-archive policy.
3

Point the viewer at your archive

Enter the OHIF viewer URL and the Orthanc DICOMweb URL (tunnelled), then Save viewer settings. That second address is what Open full viewer passes the study to.

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Who can do this

Role decides whether the page opens — owners, managers, radiologists, radiology technicians and doctors pass. Anyone else is told You don’t have permission to manage imaging modalities. Please contact your clinic administrator. An owner can also hide Radiology from a role under Role navigation. Where per-person permissions apply, enforcement is opt-in: someone never saved in the permissions sheet is unrestricted, and the sheet warns “Saving starts enforcing”. A denied action is recorded in the audit log; an allowed one is not. See Staff permissions.

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Check it worked

  • The machine appears in the registry as Active, and Last seen fills in after its first study.
  • New studies stop appearing under Studies awaiting review — they attach themselves.
  • A report for that study shows {n} images attached and offers Open full viewer.
  • Prior studies appears on the report where the patient has earlier imaging.

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Common issues

The imaging bridge is off for your plan, so the page is locked. Everything else in Radiology works without it — you attach images by hand instead. See Change your plan.
The bridge PC is not sending, or the key on it is wrong. Confirm the key is set as the X-Modality-Key header, and remember that generating a New key invalidates the previous one instantly.
The accession the machine sends does not match the one on the order. Fix that at the machine — attaching by hand every time is a symptom, not a workflow.
Discard has no confirmation and no undo. The machine can re-send it; the images are still in your own archive, so attach the next copy rather than reporting from memory.
No viewer address is saved. Fill in OHIF viewer URL and Orthanc DICOMweb URL (tunnelled) and select Save viewer settings.

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FAQ

No. It stores addresses, plus small preview images for the report. Full diagnostic pixels stay in your own archive and are served from there over your secure tunnel.
It stops that machine’s studies being accepted while leaving its registration intact. Use it while a machine is being serviced or moved, rather than deleting it.
Per machine, so one compromised or replaced bridge PC never affects the others. Each row generates and rotates its own.
Yes — the Diagnostics edition runs the same integration, including auto-archive policy in detail. See Modalities.