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Once your machines are registered, a finished study finds its own order. The Modalities page explains itself in a line: “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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Your images stay in your building

This is the first question every lab asks, so here is the plain answer: the image pixels never leave your premises. ClinikEHR stores two addresses and nothing else. The viewer runs inside the radiologist’s own browser and reads the images directly from your on-site archive over an authenticated connection. No study is copied to us in order to be viewed. The one exception is the optional Auto-archive to cloud setting further down this page, which you switch on deliberately and can leave off.

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What you’re looking at

The page is four stacked sections, and each does a separate job. Status is Active or Paused, and Last seen is the honest answer to “is this thing actually talking to us”. The empty state. Before you register anything the registry is empty and Studies awaiting review shows nothing, because nothing can arrive until a bridge holds a key. Below the Professional Lab plan you do not see any of this — the page reads Modality integration is a Professional feature with a View plans button.

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Register a machine

1

Add the modality

Select Register modality and fill in Name (“CT Room 1”), AE title (optional) (“CT_SCANNER”) and Type (optional) (“CT”). The AE title is what the machine calls itself; getting it right is what lets studies match without a human. Type is free text — nothing validates it, so agree one spelling across your machines or the Modality Distribution chart splits into near-duplicates.
2

Copy the key — now

Registering opens Bridge key for {name} with a copy button; Copy key gives you Key copied. Paste it straight into whatever configuration your bridge PC uses, then select Done.
3

Check it is talking

Back on the registry, the modality should show Active and pick up a Last seen time once the bridge connects. If it never does, the key was not saved on the bridge.
The bridge key is shown once, at registration or rotation, and cannot be retrieved afterwards. Close the dialog without copying it and the only way forward is New key, which invalidates the old key immediately and stops that machine’s bridge until it is reconfigured. Copy it before you close.
Use Pause to stop accepting studies from a machine — during maintenance, or when a bridge PC is being replaced — and Resume to bring it back. New key issues a replacement when one has been lost or should be rotated.

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Studies that arrive without a match

Automatic attachment depends on a matching accession number. Anything else waits for a person, under Studies awaiting review ({n}) — “These arrived without a matching accession. Attach each to the right order so its images show up for reporting.” The table shows Received, Modality, Patient / accession and Study, with two actions:
  • Attach to order opens Attach study to an order — “Search by accession, patient or test…” — and on success gives Study attached — images are now on the order.
  • Discard removes the study, and the toast reads Study discarded.
Discard acts immediately — there is no confirmation dialog. It is a plain button beside Attach to order, so treat that row with care: a discarded study has to be re-sent from the machine.
Work this queue daily. A study sitting here is a study a radiologist cannot report, and the usual cause is a typo in the accession number at the machine rather than anything wrong with the bridge.

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Prior-image sources, archiving and the viewer

Prior-image sources (PACS) lists the remote archives the bridge may pull prior studies from, so a radiologist can compare today’s film against last year’s. Add one with Add a PACS source, giving its Name (“Regional PACS”), AE Title (“REMOTEPACS”), Host and Port. Each source can be removed again from its row. Auto-archive to cloud is a switch, and it is off until you turn it on. Select Save auto-archive policy — the toast reads Auto-archive policy saved. Set Minimum images deliberately: without it, every stray single-frame acquisition is archived alongside the studies you actually want kept. Two addresses turn on Open full viewer in the reporting form: OHIF viewer URL (where the viewer is served from) and Orthanc DICOMweb URL (tunnelled) (where the viewer reads your images from). Select Save viewer settings — Viewer settings saved. See Report an imaging study.

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Who can do this

Your plan decides whether Modalities exists; role decides whether it appears at all. Nothing on this page is behind a permission. There is no permission for modality setup. A Configure analysers and interfaces toggle sat in the Diagnostics catalogue until August 2026 and no imaging screen ever read it; it was removed. This page is reachable by anyone whose role reaches the Radiology Station, and the paid feature is the only other gate. A Lab Scientist does not reach imaging at all, which is a role rule, not a permission. Two behaviours surprise people:
  • Enforcement is opt-in, per person. Somebody never saved in the permissions sheet is unrestricted, and the sheet warns “Saving starts enforcing” — “from then on they can only do what is switched on here”.
  • A denied action is recorded; an allowed one is not. Where a figure is not yours to see it renders hidden or as a dash, never as a zero.
See Permissions.
The hardware half of this integration is rolling out site by site, and what your machines and bridge PC need varies with the make and age of the equipment. Talk to support about your specific room before you plan a cutover date.

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Check it worked

  • The machine appears in the registry as Active, with a Last seen time that keeps moving.
  • A test acquisition with a correct accession number lands straight on its order rather than in Studies awaiting review.
  • The report’s Study Information card reads {n} images attached.
  • Open full viewer opens the study for a radiologist.

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Common issues

The imaging bridge is gated on Professional Lab and above, and View plans on that screen takes you to the ladder. See Change your plan.
Issue a replacement with New key on that modality’s row, and reconfigure the bridge with it. The old key stops working at once, so expect a gap until the bridge is updated.
The bridge is not reaching us with that key. Check the key was pasted in full and that the modality is Active rather than Paused.
The accession number entered at the machine is not matching the order. Check how your radiographers are keying it — a leading zero or a prefix dropped at the console is the usual cause — and attach the waiting studies in the meantime.
There is no undo and no confirmation on Discard. Re-send the study from the machine, or from your archive, and it reappears in the queue.
Both OHIF viewer URL and Orthanc DICOMweb URL (tunnelled) must be saved, and the study must have images. Save the pair, reload the report and try again.
Either your role does not reach the Radiology Station — a Lab Scientist never does — or your plan is below Professional Lab. No permission grant opens it, so the fix is the person’s role or the plan. See Roles.

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FAQ

No. Only two addresses are stored, and the viewer reads pixels straight from your own archive. The single exception is Auto-archive to cloud, which is off until you switch it on.
Whatever your department calls the machine — CT, MRI, US, XR. It is free text and nothing checks it, so pick one spelling per machine class and stick to it, because the Modality Distribution chart groups on exactly what you typed.
They can technically, but do not. A key identifies a bridge, so sharing one makes Last seen meaningless and means rotating a key silently stops a second machine you had forgotten about.
They are not taken. Pausing does not queue them for later — the bridge simply has nowhere to deliver, so resume the modality before the machine sends anything you need.
It is the same idea and the same grant, on different hardware. Analysers have their own registry and review queue — see Connect your analysers.