North West Region EeRS - Guide for Hospital users
Access and view images in the OPERA PACS
This short lesson will explain how to access and view images in the OPERA PACS, these images are accessible via the image link sent on referrals (when images have been uploaded by the referring clinician. There is a short video at the bottom of the lesson.
Access to the PACS portal
OPERA PACS portal is a web-based system with no need to any local install of software and does not require storage within the hospital PACS (see lesson on image transfer to hospital PACS for information on how to request images to local storage).
When a GOS18 referral is made with images there will be a link on the 2nd page of the GOS18 document located just above thumbnails of the images to help highlight that fact the images are present as in the image below.
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-19.46.09-1024x527.png)
Viewing images within OPERA PACS
By clicking on the link the browser will open and take you through to the studies linked to the patients referral, this will appear as the below image:
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-17.47.11-1024x527.png)
To view the images that have been uploaded, please double click on the study of interest, in the above image there is only one study associated with this patient.
Once the study has been selected you will have a view of the uploaded images, these will initially be visible in a 3 x 3 arrangement so if more than 6 files have been uploaded you will see the first 6 images, in the below image only 2 have been uploaded:
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-17.47.24-1024x530.png)
To view the image as a full view, navigate to the box in the image on the upper RHS which is currently labelled 2×3, by clicking on this dropdown list the below view within the highlighted red box will appear and you will be able to highlight just the one box on in the LHS upper corner of the dropdown list options, by selecting this the one image will appear on the main screen:
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-17.47.35-1024x512.png)
With the image on full view you may want to manipulate the image, this can be done using the options in the bar in the upper part of the screen, the most useful of which are:
Localised Zoom – allowing you to move your mouse over the image to act as a ‘magnifying glass’
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-20.03.25.png)
Zoom – this zooms in and out on the whole image with set values of 50% / 100% / 200% or user defined zoom which when selected can be changed by moving mouse forwards and backwards
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-20.03.32.png)
Pan image – once magnified you may want to move the image around and this can be done by selecting:
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-20.03.21.png)
There are also additional options: compare mode / WWL / Inverse / Measure / Rotate / Sharpen / Print.
Where there are more than one image or when scrollable OCT uploaded you can scroll through the slices using the side bar:
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-17.48.00-1.png)
Export images from PACS viewer
You have the options to print or download the images as DICOM / JPEG to your local device should you need to, if you want to print there is this option in the upper bar with a printer icon.
To save the image to local device if you right click on the image you will have an option to ‘Export to Jpeg’
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-11-at-20.13.23-727x1024.png)
Providing feedback on NHSmail referrals or after eRS referral process complete
Due to the fact feedback can be easily provided on an eRS referral, this feature has been added to the NHSmail referral process to enable the clinician to provide rejection comment or useful feedback.
The link referenced below to enable feedback to be provided has also been added to the eRS referrals to that feedback can be provided at any point during the referral process.
On a referral where the feedback option is available you will see the below hyperlink text:
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-19-at-14.38.17.png)
By clicking on the hyperlink a webpage opens with the OPERA feedback form presented to enable comment to be added.
You have the ability to note whether the feedback being provided is urgent.
The text inserted into the box at the bottom is are sent verbatim to the referring clinician.
![](https://e-referral.education/wp-content/uploads/2022/04/Screenshot-2022-04-19-at-14.42.51-1024x649.png)