Asteris Keystone Integration – Setup and Using the Integration

Asteris Keystone integrates with ezyVet to provide cloud-based Picture Archive Communications Systems (PACS) solutions as well as viewing flexibility through Asteris Keystone’s built-in DICOM viewer.

Designed for veterinarians, the Asteris Keystone DICOM Viewer provides comprehensive diagnostic capabilities tailored to meet your practice and diagnostic needs.

With integrated features including advanced telemedicine workflow, reporting, image manipulation functions and seamless offsite data access, the Asteris Keystone DICOM Viewer is the ultimate diagnostic utility. Built specifically for veterinary practitioners and Radiologists, the Asteris Keystone DICOM Viewer simplifies viewing and diagnostic related tasks.

This guide consists of 3 parts – configuring the integration, setting up the diagnostic, and using the integration.

You can contact Erik Berger at Asteris by email:, or call their support line: 877-7ASTERIS (877-727-8374) for any inquiries.

The link to the Keystone/ezyVet integration training video can be found here:

Keystone ezyVet Integration Training 

Part 1: Configuring the Integration with Keystone

Before getting started it’s important to note that the integration will need to be configured for each modality and a supplier will also need to be added for each modality.

1.    Navigate to the Admin screen.

2.    Select ‘Integration’ from the dropdown menu.

3.    Select ‘Integrations’ from the top left list.

4.    In the ‘New Integration Setting’ screen, select Asteris in the ‘Integration’ field.

5.    Division - Select the division (if applicable).

6.    Supplier – Create a new supplier by double clicking on this field.

Take note: A new supplier will need to be created for each modality (e.g. In-House Asteris CT Scan, In-House Asteris DX, In-House Asteris MRI, etc.). 

7.    Authentication:

Authentication information will need to be provided by Asteris. Contact them on 877 727 8374 or

-    Clinic Code

-    Username

-    Password

8.    Click Save.

9.    The section “Settings” will appear after saving. Select an option under ‘Online Viewer’. There are two options to choose from - to view the images in original DICOM format, or using a native jpeg image viewer.

(Take note:  Should you choose the DICOM option, the Keystone DICOM Viewer is required and will need to be downloaded. Click to download. This requires Windows.)

10.    If your Keystone account has Modality Worklist setup you can check `Modality Worklist Enabled`, otherwise uncheck it - this will prevent ezyVet from queueing requests into the schedule. Keep in mind that without Modality Worklist configuration you are required to create the studies from Keystone.

11.    Select the Modality from the dropdown menu. Lastly, click Save.

12.    The next tab, ‘Integration Tools’, is where the account is validated and ensures that a successful connection has been established. Click “Validate Account”. A pop-up message will appear confirming a successful validation.

Part 2: Setting up Diagnostics

1.    Navigate to the Admin screen.

2.    Select ‘Clinical’ from the dropdown menu.

3.    Select ‘Diagnostics’ from the top left list.

4.    Choose the diagnostic from the below left list or create a new one.

5.    In the open tab, enter a diagnostic code.

6.    Include a name for the diagnostic.

7.    Select the supplier to link the diagnostic to.

8.    Select a diagnostic form (if applicable).

9.    Set the billing trigger or create a new one by double clicking in this field.

Note: Adding a billing trigger will ensure automatic billing capture and an invoice will generate each time the diagnostic is requested.

10.    Click ‘Save’.

Part 3: Using the Integration

Sending Diagnostic Requests

In the clinical record of a patient, select the (+) plus icon before ‘Diagnostic Request’ to open to Diagnostic Request window.

In this window, select Asteris as the Supplier and choose the diagnostic(s). Include additional notes/information in the ‘Specifics’ section.

Lastly, click the blue ‘Add’ button to send.

The request will be listed and the status will initially read as ‘Queued’.

The request is sent through to Keystone and will need to be added to the schedule at a suitable time.

Once this is done, the schedule is queued and all that remains to do is drag it to the right modality, open the schedule and click 'Start Imaging'. (The user will not need to manually click “start imaging” if modality worklist is enabled on the modality. Once Keystone begins to receive images from the modality, the status of the exam will automatically change to “imaging started”).

The schedule will now be visible on the modality selected and imaging can start. After sending images back to Keystone, open the schedule again and click 'Imaging Complete'. Once imaging and the study is complete on the modality, users will need to go back into the Keystone Scheduler, open the exam that was recently completed and manually change the status to “Imaging Complete”.

Changing the status of an exam to “Imaging Complete” triggers communication with ezyVet. ezyVet will then be informed that images are available and will retrieve them from Keystone automatically.

Take note that images will not be available for the diagnostic result until the images have been Archived to the Pacs server. To get an indication of this not being done, look for the status of Keystone in the Keystone footer on the right as seen in the picture below. Alternatively, you can open Settings → Archive Queue to see the full list of items waiting to be archived.

Alerts on the 'Work List' tab

The request will be listed on the 'Work List' tab found in the dashboard. This tab will flash red whenever there are outstanding tasks.

It will detail the date and time that the request was made as well as the status of the request.

Receiving Diagnostic Results

Once imaging is completed, a diagnostic result will be created. All the images will be added to the diagnostic result as well as reports and any additional files. You will automatically be notified when results come back by an automated memo.

The diagnostic results can be found in a patient’s clinical record under ‘Diagnostic Results’ as well as in the ‘Diagnostics’ tab on the Dashboard.

Please note if the Asteris study had a series with multiple images, only one image per series will appear as an image thumbnail on the diagnostic result record in ezyVet.

Each will include a link to Keystone to view the images inside the Keystone DICOM Viewer or Jpeg Viewer, depending on your previous configuration.

Under “Actions”, an icon with a tick appears in either black or green. Black indicates that the results are incomplete. It is possible to make changes to the study when ‘incomplete’.

The green icon indicates that the results have been marked as complete.

To edit/ update the results, click on the pencil icon or double-click the diagnostic result.

This will open the diagnostic result and will include a preview of the image(s). Notes can be added/ updated in the ‘Outcomes’ and ‘Clinic Notes / Specifics’ sections.

It is also possible to access the images in Keystone using the link (blue icon).

When the study is complete, mark the results as complete by changing the ‘tick icon’ to complete. This is indicated when the icon is green.

Receiving Unallocated Studies

If a study comes back into ezyVet and is unrecognized the diagnostic result will be unallocated. This can happen if your clinic doesn’t have the Modality Worklist configured.

One way you can help ezyVet link these studies back to the correct patients is by entering the patient code as the Animal ID. If it matches a patient in ezyVet, the diagnostic

Take note: If you are getting unallocated Asteris diagnostic results and you have Modality Worklist configured and the study was sent from ezyVet through a diagnostic request, please contact our support.

Printing images on a clinical summary

When you generate a clinical summary and add the diagnostic result section, any images on the results will show up on the generated summary under the diagnostic result.