Disclaimer: This guide only encompasses the use of the .decimal Direct website. For guidance with other .decimal software please look to the “Help” tab in the Direct website or our help site

decimal Direct is a web-based interface used to facilitate ordering and tracking of patient specific devices from .decimal, LLC.

Fig. 1: The .decimal Landing Page

As such, the decimal Direct interface is designed with the customer in mind and provides:

• An internet-based method of ordering patient-specific medical devices for manufacturing by .decimal, LLC.
• The ability to view the real time status of ordered parts as they go through the manufacturing process.
• A direct link to the shipping vendor tracking system allowing the user to track the shipment or parts.
• The ability to download order summary reports for ordered parts.
• Options for managing email order and shipment confirmations.

The following guide videos are provided for a quick look at some basic decimal Direct features:

1. decimal Direct Quick Look
2. .decimal Training Portal Videos

The following links each provide detailed instructions for a specific decimal Direct feature:

1. Logging in to .decimal Direct
2. Checking Order Status / Tracking an Order
3. Ordering a Standard Electron Cutout
4. Product Shipping Estimate Calculator
5. Setting User Preferences

• decimal Direct Release Notes

If you are a first time user, and have not been assigned a user name and password or you have forgotten your user name and password, please contact .decimal's Customer Support staff at 1-800-255-1613.

The process for sending a patient's custom files is through the p.d software. On rare occasions, it may be necessary to load .dec files that were created by the p.d software based on a patient's files. This is usually done by .decimal personnel.

If it becomes necessary to upload a patient's .dec files, full instructions can be found here, along with a list of possible error codes.

Files are manually browsed for and uploaded using decimal Direct. The files are then sent to the “File Holding Queue” for batching and order completion.

1. Login to decimal Direct (click here for login instructions).
2. Select the “Order” button.Fig. ##: The Order buttons
3. Select the “ORDER .DEC FILES” button to browse for your file(s).Fig. ##: The ordering page
4. Select the file(s) for upload(NOTE: ONLY “.dec” or “.dat” files are allowed to be uploaded for ordering, you may select multiple files at the same time to upload)
5. Select the “Upload” button on the file selector to send the selected files to the “File Holding Queue” (NOTE: your order is not yet ordered, see the Ordering Files section)

Once files have been manually uploaded they will be shown in the “File Holding Queue” (shopping cart). In this holding queue you can select and expand each individual file to view detailed order information and remove or re-upload files as needed.

Fig. ##: The order detailed information

To finalize and place the order:

1. Verify that all files uploaded are displayed. If this is not the case, please contact .decimal customer support for further assistance. It may take a few seconds for your files to appear as they are processed.
2. Select the file(s) you wish to order. NOTE: Files must have a status of “Ready to Order” in order to finalize and place the order. If this is not the case, follow the guideline of the error status below or contact .decimal customer support for further assistance.
3. Read the Terms and Conditions (By placing an order you are acknowledging your agreement to the terms and conditions).
4. Click the “Place Order” button.Fig. ##: Placing an order
5. A progress UI will be displayed until the order has been finalized.

Devices uploaded to Direct for ordering can sometimes hit an error. Typically this is the result of a configuration change or an issue .decimal staff must address. See below for a list of each status and a description and solution for how to resolve the error status:

1. Ready to Order: This status is not an error status and means the device is able to be ordered as uploaded
2. Order Placed / Ordering: This is an internal status for .decimal order processing and should not be seen for more than a second or two. If you see your order stuck with this status there may be an internal issue on .decimal's side.
   • Solution: If you see your order stuck with this status for more than 10 seconds please contact .decimal customer support.
3. Duplicate of Record in Holding Queue: There are multiple copies of the same device uploaded in Direct
   • Solution: Remove the duplicate device and click the 'Refresh' button to re-process your orders in the holding queue.
4. Duplicate of Job #<serial number>: The device uploaded has already been ordered.
   • Solution: Delete the uploaded duplicate device or contact .decimal to allow ordering of the duplicate order if you need the duplicate device ordered
5. Unknown Machine Name: The treatment machine selected when generating this order does not exist in the machine setups .decimal maintains for your site. This is normally due to a incomplete new customer setup or a change within your facility in machine name. .decimal keeps your machine setups synchronized with your physical site to ensure there are no configuration issues that would lead to a delay of your device being used for treatment.
   • Solution: Contact .decimal customer support to address the missing machine from your machine setups.
6. Unknown Machine Setup: The treatment machine selected when generating this order does not match the machine setups .decimal maintains for your site. .decimal keeps your machine setups synchronized with your physical site to ensure there are no configuration issues that would lead to a delay of your device being used for treatment.
   • Solution: Contact .decimal customer support to address the incorrect machine setup
7. Machine type mismatch: The manufacture (e.g.: Varian, Siemens, or Elekta) of the treatment machine selected when generating your order does not match the manufacturer of the machine within the machine setups .decimal maintains for your site. This could cause the ordered device to be manufactured incorrectly.
   • Solution: Contact .decimal customer support to address the incorrect machine setup
8. Error: Invalid p.d version for Electron Apertures: The Electron Aperture was ordered using a p.d version prior to p.d 5.
   • Solution: Use p.d 5 or later to generate and place the order or contact .decimal customer support to update your p.d version.
9. Error: <error> – Line <#>: This is a generic error to catch problems with the device order file meta data. The <error> and <#> will be populated with the exact error and line number of the order meta data causing a problem.
   • Solution: You can attempt to address the issue with your order file if you are aware of the problem, but in most circumstances contacting .decimal customer support will be necessary.

If you are the Site Administrator you will see an additional tab on the side bar of Direct labeled “Manage”.

Fig. ##: Manage Tab

This page allows you a few options for managing your site that would previously require the assistance of .decimal support staff.

Once you select your site from the dropdown, you will see a list the display name and default shipping information for your site. The display name will change how the site is shown on direct.

Fig. ##: Site Information tab

Once you select your site from the dropdown, you will see a list of all the applications available for that site. You will be able to see your currently selected version of each app and be able to update it using the drop down.

NOTE: Updating this value makes the change for all users in your site. The next time they launch the app through the .decimal Launcher it will download the selected version for them.

Fig. ##: Manage Apps Without Sandbox mode

If you wish to use sandbox versions for your apps, you must select the “Show Sandbox Versions” check box. Doing so will display a similar list of apps and versions for the sandbox environment.

NOTE: Updating this value functions the same as the clinical version, as described above.

Fig. ##: Manage Apps with Sandbox mode

If you select the “Users” tab on this page you will be taken to the user list for this site. The users information is displayed, along with a checkmark or x in a circle indicating whether they have multifactor authentication enabled. Here you can see, edit, add, and remove users for the selected site. If extra security is necessary, the “Require MFA” switch may be enabled, requiring all members of the site to log in with Multi-Factor Authentication.

Fig. ##: Manage Users

In order to add a new user to your site simply hit the “ADD USER” button and you will be prompted to enter the email of the user you wish to add. If the user is an existing decimal User then they will simply be added to your site along with any sites they currently belong too.

Fig. ##: User Invite

If the email that has been entered does not belong to an existing decimal user a new one will need to be created before being added to your site. Direct will prompt you to enter the following fields for the new user:

1. First Name
2. Last Name
3. Phone Number

These fields are required for all new users and you will be unable to continue adding the new user until they are filled out.

Newly invited users will be sent an invitation email. If the email needs to be resent for any reason, the invitation can be reset from the edit user dialog. If users are not receiving the email invitation:

1. Ensure the email address for the user is correct
2. Ensure the email is not being sent to the user's spam folder
3. Refer to the Site Management Troubleshooting guide for users not receiving decimal direct email invitations

Fig. ##: User Invite

You can also use this page to manage your existing users, for example if you wish to update the user information for any of your users you can simply select the “Edit” option for that user. You will see the fields you are available to update for this user displayed, and when you are finished updating the user simply “save” your changes and you will be taken back to the manage page.

You can also edit the permissions granted to this user from the following options:

• Elevated:The highest level of user permissions, generally allows for managing machines, site configurations, access to sandbox versions, plan approvals etc…
• General: The lowest level and most commonly used of the user permissions allows for standard usage of .decimal applications.

More app specific definitions of what these permissions mean can be found in the application's help documents:

• p.d: Refer to the local p.d client user guide installed with your application.
• decimal Electron RT: ElectronRT user guide
• decimal Launcher: Launcher user guide
• decimal3D: decimal3D user guide

NOTE: Users can only have one level of permission granted to them at one time.

Newly invited users will be sent an invitation email. If the email needs to be resent for any reason, the invitation can be reset from the edit user dialog.

Fig. ##: Edit User

Fig. ##: User Invite

Additionally if you no longer wish to have a particular user in this site selecting the “Remove User” option when editing will remove that user from the site.

NOTE: You are unable to remove site owners, you must demote them to a normal user first. Also this will NOT affect any of the user's other sites or remove them as a decimal user they will simply no longer be a part of your site.

Fig. ##: User Removal

Finally, you are also able to promote other users to be site owners and they will be granted all the same rights to manage apps, invite/edit users, and any other permission tied to site ownership. As a site owner all you have to do to promote another user is to check the “Manager” checkbox by that user's name.

Fig. ##: User Invite

Direct will provide you with a confirmation message and once that is approved that user will be a site owner as well. If you wish to demote a site owner you just simply un-check the box and confirm the removal of this user's owner rights.

NOTE: You may not demote the last remaining owner this way.

Some .decimal applications have permissions that can be changed, either site wide for all users, or on a single user-by-user basis. These permissions can be seen in the “App Permissions” tab. Site wide permissions are shown at the top, and user permissions are underneath. Clicking on a user will show or hide the permissions applied to them. The checkbox to the right indicates whether a permission is enabled. Permissions noted as “*managed by .decimal” can not be changed by users and must be changed by .decimal staff (e.g.: this is a separate purchased license).

The .decimal Applications with app specific permissions include:

• p.d:
  • For p.d's available application permissions please refer to the p.d user guide installed with your p.d software for your specific version of p.d. Note: the available permissions are also dependent on the application version of p.d you are using.
• decimal eRT:
  • eRT's application permissions can be found on the Account Permissions user guide page. Note: the available permissions are also dependent on the application version of decimal eRT you are using.

An example of the application permissions are shown below (note, these permissions may differ from what you see in Direct and have available in your local version of your applications).

Fig. ##: App permissions

To modify the permissions, click the edit button. This will allow the permission boxes to be checked and unchecked, with the exception of permissions managed by .decimal. Remember to click “Save” when your changes are complete, or “Cancel” to discard them.

While each individual user can manage their own email notification settings as described in the section above, as a site manager you can also control a secondary list of email addresses to receive notifications regardless of which user in your site orders a part.

Fig. ##: Site Wide Emails

As stated a user's personal email settings still apply regardless of what is listed here when they order a part. Meaning, if the Site Emails list is empty but they choose to receive email notifications when their part ships then they will still receive their desired email.

If you wish to edit this list simply press the “Edit” button and this will open the editing interface.

Fig. ##: Editing Site Wide Emails

Pressing the plus icon labeled “Add Email” will allow you to add any number of emails to this list. When adding a new email to the list you will see the following:

Fig. ##: Site Wide Emails

1. Email Address textbox: where you can enter the email address you will be adding
2. “Send on Order” Check box: If checked this email address will receive a notification when any user in your site submits an order for a part.
3. “Send on Shipped” Check box: If checked this email address will receive a notification when a part that was ordered by a user in your site gets shipped from our facility
4. “Save changes” button: Saves all the emails and their settings then disables the editing interface.
5. “Delete” icon: Removes this email from the list

The following devices are compatible for using .decimal Direct:

Windows/Apple Computers (recommended)

1. Apple iPad
2. Apple iPhone*
3. Android Phone*

*Some functionality may be limited on this device. Using the device in landscape mode will provide the best user experience.

The following web browsers are supported and recommended for using .decimal Direct:

1. Google Chrome
2. Mozilla Firefox
3. Microsoft Edge
4. Apple Safari

The following web browsers are supported but not recommended due to compatibility issues:

1. Internet Explorer (11+)

The following web browsers are not supported due to missing features and security issues:

1. Internet Explorer (10 and below)

1. Javascript must be enabled.

Common issues that users may encounter and ways to resolve the issue.

• decimal Direct Terms and Conditions

• decimal Direct Processing Agreement