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Opal (20/20 Imaging) X-Ray Integration Guide
Opal (20/20 Imaging) X-Ray Integration Guide
Updated over a month ago

Integrating with Opal (20/20 Imaging) in ChiroHD is easy! Just follow the steps in this document. If you need assistance, please contact our support team at [email protected].



Step 1: Important information to know before you get started

  • Please make sure to open the integration guide and follow these instructions on the x-ray computer. You will not be able to complete the integration or sync previously taken x-rays if you are not on the x-ray computer.

  • Make sure you are using a Chrome browser as that is the only browser that ChiroHD supports.

  • Just to clarify, this guide will allow you to auto sync x-rays directly into ChiroHD from this point forward after the integration is complete.

  • If you want previously taken x-rays (before the integration) to sync, please follow the steps below:

    • Open the patient's exam on the x-ray computer

    • Update the patient ID so that it matches their ChiroHD patient ID (otherwise it will not sync)

    • Click through each image in the exam

    • Close out of the exam to save.

  • This integration requires that you use the ChiroHD Patient ID as the ID in Opal (20/20 Imaging). If you do not set this correctly, they will not be synced correctly.

  • There are several versions of 20/20, if this integration guide doesn’t match what you are seeing, please contact ChiroHD Support and include screenshots of the screens that are not matching so that we can update our guide to accommodate all versions!



Step 2: Opal (20/20 Imaging) setup

  1. Open up an exam

  2. Click the Opal (20/20 Imaging) Icon in the upper left

  3. Select Settings

    a. some versions may require that you click on Settings, then click on Edit

  4. On the bottom left under “Interface Options” use the drop down menu under Integration Type and select JPEG Auto Export



  5. Create a folder on your desktop and label it Opal Xrays

  6. Right click on the folder that you just created on your desktop click on properties highlight the Location path (starting with the letter C and copy all the way through the word Desktop) right click copy


  7. Click back into your Opal screen and paste that location path into the box labeled Integration Drop Path

    a. If the location path that you just copied does not include the folder name at the end once you paste the location path please add a backslash (\) and the title of the folder exactly as it appears here. You can include spaces if your folder title is multiple words. For example, this is how the below location path should be entered into Opal: C:\Users\Ellen\Desktop\Opal Xrays

    b. When pasting the folder location path, please ensure there are no quotation marks at
    the beginning or end.


  8. Click Save


Step 3: ChiroHD Steps

  1. Download the ChiroHD Uploader App

    Click here to download the app

  2. Install the App and follow the steps

  3. If you see this screen - click More Info > then Run Away (not everyone will see this prompt)


  4. When the Select Installation Folder window comes up - just click Next - do not change any folder settings.



  5. When the Installation Complete comes up - just click on Close



  6. Log into ChiroHD

  7. Navigate to Settings > Initial Setup > Integrations


  8. Click on X-rays

  9. Click the "Copy" button that is next to the Authentication Key


  10. Paste the authentication key into the Uploader App in the Authorization box. The next steps will not work if you do not do this step.


  11. Click on the gray Choose Folder button. Use the prompts to location the SAME folder that you setup on your desktop (the file folder that the x-ray software is exporting to). The location path to that file folder will appear. To the left of that field, click on the drop-down menu and select X-rays and then click the add button. You will see the file path populated at the top of the uploader.



  12. Click Save Changes and Restart Service.

    This step is VERY IMPORTANT.

    If you ever add more folders or make changes to any folder path, you will always have to hit this button.


  13. You should see a message that says "Setup Complete, Configuration saved for..." This message should display your office's name (the below screenshot is a blank example). This means the uploader has successfully been connected to your ChiroHD location.


  14. Restart your x-ray computer.

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