📝 Overview
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.
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 to Sync:
Open the patient's exam on the x-ray computer
Update the patient ID to match their ChiroHD patient ID
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 not set 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 mismatched screens so we can update our guide.
🖥️ Step 2: Opal (20/20 Imaging) Setup
Open up an exam
Click the Opal (20/20 Imaging) Icon in the upper left
Select Settings
Some versions may require that you click on Settings, then click on Edit
On the bottom left under “Interface Options”, use the dropdown menu under Integration Type and select JPEG Auto Export
Folder Setup:
Create a folder on your desktop and label it Opal Xrays
Right click the folder > click Properties > highlight the Location path (starts with C:\ and ends with Desktop) > right click copy
Click back into your Opal screen and paste that location path into the box labeled Integration Drop Path:
If the copied path doesn’t include the folder name, add a backslash and folder title (e.g.,
C:\Users\Ellen\Desktop\Opal Xrays)Ensure there are no quotation marks at the beginning or end
Click Save
🧩 Step 3: ChiroHD Steps
Download and Install the ChiroHD Uploader App
Install the app and follow the prompts
If you see a Windows security screen:
Click More Info > Run Anyway (not all users will see this)
When the Select Installation Folder screen appears, click Next (do not change folder settings)
Click Close when installation completes
Configure the Uploader App in ChiroHD
Log into ChiroHD
Navigate to Settings > Initial Setup > Integrations
Click on X-rays
Click the Copy button next to the Authentication Key
Paste the key into the Authorization box in the Uploader App
❗This step is essential. The integration will not work without this.
Link Export Folder in Uploader App
Click the gray Choose Folder button
Locate the same folder you created on your desktop that Opal is exporting to
The path will populate
In the dropdown to the left, select X-rays > click Add
The folder path will appear at the top of the uploader
Finalize the Setup
Click Save Changes and Restart Service
This step is VERY IMPORTANT
Any time folder paths are added or changed, this button must be clicked
You should see:
"Setup Complete, Configuration saved for..." (your office name will appear)
Final Step
Restart your x-ray computer to complete the setup
✅ Key Takeaways
The setup must be performed on the x-ray computer
Use ChiroHD Patient ID in Opal (20/20 Imaging) for sync to work
Folder path setup must be accurate, including exact folder name and no quotation marks
ChiroHD Uploader App must be configured with the correct Authentication Key and folder
After changes, always restart the Uploader Service and reboot the x-ray computer
🏁 Conclusion
Once you've followed the steps above, your Opal (20/20 Imaging) software will automatically sync x-rays into ChiroHD, keeping patient records complete and accurate. For any issues or version mismatches, reach out to [email protected] and include screenshots. This setup is essential for reducing manual work and improving workflow in your office.