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Hi folks,

Long-time user here, infrequent poster. Glad the board is still here.

We decided for several reasons to try moving from our server-based set-up (AC user since 2003) to the cloud. We scheduled the install for a Friday afternoon (yesterday) at 3pm local time. Seemed like a good idea at the time.

By 9pm, I was rolling us back to the server (still ver. 12.3.1 as of today). Some strange glitch appeared inside the Citrix environment when I tried to repeat the install on machines 3 and 4 (of 11 total) that asked me to try and start AC as an administrator, from a menu prompt that looked antiquated. Server install went fine, tech support walked me through all of it, then machine 1 on my desk worked ok, but after attempt on machine #3, couldn't get into VAC at all from anywhere., even the original "main computer".

Of course, tech support not available until Monday morning and I couldn't go the weekend with no access to our patient records. I felt completely abandoned.

Now thinking about sticking with our old server-based version. But I had a few questions that I hoped folks here might be able to answer, if anyone here uses the cloud-based version:

1. How often is the cloud version down/wonky enough for you to hate it?
2. I understand the newest version of AC 12.4 includes a patch for SQL server so it remains supported. I can update the current version of AC to 12.4 this weekend if necessary. Is there a longer-term fix needed for SQL server (a new version entirely?) that will be necessary soon to continue using AC longer-term? How well is a server setup likely to remain viable? It's getting close to the end of my server's life now, I think, which was one of the reasons we decided to go cloud-based. Unclear how committed Harris is to older users like me.
3. We're at that tricky point in one's career where we'll probably be active in full-time practice for 5 more years, but not 10. Maybe not even 7. Trying to figure out whether it's worth it to make major disruptive changes or limp to the finish line. We even considered changing entirely over to Epic - which 95% of the docs in our local hospital network use and which of course can't interface meaningfully with amazing charts, because Harris doesn't participate meaningfully with TEFCA - but that's a huge pain point that my partner (who also happens to be my wife) hasn't been willing to stomach.

I assume someone from tech support will be calling us Monday morning, as promised, to "check in". Looking forward to that.

The joys of private practice! But I wouldn't have it any other way. Thanks for any thoughts, y'all.

Jim

I am attempting to take my office into the future with our computer system. Currently we have around 20 client computers and 6 virtual machines.We are server based because of Internet instability but also due to the large number of people that need to access the chart system. Updating each machine to the newest version of AC is obviously a time consuming process. I'm thinking I can use group policy on the main server and use a simple powershell script as detailed in this link. .Anyone have experience or suggestions?
https://www.aggia.co.[censored]/how-to-push...using-gpo-and-powershell-startup-script/

Done. Thanks

Awesome. Thanks for the feedback on that.

Great suggestion. You can submit this directly to development by clicking "Help" and "Recommended Improvements". That goes directly to our development team.

Unfortunately the PopHealth module cannot do that with the specific measure. CMS has told us that the results need to be in the medical record, as this measure is no longer patient reportable. We found the easiest way to look at this is by the imported items (where most practices document the results).

If we could do it just by documentation (like we do with Depressions Screening), then we would. That is usually the first method I try to implement when I am looking at measures. But sometimes the rules work against us. Breast Cancer screening is the same.

If CMS changes the measure back to patient self reportable, then we will add in some text phrases for you to use.

Did the 12.4 update this past weekend. Is typical straight forward install. New SQL Server 2022 express installed. So far no problems.

The population health module is surprisingly good. We just got it. I personally document outside colonoscopy results in the PMH with who did it, then the month and the short abbreviation for year. For instance Colonoscopy Smith 5/26 HP x3, 5 yr fu. It would be great if the pop health module could scan this section as well. I know it would be more difficult than the current method and that it's a work flow/documentation issue for my staff but it's a suggestion

It would be great to have the ability to turn on automatic uploads to the portal for individual patients and not the entire patient panel. Additionally to be able to select what gets uploaded for each patient.

It would be super helpful if the clinical assessments had a phq2 that would automatically convert to phq9 if it was positive. Additionally if the screen was positive (according to CMS guidelines) it would be great to have a few click/check boxes on the screen with results with acceptable documentation requirements similar to what the population health module looks for in the documentation.

I noticed in 12.4 when you go into the NewCrop screen you now have the PDMP link. I have access through my state and have to log into a separate site. It would be super helpful if there was the option to directly link the state sight amazing charts. I signed up for a bamboo health account but they want me to pay. A simple button in the standard prescription writer screen would be great. It wouldn't take much to change things around especially with AI code writing.

I usually live in the prescription generation screen when editing meds. The ability to add a med on that screen is great. It would be super helpful to be able to click the med reconciliation button from that screen now that it is part of the new CMS ACO measures.

We did it. Pretty easy

Bump