We decided to take the plunge last week and go from V6.3.3 to V8.
To summarize briefly: installation went smoothly, with only a couple of hiccups. We have a couple issues with usability, but nothing too serious in very preliminary use. V8.2.2 is definitely slower than 6.3.3, despite better hardware. The difference is noticeable and sometimes annoying, but not disastrous.
Installation was done on our own, without scheduled help from AC support. We did get prompt help from support with a brief issue. The process was smooth and relatively easy, even compared to past upgrades. Installing on the new ?server? on our peer-to-peer network took about 40 minutes. Downloading actually took most of that time. Each client (we have 6) took about 20 minutes. The biggest delay was caused by an unrelated networking issue (resulting from our prior mistake in buying two Win8 machines; an error we won't repeat). For a couple machines I used Revo for a ?clean install? but for most, I just installed on top of the old version and that went fine.
Out of concern due to reports of speed problems, we decided to upgrade the ?server? on our P2P network before the AC upgrade. We got a Dell XPS 8700 running Win7 Pro with 8gb of RAM and an i7 processor. We did not change our clients which are all Dells with Win 7 and 8, with a range of slower processors and memory. Our network is all hard-wired.
There are so many variables and considerations regarding speed that it is difficult to objectively compare one version of AC to another? let alone one practice?s experience to another. I timed an assortment of tasks on our old system with 6.3.3 and the new one with 8.2.2. This was not an ?apples-to-apples? comparison by any means; the new ?server? is faster and higher-powered. I realize that this limits the value of the comparison times, but my goal was not to have a fair test: it was to avoid upgrading and then find that the new version was unbearably slow.
The biggest issue for us is chart opening as well as closing after signing-off. Each can now take 4-8 seconds; several seconds longer than prior to the ugrade, and long enough that you notice that you are sitting and waiting. Opening the letter writer takes several seconds longer than it did in V6.3.3 (this of course is an all new LW with that upgrade). On the positive side, the longest delays are for ?one-time events?. For example, opening the program takes significantly longer than it used to, and logging on is a bit longer. Opening the first chart after logging on is slower than all subsequent ones. Since you may only do these operations once a day, these delays are not so significant. Pulling up messages or a schedule and creating reports is quick. I have not done much e-prescribing but it seems to be only slightly slower. The size of a chart does not seem to make a significant difference in time opening or closing. As in the past, opening the chart to certain tabs (e.g. by hitting F9 to open) is quicker than double-clicking the name and going to the Most recent (actually, current) encounter. This still saves a bit of time.
What I have not done is count how many times we open and close charts in a single day. I am sure I do this well over 100 times a day. 250 might be more accurate (including work on patients seen that day plus prescribing, checking labs, looking at old notes, dealing with messages, etc). 250 times 5 seconds gives a rough estimate of 20 minutes of daily lost productivity related to this issue alone. This is major, and I certainly hope AC makes good on their promise to address it. On the other hand, it is not enough to make me want to roll back the upgrade. Hopefully as we use the program more in coming weeks, the benefits of the upgrade will become more apparent and the slowness less so.
Two other issues bear mentioning if you are moving from V6.3.3 or below to V8. There are plenty of warnings (and instructions, including videos) from AC about migrating insurance, which is part of this upgrade. After upgrading, it first seems that all your old insurance information is intact, though not in the newer codified format. In fact, if you print a patient?s insurance information, nothing appears on the demographic page. I assume the same is true if you try to use AC for billing. Migrating insurance is something that cannot be started until after you upgrade; at that point you have a fair amount of ?figuring out? and grunt work to be done before you are fully functional. This is not work that can be done in a sandbox, and can only be accomplished after you upgrade and as you try to resume normal work and billing.
To some degree the same is true of the new Letter Writer. It is a big improvement on the old one, and it offers far more flexibility and a much better finished product. On the other hand it takes some time to understand its workings and to develop a process for creating a series of templates. This also cannot really be done until after the upgrade.
My goal here was to share my personal experience with the people above who are working on the issue who are far more technically skilled than I.
