Well, it has been a while... I have been incredibly occupied with moving my practice and life in general.
I am so sorry to hear about Indie.
I used to host AC locally in office with a dell server. Very happy, excellent speed. My IT guy was very responsive and managed most of the issues online. Unfortunately, for reasons beyond my control, my practice moved to a different hospital and changed from fully private to private within a hospital outpatient clinic. Bottom line, my employees are now employed by the hospital and I am now in a hospital outpatient clinic. My associate and I remain independent and essentially just rent space and employees from the hospital. This lowered my overhead (great!), but required a change in the way I hosted AC as my server did not meet the hospital's IT criteria. The easiest solution was to go to AC clouds. The hospital actually wanted us to go to a different EMR (Athena vs Epic). This was a deal-breaker and the hospital quickly acquiesced.
I have two providers and 10 users. The transfer was slightly and needlessly annoying, but not enough to jump out of the window. The biggest issue was transferring the 500 G/b of imported items to their server. I do not have the connection issues that Aldo describes. (Sorry Aldo! If I were you, I would already be back to hosting AC locally.) I do agree that AC freezes every so often, and slows down a bit during a busy clinic, but is still usable. I believe AC freezing is an issue with AC, as it happened before transferring to the cloud version. However, before all I had to do is ctr-ALT-delete, go to task manager, close ac on the client, and restart ac. Now you have to contact Support. For those that do not know, AC clouds is just a remote desktop connection to a server off site, but you do not get access to the server, just the program. This is understandable, but in order for this to work well, support needs to be available 24/7. They are not. They are available only during regular business hours, eastern time. If your ac freezes at any other time you are out of luck and can't use ac until support is available during routine business hours. I have not gotten a response from AC support with issues after hours at all.
My biggest issue right now is the pdf reader for the imported items. AC clouds uses adobe free pdf reader. I require full pdf editor as I import pdf forms (roadmaps) for patients who are going through the process for bariatric surgery, which routinely go through a six month process. I need to be able to add pages, delete pages, sign, etc. So far AC clouds has been unwilling to install a full pdf editor. I offered to, of course, pay for the licenses. (In fact, I already have the licenses as I have a Nuance full pdf editor in the office). I started this migration process 3 months ago and I was explicit on my need to use a full pdf reader, not a free version. Initially they said yes and commented that other practices were doing the same. Now that I transferred to AC clouds, they tell me they can't / won't do it. A bit of a bait and switch if you ask me. What is more annoying and upsetting is that now they claim I did not discuss this before the transfer. It is true it was discussed verbally with Paul Lucia and their transfer specialist. So, word of advise, document with email all the promises they make.
There is, of course, a work around. I have to download the pdf form locally, add pages, then reimport. This is doable, but a hassle, mainly because the hospital has quite a few security walls to jump through to download something from the outside. You have to download to a sandbox, security scan, import, then print to updox, reimport. It turns a process that was seamless before, to a cumbersome and slow process.
Dealing with support for the cloud version is the most frustrating thing. Chat is only available during regular business hours, and often are not available at all. Email support is pathetic. Emails often do not responses for over a week or are just completely ignored. You also have the option to leave a phone message, but I have yet to have a phone call returned. It is very frustrating.
Bottom line, if my practice environment had not changed, I would not have switched to AC clouds. I could revert to hosting AC locally, but it will be a fight with the hospital. I moved my old server to my house and is working. I may need to update internet access, but probably don't. I would have to pay for all the maintenance and IT support myself. Not a big issue. All I need to do is download current backup and imported items. The issue would be dealing with the hospital IT. And of course, there is the issue of security. I already suffered an episode of attempted cyber attack in the past, which thankfully was dealt with swiftly by my IT guy. (BACK UP!!!). In the end I may stay with AC clouds just for this fact alone.
I hope everyone has a happy New Year!
Gerardo
