Home Forums Discussions Problems Version 4 annoyances

We just did the V4 upgrade from 3.7. I miss some of the old features and wonder if I am missing something.

First thing I noticed was that I can no longer sign off on imported items using the 'check all' button. We are just beginning to scan in all paper charts and my inbox fills up quickly with items needing to be signed off. With 3.7 I could simply check all and sign off. Now I have to go thru each one individually and if I go too fast, it bombs and closes.

A minor annoyance is that I used to check the AC status each morning to follow the growth of active patients. It no longer displays that. Oh, well....

I see no improvements in Vaccine tracking.

The program is not as stable; it closes several times a day and needs to be restarted. All users in the clinic have noticed. Is this likely a configuration problem? We have AC installed on about 15 or more machines.

Maybe someone can cheer me up by pointing out some of the improvements. I'm not appreciating them yet.

Thanks,

Sky

Yes, the update is gone. I guess you will have to have your receptionist or office manager check it in Admin and mail the stats to you.

I find it is WAYYYY more stable than V3. So, there may be something wrong with how you set it up. Again, that comes down sometimes to what OS you have, computers, different versions, etc.

One of these days, maybe I can get VIPER up and going with AC. We'll see.

The best feature: It is very, very fast compared to V3. I used to have to wait for a chart to open, now it is right there as if it is on my computer. And, ask Adam about his Import files and how quickly they open.

Can't say much for imported items and scanning as I don't use it.

I've found it DEFINITELY faster and WAY MORE stable.
Those dreaded "run-time errors" that cause AC to crash are virtually gone. I still have trouble though when I do a consult letter attached to a long office note. When printing it "as one report," if it's too long the run-time error pops and the thing crashes. Aside from that, I don't have the problems that used to exist in V3. Plus there are so many better things about V4 that the pros outway the cons.

Maybe w/ V5 coming out soon and being CCHIT, we'll like that even better. I guess we'll see...

My experience with V.4: Faster, yes, but daily crashes of the client computers, especially those using Vista, especially when accessing Imported Items. Fortunately, I haven't (yet) had a corrupted database despite the crashes, and AC often offers to resurrect the "pre-crash" note.

Not really disappointed in AC ver. 4, it's still my EMR of choice. But room for improvement.

John,

That simply just shouldn't be happening. There are a couple of bugs, and AC 4.0 may crash every other day for me. You are talking about the program right and not your client computer?

But, there is something wrong either on your end or on their end. I hate asking these questions but...what version of Vista is it and how much RAM do you have on those PCs? What OS are you running on all the computers AND WHAT TYPE OF COMPUTER, OS AND SPECS DO YOU HAVE THE AC DATABASES ON?

Have you thought about (just for fun) running Win7 on one of the Vista machines? http://technet.microsoft.com/en-us/evalcenter/dd353205.aspx?ITPID=wcfeed It would be good until March 10, 2010.

Bert,

Thanks for the inquiry. I am only seeing crashes on the client machines. Never had a crash on the main (database) computer, which is an Intel Core 2 Duo with 3 GB RAM, running Windows XP. The network is peer-to-peer. The clients vary from Pentium 5's with 1 GB RAM running XP, to my personal PC which is also a Core 2 Duo with 4 GB RAM (of which Vista absurdly only sees 3 GB), running Vista. My Vista computer probably has 2 to 3 times the crashes (almost daily) as the XP PCs. The crashes only involve AC, and usually when I am signing off Imports or looking at Imported Items. I do have a client PC running Windows 7 RC, but it isn't heavily used, so I can't estimate the crash frequency.

I would be more concerned if I was losing data, but no problem fortunately. I have had an IT person check the network setup, and he claims it's a problem with AC, not the network or individual PCs. He found that AC had problems with Acrobat 9 on my computer but not with Acrobat Reader 7 on my staff's PCs. As far as my Vista computer, he just says that Vista causes problems with permissions on networks (the explanation was more detailed than that, to be fair, but I can't remember the specifics). I could roll back to an earlier version of Acrobat Reader, but I have the full Acrobat 9 program which allows me to electronically sign PDFs coming from the home nursing services, PTs and so forth, and saves a lot of time and paper. I was also advised it would be simplest to downgrade to XP on my computer, but I can't face the hours of backup and reinstallation that this entails. I've already preordered Windows 7 on Amazon, and I'll take my chances.

Boy, I wish AC ran on Macs.

It's difficult to tell. Personally, (and I am not looking at your network and don't doubt your IT person), but it is hard to say it is AC or it is the network. Obviously, like medicine, they all play together which is obvious since, unfortunately, you are having problems and a lot of us aren't.

I remember starting way back when -- I believe I was one of the first -- and our programs would crash with no warning about four to eight times per day. At that time, you HAD to run Amazing Utilities and ALL AC programs had to be shut down. Well, this was a nightmare given there was some type of leak and, even if AC did not appear to be running, it could be running in the background. You had to close it in task manager. To make matters worse, a couple of XP Programs in the back on a non-domain network had Fast User Switching. So, here we were, four to eight times a day, completely stopping with three or four of us running to each machine to make sure AC was not running, looking between the different users on the XP Pro faster user switching machines and finally going to the Amazing Utilities on the server and fixing the problem. Of course, a good many of those times, it would say AC was still running. So, someone's AC could crash in room 1, and you would be in room 6 and have no idea until your AC froze (they all crashed due to the first one) or you heard the alarm that everyone needed to get out of AC, while Bert manned the server and the nurses were running around turning the ACs off. The patients thought we were crazy, and my partner at the time who has NO patience was already switching to paper progress notes and writing out scripts on paper pads. AARRGGHH!! This went on for weeks with almost daily calls to Jon who told me that there were three practices like this. I have no idea how I continued to keep my impatient partner to hang in there. I tried everything and finally put an upgraded pro version of Access on the server (which, of course, should not have made a difference) and it never crashed again. So, see, it could be much worse.

Anyway, I think I would troubleshoot one thing at a time. I think you need to isolate as much as you can even though that is hard to do during office hours. How many doctors do you have? Can you work from less computers?

I would look at networking as it relates to the computers that are crashing the most. Look at the network cards. It is bad that 32-bit systems can only "see" around 3.2GB of the total RAM. That will all change with 64-bit computers. It sounds as though you have plenty of computing power and RAM.

You could download the .iso version of Memtest 86 at http://www.memtest86.com/ and boot to it and check your RAM. Who knows. I had a friend do this on her computer, and she had a bad stick of RAM. I am assuming this is Vista Business? Not that Home shouldn't work, but that could be an issue.

I know that many times when I have issues with a computer, it can be the video card. Vista, as you know, tends to need a more powerful video card but generally only when you use Aero. If you are using that, turn it off. But, I just fixed this girl's computer by having her download a new driver for her video card. And, my HP server I had last year was out of commission for over ten days before the HP tech came out and figured out it was a bad video card (the monitor was still looking great).

Also, is anyone using the main computer? If so, is there is anyway to isolate that computer for awhile? This would be a great time to schedule 10 or 15 patients on a weekend and just use a few computers to see.

It can be frustrating, but it has to be a combination of AC code and your network not that anything is wrong with it. Have you downloaded a newer version or just reinstalled that one?

Maybe even download a program with SQL to your computer and play with it in isolation. If it works fine, make your computer the database computer.

Just some ideas. Good luck. Let me know if there is anything else I can do.

And, there is always the six-day free trial on Experts-Exchange where you could ask the question under Vista, XP Pro and Networking. They usually answer about 75% of my questions.

Interesting, I too had trouble with AC 1.X crashing several times a day. Jon said it happened only to a few people, he told you 3. Interesting that we are both Pediatricians. I solved it with V2 but my associate never had enough confidence to continue using it. She later left.

V4 has been rock solid in my office. I did have some connection problems that I tracked down to a bad NIC (ethernet) card on the main computer. This caused havoc for about a month, but was NOT AC's fault. It has been very stable otherwise, occasionally it will still burp and not find the connection to the main but never crashed for me.


Even Jon seems to prefer Macs, almost surprising he used PCs to write the program. They are much more stable because the code and the hardware are more tightly controlled. You do pay a price for tight control, despite what Steve Jobs would like you to believe. I too prefer Macs.

Thanks all for your discussion. I'll pass it along to our IT.

We had an odd thing happen with our Quest lab imports. They are imported to our lab's computer and our tech reviews them and forwards the lab's to the ordering provider. Then after forwarding, he gets the msg saying "do you want to delete from your inbox?" If he says yes, it deletes his copy AND the copy from the inbox of the provider he sent it to! Odd.

We found this out because one of our providers was reviewing a lab and it suddenly disappeared. That's when the lab tech deleted his copy. Does this make any sense to anyone?

Thanks,

Tim

Maybe, since deleting a lab removes it from both the ordering doctors inbox and the shared lab box maybe deleting it deletes all copies of the lab message for all users. Inadvertently deleting the needed one.

Thanks Bert, some good suggestions. I'll see what I can do.

I heard that vista 32 bit can only recognize 3 gb, but vista 64 can recognize like a 200 zillion gb. But 64 bit system are a pain to look for new printer driver, incompatability with unsupported printers, scanners, etc.

An interesting article on memory on a 32 bit system can be found here: http://www.codinghorror.com/blog/archives/000811.html

I blame driver compatibility in 64 bit systems on the manufacturer of the device. Most of these people are slowing down the adoption of 64 bit devices because they do not want to keep pace with technology. Just look at how long XP 64 bit has been available, yet many companies still have not made 64 bit drivers.