Home Forums Discussions General Discussion 18 Big Ones for Dummy

I just implemented my test AC beta 6 yesteday and everything seems Ok. Took me about 3 hours. I the type don't like to read guide or help, so I don't know what they telling you in there. They might tell you better.

As a semi-retired senior, I don't want to rush, so I give my beloved doc one week to play with the Test AC, again at 3 and 4 in the morning. Oop, I just asked you to help her to not working till sunrise!

and plan to have my test moves to production next week after my fishing Sat morning

Disclaimer, use this info at your own risks.

Here is my quick guidelines for those who hate tech toys (many docs) but love free money. You even can make your MAs to read this and do it for you while you watch.

In million dollar IT projects, to deploy a new system, 3 phases, testing phase, development and productive phase. Here I skipped the 2nd phase but always like to have Test.

- Get a better, 2gig or more computer to be used as server and another not in service to be used as front. Preferably a better new one for test server, only 500.00 or more now a day (this could become main server if needs be)

We still using XP and probably don't bother with win7, at least for sometimes as all my self-assembled, 3 year old PCs, 20 of them, still running 24/7 fine.

Back up your Amazing Charts on the main server, uncheck those exclude images and imported boxes in the back up advanced section, it take a while (depend how big your database is, ours is around 8 Gigs). Copy this file into a folder on your test Sever, and remember its location.

Download version 6 Beta,and its database tuner separate exe files. Copy these two files into a folder in your TEST Server pc, share them so all computers to be installed AC6 can have access.

TO BE SAFE NOW DISABLE YOUR WIRELESS OR NETWORK CONNECTION, UNPLUGGED THE NETWORK WIRE TO THE TEST SERVER AND FRONT. (I used two old PCs and they kept looking for the old version 5 Amazing Charts on our main computer. You can change the path by right click on the login window but Amazing charts not allows you to do that if the installation not yet completed).

Install beta AC6 on both TEST server and front. I used two Pcs with AC5 already installed without the database. It takes a while so do them both at a same time. Say YES when it asks you is this the main computer for the Sever and NO for the front.

After the installation, open ACs on both Pcs.
For the TEST Server, the practice data is empty and it would ask you for info, ignore and close, just to make sure it starts up OK.

For the TEST front pc, it would ask you for the path to the database on main, the Amazing Charts XML file, open your networks icon and browse to the name of your TEST Server/Program File/Amazing Charts

Make sure the Firewall on the TEST Sever turn off. Go to Control Panel and click on Firewall.
Also right click on Program Files/ Amazing Charts/ Sharing and make sure to allow full access /read/write..., the default is SHARED and READ only.
(I saw errors on my Test front when it said not able to write to the database on the Server after succcesfull installation and restart, then I had to go in and check the WRITE box, I don't remember for sure but all older versions, you have to Share your Amazing Charts manually, but all this beta 6, the sharing setting is automatic).

Find the Backup Restore Utility exe file in the Amazing Charts folder, right click to pin it to Start list for convenient access.

Click on the Backup Restore icon and follow the instructions, it would look for the enc backup file to restore your TEST server's blank database, you did copy from your main server at the start of this note. It would take sometimes to restore.

You might have to run the database tuner one more time.

Now ENABLE and RECONNECT your wireless and network. We didn't want our test PCs to communicate whatever to our production machine as human or unexpected error could always happen.

Open AC on the TEST Server and Front everything should be ok, latest data there. Sweet thing is that there a Meaningful use button right in the main AC window so we can check to see what needs to be done.

Keep copy and restore backup enc files for couples days to do the test and one last time before doing full upgrade on the main server. The good thing is that now you have two Servers, the Test one can be come a backup.

I've been using this trick that I copied the everyday backup (without images and imports) to our backup server, and once a while doing the restore to see the back up still running ok, then I just compared the date on the imported items on both Main and Backup and copy the one just been modified or added only.

This would be kind of dirty backup that can be done often and only do a full restore using full backup (with images and imports). Our clinic is about to see 10 gig soon and doing with 10 gigs is not fun.

I just read yesterday that some docs in TX already received the initial checks. How come they got it so quick but not us, most ACs users are smaller group, that means we should have those funding first. DAVE if you read this, I don't think you care. haha.. we deserve your stick by not working underserved. We like to entertain and wearing shorts year round.

Any problem then you can just go to our online AC support angels and let them take over your PCs to fix any errors . I love them as they are so efficient. But like most I don't like to ask for help unless running out of time or energy.

Walter,

Thanks for the step by step. This really must have taken some time.

To clarify further as a direct recalls from my dummy brain no longer perfect.

Our test system has been running for 4 days now. I made many quick backups during the days, only about 2 minutes for a quick backup instead of a 1/2 hour or more for full backup. It seems not matter how powerful your computer is, ours only utilizes about 10-20 percent of its CPU power, a full backup with imported items included takes too long, only to be done after or before clinic time.

For many of you not familiar with a database structure, a quick review here. We have quite few experts in our forum and I did learn many tips from them so please feel free to modify or comment, Wiki styles.

Before AC changed to its current SQL express database, it used Access database. Access database is only for small storage and only accessible to one user at a time and only has limited security. A database is just storage tables with specific dimensions do we can store data.

Current versions of AC using SQL Express database. SQL Express database from Microsoft is free, otherwise AC could not be sold at such a reasonable price. A full SQL database alone costs thousands of dollars. SQL Express database is a much scaled down version of full SQL database.

A quick backup only copy doc/staff/schedules..data in some of database tables. Our own full database backups enc file around 8 gigs,8000 megs, while imported/image excluded backups only 80 megs. That the reason I did a full backup first time only and one more before ready for our real upgrade.

When you run a quick backup and copy the file over to the Test server then run a restore, you have to run database tuner version 6.09 application because the backup is still under version 5's. As I mentioned above a database merely tables with different dimensions, a table in version 5 has different dimension compared to its comparable table in version 6, so the database tuner as a transformer would either transform old table dimensions or modify version 5 data, make them smaller or larger so they can fit.

remember that on the test system we currently have two computers, one is server and one is front. So test front talks only to test server but not to our production server. You can play with them whatever you like without any harm done. As we only made a full copy with Imported the first time, during our testing, if you click to open an image or a scanned doc that has been updated after our first backup then AC would return errors as no files there.

Sitting at home or outside loging in remotely and I even could copy during the days any imported files been updated in the production over to the imported folder in our test pc. Compared those time stamps of imported files so you know what files new and need to be copied over. So our test server even it is not real time mirror of our production server, it data only couple hours behind.

Btw we just registered with Medicare and want to have reward money asa so we can spend it, might be this coming Xmas holidays. My beloved doc badly deserved a Hawaii vacation and 18 grands is more than enough if not all the way first classes.

I'll do one more full backup with imported items this weekend, even burn to a double sided dvd or blue ray and put in my gun safe, full HIPPA compliant. Then run one last restore AC6 on the test server and on many of our Pcs, change their database path to the test server to see if they read and write.
If no problem then take a deep breath and click on the AC6 app on the production server and like watching a good action movie...

Then change those pcs already installed AC6 paths aiming for production server and do more tests.

Install AC6 on the rest of them and test one by one. Seems this should be an 8 hour job.

ANOTHER SAFE AND SOUND OPTION

Make our Test server to become a Production server, remember we going to do one last backup and restore using latest data on the Test server?

Then our Production Server would become a backup with its version 5 installation and latest data intact. Any problem whatsoever, we just have to reinstall AC5 and repath to it. That is why in my previous note I prefer a better and newer PC to install AC6 for testing.

I don't know why 18 grands not that a large sum, I had my hands on much larger sums before without skipping a heartbeat, causes more anxiety, any suggestions?

Happy to update that our upgrade to version 6 was so smooth. It seems that Amazing Charts team after so many upgrade versions has done a terrific job. I previously thought to install and do a careful backup might have taken me a whole day, but only about 4 hours.

Today is our first day of running in production mode and so far no complaints from our staff. They don't know anything about this upgrade and I didn't tell them. I rarely in the clinic, but today I am.

We should expect some problems down the road because no matter how good a software is, if I am not wrong this time AC integrated many third party software like Business Objects, SAP crystal reports and others into it, bugs can not be eliminated so unexpected errors. Remember this is also THE new AC to satisfy all meaningful use requirements.

I read other posts about some problem in 6 installation so if you don't have an IT staff on hand or not a techie and have not yet install AC6, please see if you can use this post as your guideline.

I don't know why but seems docs are special, either they don't care about tech so their IT knowledge limited or they so good they can be hired as an IT specialist in an instant (they need to have CIO friends). One probable reason that they are smart and passionate people, good IT quality.

Remember AC is not a large software, its usage intention is for smaller groups. So you don't need to invest in any fancy computer to be used as 'server'. I did assembled the 'server' myself using basic dependable, corporate stability components for less than 500.00. Don't put any unecessary software on it, don't need to tweak it, just let it run. Three years is a good life for a computer.

Cross our fingers, we need 90 meaningful use days to generate a report and wait for 18 grands or more directly deposit into our bank. See you in Hawaii

What basic corporate stability elements did you use? How did you come upon 18 grand, was that your full setup cost? I'm using a core 2 duo 'server' with 4 gb of Ram. I'd be curious as to some of the older machines folks are using - I've heard of one Pentium 4 with XP running fine. What processor setups are you using?

Chris, pcs getting so cheap I myself like to buy a ready to run one because we can not put together one as cheap if OS included (an extra 150 bucks). It is better now to just go ahead and buy many of same kind of low end PCs for fronts and one better one for 'server'. Bert did mention some of good models in his posts.

Over 3 years back, we started with a Core 2 duo 6600 2.4 , then last year I put together a new quad core Q9550, CPU on sale local for 180 bucks, a high user rating of 400 watts power supply, 50 bucks, a 3 year warranty corporate stability motherboard around 75 (Asus advertises some of their boards as 3 year warranty, corporate stability model, simple vga output included, then 180+50+65 plus 3 gig of memory 75.00 plus 50 case and hard drive . Wow, only around 500.00. I still have a group license XP around. Now I don't want to assemble PCs anymore but get stuck with so many different config Pcs, putting together cheap, one at a time.

I am not a fan of Raid hard drive set up for NON enterprise level server like ours, I had Raids failure before both hardware/software based. For data redundancy, Raid setup by itself is not enough,I am for simple things,extra portable hard drive , extra cloning hard drive for system boot up failure, data backup off site...


I myself much prefer a backup server with same configuration like main server. Anything you just rename your backup and re-path all front pcs to it or bring over your main hard drives. Remember our server is cheap and expendable not like those corporate mainframes.

The way I felt is that something running 24/7, 3 years is a good life span. If they advertise 3 years, then the probability of failure is low. If you put your server in a cold room like those in server farms then it might last longer. Here in TX it is so hot and I don't pamper my Server by lower the thermo less than 80, hundred of dollars saving per month. CPUs run comfortable in those less than 100 degree and almost indestructible for many years compared to others.

Amazing Charts not like image processing or game software so it does not requires much processing power but only to read, store and retrieve data from its database.

But AC is now putting in more features with a better database plus doc practice growing, a Pentium 4 is no longer adequate

A practical way to check is open your task manager/performance then ask all your staffs to click open same time patients demo or anything. If CPUs usage shoots up toward 75 percent or more then time for your 'server' upgrade else you can keep it running , not talking about Pentium 4, it is obsolete and surely more than 3 years old. Time to upgrade and keep that P4 as a backup.

Oop, sorry Chris, about those 18 grands, I might have not been that clear, but that the average amount of reward money from uncle Sam for those docs using meaningful, certified ER, AC version 6 for at least 90 days. You have to accept Medicare patients, and more than 18 grands for those who accepts both Medicare and Medicaid. I heard that it a little bit involved in patient documentation but might be worth the effort. So using AC 6 and spend a little time more than AC would generate a detail report for you and then you can submit it to get that 'rebate' money. My doc told me that the money would keep coming for 4 years? I think AC has this documented.

Many docs in TX did receive those 18 grands or more checks so the reward money is real, I read it last week. Some EMR software in the market already been certified last year.

Another quick update after 2 full days is that Version 6 running slower on my doc's desktop when she doing her e prescriptions.
This means now AC has to compare hers against its med database to satisfy one of those meaningful use requirements. For front pcs, our staff haven't notice any differences.

My IT background a long while back was also in software development. Seems that AC code development evolves thru time by change its underlying coding and but not entirely redesigned from scratch. Inherently that would not be the most efficient way to go but ok for now. If one user could feel its degrading performance then we have to wait in patience as not much can be done till next version, probably 7.

So for those AC users who have not adapted to the the AC6 and have a larger collection of data definitely need to upgrade their server to a more powerful one before doing their upgrade.

One week! No problems whatsoever in our wire and wireless environment. Our doc during the day mostly using wireless notepad.

For us AC6 beta seems stable. AC development team deserve a raise.

Per my experience in keeping our AC trouble free in the last 3* years is that DO NOT INSTALL ANY UNNECESSARY PROGRAM, do not update frequently ( I turned off automatic update ). Disable all flash programs.

To switch from one EMR to another you better uninstall former one and related programs completely.

I much prefer a clean OS install with latest update patch and AC only that way you know for sure that your computer is clean.

In Microsoft environment not like SUN/MAINFRAME, too many 'compatible' programs surely cause 'tension' among them. Computer world very much like people world, if you are by yourself, you feel lonely but then nothing happens, eat, sleep, do nothing, create waste, and getting old and no need for companionship.

One month almost, running perfectly fine, no trouble calls from staff whatsoever. Weird. So any of you PCPs dealing with big brothers money, don't be afraid to join.

Remember, simple is key. Don't overkill with elaborate set up with fancy hardware/software.