Home Forums Discussions General Discussion When is the Practice Management module expected?

I am evaluating AC and haven't yet explored all that AC has to offer, but I like to know when AC is suppose to offer the PM module along with AC EMR. I am leaning towards buying AC EMR ASAP but want to be sure if I can wait a bit for the PM module and should not look into anything else..

2) I have installed the trial version on one desktop and the am sharing the same data on two other computers. I notice AC freezes(or should I call a delay) a bit when you toggle between tabs in the application. Is it normal and how much difference does it make if there are 5-10 computers in a network are using AC off of a server(desktop)?

All the answers will be really helpful abd I offer my thanks in advance..

Thanks,
IB

I now have 10 terminals (often all being used- 4 in exam/procedure room, two nurses, my office, frontdesk, billing, office manager)-- Usually no issues with speed except when the server is doing funky things as virus check and back up (which it should not be doing this during working hours).
I really believe in being behind the curve (especially when coming down to issues regarding finances). If the computer bug hits you and you don't have stellar support, it could wipe out your clinic.

Just my thoughts.

Roy, that last paragraph completely confused me. Can you elaborate on that?

==================

IB. Yes, it is normal and one of the most frustrating things for me and my staff with AC. Certainly not enough to not use it. If you go to the computer which is working as your "server" and run AC where the database it on that computer, you should see the fastest you can move between tabs. Moving between tabs on the other workstations ill be slower depending on how your network is set up, i.e. whether you are using Cat5e or Cat6, etc. Depending on whether you are using one of the above, your switch will also limit the speed, i.e. switch rated for 10Mbs will be the bottleneck whether you have Cat5 or Cat6. Make sure you are not using a hub; that would make things very slow.

The way AC interacts with the database not being a true client/server setup also slows things down. I have noticed that the demographics window is the slowest probably a result of having to load data in multiple fields (I could be wrong). You will notice that once you go to a tab, it will open much faster the next time in the same patient's chart when it is open.

Make sure you continue to compress your databases with the AC utility. If you only have a few computers, move to a Cat6 switch and cables. Just make sure you have Cat6 network cards as well.

Finally, the number of computers shouldn't matter much. There is a limit with XP Home but not with Pro. Access, although not SQL or Oracle can handle quite a few computers. I would strongly suggest rather than putting money into computers, let your computers you have be workstations and invest in real server which is set up to provide much more throughput and provide a lot more redundancy. You could get an excellent server such as Dell or HP for around $2,000 to $2800. The server would be extra, but they tend to run deals where they throw the OS in for free. SBS 2003 Standard Edition R2 is all you would need and you could pick that up for just over $350. It comes with five Client Access Licenses which would be more than enough for now. The computer you are using for a "pseudoserver" is just that, and my guess is it is being used by someone. This will significantly slow down your system and a used PC is much more prone to "crash." requiring bootup time, allowing users to lose data in the middle of a visit and possibly causing data corruption.

IB, it is helpful to know more about your network in the future, i.e. are you using XP Pro vs Home? Are you using Vista? What model switch are you using? etc.

If you have any other questions, feel free to email me using the email address in my profile.

Hope this helps.

Cheers!

Hi Folks,

Yes there is a lag - and the slower the network, the longer the lag. Also, you should know that XP on the desktop is NOT designed to be a file server. You can see this especially when moving a large file from a shared folder on one computer to another computer.

We have on average 4 active users at any given time. (AC may be open on more computers, but idle) We use a dedicated server running Linux, although a fast windows server would work just fine. All DESKTOP machines should be wired to a good router or switch (not that I've seen anybody sell a network HUB in about 5 years). Only use wireless for your portable machines - BOTH will be faster that way.

Burt, you paid WAY too much! :-D I spent $300 for a high-speed rack mounted dual processor server on e-bay, and before deploying it installed all new hard drives for another $400 (I bought the GOOD drives!) I have it running Fedora Core Linux, and the thing SCREAMS. Seriously, though, you can get a small server running Windows for $2000 or less.

The key to making Amazing Charts run fast is a fast server and a fast network. Get a real switch, not a consumer-grade switch, as the throughput is better.

If you need a hand, give me a holler.

Regards,

V.

Vinny,

I agree completely. My server did come in at $2,000, mostly because of RAID. My buddy's Dell came in at just under $3,000. Not quite ready for eBAY, yet, lol.

But, as you say, you really have to have a server. Just can't run the thing on XP plus the fact that someone is probably using that. Hate to see what could happen to the data when he or she just decided to turn it off cold or reboots.

Vinny, you will probably flip out by my switch is over $850. But, that's only because it was the TOP of the line LinkSys, POE and I had to purchase that one because at the time I was going to go with a hosted VoIP set up, and it had to use that switch. But, it's 1GB and IT screams. <G>. Should have gone with VoIP too, but I just couldn't risk it at the last minute.

Vinny and Bert,
I've been sitting next to my server today to see if my server will scream...I kicked it but... I haven't heard it scream yet. I have heard that lobsters will scream when put in a hot pot of water, but I've never heard that personally.

I'm wondering, for all the good folks in ACville, what would be your dream team components. I rely on IT companies to tell me what is good for my network, but found that they usually have a vested interest in selling the system they make the most money rather than a system that would howl (or scream).

Screaming and howling are mandatory this week...wonder if it will affect the number of patients I see daily or whether they will be tricks or treats...

Seriously though, as I read this, I wonder how many of us are using a server vs peer-to-peer networking - which is what I do. Certainly the set up documentation supports peer-to-peer. Should I be worried?

Bert,
Post-master and Survey-master. I have often wondered the same thing as Barbara.
Can you doctor up a survey regarding what users are doing.
Server vs peer-to-peer?
XP vs Vista?
Switches?
Practice managment software?
Solo-practice or Group practice. FQHC or souls-sold-to-the-hospital?

This will give us a better understanding about the good folks who live in ACville. It'll be like a census (and I believe this bulletin board will keep it anonymous as results are reported in aggregate form). And no one will use this information to sell us stuff we don't need.

Roy,
Great Idea about a general survey there. Put Village Medical down for one vote for P2P (Not P4P, now that will make you scream like in a horror movie on Halloween...) XP Pro and Tablet, NetGear Wireless Router with Printers wired thru the ports on that router. I still think that as long as MS will allow us this cheaper and easier alternative why pay them lots of money for what we really only see negligable increases in performance for, right? Yes we see a bit of decrease in speed when someone is banging away of the "server" but that is only like when I'm sitting here with three programs open writing to you good folks...

For a really small solo practice that is just scraping by on stagnant reimbursment I refuse to invest in anymore tech than I absolutely have to. EMR's and all this other fancy stuff is like everything else...Everybody out there wants them but nobody wants to pay for them. 10% Medicare cuts still on the horizon as of right now. They keep us so busy just fighting the here and now, that we don't have the time or the resources to watch out for and fight the really big screwings that they have in store for us... Some time soon, They'll just mandate CHITT certified ones with no increase in rates to help off set the expenses on purchasing, installing or maintaining these things. Well "they" can go to hell. BullChitt.

But to get back to the original theme of this thread: Vinny have you spoken with Jon (Have you been to the mountain?) and been given any indication as when this version 4 with the PM module is due to arrive??? And will it allow us users to use like other PM programs, with or without using the AC extra services like clearinghouse, billing service and all the like??? Thanks....

AC, like most applications can work on peer-to-peer as well as a server set up. With only a few users and computers, P2P can serve anyone's needs and is even more robust than client-server networks. With each added node (PC), you add more bandwidth and resources with a P2P. There are advantages and disadvantages to each, but I have simply always preferred using a central server. The advantages are many:

It is generally faster than a P2P. Servers generally have much faster throughput than a non-server PC.
It is built to be more redundant.
It allows for centralized resources. Anything that needs to be shared or accessed by any computer is on the server. Furthermore, if need be, you can assign permissions for each user. So, for instance, if you have a data entry clerk or a biller who you think does not need access to patient-sensitive information, you can block them from the AC database. You can decide who gets read and who gets read/write privileges. If you have many employees, you can utilize group policies so that a certain group, say "nurses" can have certain permissions, etc.
Some applications are run off the server, making it easy to do upgrades, therefore not having to upgrade each PC. AC can run on a server without any client software on the client machine.
Servers allow for a central point of remote access allowing for each and secure access for users at home (again only those allowed), but difficult access otherwise.
It is easy to make changes on all client machines from the server, i.e. nearly every change you can think of: wallpaper, screesaver, time to screensaver activation, use of the start menu, use of the control panel, etc., etc. can be changed from the server.
It is also helpful to know that ALL important data resides on the server and, therefore, backups back up all of the information.

Anyway, I will work on the other thing.

OK, done. I probably should have added more questions. That was the best I could do. If you want more survey questions, please post them here, and I will try to add them. Of course, I won't be able to add them after people post there.