Home Forums Discussions Problems Just upgraded/ Write Scripts problem

Hi all,

Just upgraded to v6 last night. Seemed to go well. Today I have been using the system, and notice this:

At the main computer, prescription writing screen will open quickly and look normal. (Windows 7 Pro, i7 processor)

From all other computers, including a hard wired i5 machine (Windows XP Pro), most areas of AC are fine, speed about the same as v5. BUT when you hit the "Write Scripts" button, the Rx screen comes up very very slowly, line by line. After a painful wait, the screen is there, but the grid lines normally present in the "Current meds" and "Interactions" section are not present. So it looks goofy, to say the least. To open individual meds etc is very slow.

Any thoughts? Thanks. Gene

Update:

Just turned off interaction checking, a little faster, but still no grid lines. !!??!?

Gene

Tech support told me that the problem will be fixed in version 6.10 coming out "soon." I wonder if upgrading from XP to Win7 would help in the meanwhile.

Doubtful.

This is sad. I'm doing a demo on Amazing Charts for a local doc (his request) today and I'm not going to be able to demo the V6 because it has too many bugs in the prescription writer section.
He'll probably go with another EMR.

This only happwns on one ofmy older xp pro machines and it appears to be due to memory and a graphics card issue. I have been usig ver 6 for a long time and really have not had any issues

Ken and Gene,
Could you let us know what machines you are using? Like Steven, we have only experienced this on some older, slower Pentium machines, and not on newer ones running XP (or 7).

Steven, while our experience has been like yours, the number of people having these issues is causing me to re-assess things a little. At first I thought that the problem was relatively rare and only associated with certain slower machines. Now I am beginning to think that we were just lucky to not have eRx and install problems with V6.

Hi Jon,

Now about 6 patient hours into v6, about ready to switch professions.... But not into IT.

Overall v6 seems good, overall a little faster than v5, EXCEPT rxs.

At main computer (Windows 7 pro, i7 processor), everything, including rx, including erx PERFECT. Speed is no problem.

All network computers, all of which are Win XP pro, are very slow opening rx window, opening rx print screen, and erxing- and this is with interaction checking OFF. Some are wireless laptops, some older Pentium 4 single or dual core, but 2 are new, 1 i3 and 1 i5 processor, all equally slow. All with 3-4 gigs memory.

So slowness is either from networking, or from XP, cannot separate these.

I am intrigued by Stevens comments, wonder if video card would help the desktops?

Thanks. Gene

Jon,
I was using beta 6.0.9 and was having all sorts of problems/slowness on the prescription writer module using Windows XP Pro SP3 machines, which some of which were using the hardware only 2-3 years old with 3 GB of RAM and dual core processors. Let me say again, it wasn't just a little slow, it was unusable (so I rolled back to 5.1.7 and the speed is wonderful). The fact that people are reporting that the main computer sometimes works and that remote login as a workaround suggests that the problem is with AC 6 programming requesting too many database queries over the network. I am not a programmer (so this is just a guess), so I can't be more specific. It's like the program is not loading all the information regarding the medicines at once. I suspect AC 6.0.9 is querying the database and saying. Ok the patient is on lisinopril. (Takes one second to query the database, a normal time). What is the dose? (takes one second). It's ten milligrams (wait one second). What is the sig? (wait one second). How many refills (wait one second). You get the picture.

I have since upgraded my office to ALL Windows 7 Pro computers with at least 4 GB of RAM and a gigabit switch. However, I am not going to upgrade to V6 till I hear that the prescription module is working at a reasonable speed and that it works with the Star TSP800 RX printer.

*****UPDATE****

Just borrowed a laptop with Win7Enterprise, installed AC v6.0.09 (installation was not very smooth, it hung and I had to reboot computer), a little hard to find main AC database under Win 7, then ran AC, opened a patient chart, hit Rx box, and.....

It worked perfectly. Normal speed. Normal appearance of screen.

At least for us, this truly appears to be a Win XP issue.

Anyone know where to get about a dozen Win 7 Pro upgrades cheap?

Thanks.

Gene

The least expensive I have purchased a Win 7 Pro upgrade was on eBay for under $100.

Amazon has the full version for $140.

Ken and Gene,
Thanks for posting your details. I think Steven and I had originally reached the same conclusion, that the issue was with slower machines running XP. The above examples would suggest it is not that simple. I may be totally off-base here, but I would agree with Ken's hypothesis that the issue is too many queries; perhaps V7 handles networking in a way that avoids the problem.
One choice is to wait for V6.10,and I suppose you can't lose with that. (Though there is no guarantee that version will fix the problem). Another is to upgrade all machines to V7. No guarantees there either...of course if Ken would be willing to take the plunge with his new "All-7" network, his result would be very informative.

I just got 6 Dell Vostro Win 7 Pro boxes and 4 21 inch monitors for under $3000. As most of you know, Dell is always having a sale that ends in 3 days :-)

In my experience, it is a better deal to just get new hardware than try to upgrade the operating system on an old system. I sold my old XP3 boxes off to the employees for $50 including 17" flatscreen LCD monitors. They were happy to get the deal and the systems are more than adequate for web surfing , email ,facebook, etc.

Ken,
I fully agree. On the other hand, note that Gene has about a dozen machines, some of which are i3 and i5. That changes the calculation a bit.

So are you willing to "take one for the team" and fire up 6.09 on your new network, and let us know the result?

Jon,
Oh, I don't know if I have the stamina for a 6.09 install again. However, I will be willing to install 6.10. I'll just have to have a "lifeline" to INDY if I run into problems!

I will say again 5.1.7 is running even more smoothly with my current setup. My receptionist almost hugged me due to her new machine compared to her old 2002 Dimension XP box. (before you feel sorry for her I did upgrade the memory and ceased making her put in data with punched cards)

Hi all,

Thanks to Steven for bringing up graphic cards!!

In desperation, I bought a PNY GeForce 8400 GS video card (why this one? Cheapest card at the local Staples) and installed it into an Optiplex 745 c Pentium D 3.4 processor (dual core I believe) running XP Pro. This is one of the better older PCs, which was running script writer VERY VERY slowly.

HUGE improvement in speed!! Just as fast as v5 was!!

So I may still have to buy new laptops, but desktops may be usable.

Thanks for all the comments. Gene

Hi Everyone,

Hmmm?.

I?m going to make some educated guesses according to some helpful clues, from others. All this still boils down to the source code behind the prescription writer in v6.0.9, and maybe earlier.

PROS:

1.) eRx runs better and faster on main (or networked) PC(s) with Windows 7, with very good processor speed (dual or quad core, 2.0 Ghz or faster), and adequate memory (4GB or more).

2.) eRx runs better with improved graphics card (video card) on PC(s) running Windows XP, with very good processor speed (dual or quad core, 2.0 Ghz or faster), and adequate memory (2GB or better).

CONS:

1.) eRx runs horrifically slow on PCs with Windows XP, with decent, but single-core processor (P4 2.0 Ghz or better), and adequate memory (2GB or better).

That?s what mostly everyone is saying.

Ok, I?m going to write English and not technical jargon. What I believe is happening with the prescription writer is, it?s trying to draw out each row item in the grid?s view. What I mean by ?draw out? is the source code behind the eRx window is physically trying to draw the grid graphically, along with the querying of data. This is where it?s using more PC resources than it should.

The problem is: with the source code behind the prescription writer module or window. That?s what I believe is putting the toll on hardware. AC programmers would have to tweak the code to make it run, universally faster on both Windows XP and 7. Now, depending on how the code is written, it may not be as simple to fix.

I hope this will help.

OK. It is difficult for me to compare because all my machines run WIN 7 Pro, Intel i72600k, 8GBs RAM and ridulously fast graphics cards. The lowest WEI scores are 7.4 and the highest is 7.8, 0.1 off for memory. So, I can't tell, because on the machines I have played with, the ePrescribe is split second fast.

After reading all of these posts, I have pretty much come to the conclusion that it may be a SQL problem. One shouldn't have to have a super fast processor or RAM to ePrescribe. The SQL theory given above of getting Lisinopril, then sig, then amount would take longer, but I don't see why an application to SQL database that pulls all of the demograpic data at once, etc. would all of a sudden query the database in this fashion.

The other weird thing is if we are all doing trial and errors or upgrading and coming up with theories, then why would the place with hundreds of sandboxes and tons of code not know what is going on and filling us in?

WIN 7 is better at networking than XP Pro, but I don't think that carries over to working with SQL.

Sorry about the bragging. Just have a friend who knows someone who...kind of like REO Speedwagon.

Jeez Bert, all your machines have 2600Ks and 8GB of RAM and you left out the SSDs. That's some serious overkill.

Yes, Bert. The concluding and underlining problem is with SQL. What one has to take in consideration is the code written to make the calls to use SQL and the database.

For example: programmer 1 has written code (a function or method call) to query the demographics table from a SQL database may not be in the same style (logic), as programmer 2, that has written code for the prescription writer, which has to make similar query calls to the same SQL database.

In other words, the programming is inconsistent, or off base. If programming standards are not followed throughout a product design or enhancement, things could get real ugly. Optimization problems like speed and performance will take a huge hit. I?m just speaking from experience.

The good news is I believe they will get it right. It?ll take a little time and cleaning up.

P.S. Bert, you have a Ferrari of PCs my friend. You are completely exempt from all topics about speed and performance.

Oh yeah, the SSDs. Forgot. True, but I had a good deal.

I am using 6.09. It took me 15 minutes to do 8 Rx refills today. It takes an average of 30-60 seconds to open a chart. I have dozens of unfinished charts, my office staff morale is at an all time low and my wife and I argue all the time. . Tech support states that installing Microsoft .NET Framework 4 will fix the problem. Unfortunately, they will not assist in doing this without an appointment and my IT person ($125/hour) cannot seem to get the appointment person to return calls or emails.

I am considering closing my solo practice because I believe that unless one has a full time dedicated IT person, amazing charts, and probably any EMR is not a viable option.

Hi DJW,

I started this thread. What kind of computers/how old/ what operating systems? Wired or wireless? Please post any info that you have. We will try to help....

I think (I hope) that new video cards will cure our desktops, we will probably have to buy new laptops.

Gene

dual-core AMD opteron processor 8220 5gb memory. Using exchange server with thin clients, dsl, etc. I assume that my server hosts have amazingly powerful computers. I had none of these problems with version 5.I am solo doc and see all pts in their homes. I use a verizon mifi card to connect with my cloud server.

http://msdn.microsoft.com/en-us/netframework/aa569263

Well, here is your .NET Framework 4.

You shouldn't need a full-time IT person to run AC. Just read a little and let us do the rest.

And, $125 per hour is a bit much.

DJW,
I think I speak for many others when I say that we sympathize, and hate to see you suffering like this. There are lots of ways to diagnose and approach this. From where I sit, I would make one single suggestion: roll back to version 5.x and regroup. Wait for others (AC in particular) to fix the problems which apparently did not occur until you went to V6. Don't beat your head against the wall! It is not you, it is the software.

I run Win 7pro on a toaster-grade box (dual core, 3g memory, graphic on the motherboard as the "server". We have about 8-9 other various laptops and desktops and print servers and such networked by LAN and WiFi. Spaghetti-grade networking by "IT pro" yours truly

The RxWriter works acceptably fast most of the time. No other issues, except that AC just mysteriously crashes from time to time.

It is often slow when I use a tablet computer (Motion LE1700) in an exam room with WiFi, so recently I have changed to just running AC from my "server" and hooking to it with the tablet by Remote Desktop. This keeps most of the calls to the database off the network, and speeds things up.

Of course, this could only work with a solo practice, since only one person can use the terminal at the "server" at any given time.

On the other hand, the rest of the staff doesn't really experience speed issues -- so I have to think it is mostly a RxWriter problem, and mostly when it is networked.

Jon is correct. But, and please don't take this the wrong way -- I am trying to help -- but I do not understand your setup. It would be easier if you were more specific. What does using thin clients with Exchange Server mean. Exchange is an email server which must be housed in a server operating system. It does nothing but handle mail. Also, what are your server hosts? Yes, anything that is being hosted by a company online will likely have very fast computers, but I am not sure how you are using them.

A few posts here have attributed it to slow graphics card performance. Would that make sense? I have a hard enough time with the human hardware that comes in the office. I'm really bewildered by this.

It really should at least be noted on the "most common issues" on the download page.

When my computers have strange intermittent freezes, the first two things I think about is the graphics card and the PSU. And, I hope it is one of them and not the motherboard or something more frustrating.

In theory I could see RAM (doubtful), processor (maybe) SQL (very maybe) causing this issue. Of course, it could simply be just a very buggy part of the program, but some are having luck with the above.

I just don't see how a graphics card could slow it down. During all this time, I have not seen (maybe it is on here) what part of ePrescribe is slow. Opening it up? Writing the script? Preparing it? Sending it. One test would be (depending on the place where the problem is would be to start Camstudio and have it running, set the mouse on the right button, then remove the DVI or VGA cable from the computer. Has anyone tried using the onboard VGA? Of course, one could just go out and get or borrow a $300 card and time ePrescribe, then time it after the card, then go to another computer.

But, I should be able to test it this weekend as I will have two ways of doing so. Most of my computers have graphics and gaming graphics with WEI scores of 5.2 average. They should have no problem. Of course they are couple with 8GB of RAM, the SSDs and the i7s, so that may skew things given all the theories about processors. I also have the bookends. I have one with a WEI score of 1 for the video cards with 32-bit and a rather mediocre processor. On the high end, I have a graphics card that scored 7.9 on both Windows Aero Graphics and Gaming graphics. 7.9 is the highest score. This computer has the i7 2600k, (really wanted to go with a Xenon W3690 but I had to limit my budget somewhere}, a 240GB SATA III 6Gb/s SSD and 8GBs of RAM and the nVidia GTX 570, hence the 7.9s.

Just for reference, on the PassMark scores the i7-2600k gets 9568, the 2600 gets 8878. The Xeon mentioned scores 11179 and is the highest-rated desktop processor currently. It would have scored a 7.9. I guess a PassMark score of 8568 is only good enough for 7.8 without overclocking.

I plan on installing v6 this weekend and may upgrade SQL. I am installing it with my SQL expert friend remotely. I am purposely going to ePrescribe on the three sets of computers, take notes on speeds, then have Raja look at the connections to SQL Express first. Should be interesting.

What do people see on their servers, not main computers. I would imagine that video cards on servers would be rather cheap.

Can someone tell me the exact point or what seems to be the area of slowdown. I think between Rob, Gary and Raja, I may be able to do some testing this weekend.

Hi Bert,

EVERYTHING involving rxing is slow. As soon as the rx window is clicked, speed drops way down. Then any manipulation- view history of med, view inactive, add new, activate, inactivate, print, delete, erx, whatever- everything is very slow. The screen paints line by line, or box by box. Same is true if you click the Medications box, everything that follows is painfully slow. To delete a single med is time consuming, to delete several takes an eternity. All of the above is with interactions checking turned off. Interestingly, the appearance is a bit distorted, too. Instead of using dark lines to form boxes between meds, light lines (??ghost from prior screen) are in their place.

Orders, messages, forwarding charts, etc all relatively OK.

Thanks for your efforts! Gene

Hi Gene

Thanks. That helps. That sort of reminds me of remoting into my computer at work with remote desktop and an application will show up an inch at a time due to refresh issues.

So this seems to change everything. Obviously, it's an application problem. Now whether it is due to the code only or how the code allows it to query data from SQL is the question. Again, if it is supposed to be fixed in 6.0.10, then why doesn't AC come out and say what the problem is.

The issue is reproducing the error. The only version 6 I have is running on an XP Pro VM, BUT, again, and saving the bragging this time, the virtual machine is running on my personal super computer. This is why if I install on all machines, I may see an issue.

Going back to the top, it would also seems if there were a problem as you describe where it paints line by line, then a faster processor would do that more quickly.

Are you having issues on all your machines? Or enough that it is frustrating? If Raja (SQL friend and definitely an expert -- that is all he does) is able to see the or a problem, it may be helpful if he remotes into other people's computers to see if the fix he finds works.

Hi DJW,

I'm sorry to hear about your story. This software issue doesn't help much either. I can imagine this really suck right about now.


I would be glad to assist you with the download, if you want at no charge. Just send me a Private Message (PM). I am a .Net developer. I know about the Microsoft Visual Studio frameworks. Now, I know a lot more of what's going on with this tidbit.

Yes, Bert has provided the helpful link to download MS .Net Framework 4.0. But, tech support should have jumped for joy to help with this situation, especially, if they claim it would solved the problem, right? The .Net Framework 4.0 should be a part of AC's install package. They know this is a crucial piece needed to run their new modules in v6.0.9.

As one of the prerequisites, the installer suppose to detect on a PC if a .Net Framework is installed, if not the installer would install the latest .Net Framework (2.0,3.0,3.5 or 4.0) automatically, along with AC's application to run on and properly.

The .Net Framework is too technical and complicated for the average person. It's for programmers who are developing application using .Net technology to run a .Net framework for the windows operating system.

The head folks at AC should be telling you guys something. What is going on? This is getting wayyy...too confusing over some bugs in v6.0.9.

P.S. The .Net Framework 4.0 comes installed with Windows 7 PCs. It does not come installed with Windows XP PCs. Dr. John (ryanjo) has provided decent links to check out, too, in his above post.

Hi Bert,

This may be redundant but my summary:

Main computer Win 7 Pro i7 everything runs well, nice and fast

networked laptop, old laptop but upgraded to Win 7 runs very well

ANY networked Win XP Pro slow for anything involving rx. The slower the processor the slower, the faster processor (i5) not nearly as slow but still much slower than Win 7.

When I put a new video card in Win XP Pro machine, very very much faster for rxing.

My conclusions- either Win 7 or new video card brings big inprovement. Processor speed is a much less important factor.

All computers 2-3 megs RAM, main computer 12 megs.

Hope this helps. Gene

Bert, I didn't your recent posts. Like you I am quite curious now.

That is exactly what's bothersome.

@Lawrence Thanks for helping out Lawrence. I think you are dead on.

@Gene Thanks for the input. I can't argue with your observations as you have trialed them and they seem to work. Certainly, I could see WIN 7 and a processor (kind of) helping. Why do you think the graphics card helps? Do you think it helps with the redrawing of the lines or whatever was stated above.

The craziness of this would be like Microsoft putting out Office 12.0 and Word being very slow and all the users trying to figure out how to speed it up and what is wrong with it.

If this is to be fixed in 6.0.10, why wouldn't AC say something like, "Due to major issues with ePrescribing in version 6.0.9 with actual showstopper bugs (although that is generally during beta testing), we recommend not updating until it is fixed. We are taking it down off the website until this is resolved. We apologize for the inconvenience.

CAVEAT: THIS IS MY SUGGESTION. THIS IS NOT WHAT THE COMPANY, AMAZING CHARTS SAID.

My pleasure, Bert. We all are dead on.

Very good analogy! That's how serious this is. AC has this thread and others to piece a solution together now. We'll wait see what happens. Although, my curiosity has been sparked.