Home Forums Discussions Problems v6.0.10 slower than 6.0.9

If you PM your email address, I'll send it to you.

If I had only known I would have stayed with v5.

Thank you, thank you, thank you for saying "prescription writer."

For anyone who missed the AC News email, you can download it here:

http://tinyurl.com/AC-News

It's a sad day when 25% of the board will be comments regarding Meaningless Use and 50% is negative comments most likely due to the incorporation of Meaningless Use.

I left 25% for normal comments about printers and backups and patient schedules. You know, the things that used to take up 100% of the board.

If this is true, I'll start my research right now! That's not an appropriate response.

Sounds like Mike Tyson's defense on the rape charge. "She knows I'm a dog, so if she came with me what did she expect.?"that's a paraphrase obviously. it amounts to 'we dont cost much because we're a crappy product." I don't see Jon saying that. but if he did....looks bad.

So far as I know, version 4 and 5 of AC are still available, and can be used by those who just want a simple EMR. So I don't see much point in all this carping.

Nonetheless, the Gummint has thrown down the gauntlet -- and tossed a bone just beyond it. We are all in this together. Trying to be meaningful, trying to be good doctors, trying to do what our Leaders have mandated -- and just trying to get through the day. And maybe get the brass ring if we stay on the merry-go-round long enough.

So, we go on with V. 5 and then V.6 and maybe someday, lucky 7 -- all the while hoping that something good this way will come.

My office is now a snarl of computers, laptops, tablets, scanners, printers -- things randomly don't talk to each other, and I am pushing the limits of Windows, hoping I don't have to break down and get server software and all that entails.

I vaguely remember the days when we had a pegboard accounting system, and patients paid their bills and collected from their insurance companies themselves. I am trying to be modern, but honestly, can't see that what we have is better for patients -- however much it is exciting and cutting edge and globalized. And, Lord knows, "meaningful."

Maybe we all need to take our tents and sleeping bags and go to Providence for an "Occupy AC" campout! Martin can bring his Dutch oven.

There have been no bug fixes on versions 4 & 5 (imported items, slow eRx), plus these versions don't have updated medication list either, so you can't eRx newer meds.

You can't abandon updates on your older versions if they are offered as the "lite" version of the main product.

Go here for the post.

Here is the first part of his comment on the slowness and support issue:

"But as much as it is frustrating to not be able to reach us when you need assistance, keep in mind the bigger picture:

1. Every one of our > 6500 clinicians has paid less than $1000/year for support, maintenance, and other features, compared to the common $1000/month that users of other EHRs pay to their systems (and/or allow their EHRs to sell their patient and practice data to pharma companies and God-knows-who-else in lieu of money from the clinician)."

John, you are correct that there are things in version 5.029 that don't work right and may have been fixed... we still have to print and then manually fax to Medco because the electronic address doesn't work and the preferred pharmacy does not save. New medicines won't codify, but they will still send. But for us, these issues are much less an issue than what is being reported, and Tom has a point. The real worry, however, is some change in the operating system via an automatic security upgrade or whatever that won't be supported, and could result in coming in to work to a non-functioning system.

Very interesting discussion,

I will add a few points

1. 6.0.10 is slowing down for me in the Erx / prescription writing department compared to when I first installed it last month - this is very concerning. I have restarted all the computers and done all the easy stuff but the slowness is starting to get worse.

2. It is gutsy of Jon Bertman to allow this board to be critical/unmoderated by AC staff. My PM software started something like this and they quietly discontinued the user board. I made some minor suggestion for improvement on their board and my comment was deleted. (my comment was nice) . I appreciate Jon Bertman's allowance of this. But if the user group explodes Jon may expode and delete the user group. This happened with me with General Electrics Medicalogic' internet EMR in the early 2000s. We were banned from our data and luckily had each others email addresses and were able to rally and get our data back.

3. Jon Bertman is probably upset reading all these comments. I was going to say turning over in his tanning bed while reading his kindle but felt that was tactless :-)

4. Bringing out the PM module in retrospect, should have been done long ago, or not all all. The PM module is 10 X more difficult that EMR, before meaningful use, maybe just 5 x more difficult now. However the PM module brings in much more money.

5. I feel I have to do meaningful use if I am going to continue to accept medicare, which since I have older population and more than 50% of my practice I must do. I either do it now and get a little bonus or NOT do it get hit with a stick later.

I, for one, am not going to alter or suppress my opinions for fear of censorship. I think Jon is a big enough man to accept criticism as well as praise. All of us have praised him in the past and will do so again when this all gets turned around.

5.17 fixed a lot of the issues that plagued 5029 and it has been fairly stable (at least no more likely to crash than was 5.029)

Hi all,

Let's try not to lose perspective. If I have been caring for a patient for five years, and I don't do very well on one visit, I hope the patient will look back on the past five years and not just at the last encounter. We all have bad days, and we all make bad decisions.

Over all, Amazing Charts has been amazingly good. For the price, it has been phenomenal.

Several years ago, I actually expected to have to change EMR's this year, because I did not expect AC to be able to meet Medicare's MU requirements. That AC has been able to do this, at only a minimal price increase, has been astounding.

Having said that, from the time of our August 1 upgrade to version 6, AC has been problematic, to say the least. My computer skills are probably about average for users of this board, which would probably make them considerably better than average for physicians in general. I do not use any outside IT consultant. I have not had to put too much additional money out (perhaps in the $2500 range) for hardware improvements. I don't really want to put a dollar value on the hours of time spent trying to troubleshoot, and just generally being slower.

AC is certainly having its growing pains, and they are significant. But we are able to function on v 6.0.10, and I believe we will be able to meet MU requirements for this year.

So I'm not ready to think about jumping ship at this point. In fact, ironically, I was at PriMed in Baltimore on about August 5 of this year, at the height of our slowness situation. Even then, I identified myself as a user, and highly recommended AC to several physicians who inquired at the AC booth.

I also phenomenally respect Jon for allowing this user board to continue with no restrictions or censorship.

I believe, based on AC over the past six years, that they will be able to turn things around.

I reserve the right to retract all of the above if v7 turns out to be a dog.

Gene

Bill, I agree 100%. But i have been a sysop on boards before and have seen members degrade into "your are evil and I am going to kill your family" type talk. I don't think we would do that here. We should just keep our criticism respectful.
p.s.
Why am I posting on this board during working hours? Meaningful Use catch up! Plus my staff are sparring about Halloween decorations posted in the office (OMG). I had a light day, so said, forget it, the office is closed today. We will have to have a "kumbaya" next week :-)

I couldn't agree more.

My patients would run as fast as they could to the nearest FQHC.

That would be like getting respect for listening to the lungs with someone having an asthma attack. If Jon ever censored my post, that would be it for me.

I would love to have an incredible EMR as I used to have along with Medisoft. What a great combination.

Well, I have upgraded to 6.10 and it seems faster.

Some of that may be due to the a faster server, but I have less delay in loading all pages. I did a couple of trial Rxes and they worked well.

The rubber will hit the road next week, but so far so good.

I did not read Jon's comment as "You get what you pay for" but I suppose it could be read that way. I know he does not feel that way.

I had to contact Guardian Angel due to a firewall glitch, they answered quickly and gave me some good basic advice. I really figured it out on my own but that is not knocking them.

So did you mention this slowness issue to them and get any reasonable answers???? Does it seem like they are aware of it, how upset and frustrated some folks are, and is there some sort of an effort being made to get a fix into everyone's hands in a fairly reasonable time period????

Actually they are quite aware of it. If you look at the variety of posts on the matter, they have some solutions but no universally effective solutions. I didn't mention it because it was not my issue at this time. Like I said, my interation of 6.10 was faster than 6.0.9 and that was OK. V 3,4,5 were faster. V1 was lightning. Each version has taken a speed hit.

Time frame? They are working on V7 being out 1rst qtr of 2012. Not sure where that leaves the slowness issue.

80/20 rule. My guess is 80% are satified. The 20% are the vocal ones, however.

Well, this am things were going really bad.....so we shut off the drug interactions. Problem solved. I have had the drug interactions on since I started eprescribing and writing scripts in AC over two years ago. I didn't have the problem before. I have done my 90 days and can attest to it so we just turned the interactions off. No slowing ...the rest of the day went very well with prescription writer and eprescribing and everything else.

This is phase 1 of meaningful use. Phase two is not necessarily going to happen next year. I think all these hiccups will need resolution before any government organization expects us to function like this for 12 months. I don't think these problems are unique to AC and I don't think they are AC problems.

Seems to me like this is all about the interactions. Has anyone actually had an interaction show up that they weren't already aware of??? Maybe midlevels??? It is bogus. It is just like all the old phone calls from the pharmacy. The no [censored] sherlock stuff that we are already aware of. Maybe these are handy reminders to some but to me, they are a waste of time. I have used epocrates or other drug info for years and years and years and have looked this stuff up already so many times. I am sometimes wondering why some interactions are not coming up.

We will figure out this problem when our busy season passes. I am very glad that I started doing the MU stuff July 15th. Upgraded to version 10 once I got green light and I have my numbers now so I'll just forget the interactions til we get a fix for it.

I believe 100% of our 'slowness' is in just two areas. Loading the labs from Quest, and the drug interactions. I have turned off Drug interactions and it definitely picks up the speed. I also have begun MOST of my work in the room with the patient running my laptop as a terminal for the server which makes a small improvement in the speed of opening labs.
Mostly I print the labs before I go in the room, and open the prior labs on a different computer so that when the labs come off the printer I can hand write in the prior values for items of interest, (The PSA or A1C or the lipids for example.)
Then when I go in the room I don't need the laps open and that speeds up the visit with the patient.
I do REALLY like drug interactions sometimes, especially when I reconcile the meds, and enter some chemotherapy agent or the latest anti-arhtyhmia drug that the specialist is Rxing.
Basically life is good.

I'd rather just go to epocrates when dealing with new meds and forget the interactions that make the writer so painfully slow. I can work faster and be more efficient. Now I'm dreading the lab connection. Glad I don't have it now.

I have finished the MU for the year - turning off the interactions did work for the scrip writer and will not be an issue until 1/1/12......I know this is not good for everyone, but is an option.

It does make the scrips much, much faster.

I don't post much here. But I am the IT support for a practice in Chicago (southside) and we they are also experiencing the script writing "slow down". I warned Doc of upgrading to a BETA when 0.9 came out, but the MU$ is what pushed him forward (majority Medicaid patients).
Having looked into this I was told that when using Terminal Services for front end the slow down issues are not present.

May be an option to:
A. Maintain older equipment
B. Fix the slowness issues
C. Allow for low cost expansion of terminals and installation issues.

Anyone have a similar configuration that works this way?

Army

Good to know, Bill, but the potential non-support for OS changes remains the same. I would not expect upward support for other than the most current version.

Well Leslie, I bit the bullet and upgrade to v6 some time ago. It has some different stuff, some irritating things, and is a bit slower. But, honestly, my office didn't really miss a beat. We do things the same way. We use AC the same way. We actually think the eRx works much better and use it much more frequently now.

The meds entry is slow and irritating to me. It demands that I know the patients meds but we've figured out a workaround. Sometimes I don't have their meds. Most times I don't have their dosages. I don't know which type of metoprolol they take and neither do they. But that's ok.

A lot of this MU is crap and worthless. My staff is doing the minimum possible. We really just want a good EMR. The amount of money CMS is supposedly giving me sometimes doesn't seem worth the pain.

There once was this car. It wasn't working well, so it went very slowly. Then it came upon a hill. And, just as you would think, it got even slower. Then it got over the hill, and got faster again, but still as slow as was before. Great story.

It seems obvious to me that med interactions would slow down the prescription writer. But, I think many of us are having issues whether we have interactions on or not. In fact, interactions doesn't slow mine down at all.

Not sure about terminal services speeding it up, but logmein running remote will speed up the system. Have you tried the other fixes with turning off hardware acceleration and such. They do help. While I have upgraded to dual cores, some of my P4s remain and work at an acceptable speed.

I am also on the Southside of Chicago. Perhaps we should talk. You can send me a PM for more details.

I think what a lot of people currently on the boards may not realize is that, although AC works for them, AC works no where nearly as wonderfully as it once did. Sometimes technology is necessary but, I for one, still like the feel and smell of a good book in my hand. Medicine is hard enough, running one's office is like running through the trenches, I really cannot afford the aggravation caused by all the little "irritating things" in my EMR. A surgeon for whom I worked back in the 70"s taught me something I have never forgotten..."Never put yourself at a disadvantage", e.g make sure you have all the instruments you may ever need, make sure the light is focused where it should be, make sure your incision is adequate for you to find the problem and make sure the people in the room with you know their jobs and listen to what you need from them. I cannot tell you how many times that phrase has kept me out of trouble.

Hi all, to get back to the topic.....

v6.0.10 is intermittently slower, sometimes much slower. I thought we had the "Slow screen painting, line by line" solved, but this will intermittently and randomly surface. OS (Win 7 vs XP), processor speed, wired or wireless, no correlation with any of these.

Overall, seems slower now than 2 weeks ago.

Gene

Back to the topic? When did we leave it?

Hi Bert,

I guess I'm feeling a little concrete today.....

But .10 is worse this week than it was last week.

Gene

Well...there's always next week.

Maybe we should roll back to last week.
Do we use the calendar tuner for that?

Hi Jon,

Can we roll back to 1987??

Gene

Gene,

I think we need to roll back even farther than that. 1987 was too close to the HMO/capitation days. How about 1977?

To Captain and Tennille?

Muskrat love.