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I have moved to the cloud. Made an appt c guardian angels and Mike signed on this morning. It was quite easy. A small icon had to be put on each computer. My database flew up to the cloud in no time. The imported items took a few hours to get across. So far, I can tell no difference from my server based network. I can access imported items just as quickly, the notes come up just as fast. I have a screen resolution issue on one computer (see separate post)but other than that it seems good so far. I will keep you posted.

How are the printers working for prescriptions? If you use one.

I moved to the ac hosted cloud solution about two months ago and am very pleased. A few comments:

1. The speed is perfectly acceptable. Including for the opening of imported items. I was worried that opening large imported items would take a long time to download, but that was because I misunderstood how the cloud solution works. It's basically a remote desktop solution, so the imported items get opened on the host and the image of the file gets transmitted, not the whole file.

2. This means that any application you use to open an imported item must be present on the host. Not a big deal, though I used to use adobe acrobat rather than adobe reader (which is used on the cloud); I used to be able to edit my imported pdf's that way, can't do it anymore; not a big problem but surprised me initially. And if anyone has a custom application to use on imported items, it would have to be installed on the cloud to work (you could always download the item to your computer, use the application and then upload it again if necessary, but that would be a bit time-consuming).

3. I have found the connection gets interrupted anywhere from zero to two or three times a day. I was told it would be due to a hiccup in my internet connection; not sure about that. At any rate, when it happens the reconnection is automatic, a screen saying attempting reconnect pops up and within about 30 seconds I'm back where I had been.

4. Customer support has been good and very responsive so far. It's a pleasure not having to worry that when the system goes down, I'm the one responsible. All I have to do is make sure I have an internet connection, and the rest is their responsibility.

5. The cost depends on the number of simultaneous connections you need, not on the number of users you can have. I'm pretty much a solo operation when it comes to the EMR, so I got away with one connection. I use it at work and then at home. When I went on vacation I added a second connection so my coverage could log on and I could too at the same time without booting him off the computer unexpectedly. Adding the connection was quick and easy. If you have a setup where three or four or more need to be able to access the system simultaneously, it could get pricey.

6. Printing locally from the cloud took a bit of doing. When I first set up the system, I was able to print to my old HP printer without a problem. I then bought a new HP printer, and it just wouldn't work. Support then had to install a utility call tsprint on the host and a client for my desktop computer, which ultimately solved the problem.

All in all I'm happy with the service.

Michael
New York, NY

Bill or Michael,

Can you back your database up locally if you want to?

If your nurse is connected at the same time as you are, does that kick you off with one user?

Also, if one uses lytec for scheduling and billing on site, do you see any issue with using AC in the cloud integrating with the on site lytec?

jimmie,

Not an expert, but:

Backing up your database locally, depends on what you mean by locally. The database itself is on a hosted server, so you can back it up "locally" on that server. You might be able to back it up to your actual local hard drive, but I think that would be complicated. I haven't cancelled my backup subscription to AC, so the database (but not the imported items) gets backed up daily from the cloud hosting to AC itself, but that's probably overkill. Seems to me that a commercial hosting service like the one AC cloud uses should be backing up frequently and safely. I hope I'm right. And since I no longer back up the imported items like I used to when it was running in my office, I am depending on the hosting service.

If someone else (like your nurse) is connected and a second person logs on from another computer, the first person gets unceremoniously kicked off with a notification. I believe that when that second person logs on, the program will resume exactly where the first person was, without losing their information and without having to log back into the AC program, but I'm not 100% sure about that. Again, there can only be one person logged on per connection. You purchase the number of connections.

As for integrating with a billing service, no idea how that would work.

Michael

Jimmie, In the interest of getting you some answers, I can tell you how we do it.


Absolutely. We encourage the Doctors to pull down a backup regularly in the event of firestorm, hurricane, etc so that they have a local copy of the database when power and Internet are disrupted.

Depends on how it is configured. We have some practices that only want each long used once, and others where they want to just use a pool of connections. In that case you'll get notified that there are no more connections left.

We have clients with all kinds of interfaces or connections, some run across a VPN to another location, some run from the server instance - it just depends on what the practice needs.

Michael and Indy,

Thanks as I appreciate your willingness to discuss this, as I have a partner who may be interested in this approach.

If I come up to visit does this mean I get to go gopher-thumping?

Absolutely, and if you would like to harangue a rattlesnake or two, we can make that happen too. My partner has seen 6 in her yard this past week.

I hate snakes. The only good snake is a dead snake.

Sounds like I should bring Uncle Mossy along - he has a long history of snake charming.

http://www.youtube.com/watch?v=dL3ZIc5IL2w

Indy,

My partner just told me her neighbor found a 6 footer the other night. Which is highly unusual as the prairie rattler usually maxes out at about 3 and a half foot.

Sorry Bill--down in New Mexico I bet you have many more flavors than just the prairie rattler.
But I recall you have been using Updox, and how does Updox work with the hosted AC?

Is this a trait common to people named Indy?

Gene

The largest I have ever done with Uncle Mossy was a diamond back over 6'. Might have been closer to 7, but she was coiled when I hit her, so there were lots of chunks missing.

I would need to go over the list, but I think that ~98% of our clients run Updox. The larger group practices run with a connector running in both their office and in the managed instance.

Not how I got the nickname, but apparently there is a connection.

Re: Updox

Updox works great with AC cloud.
The connector runs on the host, so when you upload something to a chart using Updox, it works seamlessly.

In fact, I think it's even more helpful with the hosted service.
Importing an item using the Imported Items file upload can take a while if it's a large file, since it has to be uploaded via the internet, and AC seems to be monopolized while that's taking place, so you're sort of stuck while it's going on. With Updox, you just tell it to transfer to the EMR and everything happens in the background.

Michael

Truth be known, I married my wife for her guns, '90 Ranger extended cab truck, and tools, so we have a nice little 20 guauge for home protection and rattlesnake defense. We are partial to the bull snakes, as they keep the gopher holes limited a bit.

And thanks Michael.

So far, everything is working well. If anything, I think Updox and the Rx writer are faster. Everything else is unchanged. I was having a bunch of freezing issues with my computers that have not occurred in my vast 24 hour experience. I got a refund for my back up subscription. I am counting on them to back everything up. Life is a gamble. I am also taking my chances on the hurricane scenario.
I seem to have largely solved the resolution issue on the one computer by simply lowering the resolution and resizing the updox editor screen. Not perfect but certainly acceptable.

I am in the trial period (28 days) so I signed up for 5 connections. I would love to figure out how to reduce that. 1 connection each for my 2 exam rooms, 1 in my office and 1 each for my 2 MAs/receptionists. Unless you have no staff I don't see how you could get by with one connection but I'd like to hear how you do it.

I have a very small practice and share front desk staff with another MD.
I'm the only one who uses the EMR; I enter the demographics myself, which isn't very hard since I don't enter the insurance information in AC.

As for exam room / consult room, I do something different: I use Logmein to log onto my consult room computer from the exam room. I don't do much entering of data in the exam room, usually just vital signs, but I like to be able to review stuff like labs, ekg's etc in the exam room, so that works out. This has the added advantage that whatever I type in the exam room goes straight into the AC chart which is based in the consult room. So I don't have to do any saving in one room and reopening in the other.

Michael

That sounds like a Wendell idea, one of the best tips I have ever gotten from the user board for efficiency

Money saving too!!
I am going to try that.
Thanks

Bill,

I use a laptop (gigabyte switch wifi) running my "server" with my laptop and cuts out the needless signing on and off and HIPAA forgot to turn my computer screen off in exam room issues.
It is not perfect, but it works.
I primarily use my laptop to use the knowledge Base tab, Write Order tab and Write Scripts tab, and Decision Support tab in the exam room, and dictate on my "server" in my office.

Anyone use AC in the cloud and EZ claim ? I called EZ claim and they told me that I have to buy their cloud version of EZ claim in order to use EZ claim in the cloud with AC. Is this true? This can get expensive to switch to the cloud!

We have had clients using EZClaims, and they continued to use their desktop installation without changing.

I suspect that they were either mistaken, or of a mind to sell you an 'upgrade'. YMMV

Indy,
Do you know how that is done? Derek at AC told me that I have to upload EZ claim to the cloud server, so this is why I called EZ claim to ask them how to do this and they told me i needed to buy the cloud version? Do I need to upload EZ claim software to the cloud? or can I just keep using it on my desk top? All I do for my billing is import from AC to EZ claim on my desktop. Can this still be done this way with the cloud?