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#57951 11/07/2013 3:42 PM
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ErinB Offline OP
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We are a solo practioner in Idaho. To date we are using AC on a server (really just a desktop dedicated) and are quickly running out of space. Secondly we have been using data entry to transfer billing from AC to Medisoft 12 to eclaims to Availity. Last May a physician in our community transferred to out and we took over a large portion of his practice. Great for us, but be careful what you wish for. We have hired new staff, cross trained staff and I am working 60 hours a week.....something has to be done.

My choices are an expensive server upgrade or moving to the cloud? So I am looking to moving to AC in Cloud? Thoughts?

I have been waiting for the PM part of AC to come out instead of the expensive upgrade for MEdisoft, so now do I connect with the new PM software now or wait until it is intergrated later in the year? Any thoughts on this new product?

How difficult are these transitions? I want to get it done before we are slammed in cold and flu season, and it seems like everytime we try something new the hitches are just debilitating. I use a great IT guy, but I would have to say he is not up on AC....but the computer end of it he rocks.

Oh lordy, don't even get me going on the other changes coming down the pike.

Erin


Erin Bonine
Practice Manager

This is the day the Lord hath made, I will be glad and rejoice in it. Now I will simply get out of bed and try hard to make that true!
ErinB #57952 11/07/2013 3:52 PM
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If you want to move to the cloud, I HIGHLY RECOMMEND going to the website below and giving the guy there a shout. He's an excellent fellow and will treat you right.

www.bestforyourpractice.com

JamesNT


James Summerlin
My personal site: http://www.dataintegrationsolutions.net
james@dataintegrationsolutions.net
ErinB #57953 11/07/2013 3:53 PM
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Hi Erin,

My vote is AC cloud and upgrade MediSoft.

Overwhelmed! is the reason why. Don't take on more stress.

If you have a great IT company who can give you a turnkey client/server set up, then that might be the right answer. Money is not the problem, too much change is the problem.

Definitely do not put your office through a PM change on top of all the stress you have, or you will be working 100+ hour weeks, and possibly get dwindling revenues until you have mastered it all.

You will survive!



Dan
Rheumatology
JamesNT #57955 11/07/2013 4:02 PM
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ErinB Offline OP
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THanks...I like what I see!


Erin Bonine
Practice Manager

This is the day the Lord hath made, I will be glad and rejoice in it. Now I will simply get out of bed and try hard to make that true!
ErinB #57956 11/07/2013 4:18 PM
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Why are you running out of space?

It may be as simple as deleting backups.

This (server running out of space) is one of your "pressing?" needs to move forward, but will it save you time if this issue is fixed. Certainly upgrading your server is going to take an investment of time and money.

Cloud may simplify some time demands, but will still take some investment of time with transition. Perhaps short term getting IT help may allow you breathing room to determine the best long term solution.

Where is your time being used up, and how can you modify the overall system to improve it. Integrating billing may help, but many people here that do double entry billing state it is not a big time drain. If you change billing programs it will take time to learn a new system. If you outsource to a company it will possibly cost more money.

AC has a PM partner that won't probably be in place until the summer, although apparently you can work with them now expecting better integration in the future.

I would currently vote for getting IT help to get the server stable (more space) and consider short term investment in upgrading Medisoft (a program you know.) While all this is going on you can look for a longer term solution. If you have more than one location as a result of the integration of the other physician, cloud may make more sense.


Wendell
Pediatrician in Chicago

The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
ErinB #57972 11/07/2013 7:12 PM
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Erin,

Where do you back up Amazing Charts? I'm with Wendell as far as maybe it's as simple as deleting old backups.


Marty
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Fullerton, CA
ErinB #57978 11/07/2013 9:38 PM
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No to cloud. You want full control. You should not trust YOUR business even to Apple, not mentioning AC.

ErinB #57980 11/08/2013 12:43 AM
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We are backing up on the server, so I think you all are right! Indy was sweet and called me today and we are getting together to chat tomorrow to discuss some options. Wendell, my time currently is being absorbed by a lot of differing demands, one new employee who just isn't catching on and requires a lot of hand holding, having to act as triage nurse as our nurse is so busy with patients and return calls that she just cant do much more and then everything else that a practice demands...accounting, contracts...etc. The data entry isn't so time consuming as it is annoying...hoping to automate that a bit, but don't think xlink will support v12 medisoft.
Thanks for all your help and mostly for understanding!


Erin Bonine
Practice Manager

This is the day the Lord hath made, I will be glad and rejoice in it. Now I will simply get out of bed and try hard to make that true!
ErinB #58014 11/10/2013 2:34 AM
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I don't know as much about all of the billing software, but the size issue is as simple as adding a hard drive, installing an OS and moving AC to that drive. Or just to another computer.

I do have one question that I can't understand. It sounds like your IT support is great with computers. How up do you have to be on AC?


Bert
Pediatrics
Brewer, Maine

ErinB #58020 11/10/2013 12:15 PM
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I think getting your current system running smoothly may be simpler than going to the cloud. Probably the biggest difference in the cloud is decrease in tech support, but you have a good IT person. It might've something to consider, but get your other problems solved first.

Since the data entry issue is not a significantly time you have some time to get your future billing options together. If it ain't broke.... Yes, you will need something better in the future, but take one step at a time.

Hopefully your current space problems will be solved by paring back old backups. If this is the case, you can then focus on the other 59 hous in the work week. You will need to address these issues in the not too distant future, but can parcel out time to get it done


Wendell
Pediatrician in Chicago

The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
ErinB #58419 11/25/2013 1:18 PM
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ErinB Offline OP
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Okay...so some problems solved, some not. I am going to go in and delete some backups...do I delete the enc files?

Thanks!

Never mind...talked with chat and we did it! Thanks. Removed 2 years worth of backups...bet my AC runs smoothly.


Erin Bonine
Practice Manager

This is the day the Lord hath made, I will be glad and rejoice in it. Now I will simply get out of bed and try hard to make that true!
ErinB #58420 11/25/2013 1:22 PM
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Originally Posted by ErinB
Okay...so some problems solved, some not. I am going to go in and delete some backups...do I delete the enc files?

Thanks!

That's correct. For simplicity's sake use this rule of thumb, keep the last few days, one from each week of the last month, and then keep the backup from the first of each month.

Especially when practices get started, they find from time-to-time that they deleted something, and need to go back and find a deleted chart.


Indy
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ErinB #58439 11/25/2013 4:24 PM
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I recommend you plug in an external hard drive and have the AC backup program direct future backups there. I found a nice RAID solution that would be easy for you. Get the G-Safe below and plug it in, but also get the 3rd backup drive. Once your backup is done, you can swap a drive out and swap in your third drive. Take the drive you pulled out home and put it in a safe for the week. Now you have a secure offsite backup for your important files. You must do this every week, and don't leave it in your car. I suggest encrypting the backup. Now your hard drive will not get filled with multiple backups and you can probably sail along fine.


http://www.amazon.com/gp/product/B002O0KOC8?tag=b004oovihw-20
http://www.amazon.com/2TB-G-safe-Spare-Module-Drive/dp/B002RL8I4K


Chris
Living the Dream in Alaska
ErinB #58454 11/25/2013 8:43 PM
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Erin,

Some things are best done by default. This isn't one of them. Their reasoning that users will not know how to set up a backup folder leads to problems like this. Indy has a good idea, but for me at least, it would be too much trouble to continue to remember. Plus, for some restores and re-restores seem simple. I am extremely hesitant to restore data from the past over my data of the present. You can't move that chart any way, although you can get the data from it. I just look at it like it's gone. I suppose there are other things you could find.

For me, I keep five backups. Given I see 30 patients a day, that is around 150 patient visits, which is a lot to lose, so I don't go back much further. Of course, I tend to back up 100 or so, before I clean them out given my hard drive space. The main thing is that you have another path to another folder outside of your computer. And, possibly use offsite backup. Your backups will automatically be encrypted. There is a free program which will automatically delete the files for you. You can set it to delete the 5th, 8th, 100th, doesn't matter. You never have to remember to go in an clean up a folder that should never be there.

Chris has a good idea. Unfortunately, the one he recommends must be pretty good as it is sold out. There are others there as well. And, of course, you can likely find it somewhere else like NewEgg, etc. You could easily go for a four drive one. It may be cheaper than the two plus one. One thing to look at are the connections and the computer you are using. USB 3.0 and eSATA are going to be much faster than USB 2.0.

If you are backing up your .enc files (which should be the only files in the BACKUP folder) to an external drive, you can then set up Auto-Delete if you wish for the BACKUP folder in the AC folder. As backup strategies go, you cannot come up with a weaker place to put a backup. You can at least put it somewhere else in your computer, preferably where there is a lot of space. You should DEFINITELY have an external backup, but there are times when having an internal backup is advantageous. Finally, if you do need to delete all of the .enc files in the BACKUP folder, just delete the BACKUP folder. You do not need to open it, copy all of the files, then delete them. It is quicker if you delete the folder. On the next backup, a new BACKUP folder will be made. Unfortunately. Credit for Auto-Delete goes to ryango. (I think).


Bert
Pediatrics
Brewer, Maine


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