Home Forums Discussions General Discussion Upgrade to 6.6.5

I received an e-mail today listing the 10 reasons I should upgrade to v6.6.5. So I clicked on the "I can upgrade on my own" button so that I can download this version to upgrade later this week. Imagine my surprise when the version that downloads is 6.6.4 build 104. "Where's 6.6.5?" I think to myself, "must be some sort of glitch."

I chat with tech support, and they tell me that 6.6.5 has not been released yet, and that if I'm running 6.6.4 I'm good to go, because 6.6.5 "really just fixes some bugs that we have".

So my questions are:

1. If 6.6.5 is just some bug fixes and nothing really better than 6.6.4, why didn't I receive an e-mail before, touting 10 reasons to upgrade to 6.6.4.
2. Why does my current version, 6.6.1, tell me I'm running the most up to date version of AC when I first log in, if it really isn't the most up to date version.
3. Why would I get an e-mail from AC encouraging me to upgrade to a version that hasn't been released yet.

I have to say, that I'm not sure I have much confidence in this company right now.

We are curious about the claim that it is faster. Understandably, you would think going from 2005 to 2012 versions should be, but the few clients who have chosen to try an upgrade have found it slower on the same hardware.

6.3.3 currently remains the gold standard for stability and reliability.

We have been asked often about the steady drum-beat to upgrade recently, and while I could opine, the reality on the ground is a mixed bag at best.

I experienced the same dilemma and was surprised to see 6.6.4 installer being downloaded. It can be a pain installing AC on 10 PCs and then upgrading again in a few days. I will probably just wait for now.

Isn't it a case where is we no longer have a choice?

Medicare requires the new CMS 1500 form, and 6.3.3 doesn't support it, correct?

The slower response time of the latest version of AC assuredly has nothing to do with SQL Server 2012. SQL Server 2012 has several enhancements to its query optimizer that make it faster than SQL Server 2005. The latest results of SQL Server performance benchmarks put SQL Server 2005 at 1,263,599 transactions per minute at a cost of .51 cents per transaction. That's running on a $642,000 HP Proliant server executing queries far more complex than Amazing Charts will ever ask for. So even if Microsoft screwed things up royally in SQL 2012 making it a quarter slower than SQL 2005, that still would not account for the slower response of Amazing Charts.

The most likely cause of poor response time in Amazing Charts is poor coding and poor database implementation (new tables not properly indexed or statistics not regenerated after upgrade, etc.). You can have the fastest sports car in the world but you aren't going anywhere without good tires.

JamesNT

Thus validating my conceptual point that you would think that it *would be* faster on the same hardware.

As to why it isn't, well, when sharks smell blood ... a shark going to be a shark.

Gotcha. I should have seen that was the direction you were going in.

JamesNT

It goes beyond that. The version of AC coming out later this year which will be ready for MU-2 and ICD-10 will require an upgrade through 6.6. In other words, if you want to have ICD-10 or MU-2 functionality, you will FIRST have to upgrade to 6.6. It therefore makes sense that AC would like to get as many people up to speed on 6.6.x BEFORE that new version is released.

Agree with JBS.

And Amazing Charts isn't the only company making clients jump through hoops like this.

Not by a long shot.

JamesNT

Ok - so it looks like this may be the last "safe" upgrade before the point of no return (i.e. new pricing structure, cloud based, etc.)?

I am not saying anything about new pricing or cloud based, simply that if you want ICD10 or MU2, you will be upgrading to 6.6 and then a new version when it is released.

I had to chuckle when I read NeuroDawg's original post. As we've all noted on a regular basis, AC has a habit of sending out notices to users that are premature or a bit off-base.

Another good example of such faux-pas occurred yesterday: "Patient Portal Now Available. Register now to start using the Amazing Charts Patient Portal Powered by Updox." That sounds great thought I. But it turns out that there's nothing new about the portal--and won't be until MU2 when it will be integrated into AC. The Updox portal is the same.

Don't get me wrong, I love AC, but this morning I suggested to tech support in all seriousness (hope you're listening Mr. Squire), "Why don't you beta test your emails before you send info out to users?" It would save users and AC staff a lot of time/confusion/effort.

I may be missing something, but it sounds like you are talking about people who have Updox. The patient portal is free and is available. I received it last Wednesday, and fortunately, can now use a patient portal which does link with AC. When it is integrated, the messages coming in will go to your inbox. So, the email I read was completely valid.

Let me know if I am off on this?

There are entirely way too many versions, and they aren't the easiest installs. Of course, a lot of that isn't their fault with all of these government mandates. Which, all they do is drive the cost of healthcare higher. Everything was great until CCHIT.

What I meant Bert was that as best I can tell there's nothing different about the Updox portal or the way it works with AC. The announcement made it sound as if there was something new that had become available. Maybe the intent of the announcement was just to let newcomers to AC know that Updox has a portal that we can start using now even though it's not fully integrated with AC.

NeuroDawg at the beginning of this thread was pointing out the fact that the "10 reasons" announcement was misleading. I was just trying to point out that the same was true with the "Patient Portal Now Available" email. At least I was mislead--but, I admit, in my case it doesn't take much.

Now, that's not true. About the doesn't take much.

I think you could go round and round on this email. It isn't for the newbies; it's for me. I know nothing about Updox except they are providing it for free. So, their intent was basically to let anyone without Updox have a patient portal.

But, as I said, I am probably off. But, it will be good to have a few posts on it, so people can try to figure out what AC is doing.

Thanks!

Two questions about these emails from AC:
I have been using the updox and more recently their portal and I pay to do so and am pretty happy with it. Does this mean it I can now get it as part of the fee I pay for guardian angel support ie for "free"?
I am now at 6.6.1 - should I wait for 6.6.5 or go with 6.6.4? Have folks had troubles moving up to 6.6.4?
Thanks,
Avery

Bert, you should check with my wife on that. :-)

I just noticed that AC has posted a press release with more info about the portal:
"Amazing Charts customers who are not currently using Updox can sign up for the Meaningful Use portal at no cost. Amazing Charts is making this feature available early to give practices a head start toward qualifying for Stage Two of Meaningful Use.
http://amazingcharts.com/company/pr...for-direct-messaging-and-patient-portal/

Avery, since you're already an Updox customer the new offer doesn't apply. But as Updox customers the portal is free anyway. I am on version 6.6.1 as well and don't see any reason for now to upgrade.

We just tried to install the portal and have not been able to, nor has support been able to help.

We were told not to upgrade by support.

We still have problems with Social history repeating multiple times in our chart ( if we were to print the encounter we could have a 15 page encounter).

This has been very discouraging.

I might upgrade to 6.6.5 while it's available. I think 6.6.6 might stir up my old hexakosioihexekontahexaphobia.

I'm holding out for 7.7.7--threefold perfection.

I would wait for the update to 7.7.7.7

Well I've bit 3 computers up and running 6.6.5 without a hitch so far, last one will be updated later today, of course that is my office manager(my wife's) computer so you know there will be an issue.

I assume we will have to upgrade at least to 6.6.x to get ICD10 functionality.
I put 6.6.5 on a test bed.
I have a few questions --
1. Does the installation completely overwrite the previous database software when we go to SQL Server 2012? I don't find any trace of SQL 2005.
2. When I install the new 6.6.5 including database, then AmazingRestore the .enc file, I have a functional AC program. It says I have to do something with the insurance accounts -- but I don't understand that very well. We don't use AC for billing -- use standalone MedWare. Do I still have to do something besides just run the database tuner?

Everything seems to work fine just as it is, but I don't have it in the office network.
The letter writer will be a LOT better once I get a few templates into it, and get used to it.

3. Is it possible to reinstall 6.3.3, then run the 6.3.3 database tuner on a .enc file made with 6.6.5 and go back to 6.3.3.

Tom,

There is no easy way back.

Requires at least using a system restore point; more reliable would be an entire server restore. Also keep in mind that if you use the new version in production, you will have to Crash-Back. All data that you entered will be lost and have to be re-entered by hand.

If you don't do billing in AC, you can ignore the payer prompt. You will need to run the tuner.

Thanks Indy.
I have no plans to use AC for billing in the foreseeable future. Staff is happy with Medware -- could change, obviously. I will ignore the payer prompt as you indicate.

From the brief encounter I have had with AC in my sandbox, there would be no reason to go back -- it was just a question. Obviously not possible in any real world.

The 6.6.5 seems to run just fine, but no better.
The letter writer looks more professional, but is harder to use.
I just know that ICD-10 is going to be a major headache, so I suppose I will bite and upgrade so I can get the ICD-10 functionality we have been promised.

I would kill to be able to either delete or move down the ICD-9 soon to be ICD-10 codes that are not used down. I mean when a patient has a hurt knee due to a likely sprain, I would like an ICD code that says "left knee pain likely due to sprain" that pops up first, rather than "left knee pain secondary to tuberculosis and sarcoidosis" an ICD code which I will never use. Half the time, I just type them in.

It seems as though whoever came up with these codes lived in an area with a tuberculosis prevalence of 90%.

@Indy Could you use HyperV and run 6.6.5 on a VM by itself and then have a Snapshot if needed.

Although others have said they have no issues, I never install any version over an older version like I do with other software, which specifically recommends it.

Tom, the insurance isn't thing isn't that bad. It is like the way we did with medications when codifying. If it was Hydrocortisone cream 1%, but Surescripts preferred Hydrocortisone 1% cream, you would click on the former and codify it. In the beginning, you would click either this one only or all, which allowed one to change all at once so you would codify the database quickly. You had to be careful since if you changed 0.5%, then all patients with 0.5% would suddenly be 1%. It is easier to not make that error in the insurance.

So, if the patient had Aetna whatever, which was supposed to be Aetna Plus, you would codify it or change it to that. Or you could do it where every patient with Aetna whatever would change to Aetna Plus.

I am not too worried about it as we will rely on Medware anyway.

At least that is my understanding. I have tried it and it seems to work.

Bert -- my eyes just glazed over. I have no clear idea what you just wrote.

I only prescribe medicines that were available in 1986 -- even with those, we have insurance problems. Like doxycycline suddenly becomes "unavailable" or scandalously expensive.

I will prescribe specific meds that people have seen on TV, but I tell them that I will NEVER fill out a PA form for them. They are on their own.

I never do PA's, and I don't care about insurance formularies -- if there is a problem I ask the patients to call the insurance company and find out what the company doctor wants them to have. I always assume that the insurance company knows best -- after all, they have all the money, so they must be really, really smart.

I don't do many PAs either, well I guess I do. Don't you recall when you first started using v4 or v5, can't remember, you had to codify the meds? If you didn't you could not ePrescribe them. A medication must be codified (bold and dark black) in order to by eRxd. Sure, you can send them by the eRx method, but they will only be faxed and there is less chance it will get to the pharmacy.

I was just comparing that to the insurance. You had to codify the meds so they matched the database. You now have to codify the insurance companies (once) so they match the database. I didn't come up with the idea. And, AC didn't either. Just another government thing. But, in the end, it will pay off as you will have less errors and less claims to redo.

I don't want to upgrade. I am on 6.3.3 and happy. I also have Small Business Server 2003 and to get to new SQL I would need to upgrade my server to 2008 SBS. I am using Office Ally.

Someone correct me if I'm wrong, but I think 6.3.3 does not support ICD-10.

Microsoft is soon to stop supporting SBS 2003.

I'm very sorry, but your upgrades are on the way. Please start planning now. You cannot do all of this at one time. You should upgrade your SBS first and NOW.

JamesNT

The only feature I want in the 6.6.x is the fax number and phone number of the pharmacies in ePrescribe. My staff is killing me for it.

Yeah all of these government requirements are dragging all of us kicking and screaming. And, AC has nothing to do with it.

Mnemonic please go to SBS 2011 if you upgrade. It's got some years left on its tires.

SBS 2003 doesn't support 64-bit so you are stuck with 3.2GBs of RAM.

But, if 2003 and 6.3.3 are working, who am I to make you move up. I still don't know if you have to have ICD-10 if you aren't using PM.

I thought I would do a clean install of SBS 2008 not 2011 on my old hardware. I just upgraded REM to 4 gb.

SBS 2008 is based on Windows 2008 and Exchange 2007. SBS 2011 is based on Windows 2008 R2 and Exchange 2010. 4G, especially if you use Exchange, is not enough. Go 8 at the very least.

Also, 2011 has the most support remaining.

Lastly, why do a clean install? Do you not have settings and user accounts that should be preserved?

JamesNT

I would definitely go to 2011 if your hardware supports it. It may not support 64-bit.

SBS 2008 is also 64bit only. Either way, new hardware may be his only option.

JamesNT

6.5.5 for the past week, So far so good. Actually running pretty smoothly.
One readily noted improvement - the "Prescription Renewal" tab now shows an accurate number. Prior to now had to run the database tuner to update the correct number of refill requests.
Of course this does not resolve the problem of pharmacies requesting refills for medications that patients are no longer on. Perhaps that is a topic for another thread...