Home Forums Discussions General Discussion Upgrading to 6.6.5

How long should the upgrade take? Trying to get an estimate on how much my IT guy will cost to do the upgrade.

Stephanie

Depends on what version you are coming from.

Also how many computers need to be upgraded.


If you are already on 6.3x, Probably about 1.5 hours main computer, 30 minutes for the others, which can be going simultaneously.

Main one takes longer because you may have SQL upgrade and you need to have it running so you know the others will have someplace to connect. You could run all simultaneously but if it fails at the main, going backwards is a major pain.

I agree with Wendell that if everything works, it should take about that long.

His point about successfully finishing on the MAIN first is particularly important.

We have had several upgrades go sideways and fail, which required a cycle of un-install, re-installs. For a plethora of reasons, we suggest the following:

<1> Full backup first, saved off the machine in question - seems obvious and yet ...
<2> If you are on 6.3.3 or earlier, you should have a minimum of a system restore point, if not a server image - there is no easy way back
<3> If you are a large/group practice and on 6.3.3 or earlier, expect that it will probably run slower, and know what your options are
<4> Leave yourself plenty of time - don't plan on fitting this in-between last patient and dinner
<5> If you use AC for billing documentation, know that there are undocumented changes, and at least have your billing current before upgrading
<6> Know your fall-back plan - what are you going to do if AC is closed for the night and your MAIN is now gobbered up?
<7> Use someone who knows AC, not an IT generalist - several folks have documented spending days and $1000s getting back up after a well intentioned generalist thought that this was a typical software upgrade and ended up spiking the MAIN.

I'm getting the picture that I want to wait until close to ICD-10 start date to do the upgrade.
Maybe in the next few months some of the major kinks will be ironed out?

I don't really see any reason for upgrade except for the ICD-10 capability

Is that a fair statement?

The biggest reason to go to 6.6.5 is because of the new CMS 1500 form. If you do not need that, look at the other changes from 6.3.3 to 6.6 and see if there is something of value for you (best way to do this is to to the upgrade site and look at the bottom for updated things. It has more a lot of small things in prescribing, but I skipped over 6.3, so I don't remember what was there.

The version in June ?6.7? will have ICD-10 ability (you can switch back and forth to try it) and will be MU certified if you are planning on certifying.
THIS is probably the next big one and probably worth upgrading. That will give you time to bake ICD-10 practices in your office. It will automatically switch to using ICD-10 on 10/1/14, but can be toggled back for any reason (back billing).

I just heard the House passed another ICD-10 extension...

The Senate just passed the extension of ICD-10 to 2015 as well. Now, on to the prez.

JamesNT

I have been told I need to upgrade from 6.3.3 because my database is at 4.1 gig and the current version of SQL needs to be upgraded. Is that so? Or can I just upgrade SQL alone?

Versions of Amazing Charts are SQL Server version specific. For example, you cannot run AC 6.3.3. on SQL 2012 as that is not supported. You have to move to 6.5.x for support on SQL 2012.

JamesNT

Two things. SQL Express 2005 will give you leeway, probably up to 4.3GBs, but I wouldn't could on that too long.

Second, AC can remote in and compress your data. My guess down to at least 2.5 GBs.

Bert--

Are the imported items inside the SQL Express database? I thought they were in a separate file, but I don't understand how AC finds them.

My .enc file is now >13.5 GB and growing rapidly -- mostly because of all the crap that other EMR's send us, that we feel obliged to file in the patients' charts. The actual AC database file is probably about 1.5G

Will the imported items load faster or slower with SQL Express 2012? What about the "full" version of SQL 2012? Is it any faster than the free version?

Can the Imported Items file be compressed with standard Windows tools, or does AC do something special? Is compression worth the trouble?

The SQL doesn't store the Imported Items themselves, but stores the links to the files. E.g.
Lab_John_Doe.pdf=C:\Program Files\Amazing Charts\Imported Items\3921\Lab_John_Doe.pdf. Then when you click on it, it opens up.

The actual database itself is quite small for the average physician. Most are below 200 MB in size for a solo practice. If your SQL database file is greater than 1-2GB as a solo provider, you could have a build up log files in your database. Check the size of the MDF/LDF files in your AC folder.

Thanks Sandeep.
Looks like MDF file is about 27MB --
It's the imported items that drag us down, and that is going to get worse with time.

It isn't AC's fault -- we have to figure out some better way of storing data from other hospitals and doctors. Putting them all in as PDF and JPG files isn't it.

You're welcome.

You can incrementally backup those files. Full backups are really only needed for the database due to consistency/rebuilding issues. It's best to isolate those Imported Items from the backup. Then you only need to backup the full database which is ~30MB in your case and probably ~30MB of Imported Items daily. Our cloud backup does it that exact way.

Hate to impose, but how do you back up the "imported items" if you don't do it (check the box) in AC Backup?

I can probably find the file by looking around, but then it won't be encrypted, and doesn't seem like it will synchronize with the AC encrypted file.

I guess I'm actually pretty confused about how to do a backup if you don't just automatically back up everything and get AC to tie it all up in one .enc package.

You use a 3rd party program to back up the "import items" folder and do incremental (changes since the last backup) backups. Thus, after the first backup, it will only import the, say, 20 items that were imported the previous day, because the others are already in the backup.

Many backup programs will encrypt, especially those that sent it out to the web.

Some programs will allow you to "seed" the backup by moving a copy to the backup site and thus do not have a long mega-gigabyte initial backup.

Crashplan will allow you to backup to your own computers for FREE. You set it up on, perhaps a secure home computer and in the server and it will send the .enc file from the AC backups along with the import items incremental. It can be set up to run between midnight and 6 AM so it doesn't impinge on daytime internet traffic.

Thanks Wendell:
I looked at the Crashplan website
I'll give it a try.

Make sure you use CrashPlan ProE since the other versions aren't HIPAA compliant.

But why wouldn't they be if transmissions are 128 bit encrypted and it is only being stored in password encrypted storage (in your own facility), not the cloud?

I was referring to the cloud backup component of CrashPlan. A backup in the office wouldn't be very useful if something happened in the office. If you're going to pay for it, might as well use the both components.

We are using V6.6.1 and am wondering if I should upgrade to current version V6.6.7 or wait a few more weeks. I am not getting a clear answer from AC support. Any suggestions?

I'd suggest going into the client portal and reviewing the change log. See if there is anything that has been added or fixed that you feel is important. I upgraded from 6.3.3 straight to 6.6.7 so I can't really speak to your situation.