Home Forums Discussions Problems Version 8

Has anyone upgraded to v 8 and any recommendations
Please let me know of issues and bugs
Not planning to use practice management through Ac

Think 8 is still somewhere in Alpha or early Beta testing, hope it will be full of improvements

AC has posted a video with improvements under whats new
These include 2 pharmacies
Easier way for MU@ sending full patient record to portal.
Still has some bugs ctrl E to enlarge does not work.
Set up upgrade next week and was looking for anyone who has done pgrade and their issues

We have some practices that will be looking at their data on V8 in sandboxes in the next few weeks, and will have more technical, clinical, and workflow observations after we complete that process.

We will also be putting out a fresh look at upgrade options in 2015, as there are multiple factors in play.

I have been using V8 and overall have been happy. The instant spell check is very nice (but you cannot use right click for templates if you have it turned on ). It recognizes most medical words. It seems stable. It has the ability to create schedules for any user, but I personally did not need to use that. I do like multiple preferred pharmacies.

Biggest problem is that it is slower than V7. It is a memory hog (but so is V7) and often will ramp up to 250 to 400 MEG of ram when you check in Task Manager.

Again, for me it has been stable. But then again, other versions were OK for me but problems for others.

Thanks for the info, Wendell. Are you using just the EHR part of V8? What about the PM?

Thanks Wendell, I get 'buggy' now in 7 when it takes 5-8 seconds for a chart to close before I can open another chart and this with an SSD drive,16Gb fast ram, and an overclocked AMD processor: slower would not be better unless the ability to have multiple charts open simultaneously is an added feature of 8. Thinking/pining about the old 5" X 8" file card system.

So if I wanted to play with version 8..what kind of desktop guts would I need to make it work well...thanks

Heck, can I run V8 w/o buying a new computer?

I am using MedFX, not the AC version yet, it works fine. I understand the AC version will be better and slightly more intuitive (MedFX is heavy into function keys). I know they have started doing installations of the PM, but are taking it slow because of the training aspect. The PM should not impact speed because it is cloud based.



The latest recommendations from AC on hardware (for both 7 and probably 8) are for an i7 and 12 GB for server and i3 and 6 GB for workstation (minimum ram rec is 2/3 that). I have run v8 on less and it works, My server is greater than that and some of my desktops are both greater and lesser than those standards. Works on all, slower on the slower machines.

While it is nice for MU2, that the "full patient record" be sent, rather than just the "clinical summary", in actually both of these documents are C-CDA format, and don't have much information in them for the patient. I am hoping that someday the C-CDA will have all the encounter data (CC, HPI, PE, A/P) including in the file.

Currently the only difference between a clinical summary that contains data for one visit or all visits is that the one visit C-CDA includes a "reason for visit" section that prints the chief complaint and the "instructions" section, and the full patient record C-CDA includes neither of those two things but includes all vitals entered.


While v8 may be slower than v7, that memory use is no worse that what I am seeing with v7.1.3. Right now on my client machine AC is using 366MB of RAM. A possibly bigger issue will be RAM on the server/machine that hosts the database. On my server right now, the SQL server is using 1.1GB of RAM. It's making my 4GB of RAM on the server woefully inadequate. Can't wait for my memory upgrade to arrive. Hopefully v8 database changes won't change the SQL requirements much more.

Two questions relating to speed and memory use:

1. I am confused about Neurodawg's statement above. Does the amount of memory used by SQL server correlate with speed (i.e. higher memory used means slower speed)?

2. I am running AC on a peer-to-peer using as the "server" a Dell Vostro 220s with a Core2duo processor and 3MB of RAM. This has worked beautifully running AC V6.3.3. I am thinking of finally upgrading; will probably go to V8, skipping all the versions in between. A goal is to maintain the current speed of running the program. I realize that I will need to upgrade this machine (but hopefully not the clients, which are i3's and i5's). Would a Dell XPS 8700 with an i7 processor and 8GB of memory do the job?

Yes it does correlate. No higher memory does not mean slower speed. The more memory SQL Server can attain, the more efficient and fast it will be. Your confusion is partly related to understanding the difference between RAM that is used by the OS for running applications, etc. and the RAM used by SQL Server itself.

All of your computers including a server if you were using one need RAM. As you already know, everything in memory goes away as soon as you reboot or log off (not lock only). So, the more RAM you have on your computers, the better. Of course, that depends on your needs. If your client has 8GBs and you tend to need 6GBs, that is a good amount. But, having 100GBs, isn't going to help any (although it can get a bit more complicated than that).

SQL Server must run on the OS. SQL server will take memory from the server. It will access the amount of free memory as soon as you start the server and dynamically from then on, freeing up memory at times and taking memory at times. But, mostly, it is just easiest to think of it as SQL will take as much memory as it can. Difference versions of SQL can use different amounts of memory. So SQL Server 2012 Standard can take all the memory an OS has. So, to avoid SQL server from taking so much memory, the OS can't run efficiently, you use Management Studio to set minimums and maximums. With Express, one of the reasons it is free, is because it is limited to 1GB of memory. 2005 has 1GB of memory and 4GBs of database space. 2012 Express has 1GB of memory and 10GBs of database space.

If you reboot your main computer with SQL Server, all of the memory it had taken is given back to the OS. (Remember, this is for each instance, e.g. AmazingCharts instance, but you may have your billing software instance, etc.)

It is easy to understand if you look at it just like the normal RAM situation. When you first click on Word, it takes anywhere from five to twenty seconds to load depending on your hard drive speed and other factors like SSD vs HDD. But, when you minimize it, it will pop right back up when you need it, because you are no longer getting it from the hard drive; it is already in RAM.

Same with SQL. The first time you query certain information, you must get it from the SQL Server database. But, SQL will remember that you queried that info and save it in RAM or its cache as a page. The next time you query this info it only needs to obtain it from the SQL cache and not the database. Now, every page that is saved takes up some space or memory. So, there more memory SQL has, the more queries (pages), it can save. So, it is to your advantage to have a lot of memory for SQL. You are limited, however to that 1GB of RAM. Once, SQL uses all of its memory, it will discard the oldest page. So you likely won't notice a lot of difference overall unless you are making tons of queries.

So, when SQL continues to run, and it continues to utilize more of the free memory in the OS, every time you look in Task Manager, it will have more memory showing. A lot of people refer to this as a memory leak, which it is not. This is a good thing. But, it is a good thing if you have a lot of memory on your computer. So, like NeuroDawg who is anxiously awaiting more memory, if you have 12GBs or so on your main computer, what's 1GB? Not a big deal. But, if you are using a 32-bit OS with 4GBs of RAM, which the server can only see as 3.2GBs or so of RAM, now it is a different story. Now you have the interesting issue of which RAM is more important. It is great if SQL can use a ton of RAM, but if in taking the full GB of RAM, it lowers the OS's amount to 200MBs, well that's an issue. SQL isn't going to be very efficient if the OS slows down to a crawl, which it will.

So, you look in Task Manager, and you see the amount of RAM taken up by SQL, and you think it is leaking all the memory. So, you reboot, and suddenly the OS now has access to all the memory again, and it works fine. Obviously, if the OS has say 3GBs of usable RAM and SQL takes up 1GB of that, then there are still two GBs left. But, that is being used by many other processes and apps on the computer. With the advent of 64-bit OS and extremely cheap RAM, if you put 8, 12, 24 GBs of RAM on the computer, then it isn't an issue.

The only other thing you may want to consider, which goes back to the user war of P2P vs Client/Server war of 2011, servers are optimized for background services while clients are optimized for Programs. A server machine with a server OS, can manage a lot of these things more efficiently than, say, Win 7. If you go to Computer > System Properties > Advanced system settings > System Properties > Advanced tab > Performance (Settings) > Advanced, you will see those options. Changing your main computer to Background services, will not likely help much, but you can try it.

Short answer: Higher memory used means being able to query data from the memory cache and not the database.

Yes, easily. And the system you have now would work fine as well, although I am guessing you meant 3GBs of RAM. I am just playing with 8.0, so I am not completely sure, but I don't see where it would need tons more power. Amazing Charts will be running on the clients so they will still benefit from their faster processors. The statement that AC 8 is a memory hog will not affect you at all. This will only affect the clients and if AC is using 275MBs now (which mine is) and it jumps to 450MBs with 8.0, then as long as you have enough RAM on your clients, you should be able to handle the extra 200 or so MBs of RAM it requires. You can always use more RAM, so I would make sure every client has at least 6GBs of RAM. Just a ball park figure. If they are running 32-bit OS, then it doesn't matter. But, it would still be a good idea if you go to 64-bit.

As to the "main computer" it will always serve you to have more power under the hood. Having SSDs that can utilize SATA III ports will help a lot. An i7 processor would be fine. And, I would put as much RAM as you can afford on it. You likely won't need more than 8GBs, but if you ever decide to hack the setup and go with something like SQL Server 2012 Standard, which can utilize tons of RAM, then you would need that RAM available.

You could also set up the hard drives in a RAID 0 configuration (no redundancy but better speed) or RAID1 or 10 if you wanted more speed and redundancy. But, that is certainly not necessary. If you do use a 500GB or 1TB SSD for your OS, be sure to have a 3 or 4TB regular HDD for storage and other data, etc.

Again, as is always said, RAM is the best means of quickly increasing speed and efficiency. If you are not on Win 7, then upgrade to that. You can also go to the same setting I noted above and make your your Page File is set to 1.5 of your total RAM and I would put it on another drive or partition, if available. That will give you a little more RAM, although it will be coming from your HDD and not actual RAM. Your default is likely 400MBs.

Thanks for the responses; they are very helpful.

On second thought, I am thinking of getting a different Dell because I want an SSD. That would be an Optiplex 9020 Micro with a 128GB SolidState Drive (again with an i7 and 8Gb of RAM). Does that sound better, worse, or equivalent to the Dell XPS 8700 for my purposes?

I remain concerned about a loss of speed by going from 6 .33 to 8; hopefully my concern is misplaced.

What size is your AC directory on the existing main machine? Depending on your Imported Items folder, you may need a larger drive. I would also get a spindle drive for your boot drive.

It is easy to clone an SSD and put into a case, I'd go for 240GB they go for about $110-$120 (crucial or Samsung) on Newegg Intel drives about $10-$20 more. You will probably save money doing this as a DIY

I have not checked my II folder lately.... it is up to 52gb. So much for a 128 gig drive...
Can I get it with a big SATA drive and add an SSD? Is that what you and Koby are saying?

I would go with a 256 drive (or 2, in RAID), given the size of your import items. My current AC drive is a 128, the folder uses 30GB and the II folder is 10GB of that.

The problem is, I believe, that the II folder has to be in the AC folder. It would be real easy if it could be placed elsewhere, because you could use slower (SATA) larger drives for that purpose. The other thing to consider is the backups will also be in the AC folder/Backups and can add up if you don't cull them on a regular basis.

I would have Dell build and warranty with a spindle drive, just make sure that there are additional drive bays in the frame. To make it easier for you, I would also spec a hardware RAID controller.

Then you can add the dual SSDs after-market.

If you install the OS on the spindle drive, then you can use the RAID1 drive as your D drive and install AC there.

You want some help, then plan on buying a streak when you are in Laramie this summer. ;-)

I run AC 6.6.5 on a peer to peer with my desktop being the 'server' I have 16Gb RAM,an SSD as the hard drive and AMD FX processor(eh, not an i7); since upgrading from 6.3 do notice a slight delay when closing charts so only wonder what will happen when upgrade further to V8.
Think if you are going to an i7 system your basic hardware will be fine yes 8Gb RAM an SSD; my comment about cloning a SSD was if you were thinking of tweaking your current system would clone the current hard drive to a SSD then put SSD as the main hard drive along with maybe getting more RAM up to 8 Gb (assuming you are running windows pro) that would be about a $200. investment and you would notice improvement.
Of course I'm just rambling and would defer to Indy's expertise.

Version 8 is close to general release. It has been quite stable for me.
It does require a fair bit of resources, as I have stated before. Using the hardware recommendations http://amazingcharts.com/support/hardware-os-requirements/ would be advisable. It will run on less but be even slower.

Is it truly slower than V7? I'm not sure. Initially I thought so, but I really wasn't on V7 for all that long before going to 8. It is certainly slower than V6. That being said, it does a lot more than V6. Interactive spelling was the key for me. How long have we been requesting that? (Sometimes though, be careful for what you wish.)