Home Forums Discussions Problems Slow since upgrading to 7.1.3

AC was pretty fast when running 6.3.3 ; A few months ago we upgraded to 7.1.3 and now things are noticeably slower. My server and clients are very similar except the server has more RAM. My question .... would you upgrade the SERVER or the CLIENTS [hopefully not both] and what specific machine suggestion do you have [if any] ?

Server Specs:
Operating System
Microsoft Windows 7 Professional 64-bit SP1
CPU
Intel Core 2 Duo E8400 @ 3.00GHz 39 ?C
Wolfdale 45nm Technology
RAM
16.0GB Dual-Channel DDR2 @ 332MHz (5-5-5-15)
Motherboard
Hewlett-Packard 3032h (XU1 PROCESSOR)
Graphics
Standard Monitor (1440x900@60Hz)
Intel Q45/Q43 Express Chipset (HP)
Intel Q45/Q43 Express Chipset (HP)
Hard Drives
256GB SAMSUNG ATA Device (SSD) 33 ?C
Optical Drives
TSSTcorp DVD-ROM TS-H353B ATA Device

Roger,

There is a much longer answer, but the short one is this:

Going beyond 6.3.3 requires going from SQL2005 to SQL2012, there is a hefty price to be paid for that, which is just part of SQL2012. There is a secondary price in more Meaningless Usury, but that is less of the issue.

In going to the v8 series, there is a "MU2 Tax" that you will pay, although we are working with AC to address performance improvements so that the impact is minimalized.

You have 3 choices about what to do, but they are all focused on work on the server.

[We are setting aside issues of network, clients, topology, and other factors to focus on the main AC machine]

===A SideBar about Meaningless Usury===

Because Doctors and users regularly ask for it when we bring it up, we have expressed to AC that some would pay more for a "Turbo" version of AC that kept the core functionality and new improvements, but turned off ALL of the MU garbage. That concept is not warmly embraced, because it would take time and money. However, of those folks staying in private practice, more are considering going non-par or leaving the government payer business altogether and just talking what their patients can afford, which they can't do when they participate.

Thus, we believe that more, not less will tell CMS where to place their MU if they stay in practice.

===End SideBar===

So, once you move to SQL2012, here are your chocies.

1.Suck it up and do nothing, or buy newer server hardware
This is really the worst choice, because it will have least effect going forward

2.Upgrade to 64bit SQL2012 Express
We can help you do this, and there are no licensing costs, just labor time to do the upgrade. This will allow SQL to access far more of that memory you already ahve.

3.Depending on your number of users, it may be adviseable to upgrade to SQL Standard. There are licensing costs with this, but dependent on your server OS, SQL can use up to 64Gigs of memory. Obviously, we can help with this if you choose this path.

Depending on a host of other factors, clients begin to see performace impacts starting around 10 users.

Somewhere between 12 and 18 users, the performance [before/after upgrade] becomes significant that they seek us out.

Around 20 concurrent users, the practice begins to experience AC crash-outs, lost charts, and they call or email us.

YMMV, but this something we have been hearing since last year, and now that AC is working with us to address these realities in a holistic fashion, it is appropriate for us to outline the options as lots of folks are looking to finally upgrade again.

The SSD and RAM are fine, and you really don't have much room to upgrade the chip [http://www.cpubenchmark.net/CPU_mega_page.html - socket LGA775 it appears], so the logical place to focus on is your server.

Let me know if you have questions, and we can talk directly.

Don't remember the 64 bit version offered as an option when I upgraded to 6.6.5 from 6.3.3 but did notice the delays in accessing the database especially when going into demographics since I did, I am not a MU'r so I rue the day; will have to think about doing the SQL upgrade.

I'm voting for the Turbo Version or just open source the last version before MU started and let someone who can code take it over! I really don't see why we should pay more for less software though.

Koby,

Reach out if you want to, I'll talk you through it.

AC is working to do a better job of talking practices through the trade-offs in upgrades, but for folks who have already done the upgrade and have to deal with the outcome, those are your options.

We are working with AC to help practices deal with their particular circumstances.

I'm afraid I'll have to disagree with Indy on his point 2:


SQL Server Express 2012 uses only 1G of memory regardless of whether it is 32 bit or 64 bit.

Please note that maximum database size goes up to 10G from previous versions so practices that are filling up SQL Server 2005 Express have at least one reprieve when upgrading.

https://msdn.microsoft.com/en-us/library/cc645993(v=SQL.110).aspx

JamesNT

Dear James,

Is there a way to check if an AC database is gettting close to the 2005 SQL 4gb data limit?

That is, something that mimics the sql command EXEC sp_spaceused?

Cheers,

Carl Fogel

A quick and dirty way would be to go to your Amazing Charts folder and look at the size of the mdb file. Not entirely accurate, but close enough for your purposes.

You may want to check HELP | ABOUT in Amazing Charts to see if it shows anything. I believe it at least tells you were the database files are, it may also tell you their size.

Anything else requires at least read access to the database.

JamesNT

It appears I am to be corrected regarding memory usage in SQL Server Express 2012 and higher versions. Direct quote from Microsoft:


What this means is what while the database cache is still limited to 1.4G of memory, the rest of SQL Server is no longer limited. So things such as the connection pool and so forth, can use more memory thereby making the move to 64-bit a good idea.

Thank you, Indy, for forwarding me the link from the official Microsoft documentation.

JamesNT

James there is no right or wrong. For all practical points and purposes, I would say just keep it simple and go with what you are saying. The reason express is free is the memory limitation to the buffer pool. This is where all of the pages are kept. There are many other pools that can utilize more memory, but I am not sure the user that only needs Express will notice the difference.

As far as needing something with more memory for the buffer pool and having to go to a standard version, I don't think a practice with less than 10 or so users would know the difference. The other issue with going to a standard version would be support. You could have any issue that has nothing to do with SQL, and as soon as support noted you had the standard version (if they could tell), your support contract would be terminated.

I think what AC could use for practices over 10 or more full-time users would be for AC to have people like Indy, you or Raja to install the SQL standard, knowing it would be done correctly and having all of the info they may need to do it that way. I mean that is the beauty of SQL (and other databases). You can increase their capacity meaning better and faster performance.

Thanks for the advice folks !