Home Forums Discussions Problems 8.2.4 Disaster - Warning - Rant

Since going from 7.1.3 to 8.2.4 its been a disaster ....
Slowed to a crawl ....
45 seconds to open the prescription writer;
15 seconds to open a chart ....
Multiple days we just crashed all day long ....
No fix yet ....
And, we cant go back or we lose all our data since upgrading ....
"Angel Support" has blamed everything from Remote Desktop Connection, to the internal network, to 'oh he has too many messages in his inbox', to 'its not that bad' ....

Soon to say goodbye to Amazing Charts since it is now Amazing-ly Unreliable for my office ....

and yet barely a word from AC except no major changes until maybe 1st Q 2016, waiting that long not likely to happen.

Koby, actually there has been plenty of word from AC... it obviously did not help Roger but the whole idea of 8.2.3 was to address speed issues.

Roger, can you tell us more about your set-up. Are you wired/wireless? How many users? P2P or client-server?

I won't speak out of turn, but I suspect that we will find that Roger's environment is above average, and yet moving from 7x to 8x has been tumultuous.

My understanding is that he is already on SQL 64bit, and the server is still hungry for more memory.

With every instance we experience, we see my observation validated, the higher the number of users in a practice, the greater the challenge in upgrading.

I'm sorry to hear that Roger.
8.2.2 was unbearably slow for us.
8.2.4 really restored our speeds to tolerable levels.
Opening a chart on my wireless laptop takes ~7 sec.
Opening the rX writer takes ~10 sec.
Bear in mind, we have a very modest set-up. 4 users. A P2P network. Most computers have a wired connection to the main computer. No bells or whistles (remote connections, virtual machines, etc).

I'm in no way trying to justify the problems your set-up is experiencing. Larger practices and practices with technology enthusiasts should be able to have more complex set-ups that also run smoothly.

I'm also curious as to what kinda of set-up you have going on.

Also, to anyone out there, how would performance be affected if Roger temporarily moved his data to the AC cloud and his office started using the cloud service?

Roger,
Do you get those slow speeds using amazing charts from the main computer/server too?

Does anyone know how to export a superbill with more than 8 CPT codes? I can't find anyone at AC who can tell me.

@Village,

You should start a new thread on that. First, you will get more responses, and second, it doesn't pertain to this thread.

@NY Doc,

Are you using wireless or wired? Is your main computer using 1Gbps connection to the switch?

Hello All,
Version 8.2.4 was released with the goal of increasing performance over its predecessors versions 8.0.2-8.2.2. In version 8.2.4 two areas of performance were addressed. These performance increases were limited to opening and closing charts. We found the greatest performance increase to be seen by practices utilizing wireless networks. Whenever we encounter a practice having severe performance issues on wireless networks, we always like to try and have the practice attempt using a wired connection. This is in large part due to the discoveries made when researching performance in version 8.0.2-8.2.2. The typical times we have seen in testing of version 8.2.4 are as follows: 6-12 seconds to open the first chart, 3-5 seconds to open up subsequent charts. I would also like to note that after researching 100 or so practices that expressed issues with performance at least half the time we have found performance issues to be pushed into the realm of unusable by outside causes such as networking issues, some form of active/on access antivirus protection, and even Updox (when using Updox schedule in conjunction with connector versions prior to 1.5.4).

The prescription writer can be effected by a number of things namely internet connectivity (allergy, interaction checking) and the number of rows in the eligibility table (practices have issues when this reaches over 800k rows). Allergy and interaction checking can be ruled out simply turning office from the settings menu. The table size of the eligibility table will need to be checked by an Amazing Charts Tech.

Roger,
I sent you a PM Tuesday and have not heard back. Please let me know if you would like me to review all of the issues you have been having.


Thanks,

Clayton@AC

Thanks Clayton,

I think we all look forward to a version that is just as fast as versions 6 and 7. Six to twelve seconds is just too slow. I don't use allergy or interaction checking, but those who are doing MU have to.

It looks like I may be forced to upgrade to v8 for ICD-10. Any chance that 6.3.3 can be modified to create an ICD-10 compatible version that is still fast without the v8 headache?

I want to give you hope. We upgraded to 824 2 weeks ago, I started at 5:45 PM and did not get out of the office until after 11 PM, the first day was a disaster with 7 computers down, even the next Monday we had 4 computers down, by Tuesday things were running okay. We have had only miniscule slowdown compared to 662. The fonts have changed, the prescription writer no longer defaults to 4 prescriptions per page, and we will re-need to set up clinical decision making. I have found that if anyone has windows updates that have been downloaded to their computer but not restarted, the computer is very buggy with Amazing Charts now. Restart of workstation almost always restores speed and function. Overall, I am happy to have almost 2 months to prepare for ICD 10.

Hi mk,

I am glad it is going well for you. Can you just clarify a couple of things so we can compare. Why were machines "down."

And, when you so it was just a bit slower, what were your actual speeds for opening a chart, closing a chart, opening tabs and using ePrescribe.

Thanks. And, again, I am glad it is working well, and you no longer have to worry about ICD-10.

How frequently are you having to reboot the computers?

It sounds as if he is saying the following:

You know how you run Windows Updates and it shows 24 important or critical updates and maybe 2 optional updates? And, after installing them, it will say "You need to restart your computer."

It would only make sense you would need to restart your computer in order for the updates to be effective. But, it generally reminds you over and over.

Can you elaborate on what this means?
Does it imply that the upgrade did not carry forward your customized rules?

6 of 7 machines were down with machine.config file error. hard to access file to repair. AC support blamed ccleaner. Currently 53 seconds to password screen after double-clicking icon, 3 seconds to open main screen, 2 seconds for a chart. Closing a chart is almost instantaneous. Prescription writer completely random timing, very variable, I am assuming it depends upon network traffic and New Crop. All the above is on a wired computer, usually I will hear complaints from my staff on their wireless if there is an issue, all quite here.

Had almost no custom clinical decision rules in 662, using only the standard ones. With 824, the default was none of these turned on, and it seems somehow different even after turning some on.

Regarding Windows updates: We have a variety of computers from Vista all the way up to windows 10, Having multiple operating systems gives me headaches, but is robust in that if there is an update which causes problems, my whole Office is not down. This clearly will change with windows 10. I have tried to teach my staff that when there is a problem to simply restart their computer, they do not always do that as evidenced by updates installing after I look at their computer and restarting it.

Just updated to 8.2.4
I lost 2 very important functions in addition to the time lag mentioned above which makes MU compliance impossible.

I no longer can highlight a text and copy or cut using the shift and right click drop down menu.
The other big loss; I am no longer able to attach patient name to refill done / documented in message box to save it to chart.

It used to be able when I right click on pt's name from patient list and go to refill a prescription, a documentation is automatically populated in the message section. All I needed to do it attach the name to the documentation and save it. No longer able to do that.

Anyone has any suggestion on how to do above with new version? Thanks.

@fircha: Easiest way to copy/paste with the new versions is to use the quick key commands. The ones I always user are:

Ctrl+A = Highlight all text in a field
Ctrl+C = Copy Highlighted Text
Ctrl+V = Paste copied text.

These are universal Windows commands and can be used in any Windows application. I found that once I got used to using them, they are faster than the old right click method.
If you still want to use the right click method, try holding "Shift" before you right click in Amazing Charts. That should give you the classing right click options instead of automatically pulling up your templates.

As far as the refill prescription goes, I believe the ability to attach a chart to an existing message was changed in V8. This was to address a bug where messages were attaching to the wrong chart. You need to attach the patients name to the message before composing the message now.

Hi Fircha,
You or your staff will have to attach the patient to the message first. It will then remain attached when forwarding and refilling the prescription. You should then be able to add notes and save the the patients chart.

You can no longer attach patients to an existing message. This allowed the possibility of attaching a different patient to the message. When saved to the wrong chart it became a HIPAA and patient health issue. The change above was implemented to prohibited this from happening.

Thanks,

Clayton@AC

Old computer: Dell Optiplex 780 with Intel Core 2 Duo and 4GB RAM running 32-bit Windows 7 Professional and AC v6.3.3 (before update)

New computer: Dell Optiplex 8700 with Intel Core i7 and 12GB RAM running 64-bit Windows 7 Professional and AC v8.2.4 (after update)

Guess which computer is running AC v8.2.4 better? Guess where I can see PDFs in preview window AND open them in default application to edit them. Hint: it's not the new computer and it's not AC 8.2.4.

Just saying.

I know what you mean Cisco. I cant contact support when I need to, they don't call back. Upgraded to 8.2.x and system is super slow, almost unusable.
I am virtualized so I can throw more ram or CPU at the problem but it did not help so I put it back the way it was. I can understand that this new upgrade might be a little slower but !@$!! you know what I'm saying

I would love to get an email from support saying when they might call to support me as I can't fix this issue

Hp ML350G6 raid 5 32 gig ram, windows Server 2008 r2 Citrix Xen server 5.6 all desktops win 7 pro

It's funny you say "almost unusable." Everyone on the "trialing thread" keeps saying usable.

The user asked for contrasting feedback as to those who found it working, so I decided not to rain on the feedback parade.

But, I have never heard of Adobe, Microsoft, Norton, Medisoft, eMedware, ESET, AVG or any software stating you should buy their software because it is "usable."

I know they are trying, but at this juncture, usable is not an option. Support will not be able to help. It is a pure code issue with caching, SQL tables and indexing issues and CPU core issues. Which is likely why your upgraded CPU didn't work.