Home Forums Discussions Problems Problems since going onto AC cloud servers

Thanks Bert. Appreciate your well thought out advice.
Spoke with our IT guy ( which is $150.00/hour, not 50, my bad).
We'll give the cloud another chance this week with the conversion occurring Friday.
IF satisfactory, ok, will continue with AC cloud.
IF unsatisfactory, we move to an in-house server.
Can you advise me on what hardware should house my server?
What other equipment would you recommend? Solo practice Doc, 2 FTE, one PT, working 5 days a week but not full days.
Ironically, Bert, I posed this question to you in 2012 and you gave me a list of equipment to purchase that served me well for many years (Dell server)!
Now, Is it asking too much for help in writing a "father of the bride" speech?? Just kidding!

Aldo

Hi Aldo,

If you decide to go in house, please contact Sandeep. He is unbelievably good at what he does, and prices are quite reasonable for what you get. He will ship the server, then remote in and set it up.



I gave a "father of the bride" toast about a year and a half ago. Here is what I did:

Welcome everyone then thank everyone for coming and specific people who were particularly helpful.
Say nice things about the groom (hopefully sincere and true)
Say very nice things about the bride, and share an anecdote or two
Give an encouraging word or two of life advice or marriage advice
Then enjoy the reception!

Seriously, I feel for you. My wife did most of the work planning the wedding, but even then a tremendous amount of time and emotional energy goes into it. Good luck!

Gene

Gene,

Way to steal my thunder. I would have likely recommended him anyway. But man....way to bring a guy down.

I mean Sandeep is good. But, he is only better by just a touch. LOL

Plus, I offer free shipping, and I go there and set it up.

And, I second as a wedding photographer and a Justice of the Peace.

Well, it has been a while... I have been incredibly occupied with moving my practice and life in general.

I am so sorry to hear about Indie.

I used to host AC locally in office with a dell server. Very happy, excellent speed. My IT guy was very responsive and managed most of the issues online. Unfortunately, for reasons beyond my control, my practice moved to a different hospital and changed from fully private to private within a hospital outpatient clinic. Bottom line, my employees are now employed by the hospital and I am now in a hospital outpatient clinic. My associate and I remain independent and essentially just rent space and employees from the hospital. This lowered my overhead (great!), but required a change in the way I hosted AC as my server did not meet the hospital's IT criteria. The easiest solution was to go to AC clouds. The hospital actually wanted us to go to a different EMR (Athena vs Epic). This was a deal-breaker and the hospital quickly acquiesced.

I have two providers and 10 users. The transfer was slightly and needlessly annoying, but not enough to jump out of the window. The biggest issue was transferring the 500 G/b of imported items to their server. I do not have the connection issues that Aldo describes. (Sorry Aldo! If I were you, I would already be back to hosting AC locally.) I do agree that AC freezes every so often, and slows down a bit during a busy clinic, but is still usable. I believe AC freezing is an issue with AC, as it happened before transferring to the cloud version. However, before all I had to do is ctr-ALT-delete, go to task manager, close ac on the client, and restart ac. Now you have to contact Support. For those that do not know, AC clouds is just a remote desktop connection to a server off site, but you do not get access to the server, just the program. This is understandable, but in order for this to work well, support needs to be available 24/7. They are not. They are available only during regular business hours, eastern time. If your ac freezes at any other time you are out of luck and can't use ac until support is available during routine business hours. I have not gotten a response from AC support with issues after hours at all.

My biggest issue right now is the pdf reader for the imported items. AC clouds uses adobe free pdf reader. I require full pdf editor as I import pdf forms (roadmaps) for patients who are going through the process for bariatric surgery, which routinely go through a six month process. I need to be able to add pages, delete pages, sign, etc. So far AC clouds has been unwilling to install a full pdf editor. I offered to, of course, pay for the licenses. (In fact, I already have the licenses as I have a Nuance full pdf editor in the office). I started this migration process 3 months ago and I was explicit on my need to use a full pdf reader, not a free version. Initially they said yes and commented that other practices were doing the same. Now that I transferred to AC clouds, they tell me they can't / won't do it. A bit of a bait and switch if you ask me. What is more annoying and upsetting is that now they claim I did not discuss this before the transfer. It is true it was discussed verbally with Paul Lucia and their transfer specialist. So, word of advise, document with email all the promises they make.

There is, of course, a work around. I have to download the pdf form locally, add pages, then reimport. This is doable, but a hassle, mainly because the hospital has quite a few security walls to jump through to download something from the outside. You have to download to a sandbox, security scan, import, then print to updox, reimport. It turns a process that was seamless before, to a cumbersome and slow process.

Dealing with support for the cloud version is the most frustrating thing. Chat is only available during regular business hours, and often are not available at all. Email support is pathetic. Emails often do not responses for over a week or are just completely ignored. You also have the option to leave a phone message, but I have yet to have a phone call returned. It is very frustrating.

Bottom line, if my practice environment had not changed, I would not have switched to AC clouds. I could revert to hosting AC locally, but it will be a fight with the hospital. I moved my old server to my house and is working. I may need to update internet access, but probably don't. I would have to pay for all the maintenance and IT support myself. Not a big issue. All I need to do is download current backup and imported items. The issue would be dealing with the hospital IT. And of course, there is the issue of security. I already suffered an episode of attempted cyber attack in the past, which thankfully was dealt with swiftly by my IT guy. (BACK UP!!!). In the end I may stay with AC clouds just for this fact alone.

I hope everyone has a happy New Year!

Gerardo

I heard from AC cloud technical team that they will only allow the free adobe pdf reader version in their cloud servers. There is no plan to allow clients to install and use a full pdf editor in their server, even if I am willing to pay for the licenses. So there it is.

Hi,

The version of Adobe we provide for the cloud does permit you to with some advanced features such as the ability to edit your pdfs. However it does not permit the ability to add new pages to existing pdfs. Extending a pdf beyond current page lengths is much more complicated than just an advanced licensing and would require development and security changes

I have used AC since 2001 and have added pages to pdf when I hosted AC locally without any issues whatsoever. Please have the courage to say "we don't want to do it" and spare me the "it is more complicated than you think." It isn't. This is just pure nonsense.

"Complicated" has many degrees...like changing a light bulb; while on the surface it would seem to be a simple task but if that light bulb is located atop a 700 foot cell tower it's a bit more complex than it would seem initially. And in all the years I've been monitoring requests this is only the second time I've personally heard of the need to do this. If this is truly a serious impediment for you I think the best option would be for you to move back to hosting AC locally where you'll have more flexibility to alter documents received from other parties. I'm sorry we couldn't be of more help here.

@gcarcamo I wasn't going to chime in because I'm a bit swamped with upgrades and migrations but you can replicate that cloud feel/setup in house. I've done a few setups for offices who were working on hospital provided machines. Send me a PM and we can find out if it's a good fit for your office.

@cconrad Thank you for addressing the issue. We know how difficult that can be when you're in a forum that focuses just on the issues with AC. We hope you stick around. It's hard for people to understand how locked down SaaS needs to be. It's more of a one-size fits all solution rather than a custom one.

Yes, I already got the message from Paul @AC, if you don't like it leave. You like to throw that out a lot. I am considering it.

"In all the years..." Editing pdf implies the ability to add, delete, highlight, annotate, etc. If you can do one, you should be able to do them all. Just because you have not heard about it, does not mean customers don't do it. I expect many of locally hosted users do this in fact. I often delete pages (fax covers) and add (pictures to op notes), combine pdf (labs, EKG, referrals, make packages for insurance prior auth, etc)

@Sandeep. Thanks for the offer. I am already working on it. I will contact you if I decide to move forward. The issues is getting the hospital to grant my home server permission to be accessed from within the hospital environment. The hospital will not allow me to move the physical server into the new office. I would have to "virtualize" my server in their environment and then won't allow me or my IT person access to it independently. I would have to "write a ticket" just like with AC cloud. They are even less responsive than AC. They are really pushing me to go to Athena, which they say has much better support than AC. My IT person had already set up a server that could be accessed from anywhere else via remote desktop with ability for multiple users, exactly the same as AC offers (except I can use the pdf reader / editor of my choice and I can use ctr-ALT-del if frozen). My plan was to allow me and IT access to my server, and leave the office staff access only to the program like AC does. So in the end, the issue may not be going back to hosting AC locally, but of leaving AC altogether and going to a different EMR.

So, cconrad@ac, I understand the concept of degrees of complication, but thanks for the explanation. I mean this. It saddens me that my days of using AC may be getting close to being over. I really like AC, and learning a new EMR would not be fun.

By the way, as I write this, AC is again frozen and support is unavailable.

Gerardo,

I am not sure why but my AC in the Cloud has been working much better in the last month, than ever before, not sure if AC is getting all of the glitches worked out for my practice, but initially my biggest issue was a printing issue, and that has gotten much better. I am still waiting for Updox to come up with their version 5 fax/printer to take care of the margin issue but I can still work through this. Also a question for you or Chris, I have a sign out tab in the right upper corner, that I thought you could use whenever AC freezes to sign off the server without contacting AC. Mine has not frozen up lately so I have not had to do this. so I thought we could reboot our own cloud server by clicking on the sign out tab. I hope you can get this worked out, Trying to read through Athena notes from the docs around here is about as bad as trying to get through Next Gen notes IMHO, maybe the user experience is better than the end looking product.

@jimmie:

Where? I do not see a signout tab in the right upper corner. Signout in the remote desktop AC window? Or in the password manager? In the task bar? Maybe you are a beta tester? I would love to have one, my life would be so much better.

I hate Athena. I actually used it before. I will do my best to not use the nuclear option. I am currently developing a new process to deal with the pdf issue. Want to see how cumbersome it is for the staff.

One thing about the pdf issue is that the imports / pdf items I am trying to combine are already imported into AC, I am just combining pdf already imported within AC to create a package to send to the insurance. I am not talking about adding pages that have not been imported to AC and currently reside in my local computer to something already imported in AC in their remote server. I can see where that would be an issue. It really should not be an issue. Alas, I have been shut down without further discussion.

Gerardo,

It is the rdweb.virtualac.amazingchartscloud link site and it is blue in color and on the right upper section a Sign out tab in white letters, and I think if you click on that you should be able to reset the cloud server.

That sounds like the best option. You will have admin access to your virtual machine but not the Hypervisor. That's exactly how services like Azure work. You don't need access to the Hypervisor to administer your virtual machine. Makes life a lot easier because they're responsible for maintaining the hardware.

Other cases like this we've setup entirely separate networks. Just a simple access point for a WiFi network with a server onsite which is a completely separate network. There's many ways to make it work with the hospital restrictions.

Prior to the opening of this forum, Amazing Charts hosted a user board for anyone who wanted to use it. It was similar in that everyone helped each other, asked questions, shared ideas, etc. Users made suggestions and recommendations to AC. Of course, users also complained about support both in general and specifically. Amazing Charts support technicians would come on the board and try to help. Chris Conrad would post about new features coming down the pike and future versions which would take care of bugs.

Amazing Charts, unlike many other EMR companies apparently felt that users should be allowed to have both positive and negative posts on the board. In fact, it could be taken as a positive to prospective customers when they perused the board. They would take it as a good thing that AC felt so good about their product that they were fine with being completely transparent.

Over time, the negativity and disparaging remarks about Amazing Charts became more prevalent. Statements were made by AC users about AC that when read by prospective customers would be enough to make them look in another direction. This was the main reason AC did not choose to keep the user board when they changed servers.

At a great deal of expense and time, I decided to host a forum for the users for the sole purpose of sharing ideas and asking questions and commenting about both medical and non-medical issues. It was also a forum which would allow for candid discussions about some of the problems with AC. We were fortunate that some of AC's support team followed the board and tried to help with issues. Chris Conrad, product manager for AC, has been present on the board quite frequently giving feedback and keeping users apprised of new developments with the EMR as well as specifications users must meet to work with vendors such as NewCrop.

When I was the admin of the AC-hosted user board, I would monitor posts and look for issues with profanity or flame wars, etc. I never edited or deleted posts that were critical of AC as I didn't feel that was my role.

Here it is a little different. I do not want our forum to turn into what the previous board did. I am not saying one can't be critical of AC. But, there is a limit. Comments that when taken at face value would drive customers away from AC do not belong here. And, direct comments aimed at specific AC employees by name will be deleted.

I'm afraid not. That just signs you out of the account.

I spoke and chatted with AC support today. I am told that they do provide support after hours if AC freezes or the remote desktop is unavailable. Today, Wednesday, I received a call back for the first time for a message left Monday. Maybe they are just overwhelmed and / or understaffed because of the holidays, I do not know. I was given a support email (support@harriscomputer.com?) that is different than support@amazingcharts.com. I foolishly did not write it down after the chat ended and I have no way to get it back (shouldn't the chat be automatically emailed to you at the end of the chat?), but I was told emails to support@amazingcharts.com should forward to the correct email. This is actually good news as I was under the impression, given their lack of response in the recent past, that there was NO support after hours. It seems it is just a hiccup due to the holidays and hopefully temporary.

@Sandeep: It would be great if the hospital IT virtualized my server in their environment and allowed me to actually remote access the server, have access to my desktop, and access the programs. The server, and programs, may run in their environment, but I would not have access to the server OS. I could not, for example, start AC, update AC or any other program on my own. I would need to make a ticket with their support staff to do anything. Last time I opened a ticket, it took the hospital IT a week to respond. Obviously AC cloud is a far better option than this.

@Bert. I will go back to live under my bridge, lest I turn into a rock by daybreak. Feel free to delete all my posts.

Cheers.

I am using AC since 2009. There are many EMR / EHRs out there and I had the opportunity to use quite few of these. NO EMR/ EHR is perfect and there is no EMR/EHR which can make EVERY physician happy!! Despite its limitation, AC is so far the easiest to learn for doctors and medical office staff with capability of being very flexible to work with.

I agree with Bert "I do not want our forum to turn into what the previous board did. I am not saying one can't be critical of AC. But, there is a limit. Comments that when taken at face value would drive customers away from AC do not belong here. And, direct comments aimed at specific AC employees by name will be deleted."

Unfortunately, Practices with Independent physicians are reducing at a great rate as more and more of these small practices are being engulfed by larger groups and hospital mafias. It is very important for small practices / solo practitioners to feel comfortable and not intimidated by this change and I think this forum serves this purpose with excellence!!

AC UB has been a great resource of not only Learning AC but also about technology in general. We exchange ideas, give free advise and try to help each other out by putting out our own experiences.

I have not had a SINGLE incident with AC support that I asked for help, whether during work hours or after hours including weekends, when AC did not respond or provided effective help to the problem / questions I had. I am not sure if I would have been able to continue to run my practice if there has been no AC Support and if there has been no AC UB!!

Thank you every one at AC and at AC UB!!
Happy NEW YEAR!!!

Hi everyone,

As Bert suggested above, I think there is a delicate balance.

I agree with Qaiser that Amazing Charts over all has been a very very good product, considering its comparatively low price it has been a great value. I have been using AC about 14-1/2 years, the first 9 years peer-to-peer network, and the last 5-1/2 with a server on-site. I have, fortunately, not had many occasions to need AC tech support, overall I have from them quite appropriate.

But I also understand, and identify with, some of the concerns expressed by several users. At the moment it sounds like Cloud users are the most likely to have significant problems. At other times on-site users have had problems with upgrades, credentialing, and so forth. To have a very slow system, or to have a system that I could not use after hours or on a weekend, would be absolutely intolerable. The fact that 99% of users were having a much better experience would be little comfort to me.

In fact, this was actually the case, I think it was summer of 2011, perhaps version 6.09. A certain percentage of users, estimated to be about 5%, had very very significant slowness with anything involving prescribing, basically once you opened up the prescribing window any further action took about 30 seconds per action, so prescribing a medication could take 5 minutes. It took about 2 weeks to get this figured out (Sandeep actually came up with the first fix), and that was an agonizing 2 weeks.

As usual, Bert shows great wisdom with his suggestions. Absolutely we need a place to express complaints, and times just to vent. But we certainly do not want to present an overly negative picture of Amazing Charts over all.

Gene

Gerardo,

Sorry to give you the wrong information, I thought we could reboot our own servers with that SIGN OUT button. It was very helpful in the past year before the transition to the Azure Microsoft server, that we could reboot our own cloud server when we would get the dreaded black box. Thankfully, I have not had that happen but if the cloud server freezes it would be a nice feature to be able to reboot our own without bothering AC support. l am going to suggest this with feature requests.

I've been using AC in the Cloud for several years and have been generally pleased. Over the weekend since the server was migrated it's been a series of problems. The main one--still unresolved is that my Mac no longer works with the system. I've always used Microsoft Remote Desktop to access ACiC but now AC freezes and is useless. I asked AC TS and they didn't have an answer. Any suggestions?

I know one obvious solution would be switch to a PC--I have one, but I love the Apply ecosystem and I much prefer spending my time in it's habitat rather than Microsoft-World.

John,

This does not help your desire to stay with the Apple ecosystem, which after getting an I-phone (at the behest of the kids) I had to get the Apple Watch and Airpods, so I love my Apple ecosystem with those devices and I can understand your desire to stay in that ecosystem.
But thanks to Indy, he talked me into Chromebooks, and if I could get Medical Dragon to work on my Chromebook I would likely do away with my PC altogether. AC in the Cloud works great on my Chromebook, so this is my go to device at home and on vacation by using the Microsoft Remote Desktop application on the Chromebook. So maybe AC in the Cloud will eventually work with the Mac with Microsoft Remote Desktop, I hope you get it to work for you.

A chromebook is on its way.

What kind of chromebook? I hope you have good results with it. I love my 15 inch ACER!!!! Hotspot on phone, and can work from anywhere with 4G, even the office if I lose internet or electricity.

Got my Chromebook but can't access AC in Cloud. I checked with tech support and they said that : "Unfortunately, Chromebooks cannot run Windows Applications (i.e.: Remote Desktop for AC in the Cloud)." Do you have a work around Jimmie?

John that is partially true but not true, you need an application like I use, called Microsoft Remote Desktop for Android. It works slick and I had my local IT tech load it on my chromebook. But if you try to just put in the website address for AC in the Cloud it won't work until you download this free application to your chromebook.

Thanks Jimmie--I'll give it a try

I'm done, finished, had enough. AC moved our cloud server to in-house and initially 70% of the problems went away. That was short lived. Now AC simply freezes.. This happened last Saturday when "technical service is unavailable at this time"..I didn't complete the charts and waited for AC to reset several hours later. Particularly bad today. Doesn't Executive team understand that people make appointments, expect to be seen in a timely fashion, and leave with their prescriptions? Sorry, "we're waiting for our EMR to unfreeze" just doesn't elicit any sympathy. I had 3 exam rooms awaiting service while we waited for Tech support to do their repair. And after the restart everything froze again and tech support had to repair us, again. We have been talking to Tech support almost daily due to endless scrolling, a frozen screen, partial screen, or PM simply not launching. I went back to paper to service those patients.
And I purchased a Big, Beautiful, Expensive Dell Server. Yes, back to the past as we again host AC in my secure basement. I've been using AC EMR since the days of Jon. Bertman and like it, when it is functional. Thanks to all that provided advice. The wedding speech was well received...mixture of tears and laughter.

Aldo

AC Cloud Users - We just deployed a self-service logout feature this morning. When you find a session is frozen instead of calling support you can log yourself out by right- clicking on the Password manager Utility( Green checkbox in the system tray). Right Click, not double click.....you'll see an option to log off. We recognize this remains an inconvenience and we're working on a long term solution but until then this should help expedite getting you back online.

Chris,

THANK YOU, that will be very helpful !!!!! Found it--much appreciated.

Aldo, I truly understand your frustration and can't imagine going through that. I guess I have one or two more questions before you make this monumental decision. Major Caveat: I have never used the cloud option so my questions or advice may make little sense.

OK, so what i read from your post was it was moved from the cloud server to in-house. I will say that I don't know how that is done. Do they make a backup and then you install AC to your server and restore? I don't know how many AC's are on one cloud server. There is also a way to back up SQL database, which may be better. Did they back up to a hard drive and mail it to you.

The reason why I am asking is it would seem like once you have your network set up in house, with AC installed, wouldn't the .enc backup simply rerstore to the server once it is activated or whatever AC does to make it viable? I suppose, again, I am confused by "moving cloud server to in-house." Unless you mean in house network and server and "moving the data."

If you went with say, Athena, wouldn't you need all your data?

It sounds like you have this great Dell server and all you need to do is transfer that data to it. I understand that even that process would require AC support.

If any of this rings true, please PM me.

Hi everyone,

I am resurrecting this thread, hoping to get feedback from some of the people who had been having problems. As I indicated in another thread, we are investigating options, and AC cloud is one of them.

Specifically, in this thread there are several users who were extremely dissatisfied with AC cloud. Any of you guys still around for an update? Anybody else using Cloud with good results?

I am also intrigued by the "self reset" feature described above. Does this actually work as promised?

Thanks.

Gene

Gene,

Yes the self reset button does still work if things get frozen, so you can reset the cloud server without having to bug AC support. Still like the Cloud AC.

Hi jimmie,

Thanks. Do you feel comfortable giving the cost structure?

I have three users, my nurse, one staff out front and me. I pay 117$ per month. 39$ per user, and then I pay $1495 for Angel Support and Amazing Backup ($1195+$300) once a year.

That's not bad. So it doesn't charge per user per connection?

I don't think so but better check with AC to be sure.

Just curious... why is it necessary to pay for AC back-up if you are on the cloud? Don't they maintain back-ups even without that service?

It is not necessary, I am likely throwing away $300 dollars per year, I do it for the redundancy, just in case AC in the Cloud backup goes down.