Home Forums Discussions General Discussion NEW POLL//Has version 11 upgrade helped?

Hi,

Many of us have experienced significant slowing in script writer and erxing for the last 3 weeks or so. Jack (Headcase) reports that upgrading from version 10 to version 11 produced significant improvement. Please respond "Yes" as in the upgrade has helped significantly, or "No" as in it has not improved rx speed. This question is only about this specific area.

Please feel free to comment about anything else but the poll is just this issue.

Thanks!

Gene

Has Version 11 upgrade improved Rx writer and eRx speed? single choice
	Yes, it has improved rx speed
	No, it has not improved rx speed
Votes accepted starting: 05/23/2021 9:06 PM
View Results

Bump

Just upgraded this am and having to put in UOM each time but otherwise the speed has improved

bump

I understand having to put in UOM with existing meds from previous version (well, sort of...) but why aren't newly-written medications auto-populating the UOM field? This added step negates any improved speed that would otherwise be enjoyed.

It was my impression that entering UOM manually was some new government mandate. If not, this is a bit of an avoidable pain. It does remember the UOM of drugs as they are prescribed since update to 11, so it will be less and less annoying.

Since it was taking 10 seconds for the Rx window to open prior to upgrade, it is still an improvement for me even with the added pull down and click....

But, I wholly agree that if this is not a mandate, then certainly it should auto-populate.

BTW, the ads on the login screen seem to be only for drugs. I want MOVIE TRAILERS! (Poll THAT, Gene!)

Bump

Mild improvement noted, the UOM crap is annoying. The program does not remember the dosing from previous times. It is also annoying to have to check the pharmacies before sending RX, because only the first few letters are shown(ex: CVS 2304) and you do not know exactly wich CVS it is until you click "prescribe" and if it is not the right CVS you will have to redo everything.

Hi Raj.

If you hover over the medication in the pending area, you will see a window expand that includes all the information on that med, including which pharmacy it will be sent to. This is a quick way to make sure the information is correct before hitting the "Prescribe" button

An downright annoying thing prior to this release which has never been brought up is there is a medication such as Amoxicillin 400 mg/5mL, 1 tsp po bid times 10 days, 0 refills (hover over medication -- sent 187 days ago). For whatever reason, if you select the medication as if you are going to send it and get it to the step where you can send it but change you rmind, the medication now shows as sent 0 days ago. That is actually more than misleading, it is dangerous. And, oh so, frustrating. When the drug is sent to the pharmacy, it should show it was refilled that day, not before.

Mark, Can you answer about the UOM needing to be manually put in is it a gov reg or just a need for better programming? Hovering over does work but would be nice if the window was just a little bigger to show the pharmacy info better, even making it full screen does not help.

Bert, I'll look at the refill info later today, I agree showing a med has been refilled when you never actually sent it could be a liability, so far not a problem but there is potential. One thing that I have noticed is after you send in refills via the electronic refill requests from the pharmacy there is a note that stays in the "note to pharmacy section" that says it was refilled via electronic request (wording is not exact), I will try to screenshot and post.
We moved to Version 11 last week.

Hi Chris,

I checked and yes, manually selecting the UOM is part of the new regulation. Our other EMR, CareTracker (web based EHR with LOTS of bells and whistles) does the same thing with their script writer.

As for Bert's issue with the script writer, that is working as it should. There are two buttons you need to click for prescribing meds, "prepare" and "prescribe". The prepare button puts the med in the pending meds section. At this point the med is not officially prescribed yet. Once you hit that prescribe button, however, you are officially prescribing that medication. The following screen is just the delivery method for that medication (electronic, printed, or even no method if the medication was dispensed in house). Think of that prescribe button as a "sign off" button just for meds. Once you click it, you are making it official.

Mark, do the bells ring and do the whistles whistle?

LOL... They ring like a church bell on Sunday.

There are a lot of features in CareTracker that are pretty awesome. They have an interesting take on what AC calls "templates" (they call quick text) that allows you to select different options within the text. Example.. you can have the following text templated: The patient has a cough that is <[mild, moderate, acute]>. And then be able to tab to the options in the brackets and select what you want instead of typing. Plus they can change the format of the note (like changing the fields themselves for certain types of visits, instead of having them all shown all the time), they have real order sets, a better portal (in my opinion), and can ERX and EPCS from the same screen (no more newcrop).

The downside is it can be a little busy on screen. When I first looked at it, I was so used to seeing Amazing Charts that this looked a little much. Things are not in the places you are used to and the workflows are a bit different (not better or worse, just different) It can be intimidating, but you get a good amount of training with it, and they make sure you are comfortable before you go live. It might be worth a look if you are looking for something web based.

Thanks Mark, but I would have to disagree with that logic whether it says prescribe or not. If I hover over a medication in the med list and it says 0 days, it should mean it has been prescribed, i.e. SENT to pharmacy. The fact that it says "prescribe" as the second button does not show that it was prescribed. In fact, that button could say "taken to the pharmacy via Amazon and UPS) and that doesn't make it true." Clicking that button simply takes the med one step closer to being Sent or Prescribed. In fact, if you are reconciling medications and you change a med taking it to prepare will not save the med. You have to click on prescribe to do so. This actually causes problems for us I would estimate five or six times a week.

I can see your point on this, Bert. I was just describing the way it was designed to function. It sounds like the real issue is that the "Prescribe" and "Transmit" functions are 2 separate processes when ideally they should be one (our CareTracker product does it like that.. one button prescribes and transmits the med). I will write this up for dev and submit it. I'm not guaranteeing anything, but its at least worth putting a bug in their ear about it.

Are other doctors also experiencing crashes with V11? My staff reports 1-3 crashes a day and I get close to one crash a day. Usually while flipping through different sections of the chart. I usually get it while signing off on labs or the note. Used to get many more crashes with V11 Beta.
Agree, if transmit or print button can be incorporated on to the Prescribe screen, that will save some time.

Thanks Mark, but there are numerous benefits of the way it is now. Just one example:

You write a script for 14 tablets, because that is MaineCare rules. After sending, you don't want to forget so you "kinda subscribe it again" without sending so it will save. Or you write a message to the pharmacist that you don't want to carry over the following time. Especially when your staff sends a refill. They rarely catch that. Would be cool if you could load it again and save it while in the script writer.

Yes I'm getting crashes still on a daily basis, I've begun the habit of shutting down AC during a slow point then restarting AC and it seems to help prevent the unexpected crash(I've been getting crashes either opening up a chart or looking into Imported Items Folder. Currently I'm on Ver 11.1.0 build 778

Well had a new type of crash today, AC was up on screen, I had no chart open and was doing nothing in the program and it just crashed.

Crashes are the single biggest pain point that drives abandonment sentiment. Please track theses down-we are not crazy docs. They are real!

I'm stay in on 10.2 a bit and still get crashes on 10.2. afraid of more on 11.1

We're on version 10.0.2 and this happens to me ALL THE TIME. I had hoped that our pending update would help that. I guess it's going to be another pipe dream that the EHR doesn't crash when I open the Imp. Items tab.

These are called showstoppers.

The upgrade fixed the pharmacy slow window, but the upgrade version is less stable (crashes) than what I had. I get a crash about every other day.

Don't you also get a choice on the new version to either close the script writer to "save" and close vs just "save," i.e. now no matter what it closes. I think I could take a crash every other day and have a normal script writer. The slowness kills me.

I am on v10.0.2 and do not get daily crashes. I cannot remember when I had a crash, actually. Being forced to go to v11.1 and then experience daily crashes is not something I am looking forward to experiencing. I have a few questions/thoughts if anyone can answer:

1. Are daily crashes on v11.1 really widespread? Or is this just isolated to a minority of the user base?
2. I run AC in a VM on a local server. Are the above users with daily crashes on local server setups or the cloud? Does one setup have more crashes than the other?
3. Are the above users seeing more crashes on wireless vs wired setups? (mine is fully wired).
4. Is automatic updates from Windows 10 a contributor to the crashes? I use Win 10 Pro and have auto updates turned off and do manual updates.

koby: That crash sounds like a bad memory leak. You could check the Windows Task Manager and see whether A.C. hogs up huge amounts of memory resources during its normal operation, perhaps even when idling, apparently. Hopefully that was just a fluke that a system reboot solved.

new version 11.1.1 has pharma ad
new way to use AC
may be that is why it is crashing !!!!!
Hope, just few more days and will get ironed out.

I am getting frequent crashes with version 11(4-5 times /day). Error messages vary from "run-time error, out of memory or no error message and restarting immediately. It seems that double clicking on anything( write orders, lookup diagnosis, selecting a scanned document, etc.) when in the patient's chart may cause the crash.. It only happens with my computer. The front desk states that they do not see any crashing. They however do not open the amount of sections of the patient's chart. When it happens and you restart AC, only sometimes it would ask you if you want to resurrect the note. You can imagine what happens if you do not get that option on restarting.
This version seems to be the most unstable from previous portions (almost like it wasn't ready for primetime?).Very annoying and seems to be functioning better if you frequently shut down AC multiple times a day and be patient when clicking on something and waiting.

This is my opinion, hoping for a more stable version soon.

I am the same as ffac. We are on 10.0.2 and do not experience a lot of crashes. (But the eRx is still slow.) We are also wired on a local network. Worried about having to upgrade to v11 and getting the daily crashes.

I may get one crash a day if that, so IMHO it is well worth doing the upgrade because of the pitifully slow eRX with the old version. The eRX is lightning fast but you just have to add tablet or capsule every time you prescribe which is a pain but still faster than the slow older version of eRX.

If Sandeep were here, he would say it was all due to hardware acceleration.

He was right the first time

We're also on 10.0.2 and we get 2-3 crashes a week per doc so we'd love to stay put. Thats manageable compared to issues in past versions.

Searching for the courage to upgrade to v11 before the deadline. This thread isn't really helping

So upgrade and tell us and make the thread helpful.......

Gene

Anyone from AC here? Paging Chris Conrad. The crashes are variable but real cannot simply be written off.

I'm guessing they stem from old code libraries that slowly become less compatible as windows 10 keeps changing. This might not be fixable without replacing large amounts of legacy code, hence the radio silence from AC.

A compromise is to recommend stable setups with a particular windows 10 version, particular settings/ options, particular PDF reader, even particular supported computer processors/ models, etc. Or give us stable virtual machine setup we can run on our own servers.

Anyone in the AC cloud getting crashes? If not then they have a stable VM setup they could share with us.

If they don't share info or fix it, users will slowly leave. Sometimes the best fix for legacy code is to abandon ship and jump to a quality modern platform - if it exists.

That's really encouraging, Jimmie.
I will schedule the upgrade and report back...

Hi Serene,

I believe Jimmie uses AC cloud so you may not have exactly the same results if you are locally hosted.

Please let us know how the upgrade goes, and how much improvement you get.

Thanks

Gene

I think I'm going to do it tomorrow afternoon.
I read the description on the portal. It says we just need to tell AC the date we switch so they can make some change for eRx to work. I will them them Friday and if we don't have eRx for a day, that's ok.