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Anyway to improve CCC full visit load times?

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CPS, C-EMR, PM

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petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

Previously I asked what people were experiencing for the update open time in EMR for a full CCC encounter. I got one response that said on average 15 seconds, we are experiencing similar.

Is there any way to improve this? Should we comment out specialties, etc we are not using in some of the text files (and then do that again every time there is an upgrade)

Nothing else in our system is relatively slow, so it really is just the time it takes for CCC to load.

Posted : October 26, 2016 7:59 am

chews on straws

(@jwollard)

Posts: 46

Trusted Member

I would try flash drives for your hosting servers(rdp/citrix) or local machines(fat clients)

Posted : October 26, 2016 9:32 am

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

Thanks for the suggestion... I would... but my experience with reliability of SSDs is not good.

most of our workstations have mirrored barracuda 10k drives, which should be good enough for any application, unless doing massive number crunching...

Posted : October 26, 2016 9:43 am

chews on straws

(@jwollard)

Posts: 46

Trusted Member

The Intel brand probably has the best life span, however the gains of a flash drive over a spinning disk are through the roof. We are currently install the Samsung 850 EVO 3-D Chips ($160)

Those numbers above int he pictures from moving a computer between

7.2k (Single Drive Workstations)

15k (22 Drive Raid 10)

Flash Accelerated storage unit (Nimble Storage)

You should try a flash drive, 2009 called, wants it's drives back.

Posted : October 26, 2016 10:09 am

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

My personal machine has the latest Samsung m.2 pci express 3 x 4. Unfurtunately it is Windows 10. If the software requires the latest hardware don't you wish it supported the latest software? I might fire up a win 7 vm and see how it performs.

1998 called and it wants me to take back my decision to buy this horrible software.

Posted : October 26, 2016 10:57 am

DavidShower

(@davidshower)

Posts: 1255

Noble Member

How long does your full encounter take to load on a patient that has no clinical data? Is it still 15 seconds? One of the reasons for slowness is the complexity of patients. As visibility regions are being calculated, drop-downs populated, etc. by turning Medications, Problems, User Lists, etc. into arrays and running matches against them, it takes time. The more complex the patient, the more calculating is done in the background. We had a very complex Preventive Care form that by itself took several seconds to load on a complex patient with all the checking for needed services/screens.

One way to help is to have your visit load only the bare necessities and give them a form that has buttons to load other sets of forms for certain types of visits as needed. Say a Vitals and then a Visit Choice form with action buttons to load forms. Or, if you just want CCC only, just load a few forms and use the navigation buttons at the bottom for loading other forms as needed.

Posted : October 26, 2016 11:45 am

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

Thanks for the comment. User with no data takes same time. I agree about your buttons, but we are a small office, don't own vfe, we just want a product.... Like allscripts, that just works....

dont want to develop. Yes then maybe we have the wrong solution, but bought in 98 when it was medicalogic and a great product

not it sure loading just the core CCC form and clicking the buttons will add the forms to the encounter.... Will it? My initial thought is no, but suppose I will try.

Posted : October 26, 2016 12:05 pm

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

Also. Once the forms are added which would probably be after the initial encounter is started, subsequent joins to the update would not benefit. But I do appreciate the suggestion.

Posted : October 26, 2016 12:24 pm

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

Just tried on a machine with a SAMSUNG-MZVKV512 (one of the fastest drives out there) with

Avg. Sequential Read Speed 1,796MB/s

Avg. Sequential Mixed IO Speed 1,350MB/s

starting the update still took 18 seconds.

Posted : October 27, 2016 5:53 am

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

I just recreated our document template form by form. And it is the Cardiovascular Risk-CCC form that adds 10-15 seconds to the load.

Also, if you add it from the HPI form you can also tell it takes at least 10 seconds to add it to the update.

Posted : October 27, 2016 7:39 am

DavidShower

(@davidshower)

Posts: 1255

Noble Member

Good sleuthing. You could trace that form and maybe discover why it is taking so long. Might want to turn on SQL tracing as well as MEL tracing.

Posted : October 27, 2016 8:19 am

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

Just did a Mel trace, no individual call stands out as taking longer than anything else.

Form takes 14 seconds to load on a small chart.

Posted : October 27, 2016 8:42 am

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

longest individual call is 00:00:00.055

Posted : October 27, 2016 9:02 am

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

the MEL trace for loading just this form and only this form is 125,838 lines long LOL

Posted : October 27, 2016 9:04 am

petemarkey

(@petemarkey)

Posts: 373

Honorable Member

Topic starter

Also having this form in the visit dramatically reduces the performance of other forms such as PE form

problem is the cardio risk form is considered to be one of the most important

Posted : October 27, 2016 11:13 am

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