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Slowness on virtual servers?

CPS, C-EMR, PM

Last Post by Anonymous 1 second ago

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chris.cole

(@chris-cole)

Posts: 12

Active Member

Topic starter

What sort of things should I look at to try and alleviate slowness issues in the following scenario. When accessing CPS via RDP to a virtual server there's a distinct slowness when accessing large charts (patients with lots of documents/meds etc...). However when accessing the same charts via a local fat client there is not any appreciable slowness.

I'm not a hardware/network expert in the least but the virtual servers seem to have plenty of RAM and such.

Thanks,

-chris

Posted : May 28, 2019 3:40 am

crendon

(@crendon)

Posts: 39

Trusted Member

I don't know but when you figure it out please pass it on. We have the same issue.

Posted : May 28, 2019 3:54 am

batman

(@batman)

Posts: 12

Active Member

What's good Chris? There's a few things you can look at. I like to work from the DB server backwards. DB>JBoss>RDS>Client.

Since the speed is good on a fat client you know it's not the DB or JBoss. It's either the terminal server or the connection between the terminal server and the client machine.

For the terminal server I would pull one out of the pool and see what it does with no other users logged in. If it's fast then most likely that server is over-saturated at peak times. You might have to add more RDS servers.

The last piece to focus on is finding out if the client machine is going over wireless. If network drops are happening a symptom the end users will see is slowness since Microsoft will try to keep the connection active even if drops are happening in the background.

Hope this helps point you in a direction. Let me know if you need to bounce anything else off me.

Batman

541-610-2746

[email protected]

Posted : May 28, 2019 6:51 am

SLHV

(@slhv)

Posts: 478

Honorable Member

Based on the details so far, I would also start looking at this as an issue between the client on the TS and the database server.

You can think of the client on the TS as a fat client at the physical location of the TS. The client is extremely chatty with the database (try a packet capture sometime), so the client is very sensitive to network latency.

You might want to start a ping from a TS and monitor latency while pulling up a large chart.

You could take a PC/laptop to that location, connect it, and see if you experience similar behavior. If you do, then it would sound like a bandwidth contention issue between the TS location and the database server location (most likely).

-dp

Posted : May 29, 2019 2:04 am

chris.cole

(@chris-cole)

Posts: 12

Active Member

Topic starter

Thanks Brad, I was hoping you'd chime in. It doesn't seem to be an issue with over saturation, I'll find out the details regarding the location of the TS and how it's connected to the network.

Posted : May 29, 2019 2:48 am

chris.cole

(@chris-cole)

Posts: 12

Active Member

Topic starter

Thanks dp, now for a remedial question. To use the ping while opening a chart is it as simple as pinging the server via command prompt?

-chris

Posted : May 29, 2019 2:54 am

SLHV

(@slhv)

Posts: 478

Honorable Member

It's that simple. Open a command prompt and type "ping -t <database server name/IP>" and let it go while bouncing around a few different charts.

The -t sets ping to continue until stopped.

I just tried a ping from one of our term servers to our database server and bounced around a few charts. The RTT was consistently less than 1 ms. Each chart desktop displayed in under 2 seconds--probably closer to 1 second (I didn't actually run a stopwatch--just an estimate). The particular TS I tested on has 20 active user sessions.

-dp

Posted : May 29, 2019 4:21 am

whitfields

(@whitfields)

Posts: 9

Active Member

You can configure Centricity to only load a certain number of months back in the document view. It adds a button to the document view that you would press if you want to load all patient documents. This is intended to decrease the time is takes to load the document view.

Our practice set this to 24 months. This way large charts would not pull the full chart on initial opening. You can then click an area in the documents to load more information if needed.

Posted : May 29, 2019 6:24 am

chris.cole

(@chris-cole)

Posts: 12

Active Member

Topic starter

Well, I was wrong. At least some of the issue is related to over saturation. Brad and dp, thanks for the insight and tips on how to go about investigating this.

-chris

Posted : June 5, 2019 3:23 am

batman

(@batman)

Posts: 12

Active Member

No problem Chris, happy to help. Glad you were able to start isolating the issue. If you ever need anything else feel free to reach out directly to me.

Also, if you hear of any customers needing hosting services, disaster recovery solutions, backups, or upgrade/migration help please send them our way. I'll email you my latest contact info. Hopefully I'll see you at CHUG this year.

Batman

Posted : June 5, 2019 4:36 am

bahasang1

(@bahasang1)

Posts: 11

Eminent Member

Hi there,

can you elaborate on where I can make that change that only limited documents will load? My practice wants to limit Document Display to 2 months and see if that helps the slowness of RDP.

Please advise.
Thank you

Baha

Posted : June 12, 2019 4:39 am

whitfields

(@whitfields)

Posts: 9

Active Member

You can find the setting here:

Administration->System->User and Resource Management->Users->Preferences->User Preferences

From there you can select User, Group, or Enterprise to target the change.

The setting is under Patient Charts->Documents

Let me know if that gives you what you need.

Sean

Posted : June 13, 2019 1:15 am

lic08

(@lic08)

Posts: 286

Reputable Member

Hi Chris,

We are planning to upgrade our app and db servers to hyper v with windows 2016 server and sql 2017 on all ssds hardware. I was wondering if you can shared your experience with having virtual hardware for CPS? Thanks.

Posted : June 18, 2019 7:50 am

chris.cole

(@chris-cole)

Posts: 12

Active Member

Topic starter

Well, I'm probably not the most qualified person to answer this question as I don't generally manage the hardware/environments for any of the clients I work for. However, virtual environments seem to be pretty standard at this point. As far as best practice for configuring them, I'd defer to more knowledgeable folks than myself for that.

Posted : June 19, 2019 3:08 am

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