I am have a big problem with CPRS being slow. I've
mentioned some of this before, but I'll repeat my
situation and see if anyone can help.
We have two offices connected by a VPN running on a
commercial grade DSL (still apparently klunky). The
server is in my office. The other office is having
terribly slow access. It takes 30-60 seconds to enter
all the information needed to start typing a note on a
patient. Just too long in a busy office. And that is
with just one user at the other office. If I bring
the 15-30 users up that will eventually be on the
system, I am looking at big problems.
I really want to have two servers, one in each office,
that are kept in sync with each other. I have asked
Bhaskar several times if this can be done at a GT.M
level via journaling, and he assures me that there can
only be one active server and then a backup server.
But I was also told (I think by Chris R.) that there
is a system built in to VistA to handle times when
connectivity breaks down. A local server is used, and
then when connectivity is re-established, HL7 messages
are used to bring everyone back in sync.
So my question is, could I use this system for each
office to have their own server, kept in sync with HL7
messaging? If so, can I use the existing system or
will I have to tweak the code? Where would be the
best place to start learning about this?
Another issue is to look at CPRS and see what is being
passed back and forth. I suspect that it is sending
the entire list of all my patients (i.e. 75,000
names), all the medications etc. etc. When I was
looking at VistA initially I came across a doctor
complaining about how slow the system was. Everyone
insisted that M and VistA was fast. I think both are
right. The server is fast, but it is being asked to
put a lot of data across the network.
Any help would be greatly appreciated.
Kevin
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