whimmel wrote on Wednesday, September 07, 2011:
We did some work on this locally. Some browsers default to only TWO concurrent requests, queuing the rest. The ajax fragment that was slowing us down was vitals. There are a lot of classes that instantiate others and the amount of data a given patient has causes a TON of stuff to get loaded up (and thrown away-TWICE). What we did was just include() those bits on demographics instead of loading via ajax.
bradymiller wrote on Wednesday, September 07, 2011:
Hi Whimmel,
Can you provide some more details such as size of database (number of patients, encounters, etc.) and approximate time to load up the elements on the patient summary screen. Also, curious how the Clinical REminders and PAtient Reminders sections are loading up for you on the patient summary page.
My guess is that placing a mysql index on pid in the form_vitals would improve the form_vitals slowdown.
-brady
drbowen wrote on Wednesday, September 07, 2011:
Bill Himmel’s experience jives with what I was seeing. While the behavior was erratic based on race conditions between the different Ajax calls. The last two were almost always the “vitals” and the “Clinical reminders.” The “clinical reminders” would complete after the “vitals” due to the Clinical Reminders being based on weight. Our “vitals” table has over 100K rows.
Sam Bowen, MD
bradymiller wrote on Thursday, September 08, 2011:
Hi,
Need more specifics here; otherwise tough to know how to best attack these issues 
-brady
drbowen wrote on Wednesday, September 21, 2011:
Jeremy Wallace of http://www.mi-squared.com upgraded our system to OpenEMR-devtip, date of download 09-20-2011, last night. The upgrade went very smoothly. The database tables are very spritely, no slow-downs of any sort detected, the auto-esignature is working correctly. Kudos to Jeremy Wallace.
The LEN is up and functioning very well.
We are downloading labs from LabCorp on a daily basis. This is a service available through http://www.mi-squared.com. MI-Squared has results available through Solstas and are working on bidirectional connections with LabCorp and Quest Diagnostic.
Messages:
We are not able to send messages to ourselves which find a very useful feature to send reminders to ourselves to complete patient specific tasks.
To sign off on a lab message I have to click done first, then send the message to some other practitioner, then click Save. This is cumbersome and slows down the lab review process. The button that we could directly into the patients “pending review” area is sorely missed. Having to select another user first, then click done, and then save is kludgy.
From our functional status as practitioners, having the button to go directly to the patient pending review (and marking done, and signing off the message) with one click would be better. A possibly even better solution would be, being able to select the behavior to either 1) close the lab results message automatically (better for experienced users) 2) not closing the message (better for new users) which is the current behavior.
E-Prescription:
The most recent OpenEMR dev-tip has the patch for the ZMG e-prescription service. This available through both http://www.mi-squared.com and http://zhservices.com/ . I will be configuring this for our practice as soon as is practical.
Sam Bowen, MD
http://www.oemr.org