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Re: CottageMed improvements
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Roger Bailey
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Apr 25, 2009 23:06 PDT
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Hi Malcome
I was wondering if you had any issues with FileMaker Server. My admin console was working just fine then one day, boom, it's gone and won't open. The application still runs and all is well from that regard but the admin console hasn't worked in months. There is a software update but I am nervous about using it.The other odd thing is that my server is server.thepainclinic.com, but I can access the cottage med database via that name OR with the name of my server (server.superbehemoth.com)...runs just the same and when CottageMed opens it always says its the server name, not server.thepainclinic.com. Just was wondering if you'd had any similar issues.
One thing that happened to me the other day was very frightening though. My nurse was in the exam room and entered some data (vitals, etc), then came out to her computer and noticed all the data was gone. I entered some data on the same patient a few minutes later and while I was talking to her I noticed the entire day's entry was gone...then seconds later the entire list of prior visits disappeared, too. There were a couple of error messages (hard drive space?), too. I stepped out and noticed that on the server the visit on that day was gone but fortunately the prior visits were still there. I rebooted the server and though I had to redo that day's entry, all the others were there and I've had no issues in the last few days. The only thing I had been doing out of the ordinary was I was trialing 'Backblaze' (an onine remote storage service) that had been backing up my server (but only 1/3 of the way done). It had been running for over a
week but since that was the only other variable - I shut it down and later uninstalled it. Very strange. Not sure if the backup app had anything to do with it.
Also thought I'd ask if you had any experience with online backups. I have been using FilesAnywhere, which has an online Fax service (inbound number/outbound) but is a little more expensive. I've trialed Carbonite, which did not work on OS X server at all. I'm thinking about a MozyPro account (which supports MAC OS X server) and am currently in the middle of a Zumo trial. I have also trialed CrashPlan, which is useful to have inhouse backups to other computers in the office, but their remote service is awful so far...very very slow and unreliable.
Roger
--- On Mon, 4/20/09, Malcolm Sickels <mjsi-@umich.edu> wrote:
From: Malcolm Sickels <mjsi-@umich.edu>
Subject: Re: CottageMed improvements
To: Cotta-@topica.com
Date: Monday, April 20, 2009, 7:12 PM
Yes, I am on FileMaker Server, and despite opening the databases with a single user copy of FMP (after turning the server off and moving them out of the Database folder and opening it with FMP (where it does what it's always done when not run through Server: default to printing current record only), then turning the server on and importing them into the Database folder via FMS) it still defaults to printing all records. Any other ideas?
Also, I had the troubling experience of FMS not knowing that it was out of date and denying that there was a newer version when I upgraded the computer it's running on. The new computer had 10.5.6 and I was running FMS 9v2 and you need the latest version of FMS (9v3.326) to run on 10.5. Just a heads-up.
FYI, we're still plugging away with insurance. I can't bear to cut off the people who can't afford to pay out of pocket, and am paying the price with a lower income. It's values vs pocketbook. If it wasn't sustainable, I'd change it, but it is (just barely).
Malcolm Sickels MD210 Little Lake Drive, Suite 10Ann Arbor, MI 48103http://drsickels.com734-332-9936
On Dec 20, 2008, at 8:09 AM, Stefan Topolski wrote:
Hello Malcolm,
Yes, great points. We really appreciate your suggestions and hard work.
When you see a feature or behavior not hold after restarting, it means you are using FileMaker Server. These often involve global variables which are unique for each user when you log in to CottageMed. When each user logs out, however, their unique global value is discarded and the original global value for the database remains on the hard drive file.
This is normal, it's not a bug, it's the way databases manage multiple users. The solution is to turn off the Server program, pull your files out to your desktop, open them up with a single-user copy of FIlemaker Pro, set the variables and values and behaviors the way you want, then close Filemaker Pro. When you re-upload these database files to the server as your new copies, your new settings which you set in Filemaker Pro single-user will be the settings that come up as default when the files are shared to others through Filemaker Server.
As for billing, failed promises of billing companies is the norm. Their performance, in my opinion, gets worse each year as they are outmaneuvered by the gamesmanship of much larger insurance companies they seek payment from. Doing it yourself, though, is an even riskier venture that is a step further backwards.
THIS IS WHERE EVERY NEW AND YOUNG PRACTICE I CONSULT FOR FAILS IF IT FAILS. In U.S. health care today there is a huge crime. It's not LOCATION, LOCATION, LOCATION. It's BILLING, BILLING, BILLING...
I know that you've had problems with your state laws and considering firms like Athena. I get nothing from Athena for this suggestion. They are INCREDIBLE, and you need a large outfit that's national like Athena, any outfit as big as Athena, with the resources, people power, and computer automation skills to keep up with the insurance 'big boys' and play the insurance billing game to win.
I hope you can find some arrangement like this, or go cash-only. Billing insurance yourself is a dead-end game that's too dangerous for me to play. I do hope that you have better luck at it than almost everyone else. I really want you to keep growing and succeed!
Yours Truly,Stefan
"One gathers peace as a feather in the palm of one's hand." -anonymous
Stefan Topolski MDU. of Massachusetts School of MedicineU. of New EnglandCaring in Community, Inc.1105 Mohawk TrailShelburne Falls, Ma.http://www.cottagemed.org
On Dec 18, 2008, at 9:26 PM, Malcolm Sickels wrote:
Yeah, doing the jump once was a more painful endeavor than the smaller jumps, but it's hard to find the time to do it and deal with the unknown consequences of the changes. Upgrades are always a leap into the unknown and I want to subject me, my staff and my patients to as little as possible. I take full responsibility for the unusual upgrade path and expected the pain, so was documenting the changes I made for myself (since I'll have to re-do some them every time I upgrade for my idiosyncrasies (another reason I do it as little as possible) and if it just put it on paper it'll get lost) and for anyone else who might be in the same boat. If anything it's a testament to how good 1.9.1 was: no compelling reason to upgrade.We've since stopped using our billing company and are doing it ourselves.I think the PDF saving problem went away. No idea why.We switched to FileMaker Server (running on my old G4 768DP MDD) over gigabit ethernet (except one
notebook on the newest airport), and some things are actually faster than they were before and there's fewer problems! There is one new issue, though: when quitting and restarting FMP, the print dialogue defaults to printing "all records" rather than only the records being browsed, so if I don't fix it each restart I end up getting all of a patient's prescriptions printing out instead of the one I'm printing.
Dr. Malcolm Sickels, MD210 Little Lake Drive, Suite 10Ann Arbor, MI 48103http://drsickels.com734-332-9936
On Dec 18, 2008, at 10:09 AM, Stefan Topolski wrote:
Thank you , Malcolm -
Your suggestions are very helpful. Some are unique to your install, some are useful to all users. Some such as not being able to save a print preview are not the purview of Filemaker or CottageMed and you'll have to look to the Mac OS for the problem there.
The Rx changes were required and all fields have more advanced functions for specific user needs. We will fix the tab order again. Some users prefer to have the past cc: and vitals present for their workflow. We will debate those changes some more.
The most important advice we can give you to make the upgrade process smoother is to upgrade much sooner. Jumping from version 1.9 to 2.5 is a huge jump over several years of program development. It's a bit too much to ask the program and programming team to make painless for you.
So in the future, please upgrade each year so that your experience is as smooth and enjoyable as that of other CottageMed users.
Yours Truly,Stefan
"One gathers peace as a feather in the palm of one's hand." -anonymous
Stefan Topolski MDU. of Massachusetts School of MedicineU. of New EnglandCaring in Community, Inc.1105 Mohawk TrailShelburne Falls, Ma.http://www.cottagemed.org
On Jul 7, 2008, at 5:12 PM, Malcolm Sickels wrote:
Other changes I made to the 2.5.1b version I moved to today and yesterday:-edited the startup script to hide _all_ the windows except the main one (Alerts and AllPhonesAddresses were previously left showing but I never use them), and switched the inequality in the 4th to last line to <= since it seemed to always show the alert even if I just backed up.-edited the layout of the Superbill to include "Checked Dx is primary!" above the checkboxes, made more room for the pt paid amount and added 2 decimal places to that display and the total, and moved things around to make room for the numbers.Also, somehow the page setup was set to horizontal orientation and the print dialogue defaulted to 2 copies, but that might just be something on my end (though these are brand-new installs of FM9).Also for some reason we can no longer save a print preview of the superbills (we have been hitting preview and then saving (to their files) a PDF of the superbill and then
hitting the print button and printing it out for the billing company). Any idea why that's happening?The prescription list seems to be sorted differently now, too. I don't see the logic in it any more.There's also some weirdness with the dates logged in the Rxs. On several Rx written today (often on spaces left from old scripts) or refills, the date entered into the Rx log is a previous date, often the date of the last time that prescription was printed. Interestingly, the log still has them sorted by when I actually printed them (so even though a script I printed today has a date before some other things further down the log's list).Also, there's this "Date" column in the Rx section that doesn't seem to relate to anything (it doesn't have the date of the Rxs I just printed today!). I'll go in and see what it's supposed to do. I didn't get vary far since I don't know what all the script-maker functions are.
I also turned off drag and drop text selection since it gets me in more trouble than it's worth (since dragging is a good way to get around in a note).I'm also having trouble with all clients logging in with the same credentials (whatever the serving computer (mine) logs in as, so do all the others), but this may get fixed when I move it to a dedicated server.The new find function (from pressing the button) while having a good warning now leaves the person in the list view which makes more work, but if cmd-F works just as well, it may not be a big dealI had to re-designate the tabs to make the tab order for the Rx lines all in a row (24-30) in the Notes layout. Otherwise, hitting tab goes awry and you can't enter a bunch of Rx one after the other (like when putting in a new pt) without using the mouse. I would like to not have the Rx pad window show up (in back) every time I start a SOAP note, but it's not plain in the script. It'd also be good
to have it clear the vitals/CC box when it puts them in a note.
Dr. Malcolm Sickels MD210 Little Lake Drive, Suite 10Ann Arbor, MI 48103http://drsickels.com734-332-9936
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