Resolving slowness issues

Compare the Windows user permissions for users with slowness issues with the permissions of users with no issues.

Try updating Windows user permissions where a difference might affect performance.

Log a user with slowness issues on to another Bp Premier workstation with no reported issues. Does the user still have issues?

If yes, the user may have a corrupt Windows profile. Try creating a new user profile.

If no, the problem is probably on the user's PC.

Log a user with no issues on to the problem workstation. Does the new user have slowness issues?

If yes, the problem is the user's PC.

If no, the problem is probably the first user's Windows account.

Has this workstation been configured to import lab results or the Patients.in file?

Select Setup > Configuration > Results Import. Is Import investigation reports on this computer? ticked?

If so, untick this option. This option should only be ticked on the Bp Premier server so that only one machine imports results.

Check that the slow workstation meets the minimum system requirements for the version of Bp Premier installed.

Upgrade any components that do not meet the minimum requirements.

Is Bp Premier slow when typing patient notes?

If so, and your practice uses anti-virus software to regularly scan machines on your network, try excluding the following folders from your anti-virus software's scanning policy:

C:\Program Files\Best Practice Software\BPS\Spelling

C:\Program Files\Best Practice Software\

C:\Program Files\Microsoft SQL Server\

Run an anti-virus scan

Update your anti-virus software with the latest definitions according to the software's online help, or install a recommended up-to-date anti-virus application and scan the workstation that is slow.

Run a check on the hard disk

Use Windows administrative tools to run diagnostics on the workstation's hard disk to identify and repair any errors.

Check network connectivity

'Ping' the Bp Premier server from the workstation to check for unreasonable response times.

If so, try a different network port to plug the workstation into, or install a different network card.

Check IP address conflicts

If your practice uses static IPs for its network configuration, ensure that other PCs in the network do not share the same IP address.

Check Bp Server DNS resolution

By default, the server name is used to connect to the server. DNS problems could cause slowness due to issues resolving the server name. Use the IP address instead to connect.

Update the following registry values using REGEDIT on the workstation:

• For 32-bit machines, update HKEY_CURRENT_USER\Software\Best Practice Software\Best Practice\Database and HKEY_LOCAL_MACHINE\Software\Best Practice Software\Best Practice\Database
• For 64-bit machines, update HKEY_LOCAL_MACHINE\Software\Wow6432Node\Best Practice Software\Best Practice\Database

Set the Server value to the IP address of the Bp Premier server.

Check driver updates

Out-of-date graphical and hardware drivers can cause slowness issues. Check that the drivers for the workstation are up to date.

Reinstall Bp Premier.

If none of the above resolves the issue, uninstall and reinstall the software. See Title for more information.

Log in to the Bp Premier server. Is Bp Premier still running slowly?

If yes, continue troubleshooting below.

If no, the problem is probably with an individual workstation. Try resolving using the checklist If only certain users are experiencing slowness.

Check that the Bp Premier server meets the minimum system requirements for the version of Bp Premier installed.

Upgrade any components that do not meet the minimum requirements.

If the number of concurrent users at your practice is more than 10-15 users, the server will need to have greater requirements than the minimum, particularly system memory. You may also need more memory if the machine hosting the Bp Premier server hosts other applications running concurrently.

Check the documents database is configured correctly

View the SQL error logs, found by default at C:\Program Files\Microsoft SQL Server\MSSQL10_50.BPSINSTANCE\MSSQL\DATA.

If the log files are not there, log in to Bp and select Help > About > System info to confirm the log file path. Look for repeated instances of ‘Starting up database’ for the same database.

To resolve, run the utility Attach Database.exe from the folder C:\Program Files\Best Practice Software\BPS. Zip and email the log files to support@bpsoftware.net for evaluation.

Is Bp Premier slow when typing patient notes?

If so, and your practice uses anti-virus software to regularly scan machines on your network, try excluding the following folder from your anti-virus software's scanning policy:

C:\Program Files\Best Practice Software\BPS\Spelling

Remove this folder from scanning for all workstations and the Bp Premier server.

Has more than one PC been configured to import results or messaging paths?

Results import and messaging provider settings must be configured to run on one machine only, usually the Bp server.

Contact Best Practice Software Support, who can provide a utility which will export the full list of machines configured for importing at your practice. Support will provide you with the list after the utility is run.

If there are only one or two workstations affected:

1. Log in to Bp Premier on the workstation.
2. Select Setup > Configuration > Results Import.
3. If there are paths listed in Report file search paths, write these down so they can be set up correctly on the server, then delete the entries here.
4. Untick Import investigation reports on this workstation?.
5. Select the Messaging paths tab.
6. Are there paths listed in Paths set up for this provider? Are any of these paths invalid? They should all be pointing to the same shared folder on the server.

If there are numerous workstations affected or out-of-date import or messaging paths, contact Best Practice Software support to obtain a utility to clear all paths so they can be configured correctly on the server

Check Bp Server DNS resolution

By default, the server name is used to connect to the server. DNS problems could cause slowness due to issues resolving the server name. Use the IP address instead to connect.

Update the following registry values using REGEDIT on the workstation:

• For 32-bit machines, update HKEY_CURRENT_USER\Software\Best Practice Software\Best Practice\Database and HKEY_LOCAL_MACHINE\Software\Best Practice Software\Best Practice\Database
• For 64-bit machines, update HKEY_LOCAL_MACHINE\Software\Wow6432Node\Best Practice Software\Best Practice\Database

Set the Server value to the IP address of the Bp Premier server.

Check database for fragmented indexing

Your IT support or Best Practice Software support can advise on whether fragmented indexing is causing slowness. Best Practice Software support may recommend running the re-index utility.

IMPORTANT  Do not run this utility unless Best Practice Software support has advised you to do so.

On the server, browse to the folder C:\Program Files\Best Practice Software\BPS and run the file BPS Utilities.EXE. Log in, scroll down and double click on the function Rebuild SQL indexes.

Click the Run button. When complete, run the utility again.

Check that a backup or background process is not running

A database backup will slow regular Bp Premier use. You should schedule regular backups to be outside of normal opening hours.

To check that backups have completed, open Windows Task Manager (Ctrl+Shift+Esc) to ensure that there is no process called ‘BPBackup.exe’ still running. Check the log file in C:\Documents and Settings\All Users\Application Data\Best Practice\Log to identify when a backup completed.

If the machine hosting the Bp Premier server also runs other applications or scheduled tasks in the background, for example, another clinical software application or accounting software, check that the background tasks are not consuming resources such that Bp Premier is affected.

Run an anti-virus scan

Update your anti-virus software with the latest definitions according to the software's online help, or install a recommended up-to-date anti-virus application and scan the Bp Premier server.

Check peripherals (such as scanners and printers) and any external hard drives attached to local or networked machines

If there is a peripheral or mapped external hard drive that is no longer available on the network or local machine, Best Practice or other programs may have issues trying to access them.

Make sure peripheral devices are attached and switched on. If a device has been permanently removed from the network or local machine, delete or update any shortcuts and links that programs may be using to access the devices.

Check SQL log file growth

View the SQL error logs, found by default at C:\Program Files\Microsoft SQL Server\MSSQL10_50.BPSINSTANCE\MSSQL\DATA.

If the log files are not there, log in to Bp and select Help > About > System info to confirm the log file path.

Check the size of all the files with the extension .LDF. If any are larger than 2MB, run the Shrink logs utility.

NOTE  Best Practice Software recommend that you perform a Bp backup prior to using this utility.

Run BPS Utilities.EXE from the folder C:\Program Files\Best Practice Software\BPS. Select Shrink log files and select the database or databases which have the large log file. Once run, the size of the logs files should return to less than 1MB.

Check SQL version in use meets requirements

By default, Best Practice uses the free version of SQL. The free version of SQL limits the amount of RAM that can be used by the instance, and is only suitable for practices that have up to about 10–15 concurrent users.

If the practice has more concurrent users, Best Practice Software recommend that the practice purchase a full version of SQL so that more RAM can be utilised.

Check HDD available space

Clear up space on the server HDD:

1. Run Windows Disk cleanup.
2. Check the folder C:\Documents and Settings\All Users\Application Data\Best Practice\ is working and the backup folders. Delete any old backup files that might remain from failed backups.
3. Check the folder C:\Program Files\Microsoft SQL Server\MSSQL10_50.BPSINSTANCE\MSSQL\DATA for any files with the extension .LDF that are larger than 1MB. If these files are large, run the Shrink Log File utility.

Check hard drive fragmentation on the server

Compressed backups create and delete temporary files each time they are run, which can cause fragmentation of the C:\drive. Use Windows administrative tools to defragment the server hard drive.

Run a check on the hard disk

Use Windows administrative tools to run diagnostics on the workstation's hard disk to identify and repair any errors.

Check the server event logs for errors or warnings

Check the Server Event Viewer - Application and System section for any errors or warnings that might indicate a problem with the SQL server or the network in general.

Check for faulty hardware

Check network devices (cable, hub, interface cards) and replace if any fail. Complete thorough CPU, RAM, and HDD tests.

Check power saving settings on the server

Check that the Windows power saving settings are not shutting down or hibernating the Bp Premier server when it should be running.

Checked stored messages

Bp Premier internal messages are not intended to be kept permanently and for best performance should be deleted on a regular basis.

You can use the Delete Messages function in Bp Utilities to clear out all received messages for one or more doctors. You will still need to delete all of your sent messages from within Best Practice.

NOTE  Messages deleted from the Messages screen or the Delete Messages bulk utility will be deleted permanently. Any notes inserted into a patient record from the Link to Patient function will remain in the patient record.

Compare the speed of the system on an alternate server

Install Best Practice on a PC with a reasonable specification (greater than the current machine). Restore the most recent Best Practice backup.

Run a speed test, comparing the time it takes to open the same patient on the ‘live’ server against the ‘test’ server.