Our path to improved performance includes three areas of focus for Accuro: Targeted scaling, for-purpose solutions, and consistency and responsiveness. Details of each are provided in the sections below and are informed by our knowledge of existing issues and our understanding of the right solutions to resolve them.
Targeted Scaling
Since its inception, Accuro has become an increasingly multi-faceted, feature-rich platform. That depth of functionality makes it a powerfully versatile tool, but it also comes at the cost of some amount of agility. Because it currently exists as a single database of information, any increased load from one user results in increased load for all users on that server. Likewise, scaling up to meet increased demand in one area requires scaling up the entirety of Accuro.
Our plan, then, is to decouple Accuro at the database level into multiple separate applications that work together. This will accomplish a few things:
- Increased loads will be isolated so they don’t impact other users, and
- We can scale up where there’s specific demand (e.g. for processing reports) rather than scaling up across the board and affecting core Accuro use.
In practice, this decoupling could also involve things like taking Accuro’s activity logs out of the main database—a move with significant implications. Activity logging, the running record of every action taken by every user on the Accuro system, is essential for accountability purposes. It also constitutes one-third of all the information stored in the database, so moving it to its own database will free up a substantial amount of space.
The potential for this kind of segregation is far-reaching, and by moving to the Cloud we’ve already laid the groundwork for making targeted scalability easier while ensuring you continue to experience Accuro as a single system.
For-purpose Solutions
Within a platform like Accuro, there are innumerable tasks needing to be performed—scheduling, billing, prescribing, reporting, messaging—each needing its own set of instructions for doing so. One option is to build the instructions for each function into Accuro, thereby asking it to do everything; the other option is adding tools into Accuro that are already built to perform those functions.
By using for-purpose solutions (like a dedicated logging system to generate, filter, record, and analyze those activity log messages we mentioned above), Accuro doesn’t need to include instructions for each function in addition to everything else it does. In human terms, Accuro is the project manager and for-purpose solutions are its subcontractors.
This separation of duties also has security benefits in the unlikely event of a data breach. By using discrete tools within the system, data is compartmentalized; should a hacker get in, they’ll gain access to that compartment and its small slice of information only, rather than to the entire system.
Consistency and Responsiveness
These two attributes sum up the core objective of our Accuro Performance Initiative, and our path to achieving them will take a number of routes. In addition to the targeted scaling and for-purpose solutions mentioned above, we’re also taking the following approaches to deliver consistent and responsive performance.
Data structure.
We’re currently making changes to how data is structured within Accuro: how it’s stored, recalled, and displayed in the user interface so you can find what you’re looking for faster. When accessing the patient chart now, for instance, all chart data tries to load simultaneously, resulting in a lag. But not all data is equally important for your purposes, so our efforts are focused on understanding which information needs to be available first and leaving the rest to load as it’s ready or as the user requests it.
Intelligent security.
Accuro’s firewall is an essential safety feature but like any security checkpoint, it slows the flow of traffic. By optimizing its use, we can be much more specific about which information needs to go through it (data we can’t automatically trust) and which doesn’t (data we know we can trust). That selective filtering will shorten the line of traffic at the firewall and let everything else move more quickly, keeping you protected while improving Accuro’s performance.
Big-picture monitoring.
Going forward, we’ll be working on better monitoring, establishing tighter performance metrics, and implementing baselines for things like loading time or time to navigate between modules. Overall, we’ll focus on longevity, scalability, and sustainability in the program, from an end-to-end perspective that goes beyond Accuro itself to all services and infrastructure that support it.
SQL optimization.
We’re currently engaged in a full, top-to-bottom review of SQL server use to assess how we query SQL, how it’s configured, and where we can further optimize it to maximize performance. And while describing that activity is simple enough, it’s a massive undertaking that may take up to a year to complete.
Listening to you.
Beyond the long-term activities on our radar, our immediate target is understanding where our users are most impacted. We want to know your pain points today—where you’re having the biggest performance-related issues in your Accuro use—so we can prioritize our efforts. To share your experience, join our user research group by signing up here.
The Accuro Performance Initiative is our commitment to achieving two important goals: optimizing Accuro’s performance up front as quickly as possible, and implementing larger-scale change on the back end to ensure consistent, sustained performance that will scale with you as your clinic grows. It’s not a short-term fix; it’s the start of focused effort that will continue for as long as we serve you.