Knowledgebase : Technical, Configuration and Devices > Installation and Updates

Installing Specialist Practice Manager (SPM) or Private Hospital Manager (PHM) 
Updated June 2023


  • Check Recommended & Network Hardware Requirements
  • Windows 32 or 64bit Operating System
  • Microsoft SQL Server Express or Standard edition database (include SQL Management Studio) - 2 core, 2014 or newer
    (must be installed with Mixed Authentication option)
  • Ensure that the Control Panel -> Regional Settings (Region) are set to the correct country
  • Your Windows account has Local or Domain Administrator rights to install files and write to the Registry on the workstation
  • Check the Windows User accounts have permission to Read, Write, Create & Modify in the local \SPMWIN directory and also into the shared directories on the server (e.g. \\servername\spmwin\data)
  • 'User Account Control' needs to be turned off before commencing the installation.
  • Disable all virus checkers
  • If installing to a Terminal Server ensure you have Remote Administrator rights ,or;
    • In a Command Prompt (with Admin rights) type in   Change User /install then press Enter 
      When the installation is complete and SPM/PHM running correctly, you will need to type in  Change User /execute to complete the process
  • Modify the Power settings to High Performance and in particular, ensure the network card does not have a 'sleep' option.

Installation of Incisive databases

  • If other SQL databases are present on the SQL server, create a separate Instance (using Mixed Authentication) for the Incisive databases.
  • Incisive will provide the databases, restore them to the relevant Instance and configure the login security & permissions

Configure the SQL Server database (if not already available)

  • Open SQL Server Configuration Tool and make sure the SQL Server database engine is running and is using Network Service authorisation
    If you can't find it search for  SQLServerManager12.msc (change the numeral to match the version of SQL12=2014, SQL13=2016, SQL14=2017, SQL15=2019, SQL16=2022))
  • In 'SQL Server Network Configuration' section ensure the TCP network protocol is enabled
  • Configure the port number to be fixed or dynamic
    (If not sure leave it as Dynamic [0] but make sure the SQL Browser is running as a service)
  • Check the Compatibility Level of the databases matches the database version


Installation file


  • Find and use an existing installation file on the server.  Often found in \\SERVERNAME\SPMWIN\INSTALL, or
  • Contact the Incisive Helpdesk 


Run the installation file.

  1. Right mouse click on the installation file and select 'Run As Administrator'

  2. Choose the edition to install (must be the same edition for the whole practice)
    • Integrated - choose this option for all new practice installations.

  3. Select the type of install
    • New machine, or
    • Update existing (installation of SPM or PHM on this computer)

  4. Check-on the SQL option if SPM is using an SQL Server database

  5. Check-on the Terminal Server option if you are installing on the Terminal Server

  6. Choose the type of system you are installing (if in doubt choose Workstation)
    • Select Stand-alone if you are installing SPM on a computer that is not connected to a network;
    • Select Server if you are installing the software on the Server itself.  Note this does not install the application, only the data directories and supporting files;

  7. Select Workstation if you are installing SPM on a workstation or a Laptop where it is SQL Database, running on a network where the database will reside on the server.

  8. Accept the default installation location and shortcut location, unless you are familiar with the advanced installation options. To change the default location, select Browse, otherwise select Next.

  9. Shared paths on server
    Some directories on the server are used by all workstations on the network (read/write permissions)
    • Path for storing log & shared data files
      Usually the Data directory (use an UNC format e.g. \\server\spmwin\data)
    • Update Path
      All workstations on the network need to run the same version of the SPM application and can update their files from a common directory on the server.
      Usually the Updates directory (use an UNC format e.g. \\server\spmwin\updates)

  10. Create a New Data Source to SQL Server (There are 2 data sources to create)
    You can skip this step by pressing Cancel and manually adding the ODBC sources later on (or use existing ones)
    • Enter the name of the ODBC Data source to Connect to SQL Server, this is usually SPM or SPMSQL, enter the description and select the Server\Instance.
    • Choose SQL Server Authentication
    • Tick ‘Connect to SQL to obtain default settings for the additional configuration options’
    • Enter the Login ID and Password (these should be known by the practice - if not, call Incisive helpdesk)
    • Select the Database
    • Accept the defaults for all other settings.
    • Use the Test Connection option
    • Repeat the above sequence for the SPMWORK database

  11. Click Yes to install the most recent Release version

  12. Day Code
    Call Incisive for today's code.  The application will not be installed correctly if you proceed without it.
    NZ - 0800 64 1234       Aus - 1800 467 287

  13. Installation of Java (Australia only)
    Accept the defaults

  14. Installation of HIC / Medicare Online PKI Certificate (Australia only)
    Accept the defaults

  15. The SPM files will now be copied and installed.  There are still a few steps to complete once the installation has finished and before you run the application.      


Network Share

If not already completed, ensure that the common, share directory (usually \spmwin) on the server has a network Share that all Users of the Incisive applications have permission to Read, Write, Create and Modify files.



Make sure that the SQL Server connection can get through the server Firewall.  If in doubt, turn off the Firewall (on the database server) to get things running then configure it correctly later and turn it back on.

  • Port 1433 TCP is the default used for SQL database connections
  • Port 1434 UDP is the default used for SQL Browser (Dynamic Connections)

See for details on the options.



Adjust the virus-checker to exclude, from real-time protection, the local installation directory (usually \SPMWIN).   The Incisive application will create, read, write and delete various text based files from this directory.


Incisive folder on the Desktop

The existing command (Copy pathname\Spmwin\updates\*.* c:\SPMWIN) needs the 'pathname' replaced with the name of the server
The Installation routine creates a batch file that allows you to copy the latest program updates from the \Spmwin\Updates directory on the Server to the local \Spmwin directory on the Workstation or laptop.  The batch file (update.bat) will need to be checked edited and the pathname changed if necessary.



  • Ensure the latest printer drivers are installed for the printers that will be accessed by the workstation.
  • Disable the Windows option to 'Allow Windows to manage printers'
  • Conduct a Windows Test Print from each printer
  • In Windows, choose the main printer as the 'default printer' by going to Start -> Settings -> Control Panel -> Printers & Devices.
  • Check to see that the Default Paper Tray option is set to any tray other than 'Auto-select'
  • For label printers that feed the labels from a roll ensure that the Paper Orientation is set to Landscape.
  • Ensure the User has sufficient permissions to 'Modify' the printer driver (Read-only is not enough)


Running the SPM application

  • Make sure you are logged into Windows using either Local or Domain Administrator permissions.
  • Open the Incisive folder on the Desktop
  • Right-mouse-click on the Specialist Practice Manager icon and choose 'Run As Administrator'.  This will allow the files to be correctly written to the Registry.
  • Obtain the login & password from the practice to run the application
  • Check the Images tab in Patient.  If not loading correctly add the following files to 'Data Execution Prevention' (Control panel - System - Advanced - Performance - Settings - DEP)
    - spm_ximage.exe, spm_f3.dll, spm_f7.dll, spm_xnote.exe



Download and install onto the computer that the scanner is connected to, the latest TWAIN driver for the scanner.  At worst, use the one supplied with the scanner but be aware that these are often out of date.

Ensure the paths to the scanned document directories are set correctly in the application. Setup  –>  System  –> File Locations.  Use the UNC method to name the path.


Terminal Server or Citrix

If the workstation is to connect to a Terminal Server you can configure the application so that each network login becomes a 'Virtual' workstation. 

  • Find and edit the SPM.INI file in the \SPMWIN directory
  • In the [Workstation] section add a new line     Citrix=True
  • Save the file

We recommend using TSPrint and TSScan from for environments where there are multiple remote locations with separate printer collections.



  • Can't create an ODBC connection
    This is almost always caused by the firewall blocking the connection on the database server. 
    Also check you are using the correct connection method in the 'Client' Configuration' button

  • SPM/PHM application can't find database
    Find and open the spm.ini file in the local install directory (usually \SPMWIN) and check the Login= and Password=  entries are correct. 
    As the password is encrypted you will need to contact Incisive helpdesk to provide you with the encryption.
    Alternatively, if there is already another workstation successfully running SPM/PHM you can copy the spm.ini file from there and over-write the local one.
    If you have manually added the ODBC entries make sure you have used 'ODBC Data Sources (32-bit)'  - not 'ODBC Data Sources (64-bit)'. 
    Turn OFF the firewall and check to see if you can get access.

  • SPM/PHM application can't access mdb path
    This is a bit of a red-herring as it now has nothing to do with an mdb database.  It is trying to access the common, shared directory which is usually \\server\spmwin\data on the server.
    Check that the directory is shared and that the permissions has Full-Control for Everyone.
    Make sure that the User's network permissions has the right to access the shared directory.

  • Errors when registering the files during startup
    You either don't have Local Administrator rights and/or you didn't start the application using the 'Run As Administrator' option.  Make the suitable corrections and try again.
    If you are still getting the error you can start again by going to a Command Prompt and type in  DEL C:\spmwin\spm_*.txt then press enter.  This clears the earlier attempts and allows you to start the file registration afresh
    A utility file called RegisterBatch.exe in the SPM/PHM program directory will make a batch file called RegisterSPM.bat.  If you run this file it will unregister then reregister all of the SPM/PHM files.

  • Some modules just won't start
    Check the virus-checker isn't putting the files into quarantine
    Check the Data-Execution-Protection settings (see above)

  • Various errors appear at random times
     - check that the workstation is running the same version of SPM/PHM as the other workstations.  You may need to Upgrade or Downgrade.
     - check the database structure is up-to-date.  Run 'mdbupdate.exe' in the \SPMWIN directory to ensure the database structure is up-to-date.  This is version specific and needs to be run after a version upgrade.  It can be run at any time.

These instructions provide the steps you should take if you are changing the Server   (SQL Server databases).

  1. Please notify Incisive support staff as soon as you know the date that you expect to perform the server change.
  2. Install & configure SQL SERVER
    1. Install Microsoft SQL Server or SQL Server Express (2014, 2016, 2017,2019 or 2022)
    2. Install SQL Server Management Tools (SQL Server Management Studio)
    3. If possible, create a new Instance called INCISIVE
    4. Use 'Network Service' as the login for the SQL Engine or configure permissions for Users to use the default account created by the SQL Server installation.
    5. Set the ‘Server Authentication’ to ‘SQL & Windows Authentication Mode’ (Instance --> Properties --> Security).  
    6. Use the SQL Server Configuration Tool (sqlservermanagerxx.msc) to ensure that the TCP/IP protocol is 'Enabled' (it is Disabled by default)
    7. Attach or restore a backup of both the SPM and SPMWORK databases to the new SQL Server.  Make sure that the .mdf and .ldf data files are in a directory that is NOT a sub-directory of the shared SPMWIN directory.  We recommend that you have a separate SPMDATA directory (C:\SPMdata) and provide security permissions for Read & Write.
    8. Make sure there are two Logins called  ‘IncisiveClient’ and 'IncisiveAdmin' and that these are mapped to the two SPM databases (usually SPM and SPMWORK).  Also check that there are both ‘IncisiveClient’ and 'IncisiveAdmin' Users in the Security section of each database.  Create a strong password for each login and call Incisive to tell them of the passwords you have used.
    9. Enable both databases to unrestricted growth in 10% increments. 
    10. Make sure that the databases on the old server can no longer be accessed.
    11. Ensure the SQL Browser is running if using dynamic IP port address.
    12. Edit the SPM & SPMwork Database under –Properties  -Options and change the Compatibility Level to match the version of SQL Server that it is now running on.
    13. Check that SQL Server Management Studio is available for the Incisive login.

      See Trouble-shooting SQL Server connections

  3. Firewall access
    Open the ports required for remote connections to the SQL server.
    Use PortQryV2.exe to test the ports.

  4. Create Shared directory
    1. Create a SPMWIN directory on the data drive of the new server with ‘Full Control’ access rights for all Windows account logins.  The data drive should be different from the directory the program will be installed to if the server is to be used as a workstation or terminal server.  Ideally the SPMWIN folder should be the top level e.g. d:\spmwin but if you do put it within other folders try not to make it too long a path.

  5. Anti-virus software on the server
    1. Modify the setting in the anti-virus software to allow new files to be written into the:
      1. \SPMWIN and subdirectories
      2. Shared directory
      3. Scanned documents, images and data directories if they are in different locations
    2. Exclude real-time scanning of the contents of the:
      1. \SPMWIN directory and sub-directories,
      2. Scanned document and images directories, and
      3. SQL specific requirements.  See the recommendations from Microsoft regarding virus scanning on an SQL Server.

  6. Copy data & file directories
    1. Copy all the subdirectories of the \SPMWIN directory on the old server, across to the \SPMWIN directory on the new server.  Do not copy the program files inside the SPMWIN directory, only the subdirectories.  
    2. Ensure the sub-directories have inherited the parent directory security rights for ‘Full control’.

  7. Install the Incisive application
    This option is only required if the server is also being used as an application server.
    1. If the new server is also to be used as a workstation or terminal server, the SPM program will need to be installed on to it.  If this is the case, it is desirable to install the program to the C drive (root) and have the data on another drive. 
    2. Ensure the User Account Control (UAC) option is turned OFF.  UAC is found in Windows Control Panel – User Accounts. (Turn it on again when the files have been registered)
    3. Run the SPM Setup program (SetupNZ.exe or SetupAus.exe) and select ‘Workstation’.  When running the install file use the ‘Run As Administrator) option – even if you are Domain Administrator. Make sure you put in the new server for the database and the correct path for the Updates folder.  It is important that the Update path is a valid path as this can cause problems later if they are wrong.  Always test them in Windows Explorer first to make sure they exist and that the pc has access to them.
      Note that if the Incisive application on the server will be run from multiple Remote Desktop sessions at the same time, the SPM.INI file on the server requires the entry of  Citrix=True  in the [Workstation] section of the file.  You also need to use the 'Change User /Install' command to prepare the server the installation and when complete, use the 'Change User /Execute' command.
    4. The Incisive application on the server needs to be the same version as is installed on the workstations.
      Copy the contents of the Updates directory (usually \spmwin\updates) into the \SPMWIN directory.  Note that this may overwrite existing installed files that are newer.
    5. Check directory permissions.
      The network User accounts need the ability to Read, Write & Modify in the \SPMWIN application directory.

  8. Database connections 
    To make it easier for you we provide a tool called IswUpdateOdbc.exe that will copy the ODBC settings on the server and make them available to be automatically built on each workstation.
    1. Automatically - using IswUpdateOdbc.exe  (only available from v404.4 or newer)
      1. On the server, create two new ODBC entries to connection to the SQL databases.  Call them something like SPMSQL2015 and SPMWORKSQL2015 (they need to be different from what was used on the legacy server). Check they are working correctly.
      2. Make the necessary changes to the spm.ini file  (see section 9).
      3. Run SPM  or PHM and check it is running correctly  (see section 10).
      4. From the command line, run  C:\spmwin\iswupdateodbc /setup   (changing file location as required)
      5. Complete the fields and click OK to save a .ini file
      6. On each workstation, from the command line, run  C:\spmwin\iswupdateodbc /go  (changing file location as required)
        You will be prompted to create the ODBC connections and alter the spm.ini file. 
    2. Manually
      1. 32bit Operating System
        Change the DSN entries on all existing workstations for BOTH the SPM and the SPMWORK databases to point to the new server location (Control Panel – Administrative Tools – Data Sources – System DSN – select data source(s) - Configure ).  Do the following for both DSN entries.
        1. change the sql server name (eg. newserver\incisive), 
        2. use SQL Authentication  - enter login & password ,
        3. select database,
        4. test the connection
      2. 64bit Operating System
        Note that if the computer is running Windows 7 or Windows Server 2008 (R2) and has a 64bit operating system you will need to run the 32bit ODBC admin tool called  ODBCAD32.exe  which can be found in C:\Windows\Syswow64

  9. Edit SPM.INI file on the server
    (if you have already completed this prior to using the IswUpdateOdbc.exe tool you can now skip this)
    1. Find and edit the SPM.INI file in the \SPMWIN directory.
    2. Check the DSN= & DSNWORK= entries are have the correct connection names
    3. Edit the setting MDB=[path of Shared Directory] .  This must be the common, Shared directory (see 4a. above).    e.g.  mdb=\\newserver\spmwin\data
      Even though you are not using an Access database this is still needed.
    4. If you are using the server as a Terminal Server make sure there is an entry in the [Workstation] section of  Citrix=True

  10. Run the SPM or PHM application (right-mouse-click and select the Run As Administrator) to force the new program files to be registered in the Windows Registry.  Login to the program and check the modules are functioning correctly. 
    Note that printer drivers need to be installed for the application to work correctly.

  11. Remote Access
    1. Ensure that the Incisive support team has an account that will allow us to logon to the server with Administrator rights.
    2. Enable a Remote Desktop connection (or suitable access) has been setup for Incisive to be able to connect to the new Server (and preferably each workstation) and they have been advised of the details.

  12. Updating the SPM or PHM application on the workstation
    1. Edit the batch file Update.bat (found in the SPMWIN folder on each workstation) and ensure that the path for updates is correct.
      Updates should be in the   \\newserver\Spmwin\Updates     directory.
    2. Edit the SPM.INI file  (this is not required if to have run IswUpdateOdbc /go on the workstation)
      1. Check the DSN= & DSNWORK= entries are still correct
      2. Edit the setting MDB=[path of Shared Directory] .  This must be the common, Shared directory (see 4.a above).   
        e.g.  mdb=\\newserver\spmwin\data
        Even though you are not using an Access database this is still needed.
      3. Change the Server Update path.  This will be in a section named [UpdatePaths]:

  13. Configuring SPM on the workstation
    1. Start up SPM on a workstation.  Go into Setup – System – File Locations and change the path name for each line, pointing the new server.  
    2. Incisive will need to run a program to change the path details for all images and scan documents if the server name has changed.  A check to make sure the path names are correct is to go into SPM – Reports – System Reports – Workstation Setup Report.  When you run this report, the paths for the scan docs and images should have (writeable) in front of them, if it has MISSING in front of them then you know that the path is either not correct or they do not have access to it.

  14. Bulk adjustment to database records
    The records in the database that hold the location of scanned documents and images for each patient need to be altered by Incisive staff.  Call the Incisive Helpdesk to get them to log on remotely to run an application to make the necessary change.
    The bulk adjustment process could take up to half an hour to run.

  15. Configuring the Anti-virus application on the workstation.
    1. Add Exceptions to the antivirus software on the workstation to allow:
      1. the SQL data files (see 5.b.iii),  and 
      2. the scanned document and image files, and
      3. the shared directory (see 4.a)
        There should already be an Exception for the files in the local SPMWIN directory.  If there isn’t, do include it to the Exceptions list.

  16. Secure Messaging
    1. Reinstall any messaging clients (eg HealthLink) that were installed on the old server.
    2. Check the location of the incoming and outgoing files.  Configure these in Setup -> Message Carriers and Edit the relevant carrier entry.
    3. Check that new messages are being received from the secure messaging client (e.g. HealthLink) and that they are being inserted into the SPMWORK database when the HL7.exe or HL7Aus.exe (Australia) files are executed.  The new messages will appear in Utilities -> Claimed Lab Mail
    4. Remove any scheduled tasks on the old server (such as HL7.exe). 
    5. Add new scheduled tasks to the new server to run the HL7.exe or HL7Aus.exe files.

  17. Unsecure Messaging
    1. If they are using standard email to send invoices, statements and other documents from SPM/PHM you will need to establish that there is a SMTP port available for them to access.  SPM/PHM can be configured in Setup -> User/Provider -> Email to use the new email account details.

  18. Printers
    1. Remove or reconfigure printers connected to the old server
    2. If new printer drivers have been installed 
      1. Ensure the correct printer is set as the ‘Default Printer’ and that a Windows Test Print is successful
      2. Go to Setup – Printers – select printer, and set the trays for each job type as appropriate.
    3. Go into Setup – Workstation – Workstation Configuration (on each workstation) and select the new printer drivers.

  19. Scanners
    If the server is being used as a Terminal Server and you will need either a network-enabled scanner or, if the scanners are attached to the workstations, you will require a third-party application such as RemoteScan or TSScan.

  20. Testing of SPM/PHM
    Perform the following tests to check that the application is working as expected.
    Start the SPM or PHM application.  
    1. If the database can’t be found, check the following:
      1. Can the workstation get through the firewall to see the SQL Server (turn it off and see if you can get through)
        Use the PortQuery tool to check access to the SQL server and ports
      2. Are you using the 32bit version of the ODBC drivers (on a 64bit OS)
      3. Are the DSN= and DSNWORK=  settings correct in the SPM.INI file
    2. If the mdb=  setting can’t be found, check that you have created a Shared Directory on the server and that users are able to 'write' to it (see 4.a)
    3. If you get an error straight away when running the program, check that the UAC is turned off (see 7.b).  If it wasn’t you’ll need to reinstall.
    4. Select a patient that has got some scanned documents and go to the Notes section. 
      1. Check that you can see a scanned document and/or an image.  If you can’t, go to Setup -> System -> File Locations and check the paths are correct.  If they are not it means that step 14 has been missed.
      2. If you get an error going into the Notes section it is possible an entry needs to be made into the Data Execution Prevention section of Windows.  Call Incisive Helpdesk.
    5. Go to the Letters section of a patient’s file and check that you can create a new letter, print it and save it.  
      1. If it won’t print, check you can do a ‘Test Print’ from the default printer (in Windows) and the Printer settings in Setup -> Printers.
      2. If it won’t save, check the Shared Directory settings (see 4.a)
    6. Use the Scan function in Patient -> Notes.  If the scanned document won’t save, check the’ Write’ permissions on the directory (see 6.b)
    7. Go to the Appointment section and check you can add new appointments.
    8. Run the Database Speed report from a workstation.  This report can be found in Reports -> System Reports.  From the resulting report, the Average Speed should be in the vicinity of 2m/s.  If it is around 4-5 m/s it will be regarded as slow access and if it is slower than about 6-7 m/s it is not acceptable and the problem causing the slowness needs to be determined.

  21. Check with the Practice or Hospital staff to see if there have been any special functions in SPM or PHM that were used previously, which are no longer available.

  22. SMS
    1. If the site has been running the SMS Messaging through SPM or PHM, ensure that you establish a Scheduled Task to run the SMS application once a day, usually around 10am.  Check the Task Scheduler settings on the old server to make sure the SMS messages are not sent from there as well.
      Requires Outgoing port 443 to be open through the Firewall.

  23. Backups
    It is not the responsibility of Incisive to configure or monitor the backup procedures of  the databases and data files.
    1. Reconfigure the backup system to accommodate the new settings. If no SQL backups are set, try using a 3rd party application called SQLBackupMaster; (
    2. Don’t allow the main full backup to occur during the day although Transaction Logging is a good idea.
    3. Ensure the Log files of both databases are truncated each time after they have been backed up.

  24. Exchange Server
    If Exchange Server is running on the same server as SQL Server, try to limit the maximum amount of memory that is allocated to it.


The Integrated edition of SPM & PHM provides a new interface to the applications.  The underlying functionality remains the same (or is improved) so it is relatively easy to transfer your work processes from one-to-the-other.

View this document to show the difference between the Classic and Integrated editions.

The following video demonstrates some of the main features of the SPM & PHM menu. (7:36 mins)

For more detailed explanation of the options available when using the menu, go to:
Help > SPM/PHM Help then navigate to Basic Concepts or click here


One of the main improvements that comes with the Integrated edition is a much finer level of access rights can imposed so that you are able to restrict staff from viewing or changing information that they do not need to have access to.  This involves taking some time before you start using the Integrated edition is establish the permissions and roles that you want to use.  To make it easier for you, we can provide a set of commonly used permissions and apply these for you.

To give you a better idea of how the Permissions are used you can view the following documents:

or view the following video on how to configure the menu Permissions and allocate Roles.


Unexpected error - quitting

Occurs before the login screen appears.

The only issue with Windows 10 relates to the requirement to use the 'Run-As-Administrator' option when you are first running SPM/PHM on a workstation for the first time.  The elevated privileges of the 'Run-As' option are required to allow files to be written into the Windows Registry.

If you get any errors when you do first try running SPM/PHM, exit out then start the SPM/PHM application again using the Run-As-Administrator option.

Error - StartSpmData - not a valid Win32 application

Occurs after the login screen.  Loads the application but no menu appears

If the SPM or PHM application has been reinstalled AND the install directory has a long name (greater than 8 characters) it will create a file called PROGRA in the root of the drive.

Delete the PROGRA file and SPM or PHM will start correctly

SPM/PHM on workstation is running slow but on server is fast

There are a number of things to check
  - Virus checker software on the workstation excludes the SPM/PHM install directory
  - The workstation is connecting over a wireless network rather than ethernet cable
  - The IPv6 protocol is enabled on the server (and workstation) but the network/router is not fully configured to use it.  Disable the IPv6 protocol on the network adapters.  (this can make a significant improvement)
  - The compatibility of the SQL database is different to the version of the SQL Server.  Change the Compatibility of each of the databases in Properties > Options  (SQL Mgt Studio)

To enable the inTOUCH application to access your Incisive database and related document or image files, the application needs to be installed on-premise and run on your network domain.  The following are the requirements to run the inTOUCH web application:

  • Windows Server 2016 or newer (fully patched)
  • Microsoft .NET Framework 4.8 or newer
  • IIS (Internet Information Server)
    • IIS8 or newer
      • Web Deploy-3.5 for Hosting Server (optional)
    • Separate Application Pool in IIS for the inTOUCH application
    • Digital certificate issued by a CA (Certifying Authority) for the IIS server (to encrypt the data feed).
      Requires annual revalidation.
    • Features enabled
      • IIS Management Console
      • Application Initialisation
      • Default Document
      • HTTP Errors
      • Static Content
      • ASP.Net 4.8 or newer
  • Website hosting account with an ISP
    • Static IP address allocated for your router/internet connection
    • DNS Zone entry linking an 'A' Record to the Static IP
  • Firewall configured to allow in-coming connections on port 443 (or other port if not 443) and out-going connections to port 445 (SMB)
  • Read/Write permissions for the IIS Application Pool account to the directories & files that store the patient scanned documents, images & pdf files.
  • Modify permissions for the IIS Application Pool account to the \Appdata directory
  • Ability to create a data connection to the SQL Server 
  • Remote access for Incisive support staff 

Incisive support staff are able to assist as a chargeable service.

Incisive recommend that if you are hosted in the system or you have your own Terminal Server (Remote Desktop) environment, you should be using TSPrint or TSScan to get an optimal experience.

You will need to install the TSPrint Client and TSScan Client applications on the local workstation/laptops so that they perform correctly.

The installation process is very simple and no additional licensing is required.

Instructions to install and configure TSPrint for SPM & PHM applications

The TSPrint guide from Terminal Works is available:

Windows -

Mac (this is a bit old)

Configure TSScan for Windows

The TSScan install file is downloaded from 

After installing, go to TerminalWorks > TSScan Client Settings in the Windows Start menu and select your default scanner

Configure TSPrint for a Mac

The TSPrint install file is downloaded from this site: 

After installing the app, check the inCLOUD → Mac printer mappings are correct.  If not, delete then choose the correct printer when printing the next time.

Delete any that are incorrect or obsolete

Print from SPM and choose the correct printer when the prompt appears.

Configure TSScan for Mac

Scanning from an Apple Mac Book

These instructions are only to be used for Minor-Updates, as specified by Incisive.

There are three parts to the update process, which can be run independently.

  1. Downloading the update file to the onsite ‘server’ and preparing the files for deployment to the workstations
  2. Updating the program files in the \SPMWIN directory on the server and updating the database structure
  3. Deploying the updated program files to the application terminal servers, workstations and laptops

Downloading to the Server

This process should only be performed by either Incisive staff or IT technicians who are familiar with the Incisive update process.

  1. Notify Incisive of when you wish to apply an update.
  2. Go to the Downloads page and download the correct update installation file.  You need to login or register.  Check that the file size is correct.
  3. Find the \Spmwin directory on the server.
  4. Rename the  Updates directory to PrevUpdates
  5. Delete any existing folder called NxtUpdate
  6. Right-mouse-click on the downloaded updates installation file and choose ‘Run As Administrator’.
  7. Ensure the location of the \Spmwin directory on the server is correct
  8. Complete the installation process to the NxtUpdate directory

Updating the Server

Just before the terminal server, workstation update process is about to be performed, the following steps need to be conducted.  It is preferable that the server is restarted before this process is performed.

This process should only be performed by either Incisive staff or IT technicians who are familiar with the Incisive update process.

  1. Backup the databases and all of the associated image and document files.
  2. Create a Snapshot or Restore Point on the server.
  3. If possible, restart the server.  If a restart is not feasible, use Task Manager and make sure that xpmmenu.exe is not running nor any other processes that start with spm*.*
  4. On the server, login using local admin or domain administrator rights.
  5. Rename the directory called NxtUpdate to  Updates
  6. Copy all the files from the Updates directory to the \Spmwin program directory on the server.  Overwrite the existing files.
  7. Update the copy of SPM on the server by copying all of the files from the Updates directory into the Spmwin directory
  8. In the \Spmwin directory use the Run-As-Administrator option on the following three files:
    • mdbUpdate.exe
      This process will update the data structure of the database.
      It can be performed ahead of the workstation update process and even if staff are still using the SPM/PHM database.
    • reregister.bat
    • XPMMenu.exe
      Log into SPM and test that it has updated correctly.
  9. Check the version numbers at the login screen.
  10. Go to Setup -> Personnel -> Permissions and modify the menu permissions for each of the Roles
  11. Go to Patient -> Notes and check that you can display the Notes for a patient.
  12. Go to Appointment Book and display the appointment list for a specialist.
  13. Complete any other acceptance testing you require.

Deploying & updating Application servers, Workstations & Laptops

If the Workstation has been setup correctly then updating to the latest Version should only take two easy steps.
Incisive staff may assist with the updating of a single application server, workstation or laptop.  Thereafter it is your responsibility to perform the task on the other devices.

  1. Restart the application server or workstation/laptop
  2. Temporarily disable the virus-checker (if possible)
  3. Login using either a Local Administrator login or the Domain Administrator login

    If installing to an application Terminal Server
    - Create a Restore Point or Snapshot
    - Exit to a Command Prompt (as Administrator) and execute the following command
             Change User /install
    - Use Task Manager and make sure that xpmmenu.exe is not running nor any other processes that start with spm*.*

  4. Find the Incisive folder on the Desktop and double-click on the ‘Update Program Files’ icon.
    This should cause a command window to appear and display the files that are being copied from the Updates directory on the server to the \Spmwin directory on the local device.
    Note: If the command window flashes up quickly and disappears, then something is not quite right with your setup and you will need to rectify the batch-file instruction or remedy the network connection.  Call the Incisive Helpdesk for assistance.
  5. In the \Spmwin directory use the Run-As-Administrator option on the following three files:
    • mdbUpdate.exe (only if it hasn't been run already on a different server)
    • reregister.bat
    • XPMmenu.exe
      Log into SPM and test that it has updated correctly.
  6. Check the version numbers at the login screen.
  7. Go to Patient > Notes and check that you can display the Notes for a patient.
  8. Go to Appointment Book and display the appointment list for a specialist.

    If updating an application terminal server
    - go to the command prompt (as Administrator) and execute the following command:
         Change User /execute

  9. Enable the virus-checker
  10. Make sure all of the workstations and laptops have been updated to the correct version.


If you are unsure at any stage during the update process, please call the Incisive helpdesk for assistance.

If you have tried to register files without using the Run As Administrator option and are getting errors during the file registration process, you may need to perform the following:

  1. Exit to a Command Prompt window
  2. Change to the SPMWIN directory
  3. Type in and execute the following command (which deletes three text files)
       DEL   spm_*.txt
  4. Exit from the Command prompt window.
  5. Right-mouse-click on XPMmenu.exe and run using the Run As Administrator option

If serious problems with the deployment and updating of the program files to the applications servers, workstations or laptops is encountered, you may need to perform a roll-back to the previous version.  Contact the Incisive Helpdesk. 


Most computers are now configured to automatically install Windows updates and this update process can cause the Specialist Practice Manager or the Private Hospital Manager to   not start up correctly.  


After you have tried to start the application you may receive error messages saying 'Automation Error' or 'Object Not Found' or similar.


  1. Restart your computer.
  2. Log onto your computer using a login that has Administrator rights (you may need to ask your technician or even get them to do the following process)
  3. If you have an Incisive folder on your Desktop, open it and look for a shortcut called something like 'Register Program Files'.  If there is one right-mouse-click on the shortcut and choose 'Run As Administrator'.
    This will cause a black window to appear and it will register all the programs in the Incisive program directory.
    You can start SPM or PHM up again once it has completed.
  4. If you do not have an option to register the program files you will need to do the following
    1. Click on the Start button
    2. Type in the word RUN and then select the Run app from the search results
    3. In the Run option type in the following:
      C:\spmwin\registerspm.bat      then press the Enter key
    4. A black window will appear and the files will register automatically.
      You can start SPM or PHM after it has finished.

If these options do not correct the problem please contact the Incisive Helpdesk or your technician.

If clients are unable to access tabs in Office Mode (plus also Setup - Appointments - Sessions or Setup - Personnel - Operators) this is because a control that is used in these areas of the program is not correctly registered.

The tabs work correctly from Newlogin.

The control is 'Spmd_interopcontrols'.

1. Try deleting the manifest files (*.manifest).

If this fails to resolve the problem, the files need to be re-registered.

Start - Run

c:\spmwin\Regasm32 spmd_interopcontrols.dll /s /u /codebase

c:\spmwin\Regasm32 spmd_interopcontrols.dll /s /codebase

When updating SPMc (Classic) to version 407.4, you can get an error when you login saying "Out of Memory".
To resolve this, you need to run the Setup application for version 407.4 & reinstall the application.
This clears a problem that is related to the SPM fax driver.

It is a requirement for the Medicare Online adapter to function that Java version 6.0 is installed on the workstation or server that the claiming is being performed from.

Click on this link to go to the Java site and go to the latest 'Java SE Runtime Environment' section and download the relevant edition for your operating system.  


  1. Install the 'Microsoft Remote Desktop' app from the App Store
    Click here 

    If the MacOS is 10.12 or older the Remote Desktop app in the App Store won't install as it needs MacOS 10.13 or newer.

  2. Open the Microsoft Remote Desktop application from LaunchPad or MenuBar

  3. Select the Add Workspace and enter the following URL into the Workspace field.

     Workspace URL:

  4. Add a User Account if it is always the same person who will be using this computer, or leave it as 'Ask when required' if different people use it.

  5. Open the Microsoft Remote Desktop  and select 'Specialist Practice Manager' or 'Private Hospital Manager'

  6. For security reasons, the 'Multi-Factor Authentication' function will prompt you to either 'Approve' the connection or to enter in a Passcode from your Authpoint app or Watchguard hardware dongle.
    See Multi Factor Authentication (MFA) - Watchguard Authpoint

  7. When the Incisive application appears, enter your login details, password and location.

If you minimise the Incisive application you will be able to display it again by selecting the >< icon in the top title bar 

Printing & Scanning settings

To improve the process of printing from the Incisive inCLOUD applications or scanning documents to attach to a patient's file, two applications called TSPrint & TSScan can be installed and configured.
See Installing TSPrint and TSScan client applications

Advanced configuration

Use the Preferences option to:

  • Configure the Interpolation (Resolution)
  • Add a User account
  • Add the path for TSPrint & TSScan