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[AMA] Hi, r/medicine, we are clinicians and researchers with experience in sharing clinical notes with patients. Ask us anything about open notes!

Hello medicine! We are clinicians and researchers—from Beth Israel Deaconess Medical Center, Harvard Medical School, Stanford Children’s Health, Sutter Health, and University of Kansas Cancer Center—with experience sharing clinical notes with patients (we call these “open notes”). Read on for more details and Ask Us Anything!
We’ll be answering questions live from 5-8pm Eastern on Wednesday, October 21, 2020. We started this discussion thread 24 hours in advance of the AMA to allow Redditors additional time to begin submitting questions.
Update 8pm ET: We're signing off from the live AMA now. We'll check back over the next 24 hours and respond to anything new. This was super fun, thanks for all of these great questions!
Proof it’s us here:
Learn more about us below.
Here are some high-level points off the bat:
  • Terminology: When a clinician shares a visit note with a patient it becomes an “open note.”
  • Patients benefit: As a result of reading clinic visit notes, patients in numerous studies report: having an improved understanding of their health and medical conditions; recalling their care plan more accurately; being better prepared for visits; feeling more in control of their care; taking better care of themselves; more frequently taking their medications as prescribed; and having more successful conversations and stronger relationships with their doctors (J Med Internet Res).
  • New policies in the U.S. mandate clinician notes be shared with patients: Starting November 2, 2020, a U.S. program rule on Interoperability, Information Blocking, and ONC Health IT Certification (which implements parts of the 21st Century Cures Act passed by Congress in 2016) requires patients be provided access to all the health information in their electronic medical records without charge by their healthcare provider.
  • Who has been sharing notes (doing “open notes”) so far? As of October 2020, more than 250 health organizations around the U.S. (and parts of Canada) have chosen to offer open notes to more than 50 million patients registered through online patient portals.
  • Impact on clinicians: None of the >250 organizations that implemented open notes prior to November 2020 reported a significant increase in visit time with patients or in e-mail traffic. Some organizations reported a decrease in e-mail, as patients are able to resolve confusion or forgetfulness by reading their notes. In a study of clinicians (N=1,628) who have been sharing notes for at least 12 months, a majority (74%) believe open notes is a “good idea,” although about 1/3 report spending more time on documentation (JAMA Netw Open).
  • Is there evidence that patients benefit from reading clinician notes? Yes. More than 100 studies have been published on the concept of open notes.
  • Technologic readiness: Nearly all electronic health record (EHR) platforms (and their patient portals) have the built-in capability to share visit notes with patients.
  • Who is “OpenNotes?” OpenNotes, based at the Beth Israel Deaconess Medical Center in Boston, MA (United States), studies the effects of shared clinical notes on patients, care partners and clinicians, and disseminates its findings. It is funded entirely by federal government and philanthropic grants and gifts. The OpenNotes team works with collaborators around the country and overseas to foster and evaluate the spread and implementation of shared clinical notes (“open notes”). OpenNotes does not develop software, and is not a technology company.
  • Does OpenNotes have a public policy agenda? No part of the OpenNotes budget goes toward lobbying. However, we have been keeping our eyes on the 21st Century Cures Act “Information Blocking” rule because progress notes are among the information that "must not be blocked"—and thus be made available to patients. This is our cheat sheet on the Rule as it relates to open notes.
  • Conflicts of interest (COI): The participants in this AMA report no conflicts related to this activity.
About us (+ the initials to be used by each expert in response to your questions):
  • Sigall K. Bell, MD (SKB): Director of Patient Safety & Discovery, OpenNotes, Beth Israel Deaconess Medical Center; Director of Patient Safety and Quality Initiatives, Institute for Professionalism and Ethical Practice (IPEP), Boston Children’s Hospital; Associate Professor of Medicine, Harvard Medical School
  • Cait M. DesRoches, DrPH (CMD): Executive Director, OpenNotes; Associate Professor of Medicine, Harvard Medical School
  • Leonor Fernández, MD (LF): Director of Vulnerable Populations & Health Equity, OpenNotes; Director of Patient Engagement, Health Care Associates; Internist, Beth Israel Deaconess Medical Center; Associate Professor of Medicine, Harvard Medical School
  • Stephen (Steve) F. O’Neill, LICSW, BCD, JD (SFO): Social Work Manager and Behavioral Health Specialist, OpenNotes, Beth Israel Deaconess Medical Center; Faculty, Center for Bioethics, Harvard Medical School
  • Steven Lane, MD, MPH, FAAFP, FAMIA (SL): Primary care physician, and Clinical Informatics Director for Privacy, Information Security & Interoperability, Sutter Health; Co-Chair, Interoperability Standards Priorities Task Force, Office of the National Coordinator for Health IT
  • Chethan R. Sarabu, MD (CRS): Pediatrician, Stanford Children’s Health; Clinical Instructor, Stanford University School of Medicine
  • Christian T. Sinclair, MD, FAAHPM (CTS): Lead, Outpatient Palliative Care, KU Cancer Center; Associate Professor, Division of Palliative Medicine, University of Kansas Health System
You can ask us anything, but we’re most knowledgeable about:
  • Anything related to sharing ambulatory visit notes with patients (aka “open notes”)
  • The effects of open notes on clinicians (e.g., attitudes toward open notes, workflow)
  • The effects of open notes on patients and family/friend care partners
  • The effects of open notes on patient safety and quality (JT Comm J Qual Patient Saf)
  • Documenting (SOAP notes) when patients are reading
  • Open notes in: pediatrics/adolescents, mental health, palliative care
  • Open notes for: caregivers/care partners, people facing serious illness, non-English speaking populations
  • The new U.S. federal rule ("Information Blocking") mandating the sharing of progress notes and other parts of the medical record (including test results), and its exceptions
  • Some emerging understanding of open notes in inpatient settings
  • How open notes “works” in some of the major EHR platforms
  • Open notes on the international scene
  • American baseball
This is a conversation in English, but we welcome comments in other languages. Any Spanish language questions will be directed to Leonor Fernández, MD (LF).
Follow the research of OpenNotes on Twitter, YouTube, or LinkedIn!
Disclaimer: All responses expressed are those of the respondent, identified by their initials, and not that of their past or current employers.
submitted by myopennotes to medicine

XMG Gaming Laptops: First Steps & Troubleshooting

So you got yourself an XMG Gaming Laptop laptop, huh?

Congratulations! :-)
Follow this handy guide to go through your first steps and some commonly recurring questions. This guide is pretty long and might look frightening on first look, but please note:
  • Sometimes it's not a bug, it might be a feature
  • Sometimes a thing might be caused by Windows or might be a known issue for a generic hardware components (including NVIDIA Optimus), i.e.: not caused by us
  • Some issues covered in this guide are extremely rare, have only been reported once or twice and might be very easy to fix

Let's dive right in:

I unboxed my XMG Laptop – what are my first steps?

1. If you purchased with Windows.
When building our laptops, we always make sure to install the latest firmware and drivers. If you purchased with Windows, all drivers will already be installed and you can pretty much start working. NVIDIA updates their driver pretty often, so they might already have a new driver out. Open up GeForce Experience, log into your account and see if the app offers any driver updates.
2. If you purchased without operating system.
Your SSD will be empty, but your firmware will be up to date. Even if you purchase without operating system, we will already have updated the latest BIOS and latest Thunderbolt firmware. Now it’s time to install Windows and install our drivers.
If you don’t have your own Windows install media at hand, you can get the latest official version from here:
The drivers for your XMG Laptop will be on a USB thumb drive in your shipping box and those drivers will be reasonably up-to-date. Alternatively you can download drivers and firmware for your system from our download portal:
The principle is the same for each model. Download the ZIP files, extract each one of them and install them each by each. Most models have the ZIP files numbered so you know the sequence. In practice, the sequence of the driver install does not really matter. Exceptions: 1) it's generally recommended to install the Chipset driver first and 2) some Audio driver components stack on top of each other, such as Realtek first, Soundblaster or THX second.

++ Troubleshooting (all models) +++

The following items might apply to any XMG or SCHENKER model. In fact, they might also apply to laptops from other brands. Further down below, you'll find a section that is more specific to individual models.

My Gaming Laptop is pretty loud/hot when playing games

To judge whether or not your system runs at spec, please compare your benchmark values against various press reviews of your CPU, GPU and your laptop itself. If your results are similar to the published numbers, your system is probably working just fine. If they are widely below expectations, please contact us.
If you want to know more about how to tweak your system to run a bit cooler, please check out these threads:
If you have any additional content suggestions on this topic, please write a PM or start a new thread.

My battery life is less than it should be / I have high Idle power consumption / My fans are loud in Idle / my dGPU is not turning off.

Battery life and power consumption are closely interconnected. If your system consumes too much power – even in Idle – your battery life will suffer.
Preliminary: check your CPU usage, sorted by tasks
Your first look should be into Windows Task Manager, tab "Details" and then sort by "CPU" usage. You should know that your CPU has multiple cores and threads. For example, on i7-9750H (6 cores, 12 threads) if one single-thread task is running at 100%, it translates to "only" 8% CPU load in Task Manager (100 divided by 12 = 8.33). 8% might not look like much at first glance. But in reality it's one core that is running at maximum speed, taking almost as much power as if all cores would run at the same time. This is because the CPU would boost a single core to much higher speed than it would boost all cores together.
In other words: CPU usage values in Task Manager can be misleading, especially if some broken or badly programmed software is going rogue on a single thread. Do the math!
So, on a 6 core CPU, if you have any process in Task Manager constantly running at 8%, something is off. Please identify which task it is, and either end it right there it or uninstall the related software altogether.
Another way to check is to separate the Task Manager CPU activity graph into logical cores. Check these two screenshots:
In my example you can see one core in the middle was almost maxed out for a short amount of time. Thanks to the nature of Turbo Boost, this core would induce a boosted clock speed, leading to almost maxed-out power consumption and high temperatures. This is not always immediately visible because most programs would keep jumping from core to core, so you always see individual spikes to 100% on single core. You can try this yourself by using Prime95 and running it on only 1 thread.
All systems nominal? CPU is nice and idle? Check the dGPU status.
If you don't have any rogue tasks clogging up you CPU but your Idle power consumption is still off the charts, it might be because your NVIDIA GPU (dedicated GPU, dGPU) is not turning itself off.
Under the system of NVIDIA Optimus (MSHybrid), all common Windows apps are run on the Intel UHD Graphics (integrated GPU, iGPU) by default and the dedicated GPU (dGPU) should turn itself off when it is not needed. This removes the dGPU from the power source but it also saves power on the CPU side, because the CPU can turn off the PCI-Express x16 dGPU connection and thus achieve lower sleep states in each CPU cycle. This system can be disturbed in a number of ways, leading to higher power consumption which in turn leads to lower battey life.
1. Check which system monitoring tools you are running in the background
Some system monitoring software intentionally wakes up the dGPU. Keeping such software running in the background will inevitably lead to higher power consumption. We will keep a list of tools here which do and which do not keep the dGPU awake.
Does not keep the dGPU awake Keeps the dGPU awake
CoreTemp AIDA64 (only when “Sensor” pane is open)
HWiNFO64 ASUS GPU Tweak II
Intel Extreme Tuning Utility CPUID HWMonitor
NVIDIA Control Panel MSI Afterburner
Speccy NVIDIA GeForce Experience
TechPowerUp Real Temp NVIDIA Inspector
ThrottleStop NZXT CAM
Windows Task Manager Open Hardware Monitor
TechPowerUp GPU-Z
XMG Control Center (only when “System Monitor” pane is open)
Please check if any of the programs on the right side of the table is running in the background on your machine. If they are, please remove them from Startup in the Task Manager.
Some of the programs on the left side of the table might wake up the dGPU once for a few seconds during initialization. But according to our testing, they won’t keep the dGPU awake during normal operation.
If you want to see, whether or not your dGPU is awake or not, the best bet is to use the “Sensors” function in HWiNFO64 and keep an eye on the GPU Temperature of your NVIDIA GeForce card. If the temperature reads 0°C, the dGPU is sleeping. With a right click on the Temperature value, you can even set up an alarm in form of a sound file, notification popup or logfile entry if the temperature reaches a value ≥ 1.
2. If external monitor is connected, dGPU will be awake.
Both HDMI and USB-C/DisplayPort/Thunderbolt are connected directly to the NVIDIA GeForce card. This dedicated connection gives the XMG FUSION 15 the power to drive very high resolutions, refresh rates and to support G-SYNC and FreeSync on external screens. The trade-off: the dGPU will always be awake as soon as an external monitor is connected. Rendering can still happen on the iGPU (Intel UHD Graphics) - but the dGPU will always be "awake" to deliver the pixels to the screen.
3. The choice of running apps on iGPU vs. dGPU has to be done in Windows Graphics settings now.
Microsoft is taking over the NVIDIA Optimus (MSHybrid) control from NVIDIA. On latest Windows builds and NVIDIA drivers, the NVIDIA driver now shoes a very small warning notification:
Windows OS now manages selection of the graphics processor. Open Windows graphics settings
If you notice that certain apps wake up the dGPU, please see if you can assign them to the internal graphics in this new Windows setting dialogue. Please note that the aforementioned benchmark and system monitoring apps apps will override/ignore this setting anyway. But it should work fine for most if not all productivity apps and games.
4. Every app is running on dGPU as soon as external monitor is connected? No.
NVIDIA’s Control Center has a hidden function called “NVIDIA GPU Activity” which supposedly shows which app is being rendered on the dGPU. You can find it by enabling "Display GPU Activity Monitor Icon in Notification Area".
Unfortunately, this function is not accurate when using an external monitor. As soon as you have an external monitor connected, the notification window shows every newly launched app as if it’s being rendered on the dGPU, even though it is not. This has been confirmed by our NVIDIA contacts to be a general issue that affects all laptops with NVIDIA Optimus (MSHybrid) of every brand.
It does not look as if NVIDIA has any plans to resolve this issue. Therefor, the “NVIDIA GPU Activity” will continue to show inaccurate information and should rather not be used at all.
5. dGPU does not go back to sleep after disconnecting external screen while browser is open
If you launch your browser (Chrome, Firefox, Edge) while you are connected to an external screen, the browser’s hardware acceleration will use the dGPU. This happens despite the fact that you are forcing that app to run on Integrated Graphics. If the browser keeps running after you connect the external screen, it will keep the dGPU awake.
Even sending the laptop to Standby and waking it up again won’t change that fact. The dGPU will only go back to sleep after you close the specific app that triggered this behaviour.
This seems to affect every laptop with NVIDIA Optimus (MSHybrid) – not only XMG laptops.
We have filed a report with NVIDIA and we are awaiting their feedback.
Here is a short list of apps that are affected and not affected by this issue:
Affected Not affected (Control Group)
Google Chrome Microsoft Word
Mozilla Firefox notepad.exe
Microsoft Edge
This might also affect other apps if they are secretly using the dGPU for Hardware Acceleration. But so far, the 3 major browsers are the only apps we have confirmed to trigger this behaviour.
According to what we heard, NVIDIA does not seem to have any plans to fix this issue on a fundamental basis.
Workaround #1: Restart your Browser
Close your browser and launch it again after disconnecting from the external screen.
Workaround #2: Disable Hardware Acceleration in Browser
You can find this in the Settings menu of your Browser.
Workaround #3: Disable and re-enable the dGPU instead of closing your Webbrowser
Download here: dGpuCycle Script.zip
Written by Notebookcheck user ‘Stepon’ (source). You can open the script with Notepad to read the source code.
After disconnecting the external screen, run this Batch Script with Admin privileges. The script will disable and re-enable the dGPU in Device Manager. During that moment, your browser will drop the Hardware Acceleration from dGPU and go back to iGPU. Chrome will flicker for a fraction of a second. If you play any videos on your browser while running the script, you might have to restart playback by jumping to a different point in the video timeline.
With some programming skills can be further automated to always run in the background.
6. Same as above, but for most if not all apps that use a browser engine underneath.
The browser hardware acceleration issue applies to apps that are using a browser engine to create their GUI. If you launch such an app while you're connected to an external monitor, they will use the dGPU for hardware acceleration and won't let go of it until you either close the app or manually disable the dGPU. The most popular such apps are:
  • Microsoft Teams
  • Microsoft Visual Code
  • Slack
  • Discord
  • Spotify
The most widespread framework for such apps is Electron, but it's not limited to that. For example, Spotify uses a different implementation, based on Chromium browser engine.
We are not aware of any way to disable hardware acceleration on these apps. Disabling hardware acceleration in your browser won't affect those apps. The only workarounds are:
  • Start the apps before you connect your external screen
  • Restart the apps after you connect your external screen
  • Disable and re-enable the dGPU with the above dGpuCycle script
As with other root causes in this section, this seems to apply to every laptop with NVIDIA Optimus. We have asked NVIDIA to comment in April 2020.
7. Outdated Killer Wi-Fi driver increasing power consumption.
We had a report where an outdated Killer Wi-Fi suite caused high background CPU load. If you are using a Rivet Networks Killer Wi-Fi module, please download and install the latest drivers here.
8. Missing NVIDIA USB-C and Audio drivers keep the dGPU awake?
We have a report from a user who made a custom install of NVIDIA drivers and unselected the NVIDIA USB-C and Audio drivers because he thought we won't need them. In this case, not having those drivers will cause the main driver to not shutdown the dGPU when searching for those two drivers. We were not able to reproduce it but we'll leave it in this guide for future reference. Solution: reinstall NVIDIA drivers and include every driver, even the optional ones.
9. Outdated Windows and firmware?
If you haven’t already, make sure you are running the latest Windows updates and the latest BIOS. Some major Windows milestones (also called “Redstone” updated) need to be triggered manually by opening Windows Updates, then “Checking for updates”. Under “Optional updates”, there might be a “Feature update” which you can initiate with “Download and install now” (screenshot).
10. Third party PCIe/NVMe SSD preventing CPU from sleeping?
We had recently a few reports on budget SSDs from smaller brands preventing the CPU from reaching C8 sleep states, severely cutting battery life. If you upgrades your SSD yourself with a model that is not listed in our online shop, please consider to swap it out, re-install Windows from scratch and try again. If you found your SSD to be the culprit, please share the product name with us.
11. Corsair iCue Software causes +10W power consumption?
We have seen this report from multiple users. This one was the first:
I spent a week trying to figure out why the processor on my Fusion 15 was consuming so much power when idle (around 10W!). My battery life was absolutely abysmal at about 2.5 hours on a full charge. I thought I had ruled out the iCue software because I closed the app completely, but it turns out only a complete uninstall will allow everything to return to normal so it must have been the mouse driver itself rather than the iCue software.
Source
We haven't checked it ourselves but any kind of hardware-related 3rd party software could potentially cause power saving issues on any system.
12. Epic Games Launcher running on dGPU
First reported here]. Solution is in the top reply to that thread.
13. Paint 3D causes the dGPU to stay 'ON' by running in the Background, even after Reboot
This seems to be a real issue based on a bug from Microsoft. Check this thread for details.
14. Other reason? Cannot reach CPU Package C8 Residency? Please take part in our survey
Please read this post for an introduction into CPU Package C8 Residency states. The post includes a link to a survey to collect analytical data from users who just can't get their power consumption down despite already having implemented all prior suggestions.
15. Dig deeper? Check out this amazing in-depth guide about Windows power saving optimization and C-States.
Written by user Che0063 on Notebookreview in 2018 and constantly updated into 2020, this guide is a deep dive into all things C-States.
You can find a PDF copy (pulled on 2020/05/26) of this guide here.

Random short spikes in lag and stutter

Intel Driver and Support Assistant (DSA) is acting up, causing CPU spikes up to 40% every 1-5 minutes.
Taken from this post:
Intel Driver and Support Assistant (DSA) is acting up, causing CPU spikes up to 40% every 1-5 minutes. See this picture of task manager cumulative CPU time. Funny you already mentioned that it stopped working, as I experienced the same thing.
Solution (TL;DR):
Uninstall Intel DSA for now. You can do this via the windows Apps and Programs, or if it fails for any reason, download the official Uninstaller from the intel website.
[...]

My laptop randomly wakes up from Standby.

1. Firmware solution for Wake-up 3 hours after entering Sleep/Standby. (XMG FUSION 15 only)
There was an issue with the NVIDIA USB-C driver which caused the laptop to wake up exactly 3 hours after entering Standby. The laptop was trying to transition into Hibernate (Suspend to Disk) but failed to do so. This issue is resolved in BIOS 0062 and beyond.
2. Disable Wake timers (applies to any PC and Laptop)
Depending on your Windows configuration, there might be certain task schedules (including Windows Updates) which prompt the laptop to wake-up from Sleep or Hibernate. To check on these issues, please read this article. The most common solution is to disable the “Allow wake timers” option for both “plugged in” and “on-battery”. Please note: this setting depends on each power profile and your laptop has three of them: Silent, Balanced, Enthusiast. Please switch to each of these profiles and modify “Allow wake timer” in the Advanced settings in Windows power options for each one of these.
3. Check the Wake-up cause
There is a simple command that will tell you the reason why your laptop woke up for the last time. Usually this is something like "Power Button" or "Lid Opening", but in your case it might point to a different driver or Windows component. Find "Command Prompt" in Start Menu and type:
powercfg -lastwake 
This command does not need Admin right. Please copy it by marking the output text and pressing Enter. The marked text from the Command Prompt windows is now in your clipboard and can be pasted into a text file or message box. Alternatively you can take a picture and report back to us.

My laptop needs a long time to boot up.

Cold Boot and Wake-up from Hibernate should not take much more than 12 seconds between pressing the power button and seeing the login screen wallpaper. If your laptop takes much longer, please consider the following options.
1. Enable “Fast Boot”.
Enabling “Fast Boot” in BIOS is a requirement to use Microsoft’s “Hybrid Boot” technology which saves a lot of time on Cold Boot. Before shipping, we always enable “Fast Boot” in all XMG laptops – but it might get disabled by user operation. On some models, it might also get disabled during BIOS Reset. To make sure, you have “Fast Boot” enabled, follow these steps:
  • Reboot and enter BIOS Setup [F2]
  • Open [Boot] menu and enter [Boot Priority]
  • Find [Fast Boot] and set it to [Enabled]
  • Back in [Exit] category, select [Save Changes and Exit], Reboot
(the location of the "Fast Boot" option might be slightly, depending on your model)
2. Flash firmware again
You can clearly seperate the boot process between BIOS time and Windows time. Everything that happens before you see the XMG boot logo is BIOS time. On XMG FUSION 15, it usually takes about 7 seconds between pressing the power button and seeing the XMG boot logo for the first time. If this time period is much, much longer in your case, the root cause might be in hardware or firmware.
One potential solution was found in this post. This user already had a system with Thunderbolt Firmware NVM v56. But based on a hunch, he just tried to update the same firmware again and it instantly fixed his long BIOS time.
It makes kind of sense. VBIOS, Thunderbolt... those are large, complex and kind of external components that are initialized in the very early steps of the the BIOS. If anything is stalling there, you won't see the boot logo because the BIOS hasn't even attempted yet to start talking to the SSD.
Rule of thumb: if you have long BIOS time before you see the XMG logo, please consider to flash the BIOS and the Thunderbolt Firmware again.
Now, let's look at various Windows-based causes:
3. Clean up TEMP folders
Taken from this post.
Found out, during each boot Windows (namely it's ProfSvc service) takes everything you have in users/yourprofile folder and writes over those files. I suspect it's changing some meta data in the files. Probably edditing read/write premissions. But it goes one by one. And logon process waits for it to finish. As long as your computer is relatively clean, this operation takes a second or two. But when Visual Studio update "forgets" 160 000 files in your AppData/Temp folder, it results in 35 secs of profile loading during boot. All I needed was to empty the Temp folder and the bootups are back in normal!
You can either clean the Temp folders manually or use a software like CCleaner. Please beware, we would only recommend CCleaner to clean temp files, but don't clean the Windows Registry. It's usually safe to do but it can sometimes lead to false positive situations and side-effects.
4. Riot Games 'Vanguard' might block one of our drivers
If you have game titles from Riot Games installed, the software 'Vanguard' might be blocking the 'inpoutx64.sys' driver on some of our systems. This driver is related to the Control Center. We have heard of one single case where the presence of Vanguard lead to a significantly increased boot-time. In other cases however, it had no effect despite getting the 'Vanguard has blocked' message in Windows.
We will share this information with our ODM to see if our signed inpoutx64.sys/dll can be whitelisted. Meanwhile, please consider disabling or uninstalling Vanguard to see if it improves your boot time.
5. Consider a clean reinstall
It might be inconvenient, but if you have any boot times that are wildly longer than above reference data, please consider a clean Windows installation. 'Clean' means deleting the system partitions on your SSD in the first step of the installation procedure. Before you do this, you should backup all important data on external storage.
6. Other causes.
If your system still takes a long time to even display the XMG boot logo or to boot into the Login prompt, there might be another issue at hand. Please make sure to update your BIOS, load setup defaults, enable “Fast Boot” again and make sure that your Windows and drivers are up to date. Please also consider to follow the generic advice in this article.
There is currently no other known systematic issue that prevents our laptops from doing a fast boot or fast wake-up. If you cannot resolve the issue on your machine, please consider to backup your data and do a clean Windows re-install.
7. Discussion
For XMG FUSION 15 we have opened a dedicated tread about expected boot times after a clean install. Please move all relevant discussion to this thread:
Thank you!

My microphone does not sound right

(I might be using Discord)
First, please make sure you increased the microphone gain to 100% and added the +20dB boost.
  • Find "Sound settings" in Start menu
  • Scroll down and click on "Sound Control Panel"
  • Select "Recording" tab and double-click your microphone
  • Select "Levels" tab and put everything to maximum (screenshot)
Now, some apps including Discord put additional processing on the microphone, including echo and noise cancellation. This can have a negative effect on microphone audio quality. Please see if you can disable all such options from your chat application and from the Realtek Control Panel.

I have random Bluescreens or other random issues / might be memory-related

Bluescreens and other randomly occurring issues can have a number of reasons. Sometimes, the error message or driver reference can already point at a root cause. If there are too many possible root causes, here are some generic tips.
  • If you have Undervolting in BIOS, disable it (set it to Zero)
  • Update your BIOS
  • Reset your BIOS (Load Defaults)
  • Make sure you have all drivers installed correctly (at least no yellow exclamation marks in Device Manager)
  • Make sure you are not running any 3rd party system software or drivers
  • Consider to do a clean Reinstall of Windows
  • Test your RAM with MemTest86, booted from USB
How to use MemTest86 to test my RAM
Follow these steps:
  • Download MemTest 86 Free from here (you do not need to purchase the Pro version)
  • This will download a file called "memtest86-usb.zip". Extract it to a new sub-folder
  • Plug-in your USB stick. Make sure there is no important data. The next steps will delete all data on your USB stick.
  • In the new folder, run imageUSB.exe and confirm the Admin prompt
  • You will be greeted with this interface. Confirm the Drive Letter of your empty USB Stick
  • Click the "Write" button and read and confirm all prompts
  • With the USB stick successfully prepared, reboot your laptop and enter BIOS Setup (F2)
  • Make sure your laptop charging cable is plugged-in and connected to external power
  • Find and disable "Secure Boot" and "Fast Boot". Those are the only options you need to change. Enabling CSM or Legacy Mode is not required for this version of MemTest
  • Save & Exit from your BIOS setup. During the reboot hold F10 (XMG FUSION 15) or F7 (all other laptops) to enter the Boot Media Selection prompt
  • Select your USB drive from the Boot Media menu
  • MemTest86 will start automatically and look like this. If any errors are detected, take a picture of the screen and contact support
  • If you complete the first pass (Pass: 1 / 4) without any errors, there is a good chance that you won't see any additional errors and you can cancel the test and reboot with Ctrl+Alt+Del. When in doubt, you can also run it overnight with multiple passes. On a typical gaming laptop, running MemTest86 will constantly pull about 100W out of the wall socket
  • When you finish your tests, go back to BIOS Setup to undo earlier changes or just Load Defaults to reset everything
PRO TIP: If you have MemTest86 errors, you can try to open your laptop and test both memory modules individually. Remove one module and run the test again. If the errors only show on one of the modules, try the same module again in the other (empty) RAM slot. If the module shown errors when run individually in both of the RAM slots, it might be indeed faulty.
If the RAM modules are actually not faulty, it can sometimes also help to just remove and replace (reseat) them. Sometimes, if they are not properly connected, they might also prompt random errors including iGPU graphics artifacts.

+++ Troubleshooting XMG FUSION 15 (2019) +++

The following items apply only to XMG FUSION 15. Please check first if your issue is covered under the general section above. The latest BIOS and Control Center update can be found in this thread.

My speaker sound is underwhelming / I cannot get Soundblaster Connect running.

Sound Blaster Connect is an important app to improve the experience of the audio system. It can increase volume (SmartVol) and Bass of the speakers.
1. Reinstall Audio drivers in the proper sequence
Normally, when all pre-requisites are met, Soundblaster Connect should install automatically from Windows. You can then find it with a simple search for “Sound Blaster” in the Windows Start menu. If Sound Blaster Connect is no where to be found or if it only shows an empty screen, please follow the sequence precisely:
  • No prior steps necessary – you do not need to uninstall prior packages
  • Please download the Audio drivers again from our download portal
  • You only need the file “AudioDriver_Package_3-in-1“
  • Extract the ZIP Archive
  • Install Audio-with-SST and reboot Windows (!)
  • Install Soundblaster-EQ
  • Install Soundblaster-Creative_Audio_Effects
If you are connected to the Internet, the system will now automatically install "Sound Blaster Connect" from Microsoft Store. This might take a few minutes or more. When in doubt, reboot once more after the Soundblaster-Creative_Audio_Effects.

My CPU shows high activity in idle while having devices connected to USB-C port.

We are currently tracking an issue where users have reported >10% CPU usage in Idle while having certain devices connected to the USB-C port.
Current Workaround: Disable Automatic Sleep on Thunderbolt controller
Device Manager > System devices > Thunderbolt Controller > Power Management > Disable "Allow the computer to turn off this device to save power"

I’m unable to turn off my keyboard backlight during boot.

Normally, if you disable the keyboard backlight in Control Center using the slider switch, it should also be disabled during Reboot, Cold Boot etc. We had one report of a rare issue where this settings was not applied to firmware anymore. If you encounter this issue, please click the “Restore” button in Control Center to reset all you Keyboard Backlight settings. Then, try again to disable the Keyboard Backlight and reboot.

My keyboard backlight is not turning on anymore.

We had a few reports of keyboard backlight not being able to turn on anymore. If you encounter this issue, please reset your BIOS settings.
  • Reboot and enter BIOS Setup [F2]
  • Open [Exit] menu; select and confirm [Restore Defaults] but do not reboot yet
  • Open [Boot] menu and enter [Boot Priority]
  • Find [Fast Boot] and set it to [Enabled]
  • Back in [Exit] category, select [Save Changes and Exit], Reboot

I cannot access my BIOS Setup (F2) anymore.

This is another very rare issue that was only reported once so far. If you cannot access your BIOS Setup, you cannot do a BIOS Reset anymore.
Solution: Remove CMOS Jumper from Mainboard and Reboot
The mainboard of XMG FUSION 15 has a jumper to control the BIOS Reset. In order to reach this jumper, you will need to remove the bottom case of the laptop. This is as easy as removing the 10 screws on the bottom side and then simply lifting the bottom cover away from the laptop.
The jumper is located next to the WiFi module
If the jumper is removed, the laptop will show a special menu after on boot which will allow you to reset the BIOS Settings to Default.
After having done this Reset, please place the jumper again it it's original position, connecting pins "1" and "2" as seen in the "Top View" picture linked above.
Now, please see if you can now get back into BIOS Setup with the F2 key during boot.

My external USB mouse sometimes stops moving.

We have some reports from USB gaming mouse with ≥1000Hz polling rate that sometimes stop working when used together with USB hubs, both on USB-A and USB-C (Thunderbolt).
Please install the latest official drivers from your mouse vendor and see if you can reduce the polling rate to 500Hz to see if it makes any difference.

My system consumes about 1~2% battery in Standby/Sleep mode

This is normal and also affects both XMG FUSION and XMG NEO series with opto-mechanical keyboard. Reason: the keyboard consumes slightly over 1W even in standby, because it is still firing up the Infrared barriers for every individual switch. This is to make sure that the keyboard can wake the system from standby. This translates to a power consumption (witch charger, measured at wall socket) of up to 1.8W in Standby if the battery is already fully charged. Due to a hardware design constraint, the power of the keyboard switches cannot be turned off, unless the system is sent to Hibernate (S4) or Shutdown (S5).
Workaround: use Hibernate. By default, Standby automatically transitions into Hibernate after 180 minutes. You can shorten this timespan in the Advanced Power Options in Windows (Screenshot). You have to do this for each of the Performance Profiles that you use (Silent, Balanced, Enthusiast). Before that, you have to enable Hibernate in this menu.

I would like to improve my DPC Latencies.

For guaranteed low DPC latencies, please check out our SCHENKER Audio Editions. For all other models, we're going to collect a number of tips here over time.

I have issues with USB-C or Thunderbolt 3 adapters on XMG FUSION 15

XMG FUSION 15 (2019, XFU15L19) had a bit of a shaky history with some USB-C adapters and Thunderbolt Docking Stations. It seems like the most serious issues have been ironed out with BIOS 0064 and Thunderbolt Firmware-Update NVM v56. If you plan to use USB-C port and you purchased your laptop before May 2020, please make sure to update your firmware as explained in this thread:
If you are still not sure which USB-C peripherals to buy, please check out our list of validated products in this thread:
Thank you!


That's all, folks.

For more FAQ on XMG, SCHENKER and Bestware, please check our FAQ Page: https://bestware.com/faqs/
// Tom
submitted by XMG_gg to XMG_gg

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