Assuming that you did not disable Journaling for the critical CACHE.DAT
you can take a look into Mgmt Portal / System Operation / Journal

There you click on PROFILE and sort by Size:
This gives you the fastest moving parts.
And though it also contains updates your fastest GROWING globals will leave their traces there.

In a next step you may analyze the Journal itself filtered by CACHE.DAT and SET operation
but that may take more time and effort.

suggested steps:

#1)Add   Property Experiment As %String;   to     Class SCHED.TracerEntry

#2) Write a Utility  Class to move  the existing content from  SCHED.SchedEntry.Experiment in to the all List entries.

#3)
If you are satisfied and all methods access the new location of Experiment​
You may remove all old content of  SCHED.SchedEntry.Experiment . Set it to ""
and set the property to INTERNAL, PRIVATE or just delete SCHED.SchedEntry.Experiment . BUT don't touch the storage map! 

This is not a necessary step but just kind of clean up.

NOTE:  I had commented out the two &html lines in the Testing Method... and doing a Ctrl-O still work.

Most likely your browser displays a cached version.
Clean all caches on the way to browser and you will see the changes. It's a principle issue.

with <input type="file" /> you select a file name local to your browser. That's just pure HTML.

And what you have in hands is a file reference. Not the file itself.
So what you may do next is to SUBMIT it to server.
 
But scanning your menu you expect to open, modify, copy, ...  
That's nothing to be done from Browser but by a local application.


 

I see 2 options

#1) 

add the ChangeItem holding the last change in addition to your list of Objects.
and add the appiopriate indices.
like this:

Class Rick.ChangeList Extends %Persistent
{
  Property Title As %String;
  Property Changes As list Of Rick.ChangeItem;
/// Last change added to list
  Property Last As Rick.ChangeItem;
  Index xlast On Last.Change;
}

 

This looks simple but it requires that any program that adds a change also 
updates the "Last" property.
If this isn't feasible you may use %OnBeforeAddToSaveSet() or similar to insert you "Last" object during %Save().
It requires more space on disk and is not redundant.
It doesn't generate entries for existent records.This requires a special update exercise.

#2)

Add the property to be indexed as SqlComputed and index it.
This is not so speedy but gives you the flexibility not just check the last element
and has no impact or dependency on any existing code using it.

Class Rick.ChangeList Extends %Persistent
{
  Property Title As %String;
  Property Changes As list Of Rick.ChangeItem;
  Property lastDate As %TimeStamp [ Calculated, SqlComputed ,
          SqlComputeCode = { set {*} = ##class(Rick.ChangeList).ChangeDate({ID}) }];

Index xdate On lastDate [ Data = lastText ];
}
ClassMethod ChangeDate(ID As %Integer)
{
  set obj=##class(Rick.ChangeList).%OpenId(ID)    
     ,item=obj.Changes.GetAt(obj.Changes.Count())
   quit item.Change
}

what you describe sounds pretty much like code management, versioning.
these tools depend on appropriate plugins to Word, EXCEL, Eclipse, ....
to trap the SAVE in the appropriate "editor"

BUT this always means to have a specific piece of code installed on your client if you expect some "automatic" upload.
This thing may upload/download your documents over HTTP, WebSockets or whatever.

browsers should NEVER be allowed to access your local machine without manual confirmation.

#1)
authentication is switched on/off  in Mgmt Portal 
 System > Security Management > Web Applications and bound to the specific WebApplication

#2)​ 
CSP has typically a persistent %session object. 
You can that switch off by a Class parameter. 

#3) You have 2 typical places for private Classmethods:

OnPreHTTP() before anything goes back to browser or similar. 
You typically place your private authentication there.
http://docs.intersystems.com/latest/csp/documatic/%25CSP.Documatic.cls?P...
OnPage() which means when you have already replied with an HTTP header...

Some Example

Class csp.NoSession Extends %CSP.Page
{

/// This parameter controls the CSP session support. By default CSP will use a persistent session
/// which holds a license until the session is ended or times out. If you override this then this
/// CSP page will use a transient session which is never persisted.
Parameter UseSession As BOOLEAN = 0;

ClassMethod OnPage() As %Status
{
    &html<<html><head></head><body><pre>
    <h3> %session dump </h3>
 >
    zwrite %session
    write "<h3> %request dump </h3>",!
    zwrite %request
    write "<h3> %response dump </h3>",!
    zwrite %response
 &html<
 </pre></server></body></html>>
    Quit $$$OK
}

/// Event handler for <b>PreHTTP</b> event: this is invoked before
/// the HTTP headers for a CSP page have been sent. All changes to the
/// <class>%CSP.Response</class> class, such as adding cookies, HTTP headers,
/// setting the content type etc. must be made from within the OnPreHTTP() method.
/// Also changes to the state of the CSP application such as changing
/// %session.EndSession or %session.AppTimeout must be made within the OnPreHTTP() method.
/// It is prefered that changes to %session.Preserve are also made in the OnPreHTTP() method
/// as this is more efficient, although it is supported in any section of the page.
/// Return <b>0</b> to prevent <method>OnPage</method> from being called.
ClassMethod OnPreHTTP() As %Boolean [ ServerOnly = 1 ]
{
   
quit $$$OK
}

}
I found method GetJWT gets called with localpriv and localpub as parameters

ClassMethod GetJWK(JWKS As %DynamicObject, Alg As %String, Kid As %String) As %DynamicObject
{
 Set arr=JWKS.keys                ;line +1
 Set iter=arr.%GetIterator()      ;line +2

But there is no array keys  and no %DynamicArray object found. 
so it fails on  %GetIterator().

              my guess {"keys":[  .... ]}  could be the solution. 

w localpriv
{ "kty": "RSA"
, "n": "s0hguxNL5Xb6_Fk3u_fnZrUXuRnjj1wIEGXlsnqbu4rptiDYeX9dEQm29eDe5fhXWjrPtU33WA_zz0Y9R5z7EaX4ZlZG7PlFlm5vu3bEu-qeuMp8Xb3hPMyND-87JGrbB1t5i-BgMpjQoelhYT8iqzE1fEtUGYyNn2dhSwIVwqIaRt4ly65oyW9Ea7VL92kmCEgUmIn-lrEfvygfbEL2H-9dW42dAMvEwLCQGM7iX1zuHRAH9Ec9kwnaBb2kfHzoSJXZm5WcuPYJIWZrvu1RbHcZBFff0GwCDTH1bfECmr6c-6BPeeUMw6resnbM4v3dTrbKD64HQbC33x4_Xs3pTQ"
, "e": "AQAB"
, "d": "FVOizh45hQ5mROaIDsAqsrkQHWDLBR65htnYPScAp4qayqOVnL5d38z8Cru5SDoGiiE83CBuL_eV1S5R09cEttC7f9D7lu0ALijs-avjM0dxoiHUMYKI7KaYkTCwJGDhtTpYdx810k8DYn9UqjDMevjbl_GOC4wAvNmbZUTWOdTDfVXm7D42vcUnh0e7nTYu7qGBRcfRrduzjBZMSddZoz8suWbJlQowUt6-bYOUPixeclML8oOKrtuQ_Y6fI-SNkaM5MrrJku-s1KXiOt5ZGXkpqE-PUQsw1DAzs6MfS6CcuFdYadlBd6sn6bOLNJN3DffDJQGHQUIUefTJ2I_YMQ"
, "p": "7CSQiUHeP_C2QBgQEsC_yF0Q1AFHmNEn9ua0lJ20LJSu7zzYCdE6E5X-j-9w37nzdzOClceEI2-2OAvV_Ukh3R78q9_-Mtc9AUk2BunwzfaAdJHl0YT0IpJEI-IluMpOX9RETTK3KXpjOFBefHOeHS0DyWLRXDaAt2k_9c1Q1Lc"
,"q": "wlvJ3Ap_i1vxt5q6zRT6JBxstvXLi0hQgHZnchvNluOfhzBTfYTSiK0n6Od-yj1c90iZt97B4XKWfps29xwd6wqS6X-QtG59AvlU0IOH4FSoYvyVy4yqpMSzAjgmhwZRi-API7XWd1KSmkTB8t-XfdxjdnC6kM62MqtsdC-Vhs"
, "dp": "WFFomV1AQUvG7fvR7yGV2Nst0wzTeU0olEg-26KL42yMbL-l0S4meXLM7YpQ_evvKfLi8R_YxOQgE6AhnYR_nNLdD29MBDnKADQgd7-BJ5b8_hwfBxihslhgEcef8hf_7glWrkS8ik_S0hoE7KjVRvYyB1zlDob35yD_IfBzPcs", "dq": "h5_NiIK65eBPGDQczicpNjGvmyyB0LuxkTMOlI3aNMS5-Xg7ioc48q8B_oAr9axERzqeKbSDznJLmiVtgZpZNj62rcGalI3VJlIeYTKnil8I8aoYTWXnXf5bNY2sTV32NQfIkHmMxOSqhqoz4Wia0a9tyfJ_FUG8urMT6dUkPKk"
, "qi": "WsLO8yNdoSMF3sYAISKhx_NJ5ua6PISaezUpYk6WgENHfUnwXXiDpDgx8AKae2vRpPaGoHhJkiih5JHTtVWNGUXB0-DItnX0jodM78NT31XefKuE4Pg6nLtrpPlQpRqL6Gj1en2FcVtQ5TblOaFO9dkBoBB-gGWK9dy0WPR5D9w"
}

w localpub
{"kty":"RSA"
,"use":"sig"
,"n":"ALaMFdNTmzUu1wnMGNmsIkBMJUS4EdMAe2HXpQ-k4aDk94znJuCi9OJnJQU4lm4nqgEWdzMVVQMlqZ3ihlXx5vpFzmb4m4EkAcmK0ULVCLL9QRqvuwbOjeXW8pJlcH-EAQKnkMzF6GbtmmDubK46bx2GaQh8rLYAfLvoIwXfyrXIday2VdRNz_3yGzLoxr5QxcFml46479mY3xXwmTSMvVNHEN4F1xPnsLQoNPH3guA104dm8S-f2z_vczHBdSrgiJibesdOP3ugYlxJvDDT3WSf3WW7cjAn8M3vZmCNTPWe6JEewsc6cDBiFWn9UUomulFUV_uucTsV_NXMd8nQ_Hs"
,"e":"AQAB"
}

just for better readability of the audience I transformed your WHEN condition that dictates speed.

(HL7.{MSH:MessageType.TriggerEvent}!="S14")
&&
(HL7.{MSH:SendingFacility.NamespaceID} CONTAINS "CASE")
&&
(
 (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} CONTAINS "OSU UH ENDO")
 ||
 (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} CONTAINS "OSU UH BRONC")
 ||
 (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} CONTAINS "OSU UHE ENDO")
 ||
 (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} CONTAINS "OSU UHE BRONC")
 ||
 (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} CONTAINS "OSU STONERIDGE ENDO")
 ||
 (
  (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} StartsWith "MER")
  &&
  GroupIDExists(HL7,"AIS","3.1","GIProvationMERProcedures")
 )
 ||
 (
  (
   (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} StartsWith "ONT ENDO")
   ||
   (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} StartsWith "GAL OR")
   ||
   (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} StartsWith "GAL ENDO")
   ||
   (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} StartsWith "BUC OR")
  )
  &&
  GroupIDExists(HL7,"AIS","3.1","GIProvationAVIProcedures")
 )
 ||
 (
  ((HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} StartsWith "HOC OR")
  ||
  (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room} StartsWith "HOC ENDO")
  )
  &&
  GroupIDExists(HL7,"AIS","3.1","GIProvationHOCProcedures")
 )

It shows me that you basically check on  (HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room}
I see not much opportunity for optimization of CONTAINS
But for your StartsWith you may try this construct:

  In(SubString((HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room},1,6),"HOC OR","HOC EN")
or
 In(SubString((HL7.{RGSgrp(1).AIL:LocationResourceID(1).Room},1,6),"ONT EN","GAL OR","GAL EN",BUC OR")

An HealthShare expert might be able to answer if it is possible to have an index on the fields of your WHEN condition.

A different approach could be to handle the whole WHEN in a Custom Utility Function

http://docs.intersystems.com/latest/csp/docbook/DocBook.UI.Page.cls?KEY=...

the code is already included in the CSP example
the file comes a MIME data in %request:

for easier reading compile the CSP file and see the generated class   csp.upload.cls  in SAMPLES


<!-- As form is submitted to this page look to see if we have the stream in the %request object -->
<csp:if condition='($data(%request.MimeData("FileStream",1)))'>
<hr><br>
Submitted filename: <b>#(..EscapeHTML(%request.MimeData("FileStream",1).FileName))#</b><br>
Size of file: <b>#(..EscapeHTML(%request.MimeData("FileStream",1).Size))#</b><br>
Mime Section: <b>#(..EscapeHTML(%request.MimeData("FileStream",1).MimeSection))#</b><br>
Type of stream: <b>#(..EscapeHTML($classname(%request.MimeData("FileStream",1))))#</b><br>
Content Type: <b>#(..EscapeHTML(%request.MimeData("FileStream",1).ContentType))#</b><br>
<br>
First 200 characters of stream:<br>
<ul>
<script language="Cache" runat="server">
 

See also doc on %CSP.Request

http://docs.intersystems.com/latest/csp/documatic/%25CSP.Documatic.cls?P...