HI PKA,
I understand the confidentiality issue. I was in a similar situation several years ago.
I would echo some things that Bert said. Your question is a little like asking "should I live in the country, suburbs, or city?" I am being facetious of course. There are so many different design concepts the possibilities are near endless.
It boils down to this question: what are your needs and how much finaniclal resource do you have?
Regarding locale: base clinic and 2 satellites. If these clinics are open at the same time, you need high speed internet or T-1 connection (preferable). DEFINITELY NEED A REAL CLIENT/SERVER IN THIS SETUP. THIS IS CRITICAL, YOUR WHOLE NETWORK WILL NOT WORK WITHOUT A SERVER. SOME WILL TELL YOU IT'S POSSIBLE TO RUN ON REGULAR DESKTOPS USING SOME CONFIGURATION OF LOGMEIN, REMOTE DESKTOP, ETC. HOWEVER IF YOU WANT TO BE SETUP FOR SUCCESS, YOU NEED A SERVER. ANYTHING ELSE WILL FAIL. I CANNOT STRESS THIS POINT ENOUGH.
Electronic faxes coming straight to my <<server>>: This is pretty easy. Buy/lease a networkable fax (or all in one fax/copier/scanner/printer). Many options exist and you can search the AC posts for more on this, several threads have been run on this topic. This you would setup to store images on the server, so all client computers can access a shared fax folder.
Using virtual PBX/answering system: Onebox is your solution. Don't waste time researching others. Use Onebox. Go to
www.onebox.com Use the Receptionist plan. You can get up to 10 lines. It has an auto-attendant to answer phone, select by number the person they want to talk to, highly advanced call forwarding. One single toll free number answers your phone AND faxes AND email accounts are included. CHECK THIS OUT. IT's AWESOME. I threw away my pager 3 years ago, I get all after hours calls forwarded to cell phone and I'm alerted by text if someone leaves a message.
Prefer to fax electronically: again this is easy w/ a networked fax machine or via Onebox.
Have forms and photo and card and ID etc etc stored electronically: use the scanner feature of an all in one fax/scanner or buy the tiny desktop credit card/ID scanners.
Dollar bills would be the only paper in my office: You can be as papered or paperless as you want to be. I am virtually paperless, so is Bert. We do use paper daily, but very little. It funny, I can never quickly grab a sticky pad from my staff when at the front phone because they never use them anymore. They take all messages directly into A.C.
To address some of Bert's comments:
On wireless: I agree, don't use it. It sucks. I've tried it and wired is the ONLY way to go. No matter what you do, wireless signal occasionally drops for a milisecond. That breaks the connection to the AC database, and reconnection is known to corrupt the database. That being said, I had at least 250 disconnection/reconnections in the 6 months I used wireless. I never had a database corruption issue. But don't chance it. Use wired (it's also more secure). Sure you can make wireless highly secure, but the more secure the encryption the longer the encryption/decryption process and thus slower network speeds.
On laptops: I have two, for my two main exam rooms. I can easily relocate a laptop to my pap room for the 6-10 paps I do per month. Much easier to move than a desktop. Why not just have 3? Cost. Another practical reason for laptop, is tax write off and home computer use. My home PC is one of my office laptops. I just take it home most nights/weekends. I use it from the comfort of bed or sofa. One other thing I like, personability (if that's actually a word). Laptops are small, compact right? Placed on a mobile kitchen butcher block that I bought at HomeDepot, I can face the patient and type at same time. No matter where they sit, I can move the computer so that I'm facing them and making eye contact. Not many here talk about this, but it's a HUGELY underappreciated concept. Patients don't mind you typing while they talk provided you look at them once in a while to let it known you are truly listening.
On hiring IT person: you can if you want, and I highly suggest you do so. It is worth the investment in your case. Mainly due to the 3 offices being interconnected. If you had just one office, you can figure this out on your own. (Networking for Dummies is truly helpful). If you have time to mess around with your setup before your office opens, play with it. Break it and fix it. Take it apart, put it back together. That's the best way to learn. Others here have hire IT people. I never did, just figured it out on my own (50%) and with tons of help from Bert (50%). However putting 3 offices together is not simple to throw together. Some here will make it sound like it is, but in order to make it work properly it's quite challenging and costly.
On Vista: many will tell you to use XP Pro. Sure its good but Microsoft won't support it forever, so join the crowd like I did and get Vista. Use either Vista Business or Vista Ultimate. DO NOT USE VISTA HOME. This is incompatible w/ a client/server domained network configuration. I've used Vista Business for 1.5 years, it works fine. I got over XP, eventually everyone here who loves XP Pro will have to get over it as well.
On where to put the database: I agree completely w/ Bert "Do NOT put the database on a computer you will be using. SEE THIS IS MY THING AND OTHERS WILL DISAGREE." No one should be using the computer upon which the database resides. You'll hear all sorts of examples why you can still use the computer upon which the database resides. However that doesn't make it a smart thing to do, that is just not right. This gets back to my first statement, use a dedicated SERVER.
On LogMeIn: definitely DO NOT use this as a means of doing routine daily work while you are seeing patient. This is only correctly used when you are home, need to get some office work done and need to log into your desktop computer to review faxes, address messages in AC, check email or whatever. Here's a huge drawback, if two people are on at same time it's not usable plain and simple. Bert says, "I wouldn't use VPN if you have this many questions without some help." I totally agree. If you are having 3 offices interconnected AND you want reliability in connection up-time AND you want it to work quickly enough to make it usable, you DEFINITELY NEED AN IT PERSON TO HELP SETUP YOUR VPN. This requires routers for security, VPN tunnels for speed, and you can't truly make this work with an off-the-shelf firewall/router.
Hey Jon, I should get credit for like 10 posts on this one.
Hey Hockeyref, the length of my reply challenges the length of your shortest posts (just kidding, truly meant in jest)
