My advice:
1. Do it on a day that you aren't seeing patients.
2. Upgrade the "main" computer with the database first. You will have to run the database tuner, so download it also.
3. Put the AC install on a flash drive so you don't have to download on every computer.
4. Expect trouble with some computers running Vista ("429 error"). Turn off UAC (user access control) in the Users & Accounts control panel before installing AC 4 if you want to avoid trouble with Vista machines.
5. Installing AC 4 "breaks" the UpDox interface (and maybe the LabCorp interface); UpDox will be releasing an new interface for AC 4 on March 15.
I put my database on my fastest XP machine.The networking and sharing features on Vista is just too "twitchy", IMHO.
It's much faster and more features than AC 3.7. Go ahead and do it now.