Bert,
If you ever need me to help out in a conversation, please email me. I'll have my email to you in a PM.
And that goes for everyone else, too. If you need my email, PM me. I'm happy to answer questions and help out when I can.
Now, let's see what we got here. First, we start with Bert.
Your heart is in the right place and you have the right facts, but your wording is just a little bit off.
When AC used Access it had many limitations. SQL and Oracle are POWERFUL databases that scale from minimal to maximal. The reason Jon went with Express was it is free and can be packaged in an install package. Can you imagine 3500 users being told you now have to go out and spend $2,000 to $3,000 on full fledged SQL databases with licenses. When Microsoft had to fill the void between Access and SQL Server 2005, they came out with a SQL Server MSDE verion which, while powerful, was rather dumb downed. SQL Express replaced it, and it is much more like the full versions.
Access is a fine database, however, you are quite correct in that it has its limitations. For example, an Access database cannot be more than 2GB in size and that's even with the 2010 version.
You can also package SQL Server 2005 Standard and Enterprise with your application - this isn't limited to the Express Edition.
MSDE is the "SQL Express" version of SQL Server 2000, not 2005. SQL Server 2005 Express replaces MSDE.
AC has nothing to do with the ability to work with large groups to some extent. What you aren't taking into consideration is that with a "large group" they would need to purchase the servers anyway.
For the most part, I agree. And when I say for the most part, I mean like 90% agree. However, we are assuming that the database designers of AC tuned the database appropriately in that they:
1. Used indexes appropriately
2. Designed the database in accordance with the 4 normal forms of database design.
No one gets number 2 completely right but as long as they get number 1 at least mostly right they can often get away with number 2 for the most part.
Let's look at the following servers they may need:
Microsoft Windows Server 2008 Premium Edition:
This will come with Exchange and with SQL Server 2008 Enterprise Edition
Microsoft Windows Server SBS 2008 Premium Edition:
Comes with Exchange Server plus SQL Server Standard Edition
IT ALSO COMES WITH A COPY of Windows Server 2008 Standard Edition which could be used exclusively for Terminal Services.
When one chooses Small Business Server, they are thinking about a group of 75 users. When they choose the non-SBS version, they are thinking Google, Verizon, etc. with unlimited users.
Bert, something tells me you were distracted when you wrote all this. I know you know this stuff. So I correct you in all this with the utmost respect for you.
* Windows Server 2008 R2 Standard Edition
Can use up to 4 processor sockets. In other words, the number of cores in each processor doesn't count.
Can use up to 32G of RAM
Can have one Virtual Machine guest for free.
Unlimited users or workstations as long as you purchase CALS.
* Windows Server 2008 R2 Enterprise Edition
Can use up to 2TB of RAM
Can use up to 8 processor sockets. Again, number of cores doesn't count.
Can have up to four Virtual Machine guests for free.
Unlimited users or workstations as long as you purchase CALS.
* Windows Small Business Server 2011
Includes Standard edition of Windows Server 2008 R2
Includes Exchange 2010
Includes Sharepoint Foundation 2010
Has a limit of 75 users/workstations regardless of CALS purchased.
* Windows Small Business Server 2011 with Premium Technologies
Includes licenses for second server to run SQL Server 2008 - you could run Terminal Services instead but not along with.
For most small offices, Windows Server 2008 R2 Standard or SBS 2011 Standard would be a great choice. It all depends on if you want Exchange. If you dig the idea of your employees using their personal email addresses to correspond with each other, you, vendors, and patients, then Windows Server 2008 R2 is sufficient. If you want to have a company email that you control, go with SBS 2011 Standard. That way if you fire someone you don't have to worry about how much company information was in their private Hotmail account that you have no right to.
I don't recommend SBS 2011 with Premium Tech unless you have some serious SQL Server experience or have AC's blessing to upgrade their SQL 2005 Express install.
You can find out more information about the different editions of Windows from the following:
http://www.microsoft.com/sbs/en/us/compare-features.aspxhttp://www.microsoft.com/windowsserver2008/en/us/r2-compare-specs.aspxSBS would also be a great choice if you needed additional Fax technology such as GFI Faxmaker (
www.gfi.com) since GFI requires Exchange.
About SQL Server:
SQL Server 2005 Express has the following limits:
--Can use only 1G of RAM
--Each database can only be 4G in size (10G for 2008 R2 version)
--Very little Business Intelligence abilities
SQL Server 2005 Standard
--64G of RAM supported
--524PB database size supported
--Comes with BI tools (Integration Services, Reporting Services, Analysis Services)
You can read more about the edition differences here:
http://www.microsoft.com/sqlserver/en/us/product-info/compare.aspxSBS 2011 with Premium Tech comes with SQL Server 2008 R2 Standard. If you know the BI stuff and can convince AC to give you the password to their database, then this is a worthwhile purchase for you. You could run SQL 2008 Standard instead of SQL 2005 Express as your AC database engine.
I use IT people for networking, SQL, Exchange, etc., two of which do all for free. All of my SQL decisions are done from a Micrisofot SQL Server MVP from Pakistan remotely. As an FYI, I have offered the services of this SQL person over and over on here and only two groups have come through at of eight original interests. Both groups had their issues resolved in days.
Bert brings up an very important point. I see way too many posts on this forum from people who know nothing about IT looking for free help instead of just getting an IT person. If you truly want to learn IT and have no problem reading a 1200 page book on Windows Server, you have my blessing. But if you truly believe you can come to a forum such as this one and do the whole "20 question" thing thinking you can learn "just enough" to be your own IT you are sadly mistaken. I can promise you that you'll just end up taking way more time than you need to and there is a good chance you may get the wrong advice because you're not able to fully describe the situation to the expert.
I find it would be interesting if Jon created a high tech IT group which could help groups like these. The more it took off, the more that could do it. I know that Indy does some of this and JamesNT could help. But, ultimately, it needs to be done in house. I don't think it will come to fruition because Jon wants AC to stay small, but then in the beginning, he didn't want PM or Obamacare.
Quite correct. Good IT starts in-house regardless of what anyone says. Even if you put everything in the cloud, you have to have good enough IT support to get to the cloud.
I understand where John is coming from. But, I do think AC could support 8 users. It would be borderline SQL Express, but if you had a 64-bit server and upgraded to SQL Server Work Edition or Express, it would be able to use a lot more memory. I don't see what is inherent about AC as far as amount of users.
I think those with a lot of users who complain about issues with speed on here are those who concentrate 100% on SQL and do not have a sound 1GB, Cat5e or Cat6 network that is configured perfectly to begin with.
Most of the work with AC is going to be with queries of the SQL database. I think SQL should be able to handled multiple queries if it is in the 8 or 12 range. If you hire someone to set up your network (properly) and talk with a SQL guru from the start who can set it up properly and configure your page file on the server, etc. I think you will be fine.
The following is a server I recommend that should handle up to to 20 users on AC:
server recommendation Notice that this server has:
1. 4GB of RAM
2. Comes with Windows Server 2008 R2
3. Has two 15,000rpm SAS drives in a RAID 1 array (146G storage capacity)
I assume this server would also be your Domain Controller, DHCP and DNS server, your anti-virus server (I recommend Trend Micro), would backup using Backupassist (
www.backupassist.com) as your backup software, and would run Windows Server Update Services (
www.microsoft.com/wsus). This server should pull the load. I assume no other software installed on this machine.
Notice that this server:
1. Has another socket for another processor. You can add another proc without reinstalling Server 2008 R2.
2. Can support up to 32G of RAM.
3. You can add hard drives on the fly up to four.
If you need remote access, a second server like this one set up as a Terminal Server should handle up to 20 remote users with 8GB of RAM. I cannot attest to this as I have never used AC in a Terminal Server environment. I may need to download the 90 day trial and try it out.
Another big issue I see is workstations. If your idea of a workstation are the $399 deals at Best Buy, then you are probably inviting trouble. Here is my officially recommended workstation:
workstation Notice the following:
1. This is a small form factor machine designed to save space.
2. Comes with a 17inch monitor.
3. Comes with 4G of RAM
4. Comes with Windows 7 Professional
5. Comes with Office 2010 Home and Small Business Edition
You can easily affect the price by changing whether or not the machine comes with Office if you don't need it.
Altough I have strayed, regardless, time to get off Bert and on to someone else.
ryanjo:
I'm not disputing your example of the framework that could be used to run AC in multiple offices, Bert. Just wondering why tceg's group would want to go with a basic, simple EMR like AC, if they had to upgrade SQL, servers, terminal services, etc.
The attraction for me is that I can handle AC myself much of the time. When I had Medical Manager, my office needed to call every time we went down, or needed an upgrade, or a report done. The tech reps had an average turnaround of 24-48 hrs. I have the same issues now with my POL software that runs the CBC machine & analyzers. Being all paperless, I can't be down for that long. So I feel comfortable with AC on a workgroup network. That's just my level of computer smarts. I can't be calling an IT person for issues. That tceg posted on this board says to me he/she's interested in AC for the same reason. Just trying to be straight with him/her (hey tceg -- its tough when you don't have a real name).
You've answered your own question. The attraction for you to AC is that you can do all the IT yourself. But for a larger group such as TCEG they will have their own IT group or at least I think they will (and I assume they can negotiate AC for the database password for upgrade purposes to SQL Standard or something).
Furthermore, I realize everyone loves to HATE, HATE, HATE on Windows. But I say to you now for all eternity: The vast majority of problems with Windows has to do with hardware or drivers and how Windows is set up. If you buy a Dell or HP server and have competent IT, you should have nowhere near the problems you mentioned unless the software you bought is that flawed. If you have to call your IT person all the time for issues, then it's time for a new IT person.
I had to start scheduling quarterly visits with my IT clients just to get face time with them so they would pay my invoice. Otherwise, their attitude was, "things are so quiet and I haven't seen James in months or had to call him so why am I paying this???" And that's the way it should be.
JamesNT
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