I am guessing that I haven't been sufficiently clear about why I would recommend a WAN/VPN would be specifically for managing remote printing and file-sharing between the two locations. It is fairly easy to implement, but not suitable for running AC.
Because I'm always up for learning things, I contacted Dell and CDW this weekend, and got them to quote Terminal services for an install as is being discussed. I also contacted the server specialist that we use to make sure I had the capabilities and licensing issues straight.
To be clear, we are talking about needing licensed PCs at the remote location, as well as a solution (with licensing) running AC in the main office. That being said, the major differential is the cost and effort to setup the main-office solution for the remote office.
As a stand-alone solution Terminal services were quoted within $64 by both providers, ~$1124. That gets you Win Server 2008 standard, and 5 terminal services licenses.
The other solution, virtualizing the desktops onto a VM server in the main office has a different cost structure. Checking the local CraigsList, you can get 2 used machines with XP Pro for approximately $100-$200; your market may be lower or higher. So if the hardware is useless, the license cost is ~$200 at the high end.
If we are talking about comparable hardware to run the virtualization/terminal server, the hardware costs are the same.
Everyone's services costs and providers are going to vary, but we typically charge about the same for either a WinServer 2008 or a Xen/KVM virtualization server install, so again that is a push from our perspective.
Support wise, if both machines are doing automatic updates, I'll stipulate that both will run through the first year without much interaction.
One of the reasons that we increasingly suggest virtualization of desktops is the ability to replace the virtual desktop at the speed of a partition copy. It obviously *shouldn't happen*, but users can bogger up desktops, and being able to remotely re-create the instance in a matter of minutes is handy.
So, at the end of this intellectual exercise, the license cost is ~ $925 more for the Terminal Server solution.
What I can't price out is the hourly rate that Doctors are going to value their time at installing/configuring/maintaining one solution over the other. Over time, both will run undisturbed.
In having seen the breath and depth of technology exhibited on this board, I would think each solution could be DIY'ed by the folks here, it just depends on what they want.
