Again disclaimer, Bert and/or AC not responsible for personal opinion.....
Gene, words of w. sounds terrific but might cause me heart attack and you are too far away to treat, my doc refuses to provide care to her immediate partner... I always felt for someone who much smarter than myself but smart mind always go along with critical thinking ... I was so naive.... Kevin, can you tell more about those hotkey works, I am illiterate about those and not much an AC user. In clinic I just make sure it is running and all client connected. David, my forum second love after Bert, haha I very much like to put him before Bert but then changed my mind..., probably he been flying around long and high in those remote areas and see things differently.... Jon is somewhat different, he is making more money than most unless he refuses to see more than 5 a day, any hiding radiology and ortho docs in the forum?, but Jon is nice and also going for frugality, he could be our majority leader. I endorsed Jon.
Wow, we are blessed with so many wonderful members, words of wisdom and caring should be labeled to all. AC is lot more than itself with this forum. I once told my doc if you have any question just tell me to post it... when you are stressed out, post it, then forum collective thoughts would ease your pain, resistance is futile.
Jimmie, A suprise to see that your IT brother in law thinking same, even down to Dell refurbished desktop suggestions. I thought I am by myself in that because many would think of it as too cheap and not that very doctoral way to go. Really you can put down couple of thousand dollars or 10K more and go for Dell or HP or Lenovo small business leasing deals. Small monthly payments and peace of mind knowing that all equipments are new with warranty. Business expenses depreciation write off . ..
When we started we went through that. But then after 4 years, brand new option was no longer that attractive. Our little EKG, over 3000 dollars then, went dead after 3 years, only one year warranty, it cost 1500 just to look at it, so we decided to buy a used one built like a tank for 500 bucks, works fine. Yesterday afternoon, one old patient came in complaining of feeling so tired, my doc listened to his heart then ordered an EKG..a call for ambulance to get him to ER. Since we got this old EKG, not that many functions available but served well, many more times than the previously brand new EKG now dead. Same thing happened to our defibrillator. Electronics in modern time doesn't last that long, too many plastic part I guessed and they are designed to be thrown away, good business sense to boost economy. We just finished our monthly leasing deal last month for all those buying brand new then. Years back we would have not thought much about these but not any more in my opinion. To hold on to our sanity and independence by cutting expenses... and I don't know how long would it last.
AC staff needs to create a small and easy study to see how AC responses in different set ups to give more accurate recommendations instead of saying like a minimum this and that. Like 1 doc 2 employees 5 pcs, 2 docs 5 employees 2 offices 10 pcs.... no guess work or need to check around and confused by too many recommendations. I can give you an idea about ours with almost zero problem since AC 3.6 and now 6.012. Started with Core 2 6600 2.4 Ghz 2 Gig ram, 1 thousand dollars, to be used as server and 5,6 mixed and match low power Pcs and 1 tablet, both wire and wireless... it ran fine then Two years later, I upgraded our 'server' to a quad 9550, cpu on sale for 200 bucks, put it together myself, 3 wireless and 6 or 7 clients.
Another two years gone by, getting bored with our quad 9550, not much excitement at all, went out and bought this time a used Dell T5400 Xenon Quad Core, 4 gig, reinstalled with Win 7 Pro per AC tech advice, 350 bucks. Business work station/server picky about memory , requires high end ECC Ram, 8 Gig for 200 bucks. Nothing much happened still. I hardly felt any dramatic improvement in performance after living with three 'server' generations except when AC doing its encryption back up with imported files included (about 9 gigs), without imported files only less than 200Meg files. Our upgrades going along with newer AC versions. Most the time, AC loads were all under 20% AC is just data in data out application, not much more than that. The bottle neck mainly from data queue and/or other concurrent processes with higher priorities, drug interaction in the cloud, the need to wait for data request from one client to be completed before going to the next client. Rarely, assume 8 clients ask for data at same instant, than the wait is longest for last client, first come first serve. AC is still 32 bit application, there some advantages to go with 64 bit OS and lot more RAM but not that much. Mostly user perceptions but no study on performance differences from AC. Our current main has 10 gigs and it never utilizes more than 4.5 gig. Probably for Win 7 32 bits with 3 gig Ram, a bit slower but no one knows how much. Then we have to kill any unnecessary services to bring the memory consumption down. Live within your means applied. If it doesn't have enough memory then OS will swap data into hard drive.
I like our latest refurbished Dell T5400 because the way it built, heavy steel. So I bought another T5400, newer T7400 can cost you thousand of dollars, one on Ebay selling at 4K plus. Mostly refurbished pc has only single CPU, I bought another CPU to see if I could run it dual CPUs. Windows 7 failed to install with dual CPUs, not a matched pair. CPUs need to be same stepping but then runs fine under Vista business. Microsoft forum did not come up with a solution for mismatch CPUs. However our dual quad core CPUs have a total of 8 cores running. From CPU benchmark, the score of my old hardware is in the same league as many I7s. Theoretically, if AC was written in 64 bits with optimized parallel instructions then my old hardware with 8 cores would outrun Bert older generation I7. For 600 hundred dollars!
So it is not that difficult to choose, buy used and no monthly payments but need to have a tech loving kid (spouse included) around. Buy new, paying monthly or write a big check but be able to sit back and relax and no need for family/friend help.
One or three day system down is not much a problem. Have plan B with paper chart back up.
