Thanks Indy. I would have to read at least 10 hours of TechNet to even begin to understand that. Wow.

I will have to say that while likely more IT techs recommend user status and not local admins, there are many that say that, but then don't.

@Mike,

I still don't get a great understanding of your overall goal. I highly recommend hiring an IT company to set things up. You don't do tech and they don't do medicine.

Originally Posted by .
I try to keep things simple and keep costs to just what it takes to get the job done prudently. I run a small solo practice, low volume (225 visits per month, about 2 per hour, many slow elderly patients on lots of meds), and to control costs while waiting for the phone to ring, I am also the electrician, painter, toilet unclogger, and unfortunately the not-so-bright IT guy as well. This together with my wife's gracious participation as an unpaid manager holds overhead down with two other staffers, as has the low cost of AC. Through version 6.3.3 I have been lucky to get by adding random random budget computers as we grew to my 5 computer peer to peer network, which worked just fine at that pace. I'm hoping to learn enough to put together a serviceable network of replacement computers to meet V6.5's needs, and hopefully do things more efficiently than I have so I am not in the office after hours as much as I have been.

Depending what type of network you want, it may be something you can't learn to do within weeks, certainly not piecing together information from here. Partly the info on here may be over your heard, partly it may not be what you want, and mostly, you will get different suggestions from each person.

Originally Posted by .
One of my biggest challenges is updating supporting general software (e.g. Windows, Java, Flash, Reader, OpenOffice, Antivirus). The challenge for me is to have some ability to restore the prior version if the update causes problems (taking the time creating a Windows Restore Point, or imaging the HD), avoiding business/appt hour interruptions caused when updating taking computers out of service (just rebooting and logging in to all the concurrent software [AC, Updox, OfficeAlly, webmail] can take 10 minutes), and having the time to test updates against starting all the software that runs concurrently for conflicts after hours before relying on it during patient care ? multiplied by 5 computers. Perhaps I am not doing it right, but my experience has been so dismal and disrupting, that I have adopted a not-so-safe policy of avoiding updates (except antivirus) until forced to, usually just before an AmazingCharts update. Setting automatic schedules after hours to juggle 5 computers to update 6 programs over a single internet connection has been problematical, particularly for those that require a human restart intervention when I am not there. Sometimes it seems updating or running one program (perhaps antivirus) causes changes in settings of others that result in pop-ups in mid day requesting permission to update something else that I previously set to never update. Perhaps 20% of the time after an update, the mileau of programs will not run together requiring debugging and generally adjusting settings that takes 15min to hours that can't be tolerated during business hours. As infrequently as I update Windows, updates not uncommonly take 8 hours requiring constant babysitting to iteratively run Windows Update, install, reboot, and repeat sometimes half a dozen times until all necessary updates are installed. Part of this may be my ATT DSL 1.45Mbps down/0.33Mbps up limitations. All users store files only on the Main Desktop Peer to Peer computer, and this doubles as the physician's office Desktop.

I don't see the challenge of supporting general software. If you have to reformat a computer, that can be a project which would require installing Windows. You can image each computer to a backup preferably an external hard drive and not the "server. You can also do an image of the first install which could be compatible with all of the machines, but if things are too different of the target machine, you may need specialized software. Acronis comes to mind. To be honest, I almost always format from scratch, but I don't have to do it very often.

Java, Flash, Adobe, OpenOffice and Antivirus shouldn't take long. I can't recall with AVG, but with my Antivirus, it downloads definitions every 30 minutes. We haven't had to do anything for seven years. OpenOffice, no big deal. With the other three, just run them while you are seeing a patient. It just runs in the background. Be careful with Java. This is where allowing users to be local admins pays dividens. I simply don't want to go around installing those. Updates have to be done, but they don't take long and my four users can do their own updates. If they download something, they are written up. As far as restoring an original, this is where a server with Hyper-V and VMs is much better than Restore Points. I am about 46% for successful restore points. A good backup or image is safer. It doesn't have to be an image. I think you watch is different than mine. If you are sitting at the main computer to install AC, what is ten minutes to do a restore point. Plus, there are already 20 waiting for you. I don't understand the avoiding/business/appt hour interruptions caused when updating and taking computers out off service. We all must do that. You do it after hours.

I again must be missing something. All of those things you describe are things we all must do. You MUST do your updates. AV is simple.

For my server, I do 25% of the updates at a time. But, I fire away on my clients. Again, give your users local admins. When it says to reboot, have them reboot. You do the rest. Updates without SPs are a pain the [censored] during a install but after that they are barely a nuisance. Install them and be done with it. Last patient, install them. Install them on the next computer. Don't avoid updates.

Originally Posted by .
Setting automatic schedules after hours to juggle 5 computers to update 6 programs over a single internet connection has been problematical, particularly for those that require a human restart intervention when I am not there.

I guess I am still confused. First, what are you scheduling? I have nothing scheduled except a weekly backup of my CLIENTS, but you schedule it once. But, I don't get the Internet connection to update a computer.

Everyone has to log into AC. I actually don't because I lock my computer instead of log off (which is another thing industry standard won't recommend. But, you can keep all of those open with a locked computer. DON'T TURN YOUR COMPUTERS OFF AT NIGHT. Office Ally is a billing program correct? But even if you have to open the other three, do it at the same time. You could even have someone write you a script to do it.

Why are you testing updates? Are you talking about Windows Updates. Update them and forget them. I rarely have a problem with a client update.

Most of these updates have preferences that allow you to reboot and install after hours. Certainly, Java, Adobe, Windows Updates. I almost never have a popup. If I do, I either run it in the background or minimize it.

You are definitely doing something wrong if updates are causing the milieu of programs not to run together. You are DEFINITELY doing something wrong if updating Java, Flash, Adobe and Updates that takes you hours during business days. I would say, I go weeks without having to fix any of my computers during business hours or at any time.

You should run updates that even. Again, you are doing something wrong, way wrong, if updates take hours to reboot. I choose my updates, run them and reboot if necessary. It shouldn't be your DSL. These updates should already be downloaded.

It is highly recommended that you do not use the computer with the database on it as a client computer.

Mike, all of these things that you mention are part of using a computer. It has nothing to do with a network. If you told me your switch was 10Mbs, I would say that is a problem. With all due respect, everyone does these updates and downloads, etc. The only problem is you seem to be describing events that should take two to three minutes but are taking hours.

Mike, I hope you aren't offended, but what I am going to say I cannot say with more emphasis. Or conviction. Somehow there are issues there that affection things.

#1 This does not seem helpful. In fact I beg you not to do number one. You shouldn't have to rotate computers so that one ends up at home for updates. You really want computers to be consistent. In the same place as possible.

#2 Number two is more problematic than number one. Again, what are the issues with the updates. Have you ever imaged a computer. It isn't going to be a walk in the park to continue updating a computer, then imaging it to other computers. You will have huge problems. Huge! Yes, Windows will be OK, if only two or three hardware items are different. But, eventually you will run into a licensing issue. This would not screw up the router. The IP address will be given to the computer no matter where it is. Printers, no issue.

#3 There are advantages to "pushing" out updates, but basically it is the same as each client downloading them. It is very hard to learn a server. You would likely need a domain. That is a domain controller and Active Directory. From your post, I don't think you are ready for that. I don't get the babysitting. The updates will be there either way. And, you still have the other issues.

RDC is Remote Desktop Client or RDP is Remote Desktop Program (I think I botched the last word). This is for remoting from home and for remoting between computers. I put all of my installs and OS on the server on one partition and install from one computer.

Mike, I have installed a few networks. I run mine everyday. It takes me maybe five minutes a day depending on whether it is Microsoft Patch Tuesday.

This, I think, is my final advice. I can't emphasize how much you should do this. Take a $1,000 or so. Maybe more. Look for a tech company that is certified with Microsoft and SBS, etc. Have them come out and read your thread and look at your layout. Then have them install it. If you want then can maintain it remotely. But, most maintain the real server remotely. At the very least let a company who specializes in computers install it and teach you a plan of how to maintain it. You take that time and see patients. I think I read at least two or three places where it took you eight hours to do something. Let's say that is 24 hours in a month. That's 24 billable hours you could easily pay to a corporation. Would you do your own roofing even with help on here?


Bert
Pediatrics
Brewer, Maine