Hi DRM,

I been reluctant to post in this thread, my views are somewhere between dinosaur and lunatic fringe. I am a solo family physician, with one physician's assistant, in rural Western Maryland, basically Appalachia. We have a shortage of primary care physicians, which is worsening as busy solo physicians retire. Reimbursements are not very good, patients are older, sicker, with multiple problems, and lots and lots of psychosocial issues. Given all of this, I've tried to keep costs as low as possible. I started this practice in 2005, at that time it was with Amazing Charts, version 2.

We started with a peer to peer network, with myself, the physicians assistant, and the medical assistant using laptops in the exam rooms. We have had very good experience with wireless laptops, speed is about the same as wired, basically no issues here. I like the flexibility of the laptop, I can literally have it on my lap, facing the patient, as I take the history, or I can turn it 180? and show the patient the screen. Plus, if the patient is a real talker, I can go through other messages, refill requests, and so forth while they are talking.

The technical gurus, such as Sandeep and Bert, will give you many good reasons that they prefer a server, as opposed to peer to peer. You can search for many of these threads. They are right, but I'm not sure that the advantages are overwhelming. Peer to peer works. JBS also uses peer to peer.

We actually have eight hardwired computers, as well as the three laptops. Each laptop connects to AC independently, we don't use them to mirror the desktop. So, in my office, I can have two charts open, one on the desktop and one on the laptop. In the patient room, I can only have one open.

Backup is done using ACs backup program. I have a second hard drive in the main computer, and an external hard drive on the main computer, the backup writes to each of these, as well as to AC off-site backup.

This has worked, and worked well. If I were just starting, and had the money, I would let someone good set up a server and run this (you may want to talk to Sandeep about this.) I am staying away from the cloud, with the number of computers we have, the monthly fee would be quite high.

Another cloud option is offered by Indy, who posts on this board. He actually has servers which can host your practice on the cloud. I'm not sure how this compares, financially, to AC. I can say that he is extremely knowledgeable and helpful.

Good luck!

Gene

Gene Nallin MD solo family practice with one PA Cumberland, Md