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An IT consultant that we are using has asked me if there is a limit to the size clinic that AC will accommodate? Is there?

I understand that it is not a good choice for inpatient, but from an ambulatory clinic standpoint? We currently have 5 providers and love AC.

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Tell him it is "sequel" based, and then he should be able to tell you how big a network can get before it slows way down. Advice and opinions about AC being only for solo or very small groups began when AC was an ACCESS database. The effect of Version 6 (the billing) on the whole system has yet to be seen.


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Express has limit of 4GB, which is basically your AmazingCharts.mdf.

If you outgrow that, which would be difficult, buy SQL Server 2005 or 2008. Sometimes, you have to pay the piper.

Remember, your imports are just in a folder. There is a small link to them in the database. Go to Imports and delete the file there. It will still be in the imports folder.

No inpatient wouldn't be very good for AC.


Bert
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Sky,

Curious your current DB size, number patients, months/years the practice is using.

One practice in SoCal is ~ 6000 patients, ~ 5 years use, DB size is 350 MB, imported items ~ 50GIG (lots of scanned correspondence and lab results).

As a tangential question, anyone tried moving Imported Items to Network Attached Storage (NAS) to reduce network contention?


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Indy,

How would the program know to look for the Imported Items on the NAS? Is there an .ini file or something in the folder? There doesn't seem to be a way to set a path.


Bert
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Looks like our DB is 449MB; we have only been using AC for 14 months and have about 3200 pts. Wonder why the big difference?
We have added pt. photos. Our imported items file is 47GB.

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First, the size limit of SQL Express counts against your six databases which are the data and the logs. Since your meds and codes are basically constant, they won't grow, and the log files will stay relatively small comparatively. SQL will be able to handle all of the databases in each instance (Server_name\AmazingCharts) being one instance. Only data and the transactional logs are counted toward your limit.

The other files in your AC folder just reside there and do not count toward the size. There are six folders:

1. _Data001 which contains your signatures
2. Backup which is aptly named as it contains all of your backups
3. Vendors which is obvious
4. Illustrations which are linked to AC notes
5. ImportItems which contains your imported items.

None of these have anything to do with the size that counts toward your limitation as they are not in the actual databases. The only issue with Imported Items is how much disk space you physically have on your computer.

The only difference I see would be in your patient photos. As far as I can tell, since they don't reside anywhere else in the folder, they are actually contained in the note themselves, and hence in your AmazingCharts.mdf database and would affect the log files to some degree. Given a 5Mb pixel camera is easily capable of producing a 500Kb to 1Mb file (could be smaller or larger depending on certain variables), it is conceivable you could have 3.2GB of photos. Now, my guess is you don't have photos for each patient, and they are probably more like 100Kbs to 300Kbs. You would have to check. So, if you had 3,000 times 200Kbs, you would have 600 Mbs, explaining the difference.

So you could look for ways of decreasing the size of your photos. Then again, if you are not going to keep adding patients, this also would become fixed space. Another option is to import the photo rather than embed it into the demographics section.

If push comes to shove, you could always purchase SQL Server 2008 and upgrade from Express. You could do the same with 2008 Express (since it is free as well), but it still has the same limitations.


Bert
Pediatrics
Brewer, Maine


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