Home Forums Discussions General Discussion Future user 1st questions:Hardware recommendations

I am a neurologist who recently started playing with AC. We use a billing company that gives us access to the scheduling and financial modules from Allscripts. I've never liked how their software looks or works but thought I'd ask about adding their EMR. When they quoted me an astronomical price just to add that module I decided to look at AC. Another reason is that I am in Rhode Island and can easily stalk the founder if I have problem - just kidding Dr. B.

My current desktop PC is showing its age and will need to be replaced. I've seen the "official" hardware recommendations but would like to hear from someone with real-world experience.

Some practice details: At least 2/3 of our patients are seen for one particular diagnosis (I've really subspecialized) so it should be easy for me to set up templates. I've been using DragonMedical for many years and will still need to dictate in Word for a variety of medico-legal reports (both programs are real RAM hogs).

There is one front-office computer for my secretary and another for my part-time nurse practitioner. We are already networked for DSL access. My desktop will be the main computer.

I'm thinking 4gB RAM. Any other thoughts? I've had several Dell computers without any problems though given the recent issues they've had I am willing to go elsewhere if others feel strongly.

As far as scanners, any new suggestions?

Thanks

Hi braindoc,

Briefly, You already have Internet access, so I am assuming you have a router. The router could be your switch, but you will probably need more connections so a decent switch would be nice. I am thinking you are networked, e.g. you hardwired to your router/switch/firewall. Is this Cat6? If you are starting new, then all NIC cards should be GB and all your Ethernet cables at least Cat5e or higher.

There are at least 20 threads on here on just this topic from servers to networking to wired to wireless and P2P and client/server. You may want to do a search on some key words like

Computers, network, Peer to peer, server, etc. to get a jumping off point.

It doesn't sound like you will need anything fancy given you only have three computers. But, then what are you going to use for your rooms. Personally, I like hard wired desktop computers, but just as many on here like laptops. Of course, then you have to go wired. It depends which way you are leaning and your office design and whether you want to run cables. Tip: If you do have someone run cables, for every run, pull two.

Now this is just my opinion, but I feel rather strongly about it. Most on here would think I live and die by the server model, and that is what I basically recommend. BUT, if you are going to go P2P, then I would strongly recommend against using your personal computer as the "main computer." I would say they are mutually exclusive. If it is the main computer, then it's not your computer and vice versa. I know it's just semantics. So, you get 4GB of RAM. That's plenty. And, you use WIN7 and install Word and Dragon and use that as well. There goes 2GBs of RAM. SQL Server takes 1GB by default. Now you are down to 1GB. Actually less, because a 32-bit system can utilize all of the 4GB, probably only around 3.2. Of course, you and WIN7 probably won't take half, but why not have one dedicated computer that's not fancy...no speakers, video card (not an actual card), etc. and put the 4GBs on that. Get a good processor and you're all set.

Anyway, it is easier to answer questions than to just list a bunch of things. Unless, you want me to spend a whole lot of your money

Welcome to AC. And, if you could give your first name or put it in your autosig, that would be great.

Hi Bert:

Thanks for the quick reply. I will do more searching in the forums.

Our computers are hard wired, cat5E I believe, to a Linksys router. We do not have any networked programs loaded so the computers do not communicate with each other yet. Am I wrong in assuming that when all 3 have AC loaded the other 2 machines would have access only to the AC database on the main?

My practice is probably very different from yours and most of the other AC users. I see patients in my office, sitting across a desk from me, not in an exam room. My NP does use an exam room right next to her small office. However, for other reasons and needs I might reconfigure her space to convert it to more of a consultation area/office like mine. We do not move from exam room to exam room, with patients waiting in each for us. The main reason is that the overwhelming majority of our patients are adults with ADHD who rarely require much of a traditional physical exam. You must be thinking, "he's more like a psychiatrist than a neurologist."

Once in a while I need the exam table - to do an EMG or on Fridays, when I am alone (except for a technician doing some computerized diagnostic testing for ADHD) to perform an IME. Otherwise, it is mostly sitting and talking.

I hope that clarifies my situation better.

Your computers will be networked as long as they are all connected to the same router or switch as long as they are configured correctly. (Same workgroup name, etc.)

As to your AC question, when you install AC to the main computer, you will install SQL and the program. On the other machines, you will choose not to install SQL. They will then be able to browse to the database on the "main computer." With your setup, you could probably get away with using your computer as the main computer.

Thanks Bert. I'm working on the configuration of the new machine. There is a load of technical information about RAM, processors, etc and Dragon in the Know Brainer forums. Based on my reading I'll be getting a more powerful processor with triple thread and more RAM.

I'm also thinking about 2 hard drives to separate data from programs and OS. Although considerably more expensive, I'm leaning towards a much faster solid state drive for the data. Any thoughts about how big the data drive should be for my 2 provider practice?

Anything you buy will be ADEQUATE. I have one machine running AC that is a celeron 500 MHz (hey, I moved finally put down the pentium 400). Most of my machines are 2.4 GHz Pentium 4s with 80 G hard drives, running XP. They move fairly quickly although occasionally there will be a 3-8 second pause first thing in the morning.
I would totally agree with Bert, the main computer should be dedicated to just AC. If you are starting new go with Win 7 pro. You can use home on a peer to peer system but pro will be more upgradeable. If the other machines are XP, there may be some issues with networking.

Get at least 4Gig for the main computer, a large hard drive (500 to 1 Terabite), A quad core would be good and the AMD ones are not very expensive. The other computers almost won't matter, almost everything has 2-4 G and a 300-500 G hard drive with a dual core. I would strive for Gigabit networking since it made more of a difference than anything when I last upgraded my system a couple years ago. Since you are going to be using one machine for Dragon and your "main consulting computer" it probably should mirror the specs for the "main AC computer."

Research the board about backup stratagies and hardware associated. Backing up is key to a good system.

These are nothing fancy, and probably well under 2K for 4 computers, potentially a lot less.

Thanks Wendell. Any idea how large the AC database will be for a small 2 provider practice? I understand that it will keep growing, but a rough guess for 2000 patients?

3 1/2 years 2000 patients Amazingcharts.mdf and .ldf are 1.2GB.

Imported items is a totally separate thing. For me, 7GB, but for others a lot more.

Very helpful information Bert.

Have you ever used a solid state drive?

I have not. I believe they are cutting edge, and I have't been there yet.

The person you want to talk to on here is Indy. You can find him on the Tech Talk forum.

http://www.amazingcharts.com/ub/ubb...23523/gonew/1/Droid_X_Open_Thread#UNREAD

I have about 4000 patients, my entire AC folder is 1.8 G, the AC database alone is about 300K and the import items is only about 500K. And I thought we imported a lot, but that' nothing compared to Bert. My backup (compressed) file INCLUDING imports is about 1.6 G.

I and my Nurse Practitioner see about 5K patients a year. My database goes back to 2002.

I know there are a lot of folks with a lot larger databases. The big issue will be the import items.

Wendell, I'm confused. An empty AmazingCharts.mdf database is 26MB.

One 1-page pdf file is 500K. You don't have just one pdf in your imported items. I must be missing something.

And, please tell me how you batch the vaccine migrations. We still are doing them one at a time everyday.

Thanks.

I think that might of been a typo for the record we have over 74,000 pt's in AC and the whole folder is about 33gb half of that is imported items. Solid state drives are much faster but with that comes a price rather invest in a server with a radid 5 config.... : )

You really have 74,000 patients? Wow. My guess is, like all technology, SSD will rapidly come down in price. Until then, I will stick with the SATA drives. The weird thing is the prices of 7200 and 10,000RPM have always been affordable where 15,000 has never really caught on, I am guessing to the price break.