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10/01/2007 10:12 PM
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Lately I have been experiencing a lot of problems with amazing charts not accessing the database in my peer to peer network. I have a 2 doctor practice with about 15 ancilliary staff. We have over 10 computers and often one or more people get a network error and can't access the database unless I kick someone else off AC. This is getting too frustrating and I feel I need to go to a formal server/client configuration. I plan to buy a server with Windows ServerĀ® 2003 R2, Standard Edition with SP2. Does amazing chart work with it? Thanks in advance.
Gerardo Carcamo Surgeon San Antonio, TX
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gcarcamo,
First, you didn't stipulate what OS you are using. XP Home can allow five connections to it while XP Pro is restricted to ten depending on your configuration.
Pretty much anything will run on a 2003 server. If it will run on XP, it will likely run on 2003. But, to answer your question specifically, yes it will.
I definitely recommend moving to a client/server setup and running your network on a domain. The only other piece of advice given the size of your office, would be to SERIOUSLY consider Windows SBS 2003 Premium Edition.
Bert Pediatrics Brewer, Maine
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why windows sbs 2003 premium, if I might ask. I currently run a peer to peer network with a combination of xp pro and xp home. (2 old pc's, about to go to the great big server up in the sky) I have both desktops and laptops. I have a combination of wired/wireless network with a lynksys wireless router and a switch. The "server" is a machine with xp pro, with an intel celeron 3ghz with 1 gig or ram. I have a mixture of macafee, norton, and other antiviruses among the other computers. (I wonder if I have to consolidate these.) I have no experience at all with windows server operating system, so I am a bit weary of jumping in the bandwagon, but heck, how hard could it be? (I might live to regret these words). Any words of wisdom would be appreciated. Thanks for your help. 
Gerardo Carcamo Surgeon San Antonio, TX
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Before you give up on your present system. Many people rank on Linksys routers, myself included. When Cisco took them over, they very intentionally made the Linksys stuff soft and weaker so as to try and get folks to go to their pro stuff on the Cisco side. They did not think that folks might actually opt to go to a different brand all together, their stupid lose. My Linksys was nothing but trouble and at the time we were not writing to a common folder on the tower, just having one wired and two wireless machines using it for internet access and to get to the common printer. It still stunk. I tried a D-Link next and used that with AC for awhile. Although better than the first router it still left much to be desired. Finally I got my NetGear Maxrange with the seven hunting for its clients internal aetennas and it has been great! If you should choose to get the Netgear consider switching to Trendmicro's PC clilin for internet security. The two companies have a bit of a relationship and the router can see the clients and their security status and it really seems to work very well together. Also Trendmicro seems to be one of the best packages out there right now. Updates ever 3-4 hours. I've heard that Karpinski might actually be the "best" but it is more expensive, at one license per box, but they really seem to know what they are doing. Updates every hour! I'm considering giving them a try. Every now and again you do need to "re-boot" your network itself and the main machine. Do you turn all your computers off at night. As much as rebooting does the spike thing that most of us try to avoid, it is a known fact that if left running for days, the OS itself in the RAM can and does get weak, and less than perfect. A once a day re-boot (we just boot in the morning) tends to load a fresh clean copy of the OS onto all the machines and get them off to a good start. This is especially important for the main machine in the system. Same for the modem and the router too. They are but chip based little things with a bit of software of their own too. Turn them off "Hard" unplugging if need be. Turn on the modem first and let it find itself. Mine has a numbe of status lights so I wait for the three or four lights to get back to normal, about a minute or so, seems longer. Then and only then, turn on or re-boot your router. It needs to be done in this sequence or the router won't find or know about it's modem. Never the other way around. I find if one or two machines are having trouble it is a re-boot to that machine or client. If the tower itself (our main machine that we all share that famous folder on) is slow or wierd then I re-boot the tower and all the others afterwards just for good measure. If all clients are slow or weird but the tower is OK then it is probably the router that needs a reboot. I frequently find that thunderstorms (of course) bring on network weirdness. I can not stress enough how much of a different my switch of routers made. We have two other 2.4 systems just across the parking lot on two different sides of us and we use a 2.4 phone system ourselves. Compared to anything else, this Netgear is head and shoulders above the rest, really. Now as to the limit of clients allowed onto a windows XP system I have heard many different answers including that perhaps there really is no limit on the number of clients in an Pro enviornment. I tried to research this on the MS website and other places because of eventually running into the same concerns at some point in the future. I'm just wondering if the number of clients isn't as important as the actual number of clients reading and writing to the system at any given time. So unless 11 or more clients are all retrieving or sending data thru the network and only to the actual shared material or resources, would it really matter? I'd be interested in a firm, chapter and verse answer to all of this. And agian I would be suspect of the Linksys router if only a client or two are having issues at any given time. Perhaps the router is having trouble dealing with the traffic, not the server of the peers. I gather your router and network are locked down good and tight? Don't want any freeloaders riding your network and reducing its performance no less perhaps getting a peek at our patients PHI. I caught some bozo sitting in a pickup truck one night outside one of the other offices riding their wireless router after hours. And their network was set up by the clowns who set up my second router too. "oh our network guys setup our system well". Yeah right. Now I know better. If in doubt, buy the dummy's book. Now my network is possibly one of the tightest in all of CNY. Gurus my tush. On the same idea, what is the word from AC central about re-doing AC in some sort of a SQL Server form and how might that effect us folks who are using p2p set-ups. Will we all eventually need to switch over to a server based enviornment? This is the type of advanced warning and advice I wish we would be getting from the mothership so we users out here in the field can make intelligent plans based on good solid advanced planning. Anyway, be well. Paul 
"Beware of the Medical Industrial Complex" "The Insurance Industry is a Legalized CARTEL"
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Gcarcamo,
Sorry, it took so long to get back. I thought I had posted, but for some reason it didn't go through, and I hadn't noticed.
First, let me say that if anyone is considering client/server wtih 2003 server, then I am all for getting behind them and helping. You will never regret it, and your network will be much better. For one thing, you will have a domain, something you could never have with peer to peer. It is my firm believe that networks were meant to run with a file and application server. To answer some of your questions:
I may have misunderstood when you said Windows Server 2003 R2 Standard Edition, and I then said SBS 2003 Premium R2. The first issue is to make sure we are talking about apples and nicer apples versus apples and oranges. With the phrase you used, it would stipulate a non Small Business Server. So, my advice would be to DEFINITELY go with Microsoft SBS 2003 R2 either standard or premium edition. Doesn't really matter. But, even though it is $500 vs $1500, the premium version comes with SQL Server and ISA 4.0 which is an extremely robust firewall so no need for Cisco PIX 501, etc. and savings of $400. You may not need SQL, but you just may down the road. Personally, I have the standard edition. SBS would be a much better choice for you than Windows Server 2003.
I would not have the combination of wireless, and I would definitely go wired. If you are starting over, then get Cat6 with Cat6 NICs and Cat6 switch. Just pay someone $600 to run the cables. It may be cheaper if a lot are run, because the pulls are much easier. Always remember the Ethernet rule: IF YOU NEED TO PULL ONE, PULL TWO. Always! Hell, pull three.
I appreciate your peer to peer and "server," but it is only acting as a server. My advice would be (as you stated earlier) to get a real server. (with RAID). All the antiviruses are fine, but I would switch to one. They don't make Norton anymore, it's all Symantec, and no one should contribute money to the evil empire. I would recommend either TrendMicro or Sophos. The key is to get some type of Corporate Edition for the server, so you have one central antivirus "pushing" out the definitions and running virus scans on all computers when it should. You can then manage all the antivirus stuff from the server.
No experience shouldn't stop you, but you should add salt and pepper to the words, "how hard could it be?" Basically, it is simple to install it, but rather hard to install it right the first time. Most errors with a network domain is due to an incorrectly installed server. I would highly recommend having an IT person install it from the get go but only someone who will let you watch and is willing to teach you. If not, tell him/her to hit the road. It's still "See one, do one, teach one."
If you do it yourself, get the Windows Small Business Server 2003 RS Administrator's Companion. Even better, go to Google and check out Train Signal. Excellent training video. View it twice, then install while watching. It will take thirty hours but save you tons.
Of course, I will always be available if you need help. If you did get the SBS and not the premium, then you will need a good firewall/router. Definitely, go with Cisco, and you can't beat the Cisco PIX-501-10. If you are going to use more than ten Internet connections, then you have to get the PIX-501-50 instead.
Hope this helps.
Bert Pediatrics Brewer, Maine
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This is a great thread. We have a server (actually two) and used linksys wireless for some tablets and still use for two laptops. We are really ludites that are just now coming to grips with workflow issues in the office and we are evolving into several different styles of users. In general we will attempt to avoid wireless. We have really just got started but it is already one of those, "Oh I can't believe I didn't do this a long time ago." While we started shopping three years ago, and we began scanning old charts and shredding them at that time, we only got live with AC this past April. We have SO MUCH to learn about the IT issues. I feel like a pioneer with an office that has gaslights, and an ekg machine has arrived and we are looking for a way to plug it in! Martin
Last edited by DocMartin; 10/05/2007 3:45 AM.
Martin T. Sechrist, D.O. Striving for the "Outcome Oriented Medical Record".
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we are evolving into several different styles of users. Well, everyone has tons to learn about IT. It's always evolving and even the best of IT has to do a lot of trial and error. If you consider upgrading and you like the IT aspect of it, then I would recommend moving to a domain environment. Of course, you already know I love SBS 2003. Looking at your quote above, I guess one could like at that from either direction, but for me, that would be a bad thing. Users should be users or "power users" as the case may dictate, and admins should be admins. I think a network works best if everyone works within a set of rules. For instance with a client/server domain pretty much any setting on a clinet such as XP Pro, for example, can be controlled from the server: What desktop they have, what color, whether they can use Control Panel, what is on their start menu, etc. Of course, most of these can and probably should be left up to the user, but as an example, I lock down the wallpaper. It is blue, period. Can't be changed. And, the screen lockout is 30 seconds and passwords are complex. But, as the physician/owner/IT person who does most of the IT at night and weekends and troubleshoots between patients, I simply can't work on computers with the latest picture of Motley Crue on it. Nor can I have them downloading every Yahoo video game they want to play at work. But, of course, handling your own email and setting up group policies is much more important. We were very secure from the outside, but I didn't know that a biller who comes from another office to teach our biller was calling our billing software support and allowing them to access the server through her workstation and add and delete files from the billing folder on the server. While this was all done with good intent, it was scary to think that a user could add and delete files to folders that were shared on the network. So with NTFS permissions and group policies, it was rather simple to allow everyone access to the databases of AmazingCharts and Medware, but not allow them to open the folders. So, I think it's great you are moving forward with the technology. Your shredding is great. A dedicated server would go a long way with protecting that data you have shred. Cheers!
Bert Pediatrics Brewer, Maine
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Bert: Thank you so much for your help. A lot of what you said flew right over my head. I will read it a few more times and hope to eventually get it. For now, I have gone ahead and purchased a server with MS windows server 2003 R2 standard edition. It has a 2 ghz intel xeon cpu with 4 g ram. I have an IT guy helping me but he has some questions: Does amazing charts need the mdb files on the amazingcharts folder or can they be put somewhere else away from the program folder? Does that change how you run the database tuner? What about the import folder? From what I gather, he wants to place all the DATA (i.e. billing, scans, email, etc) in a partition away from the OS so if the OS fails, the data is still there. BTW, I did get 2 500gb HD with raid 1 configuration.
Gerardo Carcamo Surgeon San Antonio, TX
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And yes, I did not get sbs 2003. I have to say I followed my IT person's advise. I have a feeling I will be regreting that, but heck, that is life. I do appreciate the time you spend helping us little folks and hope the gods are kind to you in return.
Gerardo Carcamo Surgeon San Antonio, TX
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i have a server-client network, with a local domain, using sbs 2003 standard, four workstations with xp pro. i initially tried an installation of sbs 2003 in the middle of last year, with others helping, which was a disaster. since then, i have re-installed the server myself. i am slowly getting everything to work. one area i've had a problem with is remote access. i want to add my computer at home to the network, to be able to do work from home, and to do backups, so i don't have to wait for the backup at work to complete before i can leave. i've tried a VPN, but for some reason, it's not working properly, and when i try remote web workplace, i get the "you are not authorized to view this page" message. any ideas?
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Larry, How is Puget Sound? I went to school at PLU and worked in Seattle for awhile. Beautiful out there. A question and hopefully some solutions. Why do you have to wait for the backup to complete? What type of backup software are you using? If everything is set up correctly and scheduled correctly, you should be able to see that it backed up correctly in the AM. Your backup should alert you by email when it is done correctly. So, you could have it email you to your home. But, worst case scenario, you come in, and it did'nt work and you are a backup behind. From what you are saying, my guess is you are only backing up one day at a time and not multiple backups. OK, for your questions: A VPN is a very secure and fairly quick way of remote access to your remote computer. Advantages: Secure, relatively quick. Disadvantages: You are restricted to those two computers. You set up the VPN between the two routers, and its complexity can be based on the type of router you are using. You can set up VPNs with dynamic IPs, but it is easier if they are both static. So here are your possibilities: To set up a VPN from SBS 2003 Standard to your home computer, you can use the VPN setup in Windows 2003. To be honest, this can get a bit technical. You can look at the following two links which give you step by step instructions, but they will seem a bit overwhelming. You will also need to forward port 1723 on the router on the server end to the computer acting as the VPN server. When our office set up its VPN to the hospital, the hospital set up all of the configuration and the Cisco PIX's EasyVPN did the rest. http://www.onecomputerguy.com/networking/xp_vpn.htmhttp://www.onecomputerguy.com/networking/xp_vpn.htmIf you truly want to try VPN, you will probably find the software versions out there that will make it much easier such as: Ultra VNC: http://www.uvnc.com/or Real VNC: http://www.realvnc.com/products/personal/index.htmlThere is also an option you did mention, which is available with Windows XP and Vista. XP comes with a feature called Remote Desktop which will allow you to connect from your home computer to your client computer at work. You can then connect from the work client computer to the server if need be. In my opinion, Remote Web Workplace is the best way to go. It is the most secure, it is a fast connection, it allows you to connect from any computer that has Internet access and allows connectivity to any desktop, server and Outlook Web Access as well as Sharepoint management. The reason you are getting the error messages is that you most likely to not have the ports open on your router that RWW requires. Ports 443, 444 and 4125 MUST be open. Every router has a different way to open the ports. Most LinkSys routers are relatively easy. A Cisco PIX firewall is one of the industry standards, but opening the ports there can be a bit tricky. If you have a Cisco router, I can try to talk you through it. One other option would be to use the web service products which allow connectivity. These take about five minutes to set up -- you just register and follow the prompts. These would be GoToMyPC, which has a monthly fee after the trial period and LogMeIn which has a free version and a Pro paid version. The free version is more than enough. There is an entire other thread for this. Certainly, LogMeIn would solve your problems. But, you paid for SBS 2003 Standard, and the beauty of SBS is it is inexpensive yet comes with very helpful features. Not using RWW is a waste. If you are unable to open the ports (and utilize a different static IP address than the IP address on the public side of your router), then paying a good IT person who knows your brand of router and SBS would be well worth the investment. It shouldn't take more than an hour for a knowledgeable tech do set that up. Hope this helps. Please feel free to ask more questions.
Bert Pediatrics Brewer, Maine
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I agree with almost everything said about SBS. I have SBS Premium R2 and works great. One problem tried ISA Server that came with it and it was a disaster. difficult to install, really dragged down the net and locked out some secure sites even though I had no filters on. Spent 300 bucks for a "professional" IT person to fix it - didn't help - finally just took it off. Kinda reminds me of Vista on steroids.
Cary Herl Candlewood Medical Group Family Practice
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Well, I really screwed up and lost my entire post. So, I will abbreviate here.
I haven't used ISA 4.0 since I have only standard. Were you using two NIC cards or three with ISA? How many are you using now and what firewall are you using? I am going to try and set up RWW with my friend's PC which is running Premium edition, but I will just have to guess a bit as I have never opened ports or set rules on ISA.
Bert Pediatrics Brewer, Maine
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Let me preface this by saying I never got this running. 2 NIC cards 1 to internet and 1 to internal network - not 3. Didn't set up a DMZ. Firewall is a basic Linksys home grade router along with SBS basic firewall. After hours of research, cussing, and beer, came to this - ISA 2004 is designed to run as a proxy server in front of another server on the internet. Problem is that SBS doesn't play with another server on the network. Win server alone doesn't have that problem. Thank you microsoft. There is a way people that can run ISA on top of SBS but I don't know how to do this. All I know is that it didn't work for me when I did the standard install. Since I have R2 I have ISA 2006 but have not tried it since 2004 was so bad. Let me know if u get it fired up and running smooth.
Cary Herl Candlewood Medical Group Family Practice
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Well, I haven't used ISA so I can't speak from experience. My understanding though is it sits between the two NIC cards and is an extremely good firewall. I asked my friend if I should come over and help open ports for RWW on ISA, and he told me he doesn't even know where it is, lol. I do have one suggestion. A little pricey but probably worth it. I have purchased one TrainSignal video for SBS, and it is very good. Sometimes over my head and sometimes a bit too easy. http://www.trainsignal.com/index.asp?PageAction=VIEWPROD&ProdID=42This is ten hours plus on only ISA Server 2004. Not sure if you can apply it to 2006. I also know a guy who could set it up for you over the Internet, but I am not sure what he charges. It's difficult to find a great IT guy. I will say that I have been a member of Experts-Exchange (which is where I ran into this guy -- he's an SBS guru extreme) for over two years. It's only $9.95 per month, and it is awesome. Most questions are answered in under thirty minutes. Some take longer, of course, depending on the difficulty of the question. www.experts-exchange.com I am up to 206 questions. Most ended up with solutions. I just checked today, and they have a brand new zone just for ISA. And, it's the guy I was referring to who is the zone advisor. I actually can't speak highly enough of this site.
Bert Pediatrics Brewer, Maine
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Thanks I'll check it out. I really would like to implement ISA cause there's a lot of surfing going on around the office and would like an enterprise grade firewall. From what I've read, when properly set up there has been no breaches.
Cary Herl Candlewood Medical Group Family Practice
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I have a couple or more ways to curb surfing at work. It drives me nuts, because I try to allow my staff to have some freedom, but they always abuse it.
The simple thing is to remove the default gateway from the NIC card, and just tell them Internet is down for one week until you can use it correctly.
Sharepoint still works and they can access everything on the server with their IP address and Subnet mask. There is always an issue if they absolutely need access to certain sites, which I then have to do a different way. Sometimes, I will designate another computer with Internet access to allow them to get out if need be, and then it is obvious they are on the Internet.
I have a strict policy again webmail as I want them using Exchange Server and Outlook so I can monitor email.
Bert Pediatrics Brewer, Maine
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I think if you look into TrainSignal, you will be more than happy. I have books on everything, but I find I never read them at least more than an occasional reference. Experts-Exchange is awesome.
Bert Pediatrics Brewer, Maine
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