|
|
|
|
Posts: 840
Joined: May 2009
|
|
#41946
02/29/2012 8:29 PM
|
Joined: Apr 2010
Posts: 1,546 Likes: 1
Member
|
OP
Member
Joined: Apr 2010
Posts: 1,546 Likes: 1 |
Shortly after I arrived at work this morning, all of our clients suddenly got an error that there was a problem with the server. Everyone restarted, and the server was restarted without success. We were about to switch servers, a process that takes under 5 minutes, but IT coaxed the primary server back on line.
During that 5 minute interval, I started to see my first patient, a man with multiple complex issues who was here for a complete reevaluation, figuring I could take notes and catch up. I realized just how hopeless that would be. I had no accurate memory of his medications, problems, or past history. One hates to say "Gee, I'm sorry, I have been seeing you now for 20 years, but I simply have no idea what I have done for you during that time."
The point is, unless the issue is that I am alone in having a less than perfect memory, those of us with chronic care practices can't get by hoping for a backup on an external drive to serve as our means of salvation. I can wait out a 15 minute power blackout, but can't afford to wait out 2 or three days to fix a computer that has blown a motherboard. If IT had not done its magic immediately, we could have switched servers in less time than needed to brew a cup of tea. I feel really strongly that any piece of equipment on which the office is dependent needs an immediate backup, on line, and ready to go. The cost of a piece of hardware is trivial, compared to the cost of a loss of production of one or two days for 4 providers.
David Grauman MD
Department of Medicine
Commonwealth Health Center
Saipan, Northern Mariana Islands
|
|
|
|
|
Joined: Sep 2009
Posts: 2,991 Likes: 5
Member
|
|
Member
Joined: Sep 2009
Posts: 2,991 Likes: 5 |
David,
I know this is not your point...and I am sure this will not be viewed favorably by the IT cognoscenti, but in a weird way, that is another advantage of our shoestring P2P networks. When my "server" goes down, it takes about 10 minutes to use any of the other machines on our network to step into that role.
And while I am off on a P2P bender...my 29 gigs of II open in a flash. I am totally willing to accept the possibility that I have just been really lucky, but it seems to me that most (if not all) of the II slowing is occurring on servers, not P2P networks. I have no idea why (or even if that is really true)...
Jon
GI
Baltimore
Reduce needless clicks!
|
|
|
|
|
Joined: Apr 2010
Posts: 1,546 Likes: 1
Member
|
|
OP
Member
Joined: Apr 2010
Posts: 1,546 Likes: 1 |
Very good point, Jon. What is the down side?
David Grauman MD
Department of Medicine
Commonwealth Health Center
Saipan, Northern Mariana Islands
|
|
|
|
|
Joined: Nov 2006
Posts: 2,084
Member
|
|
Member
Joined: Nov 2006
Posts: 2,084 |
I have to support Jon on this one. I'm very much more confident with my workgroup network than something more complex, for this exact reason. When the office is open, it's sad that I'm the only go-to-guy we have. I'd love to have a server/domain office network with a complete backup server, an IT guy who responds in under 5 minutes, SharePoint (and the rest of the ice cream sundae).
If I had that kind of equipment and support, I'd never even have looked at AC.
John
Internal Medicine
|
|
|
|
|
Joined: Nov 2006
Posts: 2,084
Member
|
|
Member
Joined: Nov 2006
Posts: 2,084 |
By the way, congrats to David for breaking into the top 10 Posters. Your posts are always a good read.
John
Internal Medicine
|
|
|
|
|
Joined: Apr 2010
Posts: 1,546 Likes: 1
Member
|
|
OP
Member
Joined: Apr 2010
Posts: 1,546 Likes: 1 |
John, fame is a fickle friend. I have been here before. Besides, we really need an adjusted listing, don't you think? One that takes into account the quality of the posts? Then I'd never have to worry about being conspicuous.
Also, our IT guy is the husband of our office manager. It gives us an edge not known since the days of Lysistrata.
David Grauman MD
Department of Medicine
Commonwealth Health Center
Saipan, Northern Mariana Islands
|
|
|
|
|
Joined: Feb 2005
Posts: 2,002
Member
|
|
Member
Joined: Feb 2005
Posts: 2,002 |
David,
I had a similar event about a year ago when my server went down...it blew the motherboard. Although I had my data all faithfully backed up, I had no back up server in which to install it. I was down 10 days!!! My IT guy kept replacing this, replacing that...cost me a fortune. Fortunately we found the exact same server on ebay and even more fortunately, it was in a town only 2 hours away. Mr. IT traveled there to get it (more money) and then removed the racks from the old server, slipped them into the new and in about 10 minutes I was back up and running. I really still have not yet recovered from the down time nor the financial burden.
Later he finally discovered it was the motherboard, replaced it and so now the old server and the replacement one are both working. I sleep a little better at night now knowing I have a back up server.
Leslie
Hospital Employed Physician Who Misses The Old AC
"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
|
|
|
|
|
Joined: Nov 2005
Posts: 2,367 Likes: 2
Member
|
|
Member
Joined: Nov 2005
Posts: 2,367 Likes: 2 |
I have to echo Jon. I have both setups, P2P and server. I have a second machine that was setup as a AC "server" in each system (actually the old "server" in pre quad core days) and backups go to that machine.
If the server were to crash, I can reinstall a back up to the old machine and reconnect the client machines to that one in about 10 minutes. I have done this in the past, but not since using a full server. I do have a backup on the server, but suspect it would take at least 30 minutes to reinstall in another machine were the board to fry.
Simplicity is the key
Tho servers are the most reliable machines
ultimately keep it running, stupid
Wendell
Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
|
|
|
|
|
Joined: Nov 2006
Posts: 2,084
Member
|
|
Member
Joined: Nov 2006
Posts: 2,084 |
Also, our IT guy is the husband of our office manager. It gives us an edge not known since the days of Lysistrata. Quite a literary reference! Although I guess this is motivation during those cold dark Alaskan nights. (Is there another EMR forum discussing a play from Aristophanes?)
John
Internal Medicine
|
|
|
|
|
Joined: Feb 2005
Posts: 2,002
Member
|
|
Member
Joined: Feb 2005
Posts: 2,002 |
OK, David...enough! I am having to spend too much time Googling your comments!
Leslie
Hospital Employed Physician Who Misses The Old AC
"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
|
|
|
|
|
Joined: Feb 2005
Posts: 2,002
Member
|
|
Member
Joined: Feb 2005
Posts: 2,002 |
![[Linked Image from ]](/ub/attachments/usergals/2012/03/full-80-173-200px_lysistrata.jpg) We shall always have an edge!!
Leslie
Hospital Employed Physician Who Misses The Old AC
"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
|
|
|
|
|
Joined: Apr 2010
Posts: 1,546 Likes: 1
Member
|
|
OP
Member
Joined: Apr 2010
Posts: 1,546 Likes: 1 |
Nerds rule!!
Besides, there is a certain age range in college where anything having to do with sex is easy to remember. Especially if you are not getting any.....
David Grauman MD
Department of Medicine
Commonwealth Health Center
Saipan, Northern Mariana Islands
|
|
|
|
|
Joined: Sep 2009
Posts: 2,991 Likes: 5
Member
|
|
Member
Joined: Sep 2009
Posts: 2,991 Likes: 5 |
David, I will leave the answer to "what is the downside" to the more server-experienced in the group.
John, while we generally (but not always) agree, we certainly agree on the value of David's contributions here.
Sorry, Leslie but I can't resist questioning the details of your artistic post. Let's not get into the placement of Lysistrata's right hand; but can you explain to me exactly what her left hand is resting upon?
Jon
GI
Baltimore
Reduce needless clicks!
|
|
|
|
|
Joined: Apr 2011
Posts: 2,316 Likes: 2
G Member
|
|
G Member
Joined: Apr 2011
Posts: 2,316 Likes: 2 |
David,
I had a similar event about a year ago when my server went down...it blew the motherboard. Although I had my data all faithfully backed up, I had no back up server in which to install it. I was down 10 days!!! My IT guy kept replacing this, replacing that...cost me a fortune. Fortunately we found the exact same server on ebay and even more fortunately, it was in a town only 2 hours away. Mr. IT traveled there to get it (more money) and then removed the racks from the old server, slipped them into the new and in about 10 minutes I was back up and running. I really still have not yet recovered from the down time nor the financial burden.
Later he finally discovered it was the motherboard, replaced it and so now the old server and the replacement one are both working. I sleep a little better at night now knowing I have a back up server. 10 days is unacceptable. There's no way it should've taken 10 days to diagnose and repair a broken motherboard. Even if your IT guy was blindly guessing, that's way too long. If the motherboard blew, I'm assuming it didn't turn on which should've tipped the IT guy off that is was either the power supply or the motherboard. (Processor/CPU failures are very very uncommon, RAM Errors cause beeps or blue screens). A power supply tester could tell if your PSU (power supply unit) is bad instantly (<$20) or you can use a spare PSU. Which just leaves the motherboard. Should've been diagnosed in an hour at most.
|
|
|
|
|
Joined: Apr 2011
Posts: 2,316 Likes: 2
G Member
|
|
G Member
Joined: Apr 2011
Posts: 2,316 Likes: 2 |
Very good point, Jon. What is the down side? Operating System: So your main choices are Windows 7, SBS 2011 Essentials, SBS Standard. (There's Server 2008 R2, but if you know how to work that, you probably know everything on here.) Let's start with Windows 7 ($140 OEM, $250 Retail). First off, don't even consider Win 7 Home Premium for your server. Windows 7 Professional is ideal for Peer-to-Peer (setups). This involves very little configuration. Simple file sharing and printer sharing with a maximum of 20 connections. The downsides are that it's a desktop operating system meaning it doesn't run as efficiently as a server operating system. Conflicts and issues are more likely to occur. Shares showing up on some computers while not others. Printers working on some computers but not others. Less centralized control, each computer has to be configured individually. (Making user accounts, creating shares, installing programs, etc.) SBS Essentials ($400 OEM), in my opinion, is a sweet balance for Small Business Users out there. You get the reliability of a server operating system and it makes sharing files and collaboration incredibly easy. For instance, it has an SBS Connector that you can run which will join all computers to the domain including Home/Basic editions of the Operating System. Furthermore, you get remote web workplace which will let users remotely connect to his or her workstation. (NOTE: You need professional editions of Windows for the computers you want to remote into. The documentation on Microsoft's site is a bit misleading.) You don't need to forward any ports other than the SSL port 443 for the remote gateway. They also give a away a free domain name with an SSL certificate (often https://yourname.remotewebaccess.live.com) so you don't need to buy a domain name and SSL certificate. A little dashboard shown here gives you easy access to shared folders and any other places you might need to access on all of your workstations. Furthermore, they install a SBS Essentials Configuration console that can be accessed on an Administrator's workstation without logging into the actual server. Another huge plus is that the it has a backup feature which allows you to backup the files on every workstation joined to the domain. Definitely saves money and time when you don't have to backup individual computers. Though it is best practices enable folder redirection. That way you don't have to worry about having backup solutions for each and every computer in the office. That right there makes it worth it in my opinion. Honestly, sharing folders with the wizard is 10 times easier than Windows 7. You don't need to make separate users for every computer. Now if you need a little more, there's SBS Standard. From: http://amazingcharts.com/ub/ubbthreads.php/topics/40565/Basically, the more computers you add, the more work you have to do with P2P. Servers are more centralized, reducing the amount of work involved. We were P2P before too. It was simple when we had a few workstations. Now we have 10. It'd take me several hours per computer to configure each one individually with all the shares, programs, printers, and settings. With my server, I can just set a group policy or use an image and deploy it. Just this past week. One of the computers in the office died and I also needed another workstation in the office. I had an image preloaded with all the software (20+ programs, AC included) needed and installed it using WDS Server over the network. Took 30 minutes to copy the image. Ran the SBS connector and bam. In less than an hour, I had 2 fully configured desktops ready to go. Doing format and installs individually would've taken 8 hours minimum per computer (that AC install is one of the longest).
|
|
|
|
|
Joined: Apr 2011
Posts: 2,316 Likes: 2
G Member
|
|
G Member
Joined: Apr 2011
Posts: 2,316 Likes: 2 |
One downside I forgot to mention. The WDS deployment is typically an enterprise level IT skill, meaning a consumer IT technician is unlikely to know how to configure it. IT guys use it to deploy an image to 100s of workstations. It's not that hard to figure out though.
|
|
|
|
|
Joined: Apr 2011
Posts: 2,316 Likes: 2
G Member
|
|
G Member
Joined: Apr 2011
Posts: 2,316 Likes: 2 |
I have to support Jon on this one. I'm very much more confident with my workgroup network than something more complex, for this exact reason. When the office is open, it's sad that I'm the only go-to-guy we have. I'd love to have a server/domain office network with a complete backup server, an IT guy who responds in under 5 minutes, SharePoint (and the rest of the ice cream sundae).
If I had that kind of equipment and support, I'd never even have looked at AC. Not gonna lie, it's fun to have a server  . Pretty much maintains itself. I get daily reports if anything goes wrong. Wrote scripts that delete old backups, scheduled maintenance all happens. Not having to configure workstations. Makes my life 10 times easier. I do login occasionally to install windows updates every month or two.
|
|
|
|
|
Joined: Feb 2005
Posts: 2,002
Member
|
|
Member
Joined: Feb 2005
Posts: 2,002 |
@Sandeep...needless to say I have found another IT guy. But he could have told me it was the electromagnetic particle beam accelerator and I would not have known any better.
@ JBS...HAHAHA..I had not even noticed her left hand. Just like you to point it out though
Leslie
Hospital Employed Physician Who Misses The Old AC
"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
|
|
|
|
|
Joined: Sep 2003
Posts: 12,899 Likes: 34
Member
|
|
Member
Joined: Sep 2003
Posts: 12,899 Likes: 34 |
We put our II on a 1995 Packard Bell running Windows 95. Blazing speed. Most items open in milliseconds. We did try them on the server on a RAID 10 with 42GBs of RAM, but we found we could go to lunch by the time one opened.  Sorry Jon. Couldn't resist.
Bert
Pediatrics
Brewer, Maine
|
|
|
|
|
Joined: Dec 2009
Posts: 1,204 Likes: 8
Member
|
|
Member
Joined: Dec 2009
Posts: 1,204 Likes: 8 |
It's going to take me some time to get over the fact that Leslie posted a near pornographic picture on this forum.
JamesNT
|
|
|
|
|
Joined: Sep 2009
Posts: 2,991 Likes: 5
Member
|
|
Member
Joined: Sep 2009
Posts: 2,991 Likes: 5 |
Really! That was post #41962. It took all these years and over 40,000 posts to get our first "near pornographic" post? And it took our leading female poster to break the ice. Sad, very sad.
Jon
GI
Baltimore
Reduce needless clicks!
|
|
|
|
|
Joined: Sep 2003
Posts: 12,899 Likes: 34
Member
|
|
Member
Joined: Sep 2003
Posts: 12,899 Likes: 34 |
Well, all I can say is I checked the logs in the control panel, and we had over 175 Facebook Likes clicked, the highest since we started that.
Bert
Pediatrics
Brewer, Maine
|
|
|
|
|
Joined: Feb 2005
Posts: 2,002
Member
|
|
Member
Joined: Feb 2005
Posts: 2,002 |
Hey, I was surprised the picture was not censored! And that was before I even noticed her left hand. Actually, I thought I should try something drastic for my post that put me ahead of Paul.
Leslie
Hospital Employed Physician Who Misses The Old AC
"It's a good thing for a doctor to have prematurely grey hair and itching piles. It makes him appear to know more than he does and gives him an expression of concern which the patient interprets as being on his behalf. "
|
|
|
|
|
Joined: Sep 2003
Posts: 12,899 Likes: 34
Member
|
|
Member
Joined: Sep 2003
Posts: 12,899 Likes: 34 |
Yeah, I noticed you passed Paul. Congrats! Now, just one more to go.
Bert
Pediatrics
Brewer, Maine
|
|
|
|
|
Joined: Sep 2003
Posts: 12,899 Likes: 34
Member
|
|
Member
Joined: Sep 2003
Posts: 12,899 Likes: 34 |
that is another advantage of our shoestring P2P networks. When my "server" goes down, it takes about 10 minutes to use any of the other machines on our network to step into that role. Those on a domain, can do the same.
Bert
Pediatrics
Brewer, Maine
|
|
|
|
|
Joined: Apr 2011
Posts: 2,316 Likes: 2
G Member
|
|
G Member
Joined: Apr 2011
Posts: 2,316 Likes: 2 |
A domain can do everything a P2P can do.
|
|
|
|
|
Joined: Sep 2003
Posts: 12,899 Likes: 34
Member
|
|
Member
Joined: Sep 2003
Posts: 12,899 Likes: 34 |
As everyone knows, I have a friend who has about 30 letters after his Microsoft Certified name. He has been doing networking for over 30 years and does most of it remotely, receiving an email from a Microsoft server and fixing it transparentlyh. The guy is good. Many times I ask him a question on behalf of a user on here. I will tell him, the have Windows Server 2008 R2 with WIN 7 Pros on a 64-bit network. He will hear the question, then state it sounds like a DNS issue and to check Active Directory, etc. Just making this up.
In another scenario, I will state there is a user with 7 computers in a P2P environment running Windows XP, and they are having this or that issue. I don't even know why I ask him as he will always say, "Microsoft IT engineers usually won't work on a P2P. Much too difficult.
Bert
Pediatrics
Brewer, Maine
|
|
|
|
0 members (),
103
guests, and
32
robots. |
|
Key:
Admin,
Global Mod,
Mod
|
|
|
|
.png "ACUF Donor I")
