Home Forums Discussions Problems Really slow performance

I'm sure this has been talked about; perhaps someone can direct me to a good thread.

We have AC installed on about 20 workstations w/ the dbase on a server. Our server RAM is maxed out and about every 4-5 days our IT guys have to reboot the system because AC stops working. They blame in on RAM capacity not being adequate.

Today, AC was responding very slowly. 10 seconds response time for every action.

Is there a way to optimize AC w/o increasing RAM. How much RAM does one need to avoid these kinds of issues?

Thanks,

Sky

This is the latest I found.

I'm guessing you're on a 32 bit operating system. 4GB is the limit. RAM is pretty cheap nowadays. Upgrading should be easy unless you have a 32 bit OS. I think other people posted about the same issue on this board. Most of them moved to a 64 bit OS like Win 7 or SBS Essentials/Standard. You may want to consider upgrading.

Without reading John's link, I would recommend at ll least 20GBs. RAM is dirt cheap. But, as Sandeep says, you can only use 4GBs if using 32-bit, of which the OS can only use 3.2 or so. So, if you have a 32-bit, you will need to change OS IF the hardware of the OS can handle it.

I hope your IT people are not charging you to reboot the server. That would be rather simple. Just watch the RAM in task manager or 3rd party programs. You should't consider 64-bit, you have to go with 64-bit.

SQL Express is only using 1GB of RAM. When you reboot, you lose the pages (not great for performance), but it frees that GB of RAM to the server for other things, which is why it starts to work better. 3.2 minus 1 gives you 2.2 which is way too little to handle the other processes in the server. I'm not sure why your IT people aren't jumping all over this.

Of course, we are assuming a lot.

Bert has offered some excellent suggestions. Forget 32 bit and just get 64 bit ha. On SBS Standard, I usually say ~16GB for 10 users. For 20 users , 20-24GB is a good idea, especially when it's so cheap.

SBS Essentials needs a lot less since it doesn't use Exchange or SharePoint. Exchange loves RAM. You'll probably find when you start using SBS, that Exchange consumes as much free memory as it can find.

I think you have two big issues facing you. The amount of memory and a database that can use more than 1GB of RAM and 4GB of space. I as a solo doctor after four years on SQL Express still only have about 1.4GBs. But, with 20 doctors, well, multiply by 20. At some point, AC will have no option but to move to SQL 2008 Express which will give you 10GB of space. Even so, you will run out of space. Understand, that SQL is nice and gives you a bit of a cushion such as 4.4GBs.

It's too bad AC doesn't make it easier to make an instance with any SQL you want. Even SQL 2005 Standard will give you the OS maximum of RAM and no limit on database size. That would certainly make things comfortable. Of course, I would recommend, if possible, 2008 or 2012. The only advantage of Enterprise edition on 2005 is the number of CPUs and a few other things such as partitioning.

Given it can use the OS limit of RAM, you do have the option of setting the minimum and maximum amounts of RAM. If you did have 24GBs of RAM, consider using 4GBs to 6GBs of RAM for SQL.

When you see SQL taking up more and more RAM, this is not a "memory leak." This is simply SQL grabbing as much memory it can which correlates with pages which is basically remembering your most used queries. It is certainly better to have SQL delete the bottom MB of pages as it stores new than to have to reboot and loose the entire GB of memory. It would be nice to move to standard. ps: it can be done.

Hey guys,
So I recently moved the amazing charts database from my desktop computer to a separate CPU, largely because my desktop started crashing and taking down the database with it on a regular basis. my IT consultants advised me that I could get by with just a minimum amount of RAM on the CPU "server", So I just went in with 2 GB. Were they wrong??

They rationalized that since that server CPU wasn't doing anything but running the amazing charts database, that the ram shouldn't be an issue.

My set up is running 3 desktops and two laptops, all of them with at least 4 GB of RAM, On what I guess would be best described as a peer-to-peer network, Windows 7 64-bit, all the machines 64-bit. I use Dragon medical on my personal desktop which has 8 GB of RAM. everything was cool everything was groovy until January, when I simultaneously updated amazing charts, Dragon Medical, and my midmark EKG software, then all hell broke loose.
Moving the database actually seemed to calm things down a bit. I've only seen the blue screen of death twice now in the last 10 days, so things are looking up.

Also, as a side note. It's often not a good idea to install SQL Server and Exchange Server on the same server. SQL Express and Exchange are fine. Both full versions are pretty resource hungry and both want as much RAM as possible. That's why the premium add-on exists for SBS 2011/SBS 2008.

While you CAN get by on 2 GB, why would you want to? For under $50.00 you can have an additional 2-4 GB depending on whether they are DDR2 or DDR3. If you are 5 minutes a day faster, it would pay for itself in less than a week.

RAM will usually make a difference especially if it is server or Vista/Windows 7. The OS is probably using anywhere from 512 to 1500 megs of memory. Add to that SQL and you are easily maxing out 2 GB. More headroom will equate to speed.

Wendell is right. They were wrong

As a side note: 4GB of DDR3 is 20 bucks. 8GB is 40 bucks. No reason to not get 4GB at least. Unless they have it on a 32 bit system which typically uses 3.3GB of that 4GB. Gamers on 32 bit systems (scarce nowadays) use only 2GB since their graphics cards like to take 1GB of that 4GB limit on 32 bit systems.


It's not just storing the database. It's actually running SQL server which likes that 1GB of RAM. It's doing all the searching and look ups when you run a search for a patient. The more of the database in RAM, the faster it can look up stuff since it doesn't have to search the hard drive. The processor helps too since it can process the commands quicker and return the results to your database query.

This another reason why we recommend keeping a dedicated computer/server for AC. If you load any viruses or mess something up on your own computer which has the database, the consequences can be severe.

Also as a side note, it's a bad idea to run multiple installers simultaneously.

Hey Sandeep,

Where can you get 8GB for $40??? I am interested.

This is my server:

http://www.crucial.com/store/listparts.aspx?model=PowerEdge%20T110%20II&Cat=RAM

I was going to buy right from crucial, but if you have a better place let me know.

Thanks!

The $40 for 8GB of RAM was for TWH who sounds like his database is on a desktop. Just getting a little confusing because there are 3 people asking questions in the same thread ha.
8GB of DDR3 Desktop RAM is 40$: http://www.newegg.com/Product/Product.aspx?Item=N82E16820231426

Ben, you have a server motherboard (Dell T110) so you need ECC RAM. I buy all my stuff off Newegg and Amazon. You need DDR3 1333 Unbuffered ECC DIMMs. Still cheaper than Crucial's $100 for 8GB. Manufacturer's usually charge the full MSRP. Do not buy Registered DIMMs for your server, they will not work. Again these suggestions only apply to Ben's server for anyone else reading. You need specific memory/RAM depending on your motherboard/server/main computer.

12GB (3X4GB) of DDR3 Unbuffered ECC for $100: http://www.newegg.com/Product/Product.aspx?Item=N82E16820139268
8GB (2X4GB) of DDR3 Unbuffered ECC for $70: http://www.newegg.com/Product/Product.aspx?Item=N82E16820139262

As a side note:
8GB Unregistered ECC DIMMs are insanely expensive and not sold by most retailers. Almost $200 per stick. Not worth it.(Thus, the reason most retailers don't carry it). Also, most offices don't need more than 12-16GB for an SBS Standard 2011 with 10 users. You'd spend $800 on RAM for 32GB, at that point, it's just better to upgrade your server. If you do, then make sure you go with the appropriate hardware. (E.g. LGA 2011 instead of LGA 1155).

Yes, you are P2P.

I like black and white. I have mentioned this before. But, of all the issues/problems/questions on here, the most important is DO NOT RUN AC ON THE SAME COMPUTER SOMEONE IS USING.

Two BSOD in two weeks is not acceptable. I haven't seen a BSOD in over four years. That is the beauty of a server. Not that WIN 7 Pro shouldn't have that.

I would make your IT people order the RAM overnight and install it on their dime. Why would anyone advise you to get on two GBs of RAM. Think about it. You have eight on your desktop and three or four on the others, yet two on your "server." Unbelievable. Even if the RAM cost $200, why would it matter?

Anytime I see an "s" after IT, I get worried. IT consultants? Why? One person can handle your network.

At $800 for RAM, I'd probably just get a new server with more expansion options. Keep all the same stuff except get a new motherboard, RAM, and processor. $380 (LGA 2011 dual socket)+$200(Quad Core Processor, E2603)+ $120(16GBX2 (2x8GB)=32GB of RAM, 8 RAM slots) = $820. Same price. Except you have way more expansion options. Again, this is only if 32GB is necessary. 4 more RAM slots and an extra processor slot as well as PCI-E 3.0 slots.

If it were me, I'd probably spend a few hundred extra and get a 6 core (E5-2620) and a mobo with 16 RAM slots. Again, only if necessary. As a side note, there are 24 RAM slot LGA 2011 dual socket motherboards available designed by Intel themselves as well as Tyan. Keep in mind all of these boards were designed with virtualization in mind. That's you see these crazy RAM capacities.

Well we have the T110 II as our server, but it only has 8GB right now, and i have a 430 vostro i5 with 2008 R2 as our terminal server.

We have around 20 users how much RAM would be recommended? We have 10 RDP licenses.

I am also wondering if our terminal server is under powered?

Thanks!

Ben

Ill throw in my 2 cents here... I wish Amazing Charts would have an option for a MS SQL Standard Licence for more "advanced" practices. Then it could utilize more then the 1GB of ram that SQL Express has to offer.

I also think its completely pitiful that they wont give you the "SA" password to your own database, or at least help you make a SA like account.

Even if you wanted to upgrade to SQL 2005 Standard yourself, I wouldn't recommend doing it without the "SA" password.

The Doctors that I consult for all have really nice server, really nice. 12GB of RAM or more, but with SQL Express 1GB is the most we can take use of it.

Pitiful

20 to 24 Gigabytes.

amazingcharts.com/ub/ubbthreads.php/topics/43927#Post43861

Tx for chiming in Bert.
You'll be happy to know my 8 GB of RAM is on the way.
Not to discount what you said, but my peer-to-peer amazing charts network ran flawlessly for a year and a half, with the database on my main desktop.
I understand what you're saying, but nevertheless it worked.
Something else happened, between amazing charts, Dragon, Windows 7, mid Mark. In my mind at this point, software updates are somewhat akin to shooting BBs at a house of cards.

No one is saying P2P won't work. It's that client/server is more efficient. I'm not going to list all ways because we've covered it many many times. That said, everyone should be using server hardware. Sure your hard drive might not fail for 5 years, maybe 10. There's a reason people use these RAID cards and ECC RAM. Although things are unlikely to happen, in the event that they do, we want to be ready. Just a few weeks ago, I can't recall who exactly, but someone on here had their drives in a RAID 10 array. One of the disks died and he experienced 0 downtime. With a simple swap and rebuild like nothing ever happened.

Then again in that same time frame, there were two or three users who had a dead drive with no RAID (corruption due to power loss/etc.) They experienced days of downtime, wasted money on expensive consultants, and data recovery. All of which could've been avoided with a simple RAID array. In the end, it's up to you to determine how much down time you can afford. Just remember RAID is NOT a backup.

For most physicians, one day of downtime will pretty much pay for all this extra protection. For companies like Google, it's a no brainer. They make 72,000 dollars per minute. Even a minute of downtime is unacceptable in their case. It's not unrealistic for you guys to use servers with good hardware. You can get a legitimate SBS Essentials server for under 2k with RAID card, BBU, redundant power supplies, enterprise drives. You can even ditch the SBS Essentials and get Windows 7 if you're more comfortable with that. But come on, I even posted a video tutorial with step by step instructions for SBS Essentials. The new Dell T110s are using the same SandyBridge processors I specified in my server recommendations thread. Just slightly more expensive for slightly fewer features. But hey it's built for you and you get good maintenance.

I know Bert says the T410 at least, but I'd say either get the Dell T110 (designed for Single OS Server) or skip over to the T620 (designed for Virtualization/Terminal Server). The T310, T410, and T610 are all built using last generation hardware, socket LGA 1366. While The T110 has LGA 1155 (aka SandyBridge) and the T620 has LGA 2011 (aka IvyBridge), which are both this generation. It's been shown in an overwhelming number of benchmarks that the LGA 1155 processors outperform almost all of the LGA1366 processors with the exception of the $1200+ ones. It's like the i7-2600 vs the i7-920 (in desktop terms).

Gene thought creating a new thread for this was appropriate, and I agree. My response is here.

I have to echo Jon's points. I would not have considered Amazing Charts if I had the type of IT support that many here consider the standard. Fortunately, after using Medical Manager for years, I was convinced I was not going that route again with an EMR. I hope that a new user reading the posts here find that AC is in the average users skill set, and that it runs well on regular or premium.

Again, I make things sound way more technical than they actually are. I apologize for that. It's just that I like to provide evidence for the claims I make. That often involves a technical explanation. (Bert's much better at the explaining things, btw.) The main reason is so you double check if you want to and make sure I'm not just making this stuff up. The explanations are irrelevant to the user experience (and you). Just pointing A is better than B because of some complicated reason. (Like above where I say LGA 1155 is better than 1366 because of better clock speed or something like that. You'll buy it and never see it nor worry about it.) I'm sure these mean nothing to most people, but when they go to purchase, I'm hoping they'll get the best price/performance by picking the right parts (i7-2600) and not wasting it something they don't need or is worse (i7-920).

Sandeep, the info that you post, and especially the tutorials you have done, are exceptional.

And, I ran Peer to Peer for three years with no issues. Remember, once again, peer to peer (in my mind) IS Client/Server, just not the same OS and no domain. I have also said a million times, a domain set up is certainly going to perform 1% better than P2P (Sandeep, take with a grain of salt), it's just more fun to play with, and when you want to, you can do more. So please take me off the "you have to have a server/client domain list and put me on the "overall it performs better, is more fun, AND TAKES MORE TECHNICAL KNOWHOW FOR SURE".

My response is here and here for the people who don't want to go through 50 posts.