Home Forums Discussions General Discussion Server- Hardware vs OS advantages

Hi everyone,

This issue has been addressed frequently, most recently in this thread

http://amazingcharts.com/ub/ubbthreads.php/topics/43998/Really_slow_performance#Post43998

I'm starting a new topic, since that one is getting sort of long.

My situation: Our area is rather rural, and there do not seem to be many good network IT people around. Those that seem good are busy, so being able to get someone out to our office quickly (same day) may not be possible. So for me personally to be able to troubleshoot the system has been my goal.

In 6 1/2 years of using AC, we have been very fortunate to have had very few hardware failures. We have had some software problems, usually resolved fairly quickly, once requiring restore from backup.

My plan for catastrophic hardware failure in "Main computer" is to set another PC as main, load from backup, and reset paths for the other PCs. The problem, of course, would be losing that days data, entered since the last backup.

Thanks largely to Bert and Sandeep, I am considering a server. But I would probably set it up with Win 7 Pro.

Advantages:

Redundant power supply

RAID (probably 1)

??Faster performance

Still be able to troubleshoot this myself.

So this should just about eliminate power supply or hard drive failure problems. It would not eliminate mobo failures, memory failures, etc.

Is this worth doing?

Also, looking at Sandeep's RAID card recommendations

http://www.newegg.com/Product/Product.aspx?Item=N82E16816116041

Win 7 is not listed as a supported OS. On the manufacturers support page, there is a comment about

"Supported with the 9.5.3 code set drivers"

which provides a 613 MB link. I hit the link, which downloaded the file. After that finished the download, a "Burn to CD" screen opened. So I have 613 MB of something on a CD!

Any thoughts?

Thanks. Gene

The CodeSet contains drivers and software for everything. (Linux, FreeBSD, VMWare, Windows). It's essentially an updated version of the CD that they ship with the RAID controllers. LSI bought out 3ware so all the support and latest downloads have moved to their site. They're on version 9.5.4. What I do is I download the latest drivers drivers and put them on a flash drive. When Windows is booting it'll asking you to load a driver if you have a RAID controller. Plug in the flash drive and click on the driver file.

The only two things you need are the Windows Drivers+3DM2 Software listed under Support and Downloads. (Software and Driver subheadings)
http://www.lsi.com/channel/products/storagecomponents/Pages/3ware9650SE-2LP.aspx

I still think you use give SBS Essentials. Check out the videos in my signature.

There are no other extra costs for a domain name or SSL certificate. They are provided free by Microsoft. Remote access will be set up automatically as well as all the user accounts on your network.

Opening shared folders can not be easier with that launchpad on your desktop.

The quote above is from another thread, but I am responding here since I think Gene's idea to move it here makes sense.

While Sandeep is clearly stating a matter of opinion, I have to say that I think his opinion is wrong. The fact is that despite all of the motivations to adopt an EMR, only a relatively small percentage of ambulatory docs are using a fully functional one. If you talk to physicians still using paper, concern about the technological requirements of an EMR is one of their major fears. It pushes providers towards Saas products, towards free products like Practice Fusion, and away from EMR's altogether. The fact that AC works perfectly well on a simple peer-to-peer network, with off the shelf hardware, using an OS that is well-known and familiar to even basic computer users is a major plus and selling point. Of course there are advantages to servers, both in terms of hardware and software. Personally, I don't think they are worth the extra effort. Others disagree. But to say that all of us should be using a server will only scare off many users who might otherwise be very happy with AC on a simple network they can manage with minimal support. Maybe if all docs had ready access to a full-time IT specialist (or even one in the family), then I might feel differently. As Gene points out, IT support may not even be a possibility (let alone economically feasible). Many providers want (or need) to spend their spare time learning more about medicine, or perhaps about how to keep their practice profitable, and not about new technology. We may not feel that way, but we are probably in the minority.
At some point AC may require a server-based system; so long as it does not, I think we should advertise that as an advantage.

I have to echo Jon's comments above. I have BOTH systems. With 2 offices I have SBS Essentials 2011(SBSE) in one office and Windows Home Server 2011 (WHS) in the other.

Before you jump down my back for WHS 2011, it is based on SBS 2008 just like SBSE, the main difference being the active directory support.

They both work fine. I am not convinced at this time that active directory has made my life easier. It hasn't made it harder either. But it did cost $300 more.

The lack of technical expertise in many who who AC now may well drive them to a simpler solution. Peer to Peer is simple. I know there are theoretical advantages to Client Server but P2P is easier to set up and troubleshoot.

Just my 2 cents from a guy in both camps.

First off, let me say I greatly appreciate your contributions to this board. It's people like you that can lead the group. I respect your perspective, but I am going to have to disagree.

It seems your main problem with servers is the complexity involved. Server hardware is pretty much invisible to the Operating System. It doesn't matter if you're using Windows 7, Server 2011, Windows XP, Windows 98. You have to take into account that the server is replacing all of the paper charts in your office when determining how much you want to spend.

People that complain about the price of the hardware. The way I figure it, it's way more expensive than the staff hours put into filing, stapling, hole punching, and all that paper and ink that goes into charts. Not to mention storing charts, getting shelves/boxes, and the space you lose to storing those charts (storage space). I'm pretty sure it's way way way less than the price of a legitimate server and switch setup. It's so much more efficient when retrieving and looking up information as well. I think a lot of people just lose sight of that and end up putting their entire practice on some $300-400 dollar desktop from the local best buy. Come on you probably spend more on ink for the month yet you're willing to wager your entire practice on some desktop from your local electronics store.

Think of server hardware of being like the really nice desktop hardware. At the core, that's all it is. The only complexity is when it's initially set up when you buy it so that argument doesn't carry much weight. What's going to happen?

• A power supply fails, but you have two and bright red light comes on that and the office keeps going. Replacing it is as simple as sliding out the bad unit and putting in a new one at your convenience. Your desktop power supply fails, you have to open up your entire computer and rewire it from scratch when you install a new one. And if you have no idea of how to diagnose a failure or installing a power supply, you're going to have to call emergency IT technician and you will spend much much more than the price of a redundant power supply.
• A hard drive fails and there's another one that's simultaneously writing the same exact data. You simply swap it and that's it. Your desktop hard drive fails and you're down until you can copy the data off your back ups onto the new computer. Install SQL, restore the databases, etc. If you have a lot of imported items, it can take even longer. All you have to do on a RAID array is plug in a new hard drive and press a rebuild button.
• You have a memory error and you get a blue screen and have to reboot. If you have ECC RAM, it corrects the error and the server stays on. Again, no user input involved here. It just works automatically..
• Server motherboards are designed to handle continuous stress. The quality control is better and some even test every board before they send them out to retailers/distributors. Again, no user input involved. I've seen plenty of desktop and especially notebook motherboards go bad. I rarely see server motherboards go bad. (Actually, I don't think I have. I even have a 10 year old PowerEdge server that's still going, running 24/7)

This is why I find that arguing about the complexity to be a bit overstated since you're essentially doing nothing, but you're getting so much out of it. You check some boxes on Dell's customize page. My recommendations can either be used to build your own or just match the boxes to the recommendation. It's even arguably simpler than having a plain desktop hardware if anything goes wrong as I demonstrated above. Servers aren't these magically super complex machines but just desktops with better parts.

On the software side, I will agree things can be more complex. That's because there's an inherent complexity in the things you're trying to do that Peer to Peer is simply not capable of. I will have to give credit to Microsoft for trying to streamline the process as much as they can. They've definitely making huge strides forward with SBS Essentials and Windows Home Server.

Active Directory is automatically configured when SBS-E is installed. When you connect a server to your domain as easy as typing in google.com into your address bar and downloading the connector. You do save a lot of time when you have 5 or 10 computers and you don't have to go to each one individually and setup a user account and password for your staff members and yourself. This is also more secure.

Sure you have to know how to open a port on your router. Just one 443. Portforward.com has instructions with images for thousands of routers. Even with Windows 7, you still have to open port 3389 for Remote Desktop. Things start getting really complicated if you have to use multiple computers remotely. Another area where SBS simplifies access to multiple computers. Having to either mess with the internal or external ports. Microsoft gives you a free simple domain with an SSL certificate. yourname.remotewebaccess.com. So you're getting that same level of security as a credit card transaction when you're remoting in. The wizard just asks you what you want the name to be and does the rest of the setup. Again, things not possible on Windows 7. Sure you can use logmein free, but you can't print or transfer files. TeamViewer's commercial license is $800. Why would you want to pay when all you have to do is open a simple port? Microsoft even has a list of routers that it can configure automatically without any user input. It's just that most people skip over that list.

Sharing files and folders uses a wizard as well, in Windows 7, it has to be done manually. A lot of people have trouble with the permissions on Windows 7, have to manually configure it and add everyone to the permissions list. (This has a lot to do with people having different usernames and when they try to authenticate against that Windows 7, it doesn't know who the user is and gives them guest privileges. By adding everyone, this means anyone who gets on your wireless network or plugs in a LAN cable can erase your entire Amazing Charts folder or they can read other people's imported items, maybe take a copy home with them. Sure the possibility is remote, but you do really want to leave the door open for someone to do that much damage?

I can keep going on and on, but the point is the same. There's only so much they can simplify. It's definitely not as hard as people describe it to be. I've posted video tutorials with step-by-step instructions in my signature as well. You can get an idea of how much work is involved.

This is simply a case where perception defines reality. If the average doc says a server seems more complex and beyond what he or she wants to handle...then it is!
And if an IT guy says "you're wrong", it has little impact. The majority wouldn't even understand much of what you just said.

Haha, I guess so. To be clear for the people who don't know what memory, power supplies, and hard drives are, my point is that there's nothing really extra to handle. The parts that make up a desktop make up a server. Server parts are just premium parts that are actually worth it. It's stuff you buy and will likely never look at since it's all inside the computer. And if you ever have to, it'll be much easier to repair and replace as well as cheaper than the desktop counterparts. That's about as generic as I can get

I'm no IT guy Just a kid in college.

I can make sound equally complex when I start mentioning desktop hardware models like Intel 2600K processor with a Z77 motherboard and G.Skill DDR3-1866 RAM and a 650 Watt ATX Modular PSU with 80+ Gold Efficiency. It's the same both ways. I'm just explicit so people know what to buy if they're looking for the same parts. I know you guys don't have the time to do the research on what's best. That was the inspiration behind the server and desktop recommendations. I did the research so you you guys don't have to.

Now I am feeling a little guilty...

So Sandeep, after making hundreds of highly technical posts, you claim to be just some kid who wandered into the discussion. Sorry, but your reputation has already been made!


Your recommendations are appreciated and I am sure will be very helpful to those who have reached a level of comfort with computers such that they can ask about server advice, and think about building their own. There is a much bigger cohort that is just thinking about getting an EMR and doesn't know the difference between SBSE and an SSD. We need to try to bring them in, and be careful not to scare them off.

That's exactly what happened Just turned 20, 2 months ago .


Yea, I'll dial it down a bit haha. There are just something you have to learn though like sharing a folder. I'm thinking SBS Essentials might even be easier for a first timer.

Please don't. Your posts and videos have been invaluable.

I remember trying to network a couple Windows for Workgroups machines when I started my practice in the 90s. What a mess! Undoubtedly, doing the same with Windows 7 machines would be a more rewarding and productive endeavor.

I'm in a rural practice (like the original poster), and I've taken the server route (SBSE) for my AC deployment (still in trial). For me, it's the more robust solution. I've built a few desktops from "scratch" in my time, and followed Sandeep's hardware recommendations (see the sticky) for my AC server build. The most difficult thing was installing the Adaptec 6405 RAID controller's driver, but most docs aren't going to build their own server, anyway. And, as Sandeep alluded to, Microsoft has done a great job at simplifying the administration of SBS ("administration" makes it sound scary, but it's simple).

For me, the benefits of running AC on a server outweigh the costs (~$280 more for the operating system, another $1000 or so for the hardware, and a tiny learning curve). But peer-to-peer is certainly a viable option. And AC costs the same either way, which is nice.

Wow, I remember that too. What a dog of an OS!

Ha, I built my first office network with DOS machines, and used Lantastic over 10Base2 wiring.
Used Dataflex as the DB. I thought W4W was a great leap forward at the time.
Oops, I guess my first network was actually smoke signals (pre HIPAA)

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 KNOW HOW FOR SURE".

This P2P vs Server thing is getting a bit old. It breaks down like this:

P2P is fine for AC
Client/Server for those who want to run that is fine also, probably better (I won't give the reasons).

The quote above is from the same thread Jon used to start this thread. I used Peer to Peer for at least three years, and had at least ten times less problems, not from running AC, which was better, but from some issues I CREATED trying to make my server more powerful.

I may be taking everyone wrong, but I think it's ridiculous to state that we are losing sales because doctors come on here and think it's too technical. They can read. They can research. They see this thread. Sandeep's comments are incredible and time consuming, and I don't understand half of them. But, they are damned good comments.

We should let this rest. I have no problem with P2P or Client/Server. I will say I absolutely abhor running your database on a computer that is being used "even if it has been five years without an issue."

I will say that I disagree with my good friend, Sandeep's, statement that you have to have a server. I don't think he figured it was going to cause this much of a firestorm.

All of you need to be where I am right now. In Virginia Beach, VA listening to Don Jones' talk about Powershell and how to manage servers using that tool.

It appears that, as part of the certification program for Windows Server 2012, any program that wants to be certified by MS for Windows Server 2012 CANNOT ASSUME THE MACHINE WILL HAVE A GRAPHICAL USER INTERFACE.

In Windows Server 2012, a GUI will be an option that can be turned on or turned off.

Think about it.

JamesNT

Thanks for the support guys. Just one quick correction. I am not saying everyone needs a server/domain. I'm saying everyone should be using server hardware.
I even said in my server recommendations thread that you can use Windows 7 with server hardware. While I do think a domain is the way to go, I'm not saying everyone should be using it. Server hardware on the other hand I do believe everyone should be because the technical knowledge required to repair hardware related issues goes way down as I've outlined in this post. It's not like the possibilities are so remote that it's not worth protecting against. If you go back through the forums, there's people here who've had failed hard drives, bad power supplies, power outages resulting in data loss. Some have even experienced weeks of downtime. I bet if they could go back and do things differently, they would have. All I'm saying is that if you have the opportunity to tackle these issues now, why wouldn't you? The server recommendations was also to point out that you don't need to spend 5000 dollars on a server. You can have all the enterprise protection for under $2000. (That's redundant power supplies, dedicated hardware RAID, backup battery units, ECC RAM).

Everyone should be freaking out at what James said ha. If servers were technical before, you can pretty much forget about them in the future. Microsoft appears to be moving everything to a Server Core like installation with everything being managed from the command line/Power Shell. It's a dangerous move on Microsoft's part.

It definitely is. Maybe they are trying to make more jobs in the industry. They come out with desktop OS too far apart (see XP)then come flying out with SBS 2008 and 2011 and more to come. I have used Powershell, but I am not yet proficient at it. Going back to the days of all command line.

Going to the command line makes sense when you think about it. I'll explain later. Right now Mark Minasi is going on about the new file sharing in Windows Server 2012 where you can use regular expressions.

JamesNT

Command line is basic stuff, and should be within the purview of every participating physician.

I am pretty sure it is.

Is not.

I know I keep beating a dead horse, but just 6 months ago I did not know much about computers. And thanks to the lack of eprescribing, by June 30th of last year, the penalty (being meated out this year)-would be about the cost of a server-- if I had gotten off my @$$ and figured this stuff out sooner would have saved me a bit of money--but where does a guy go to learn all this lingo? I feel like I did in the 9th grade when running the mile (not the 1600M)--I grew later than my cohorts, plus I started school earlier and everyone was about a head higher than me, so I would get lapped, but I always finished the race--yes humiliated, but I would always finish. .
Well when I read all the fantastic threads on this forum, I think of being lapped running the mile all those years ago, but at least I have found a wonderful resource to not only learn the lingo and theoretical, but also put it into practice.
With that being said, JamesNT I don't understand what you mean a

CONTINUED--
about the GUI--what ramifications does that have for a someone with a server? I don't quite follow--sorry about the interruption--i must have hit the wrong button.

Don't fret, it's just Windows 8 Server stuff...

"Administrators can eschew the UI altogether by performing a Server Core install of Sever 2012, which uses PowerShell for server management. Most server administrators are used to a GUI for management and it's likely many will want to perform a Full Install. By the time Server 2012 is in final, it's safe to assume that Microsoft will make it easy for admins to opt out of including the Metro interface with a Full Server install."

http://www.pcmag.com/article2/0,2817,2403216,00.asp

You know all those windows and wizards that make life easier for the average Joe? It's not going to be like that. It's going to be more like what Andrechuk posted. This is the system that IT veterans (been in the business for 20 years or more) are accustomed too.

I do find it amusing that the desktop operating system and the server operating system are deviating so significantly. Windows 8 is trying to get everyone on touch screens with a rich GUI and using the keyboard as little as possible. While Server 2012 is being designed as to make sure your hands never touch a mouse and remain on the keyboard. It's funny flame wars are starting all over the Internet for those in the IT Industry. (Linux Admins vs Windows Admins)

There are obvious benefits to using a command line, which I won't outline here. But I see little benefit for those who don't have in-house IT. My bet that it'll only be marketed on the Enterprise/Datacenter version of Server 2012 or it will be optional during the setup. Small Business Server will probably get a better GUI. I'm pretty MS wouldn't be dumb enough to undo all the work with Essentials and SBS Standard.

understanding soho routers: http://www.youtube.com/watch?v=w44J7CN26Ig

tcp/ip and subnet masking: http://www.youtube.com/watch?v=EkNq4TrHP_U

The above links are fairly long videos (> 1hr) and delve into NAT, DHCP, and other good stuff. Kinda basic, but useful if you're going to run your own server. I know this is simple stuff for most here, but for the rest of us, it might be worth a look.

ha, indeed.

Anyone freaking out should PM Sandeep. ;-)

Wow, you missed the sarcasm.

I don't think we are going to get along.

Next time, try an appropriate emoticon, please.

Actually, I wasn't sure what you were referring to, since you didn't have the courtesy to quote who or what you were responding to.

Let's remain civil for now, if we could do that, please.

I am a new user and not looking for any trouble.

In Windows Server 2008 R2, you have to choose whether you want server core (the no GUI version) or Full installation (with a GUI).

In Windows Server 2012, the GUI can be installed or uinstalled at will even after the server has been stood up. Plus, at setup, the GUI will not be turned on by default. You actually have to tell the OS that you want the GUI.

Start learning your Powershell, folks.

JamesNT

I'm not learning Powershell and your post makes no sense.

Okay, after a second read it makes some sense. But it wouldn't apply to most of us.

Why the fear-mongering?

It's not fear mongering, this is me super excited, and a little intoxicated.

I'm at a conference with several Microsoft MVP's, including Mark Minasi himself, seeing all kinds of super cool stuff that I think is awesome that the rest of you won't see for months.

And I'm a 6 hour drive from anyone who could get on my nerves.

I doing great right now.

JamesNT

Well, you had me ascared for a moment! Thanks for the clarification/update.

Enjoy.

is this like sneakernet?