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Hellon all, I am new to AC and am trying to understand everything as best I can. It's for a brand new practice and I'm a little confused as to what the best way to set up the ofice efficiently would be. It's a solo practice with 2 laptops, one for the front desk that stays in the office at all times used for scheduling. A second laptop for the physician to be used in the treatment room for office visit documentation as well as taking home to complete charts whenever necessary. Any advice would be greatly appreciated as to how they have their office set up. I'm not sure which laptop should be the main computer, should I network the computers, can the computers be used independently. Regards, VMan
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Welcome VMan1,
I'd network them. You really need to put some thought into how you want to operate the office--both when the physician is there (you, maybe?) and when the physician isn't. For instance, if the physician isn't there, would there still be a receptionist there taking calls and scheduling patients? If so, then both need access to the database at all times. This means one machine should always be on. The second could always access the system from home remotely using a service like Logmein or Gotomypc. You may even wish to get a small server and stick it in a corner out of the way and let that run it.
Wayne New York, NY Hey, look! A Bandwagon! Let's jump on!
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Thanks for the advice Wayne. We're neighbors, I'm in Northern NJ. The office is actually for my wife but I am trying to set this up for her. It sounds like the server may be the way to go because the idea is for the receptionist to be there taking calls and scheduling appointments whether or not the doctor is there or not. I'll have to look into Logmein or Gotomypc. Anything else comes to mind, please let me know. Thanks again. VMan
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VM,
I agree completely with Wayne. First, the computer which stays in the office should be the "main" computer. You have to be networked, because both computers need to access the same datbase or you will have different data on different machines.
You can certainly connect the two which would involve either a crossover cable or, better, a switch so you could use simple Cat6 cables. I would HIGHLY recommend Wayne's advice of putting a server somewhere else which is completely dedicated to files, because basically it will be just a file server allowing access to the Access.mdb files. If you run it off either of the other two which you can you invite other problems such as slowing down the system when your receptionist is using is or having to reboot and, therefore, being down more. Hard drives tend to crash more often on clients. And, you can concentrate on putting better hardware onto the server computer, i.e. better processor speed, RAM, better hard drives, etc. It is also better for backups, etc. (you can even consider purchasing ac ACTUAL server with actual server OS but that is more costly).
You have to decide whether to go wireless or wired. I prefer wired, but if logistically that is difficult, then wireless may be the only way to go.
Finally, I agree with Wayne on the access from home. If you have to actually do progress notes due to nursing homes, etc. then taking the laptop with you and doing sync-type stuff back at the office (a whole different can of worms), then that is an issue. But, if you are just wanting to work from home, you would be much better off using LogMeIn or GoToMyPC. LogMeIn is free and has more features so go that route.
Anymore questions, just ask away.
Bert Pediatrics Brewer, Maine
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Thanks, this information is extremely helpful. I guess I need to look into purchasing a server to run the databsae off of. I'm really trying to keep costs as low as possible to start out. Any suggestions as to what to get in terms of a server. You said an actual server can get quite costly so what would be the altenative that can be used as a server that would be more economical, at least in the beginning.
Thanks,
VMan
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VMan: Bert will probably laugh when he reads this, but I have decided that I am pretty satisfied with this cheapo Visionman server from TigerDirect.com. It's going for $549 with your choice of OS. http://www.tigerdirect.com/applications/SearchTools/item-details.asp?EdpNo=2606265&CatId=3370I am running 6 PC's (wired), a laptop and two tablets (wirelessly) off this thing. I am not even using all the capabilities of this very low-end server, and my network is plenty speedy. I am using the MonitorMan as the storage place for the AC database, but I am not really running any server OS. I am just running Windows XP Pro, with a generic router for the wired PCs and the best LinkSys wireless router you can buy at WalMart.  The guy that initially set up my network was either a crook or a moron (or both, more likely). I had to undo what he did, and stick my system back together in a very simple-minded way that I could understand (I am a networking numbskull). Bert is right that you should stick your server in the corner and just let it serve files. However, I have been known to fire up Dragon NaturallySpeaking and Amazing Charts simultaneously on the server without noting any loss of speed on my network.
Brian Cotner, M.D. Family Practice
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Vman (is that for Van Man??? lol)
We run peer to peer using only Windows XP Pro (FYI, Tablet is a form of Pro, which came with our convertable laptops) with our NetGear wireless router acting as both a wired and a wireless router. Except when I've got like three apps open at the same time, things move fast enough around here for us. I'm also seriously considering purchasing a decent Quality NAS (Network Attached Server, Storage) system. With that one can point all the other computers to this NAS unit and then that frees up your extra "Server" machine even more, now it can just be another client computer on the system because the NAS takes over that function. And you can purchase these with multiple drives, frequently hot swapable too, and configure them in various forms of RAID for redundant back-up and saftey of your charts, your data.
But to start on a shoe string with only 2 or 3 computers tops, just get XP Pro running on a fairly modern tower, get an extra drive if you can set-up in RAID 1 to mirror your data (we're not even doing that yet, but we're about to) for extra, just in case, and let a quality wireless network/router act as both for right now. I love my NetGear. We have like at least 3-5 other networks close enough to be seen by one of our laptops when we hit, look for available networks, and we are running a 2.4 Panasonic 4 line phone system, and yet we almost never have connection issues. This was a whole lot better than any other rounter we have had, and this is our 3rd one. Linksys stunk, D-link, OK?, this one Yes! It is the MIMO one with the 7 internal anteanas. Wait on "N" until the draft is over and we have a real standard we can all feel secure in.
And don't buy an expensive phone system either. Our 2.4 system has been replaced by a new 5.8 system that has 4 lines. Trust me with such little staff two lines and fax line will be plenty right now. You'll quickly learn to look at the ringing phone with horror screaming, "Go away!!! What do they all want???" You'll just have more ringing phones to juggle with more folks on hold if you have extra lines. And each line cost enough as it is anyway. Our old system had a choice of both desk sets or hand helds, all wireless with batteries and the desksets also have AC adaptors that you can just leave in place. Unfortunately the new system is handhelds only, but they do have speakphone for long hold times. I just really love my desksets. But at $500 not on sale for the main base unit and one unit to start, NO Inside wiring to do, and you can walk with the phone to any room in the place, I dread the day we might out grow our beautiful little system. You can get the system at almost any large office store, Staples or OfficeMax. Buy a few extentions and you are all set, for less than half the cost of any traditional office phone system. And you don't need Centrex or another really expensive phone lines. It has an multiple line answering system that you can record different messages for different times like lunch verses you missed the call and are open, mail boxes for all 8 extention (max of ext for the system). The old one is the KX-TG 4000 (2.4 not available retail anymore) and the new one is the 4500 (5.8 and very easy to find). Why buy anything else at our budgets???
And yes most network gurus are both idiots and crooks. I bought the dummy's book about wireless networks and hacks and learned how to do a better and more secure job than either of the first two well recommended gurus did for us at way too much money for the dis-service.
FYI, I too am my wife's practice manager. WElcome to AC and Best of luck in the new year. Let me run so I can do some work and go home for dinner.... Happy and healthy... Paul
"Beware of the Medical Industrial Complex" "The Insurance Industry is a Legalized CARTEL"
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Correction:
I said "MonitorMan" at one point in my last post, when I meant to say "Visionman".
Monitorman is a guy that sells used electronic equipment on eBay. Sorry for any confusion.
Brian Cotner, M.D. Family Practice
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Vman1, keeping costs low is crucial to your start-up just like you stated. But you don't want to be "penny-wise and pound foolish." (no offense meant, that's just a saying from the 'old school.')
My opinion has changed over the last year on server vs PtP setup for even a solo-practioner. When I first set up my sister's system (and began some practice consulting) I would have said PtP (peer to peer) is OK for a solo practioner w/ just a couple of PCs. Now I'd say that is only Ok if there spouse or other family member is very tech-savvy and is working there with them. And even then its iffy. This is based off of my sister's practice--and I'm the tech-savvy one. I'd like to migrate her to an inexpensive server as soon as possibe. The PtP is just too much hassle.
oh, and HOWDY NEIGHBOR!
Wayne New York, NY Hey, look! A Bandwagon! Let's jump on!
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Hockey, you run ptp too? I thought I was the only one who did that?
Wayne New York, NY Hey, look! A Bandwagon! Let's jump on!
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Hey gang,
If my start up budget were TOTALLY limited, I'd spend the money on a high-quality network switch and/or wireless router, and start peer to peer. You can ADD a server later.. to upgrade a low-end switch or router you have to REPLACE what you bought - which means buying it twice.
That being said, our MAIN PRODUCTION server here I bought on e-bay. I replaced the hard drives before deploying it, as I'm nervous about used hard drives. The server, FOUR drives, and assorted goodies was about $500, for a dual processor RAID server with two 10/100/1GB network NIC's. Not shabby. Our e-mail and web server was $65. That's right - sixty-five bucks! It's been running without a hitch now for two years. Shop SMART, and your money goes farther.
Let me know if I can help.
Regards,
V.
Vincent Meyer, MD Meyer, Malin and Associates, PLLC
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You have all been very helpful. Hopefully I can help others once I get up and running. I'm a bit confused about one thing. Is PTP considered the same as using a desktop at the front desk as the server and than have a mobile laptop in a treatment room for the doctor? I'm wondering if this is the way to go in the beginning since we're not expecting more than 2 or 3 patients per day the first several months. A friend of mine suggested this to start up and than get a dedicated server once things pick up. I can get my hands on a solid tower desktop at a great price. Also, thanks for the info on the phone system Hockeyref. I actually bought those type of wireless phones already and they are perfect. HAPPY HOLIDAYS!!!
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Yes, that's what it means. :-) Get a GOOD machine for your front desk.. don't skimp. Fast CPU, fast memory, fast NIC card, and a fast hard drive. Put your database there for now.
If you're going to go wireless for the laptops, get one of the new 802.11n routers - they cost more but are worth the extra few bucks.
Add the server once the cashflow is positive, or you have more than 2 machines using the front desk as a 'server'
OK, here's a weird scenario.. if you are doing most of the work on the laptop, put the database THERE, and share it with the front desk if they're only booking appointments!
Regards,
V.
Vincent Meyer, MD Meyer, Malin and Associates, PLLC
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VM,
Yes, I do have to laugh at (or is that with) Brian. I agree with everyone here. If you decided to go with a true client/server setup, then get a good server and a server OS at that time. Remember, a good server or what people generally refer to as a server is the hardware that is made to run hardware for a server and the OS which is an OS made for a server such as Windows Server 2003, etc.
A pure peer-to-peer does not have clients and servers but rather equal nodes where each node acts like a "client" and a "server" simulataenously and, thus, the network can gain more bandwidth with each new node.
It's fun for computer people to live vicariously through others, so if you asked me for the absolutely best way to set up your system, I could spend a lot of your money. But, after reading through everything, probably the best thing to do would be to have your modem, a good wireless router/firewall and let your two computers connect through that. If you can run wired, then that's always better, but you would want to make that decision now as you see adding more computers in the future. You can make wireless very secure, but it will never be as secure as wired, period. Nor as fast, at the moment, anyway.
Do you already have your two laptops? Is there a reason you are using laptops for both the front office and the room? Again, I wouldn't take the computer out of the office unless you will be using it at nursing homes, etc. Desktops are cheaper and easier to make faster since they are cheaper.
And, yes, I agree with Vinny, put the database on the exam room computer since the speed will serve you more.
I wouldn't really get into RAID 0, 1, 5, 10, etc. unless you go with a full blown server and server OS. I don't believe XP Pro can even run a RAID 1. It can run a RAID 0. If you go with RAID, you will need more hard drives, they would have to be the same, you would need either a software raid controller or, preferably a hardware raid controller. My guess is this would be getting way too far out there.
Hope this helps.
Bert Pediatrics Brewer, Maine
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I've been wondering about where to put the database for a while now. The reason I mentioned having 2 laptops is that's what I have right now though one of them is not meant to be in the office if I can prevent it. Anyway, assuming I have a desktop at the front desk and a laptop in the tratment room, my concern is that though the laptop is where the majority of the information will be keyed in, it may not always be in the office if the doctor takes it home to work at night. Wouldn't that prevent the front desk from making scheduling changes or adding patients into AC when paients call to make an appointment if the laptop is not in the office?
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If it HAS to be at the office when you're not, then it has to be on the front desk computer rather than the laptop. Oh well. Get a fast wireless router, and run the front desk hard-wired.
V.
Vincent Meyer, MD Meyer, Malin and Associates, PLLC
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VMan, I agree completely with Vinny. Not a good idea not to,  . I think you may be making this harder than it is. Either go completely wireless or hard wire the desktop. Then run the laptop from the exam room wirelessly. Put a fairly speedy processor up front, but put as much RAM as possible, it's dirt cheap. This way, although I hate it, if you do go to a second room and do not wish to purchase computers for each room, you can carry your laptop with you. While there has been much discussion about taking laptops to nursing homes and, therefore, the ability to synchronize -- which has its bugs and limitations and is an entirely different subject -- becomes crucial. No matter how you try to work it, if you are manipulating data at home or she/he is manipulating data at work (appts, whatever), then your databases will not be the same. You would have to sync them. I HIGHLY RECOMMEND YOUR NOT TAKING THE LAPTOP OUT OF THE OFFICE EVER if your sole purpose of taking it home is to "catch up" on work. There are a few things in play here: 1. At the risk of sounding arrogant, I can count the number of times I haven't a) finished the note b) printed or fax scripts, c) printed or faxed lab orders and d) WRITTEN THE REFERRAL NOTE while in the room on one hand. When I am done with the patient, I am done with the note, and, more importantly, when I am done with the last patient, I am done. 2. If you do have work left over (please not charting), then do it at the office. Why do it at home when your family would rather have your full attention? OK, so I recognize that it is better for some to come home and spend time with the spouse and kids and then do some work, but as Wayne mentioned use LogMeIn or Remote Desktop or any number of free VPNs that Vinny can help you with. If going to nursing homes requires the removal of your laptop, then I guess that is necessary, but there are a myriad of reasons why it is not a great idea. I remember during the age of paper, when taking a chart home was considered a huge no no. The databases are not encrypted, and there would have to be some sort of HIPAA issue. Laptops get stolen rather easily. It is just too big of a risk in my opinion. So, in short: 1. Skip the server for now 2. Modem and wireless router/firewall 3. Fast XP Pro desktop for secretary with really nice 19" widescreen flat panel. (Gotta keep your receptionist happy) 4. Do ALL of your charting at work 5. What little you don't get done, use LogMeIn.
Bert Pediatrics Brewer, Maine
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Well, don't TOTALLY agree with Bert.. BUT
I have about 200 notes in my in-box. Not all of us can stay in real time. If you take the laptop home to chart, use it to remote control the front desk! We use UltraVNC for this, although GoToMyPC.com works, as do a number of solutions. As long as you're connected to the internet on both ends, life is good. The nice thing about laptops is that they're portable, and if taking it home means buying ONE machine instead of TWO, great!
Hardwire the front desk. DON'T "wireless" it. The computer is not going to move, the router is not going to move, and wire is one HECK of a lot faster AND MORE RELIABLE than wireless. Plug your front desk in. Trust me on this.
Otherwise, Bert's right on.
Regards,
V.
Vincent Meyer, MD Meyer, Malin and Associates, PLLC
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I think I have some good direction now. I know what I need to purchase at least. Quick question regarding the actual network. Assuming the database is on the desktop and the doctor is accesing the main database from the treatment room with the laptop wirelesly, will things be updated real time as things are inputted from either computer or is their some sort of synch that needs to be done?
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VM,
To answer your question simply: Yes.
To best understand it is this: There are two ways to set up AC in a network, you can run it on "server" and share it out. This works, but I do NOT recommend it as Jon recommds installing AC on EVERY computer. Once this is done, and you open AC, it will look for a database. You MUST make sure you browse to the database on the MAIN computer, which, in your case, will be the one on the reception's desk. This Amazing Charts folder ON THE DESKTOP ON THE RECEPTION's AC folder will need to be shared. In other words, right click on it and choose shared. You will see a blue hand underneath it, which is Microsoft's way of showing you it is not shared.
What you want to be careful of is to NOT let your AC on your desktop browse to the AC database on your desktop. Every computer whether one in your exam room on 100 computers need to browse to and find the database on the reception computer. Otherwise, each computer will be putting data on each computer's database. One way to tell is after you set up your desktop computer with all of your demographics, i.e. Practice name, users, schedule, etc. then all computers can browse to that database with no problem. If you try to use the database on your PC, it will again ask you for all of that information.
So, once all computers are connected to the same database ON YOUR RECEPTIONIST's COMPUTER, no matter where you enter data, it will be on all computers in real time.
You can set up VPN (probably something you are not ready for yet) or use Remote Desktop, GoToMyPC or LogMeIn, if you want to work from home.
Remember, you have to understand that we are all trying to help, but we all take things for granted as we are all on a certain level. I like to think that I understand AC and networking rather well.
BUT, I don't even come close to VINNY who programs for AC and has been doing networking when I was in diapers. (Sorry, Vinny, not commenting on anyone's age here, lol). So, setting up UltraVPN is easy for me, but a piece of cake for him. If you have a networking or technical question, VINNY knows more than all of us combined. Then again, he uses Linux, et al.
My recommenation would be as follows again. It may seem redundant, but it should be helpful:
Reception computer: Hard wired with main database (get it running and practice with AC on it until you feel comfortable) Laptop with wireless or wired if it is feasible to main database
I would keep it like that for at least a week or so. Do all of your catching up in your office. When you feel comfortable like that, THEN and only THEN, start taking things home and using remote connection or sync. That would be a good time to contact Wayne or Brian or Vinny or me.
You can alway PM us or contact any of us by email. Mine is:
badams_remove AT riverviewpediatrics.org (Of course, take out the _remove and change AT to @. Have to keep the bots at bay.
Bert Pediatrics Brewer, Maine
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No syncing needs to be done in the office. Once set up with the database connect to your computer, it will be like each computer is the same.
Remember also, with XP Pro, you can "invite" any of us to connect to your compute remotely to help by seeing your computer screen. There are other ways for us to connect as well. Don't worry, we won't steal your patients, we all have enough already, right guys.
Bert Pediatrics Brewer, Maine
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VM, As they say, a picture is worth a thousand words. These are a couple of good diagrams. The page below is good, because it gives at least four advantages of using a server. http://www.techsoup.org/learningcenter/networks/page4773.cfmThe diagram below is excellent, because it shows a simple peer-to-peer and a slightly more complicated peer-to-peer. In all peer-to-peers, all computers either directly or indirectly connect to each other and share files off each other. With a small LAN, 2 to 5 computers, this works well. When you get larger, then finding files and backups, etc. becomes difficult and managing it is harder, because each user becomes problematic as he or she has a lot of control over his or her files and shares plus users have less privacy. Even though the second schematic has a hub, there is no central computer. In diagram three, it shows all of the computers connected via a hub to a server. None connect directly to each other and ALL shares are on the server. While they are not connected directly to each other, they can still SEE files are on each other if they are shared. While the hub seems to be between the server and the clients, they are all still connected to the same hub or switch. http://www.seniortechcenter.org/hardware_and_software/understanding_lans.phpEven though the diagrams in each and the information I give continues to say and show a hub, you would NEVER want to use a hub unless you want to go back in time at least five years. Switches have replaced hubs. They basically are the same except that switches are much faster. Hubs divide the bandwidth by the number of connections so if 100MBs per second going in and ten computers, then each get 10MBs per second. Swithces give the same 100MBs per second to each computer and the switch is smart and knows where each packet needs to go rather than a hub which just throws the packets out there and expects the computers to figure it out. Lastly, we have ALL gone out and purchased hardware that we wish we had not done. For instance, you purchase a 10/100 Ethernet card, when you could have purchased a 10/100/1000 Ethernet card for the same price or a bit more and have one less thing to change if you go at a GB of speed. Hope this helps. I think I tend to confuse more than help.
Bert Pediatrics Brewer, Maine
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I run a PTP network which is reasonably well behaved
I am a solo practioner with one full time, one almost full time, and one half day a week staff members. I have four exam rooms, but use two for typical days The system has grown out of old pieces and new acquistions. I start with a Netgear RangeMax wireless router (G). There are three hard wired PC's. Reception/MA uses one PC, my other staff member uses one or the other (or both) of the other PC's at any given time. One is in the old "chart room" (getting smaller and less meaningful as more data gets compiled in AC. Good place for the large shredder!). This point has a Netgear 5 port ethernet switch. About $25. This PC also has a ScanSnap scanner attatched. At this switch I run a Brother 7820N network fax printer. I keep the sound on and can hear the connection from the exam rooms. Patients love this. Keeps them on my side when the pharmacy tells them I never sent the prescription.
I use a separate standalone network hard drive for my AC database. This is also connected at this switch. This gets backed up to all hardwired PC's daily with SyncBack (FREE).
I use a Gateway CX210S convertable tablet that I carry with me ($1000). A bit heavier than I expected due to the battery, but has run essentially flawlessly for a year now. I keep the charger in an exam room and plufg in at lunch or during an examif runing low. I use the digitizer pen almost exclusively, although typing would be marginally faster for me. I can hold the tablet and face the patient and make eye contact while talking and writing. Once again, they are impressed with the technology.
I have an older laptop in a front room for convenience. It is only wireless because I haven't upgraded the number of access points available at the router.
I use a network printer (Brother $100) for radiology, and PT orders, notes, and any printed prescriptions and the printer connected to the reception PC has green paper for lab orders. The documents are ready for the patient before they reach the desk for check out. I can print from any attatched printers.
I have considered putting the database on the Convertible because there can be a few second lag when switching tabs in AC, but everything else is very fast. Old scanned records of 5 mb load quickly in Adobe.
Ideally I would put the RangeMax in a central location, but everything is wired in one corner of the building. My site is over 3000 square feet and I have no signal problems.
I do find tht my speed increases if I run the AC database tool every few hours. I don't know if this is an MS Access fragmentation issue, or in my head.
I use cable modem at the router and access epocrates, lit searches, etc... for patients in real time.
Happy Holidays to all!
Bill Lien, M.D.
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You're Welcome! YES: XP Pro can certainly handle certain RAIDS, like RAID 1, mirroring. It has more to do with the machine and it's set up in the BIOS and on the motherboard I believe. Even our aging (4 years) P4 w/ hyper-thread, can be set up to go RAID 1. I have been looking at a few Dell's now that Gateway has been redone without a real business division. Sure do love Gateway's promised American based support. It's real alright as I have called once or twice and always got a real 48 state based tech. Now that is unique these days except for Jon and AC it seems. Anyway the Better Dells can also be purchased with RAID set-up.
Also here is the key to good wireless as much as anything else. Where do you put the router, right??? I put our router about 10-15 feet away from our main examroom, and even the other one is only side by side with the main one anyway. Nancy's laptop "Always" as full signal strength with our NetGear and the Intel internal wireless cards, that are A,B,G that came on the Gateway convertables. Now My laptop at the front desk has to travel thru about 5-6 layers of sheetrock some with AC current in them just to get thru. I usually have a good, to very good signal and almost always full thru put. At times it can get a little slow, but usually not too bad. But if the laptop is going to remain fairly stationary during the day you could plug and play for better thru-put...
Aren't those Panasonic phones the best, or what??? I only wish that the new ones had a deskset option, then I would buy the new 5.8 set-up. I really love the desksets for punching in numbers on carriers phone cues, sitting on hold, speaker phone and the like. So tell me how is living with the new one so far. Good signal, reliable, are the handsets and their speaker phone enough? Let me tell you, you really learn to love speaker phone with a keypad in front of you after doing enough insurance garbage. Anyway, gotta run... Paul
"Beware of the Medical Industrial Complex" "The Insurance Industry is a Legalized CARTEL"
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We are getting way off topic here, but Paul I hate to correct you, but Windows XP Home or Pro CANNOT set up any redundant RAID array. That is you CANNOT set up a RAID1 or RAID5 using Windows XP Pro. You can do it with server OS. It is important to point out that when one says that Windows XP Pro can manage a RAID1 or RAID5, then one is saying that you can use XP Pro using a SOFTWARE RAID. XP Pro cannot do mirror or RAID5 stripe as a software RAID controller.
You can set up most any RAID, if you use a SATA hardware controller card either fixed to the motherboard or as a PCI card. But, then you are booting directly into RAID and are not using any of your OS to control RAID. Hardware RAID is ALWAYS better than software RAID only part of which is if your OS crashes you no longer have a RAID.
If you read the 3rd paragraph under Dynamic Disk Storage, this will all be made clear.
In the same paragraph it does state you can use XP Pro to create RAID1 and RAID5 but this is only if you set it up on remote computers running server operating systems. This is, I believe, way beyond the scope of most users.
http://support.microsoft.com/default.aspx?scid=kb%3Ben-us%3B314343
Bert Pediatrics Brewer, Maine
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I'm meeting with a friend tomorrow to try and hook everything up and see if I can get it up and running. I might as well throw out the question about printing options. I assume I can set up the printer as part of the network and run through the front desk desktop/server. Is their a way to print wirelessly from the laptop if it is in a treatment room? Or better yet, any suggestions at what the best options are?
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Is their a way to print wirelessly from the laptop if it is in a treatment room? I am no computer guru, and I can tell you that this is no problem at all to set up.
Brian Cotner, M.D. Family Practice
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YES you can print wirelessly from the laptop.. hang the printer off the front desk computer and share it to the network.. it'll work just fine.
And Windows XP CAN INDEED support RAID.. use a HARDWARE RAID controller, which presents the RAID array to windows as a single drive, and it's all handled by the disk controller.
V.
Vincent Meyer, MD Meyer, Malin and Associates, PLLC
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You can set up most any RAID, if you use a SATA hardware controller card either fixed to the motherboard or as a PCI card. But, then you are booting directly into RAID and are not using any of your OS to control RAID. Hardware RAID is ALWAYS better than software RAID only part of which is if your OS crashes you no longer have a RAID. Vinny, please read my post more closely. As I stated clearly, yes a hardware controller can run a RAID on nearly anything at least from 2000 up. WINDOWS XP PRO CANNOT BY ITSELF RUN A RAID1 OR RAID5 OR ANY REDUNDANT RAID FOR THAT MATTER. PERIOD. It may be a matter of semantics, but when people speak about Windows XP Pro supporting RAID1 it does not -- not in the sense that Windows 2000 Server and Windows 2003 Server can as a software controller. I would hate to see anyone go out and buy four hard drives to set up a RAID5 or RAID10 with XP Pro only to find out they can only set up a RAID0 which is basically useless. Grab yourself a nice hardware RAID controller. I think we are basically saying the same thing. I don't mean to be mean or anything, but Paul is in for a rude awakening if he tries to set up a mirror without a hardware controller. 
Bert Pediatrics Brewer, Maine
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http://support.microsoft.com/default.aspx?scid=kb%3Ben-us%3B314343
Once again, the above article striaght from Bill Gates and revised on December 1, 2007, which seems rather up to date to me:
Article ID : 314343 Last Review : December 1, 2007 Revision : 3.2
Basic Storage Versus Dynamic Storage in Windows XP
You cannot create mirrored volumes or RAID-5 volumes on Windows XP Home Edition, Windows XP Professional, or Windows XP 64-Bit Edition-based computers. However, you can use a Windows XP Professional-based computer to create a mirrored or RAID-5 volume on remote computers that are running Windows 2000 Server, Windows 2000 Advanced Server, or Windows 2000 Datacenter Server. You must have administrative privileges on the remote computer to do this.
"Without a hardware RAID controller"
Bert Pediatrics Brewer, Maine
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To summarize it sounds like XP pro can support some RAIDs with a hardware RAID controller. Is this a card one puts in a tower with extra hard drives to act as synchronous backup? Or is RAID something else. (sorry for the naievity)
Gary DeCrona MD
Solo Family Medicine
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Bert, I think we were all sort of getting at about the same thing here. All I said was that I knew my old Tower was capable of doing so and that I was shopping and seeing such a configuration was possible on both XP and Vista based machines, straight up within themselves. Yeah I wasn't sure of the nuts and bolts, as I hinted it had more to do with the BIOS and the Motherboard, as I know I was told I would have to change something in my bios if I wanted to set-up a RAID situation down the road. So yes I do have a SATA Drive and card for it. So it seems both sides are saying the same thing in a different manor. One does NOT need a real server sever with server software to have the advantages of RAID. If one has a properly configured PC then it is possible. Yes those of us less knowledgable were a little off on the in's and out's of it, but it is possible on good old XP and Vista PC's whether standing alone or acting as the "server" in a P2P enviornment. But as always thanks for your clarifications... So it is on the controller board for the harddrives more than anything else. Hey how's your Jeep and the Power Steering??? Did the "StealerShip" take good care of you??? Now there is something that I know a good deal about... lol. Be well. Paul 
"Beware of the Medical Industrial Complex" "The Insurance Industry is a Legalized CARTEL"
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To start, let me try to explain RAID as I think this may help everyone understand the other things we have been saying: RAID = Redundant Array of Independent Disks; it can also be inexpensive drives or independent drives, but the first is what is generally used. The reason for raid is for data reliability and increased performance. RAID creates a virtual disk using multiple hard drives either by a software controller (OS) or via a hardware controller. A hardware controller presents the drives as a single unit and the OS is not even aware. It sees it as one drive. A software controller does the same and the OS still sees one drive, but it can also detect the single volumes. The difference is easily seen in computer management. If a software controller is used (by using the OS software), the possible RAIDs are determined by the OS used. As stated earlier, XP Pro cannot created a mirror or striped RAID unless it does this remotely to a server OS. Server OSs also can create software RAIDS and are generally not limited. RAIDS allow three things: Mirroring, which means that two disks are exact mirrors of each other. If one drive fails, then the computer will continue to run without any loss of data or speed. Obviously, since the mirror is "broken," you will need to replace the drive ASAP. The drive will be rebuilt rather quickly and there will be no hiccups in your performance. The downside to a mirror is that while reads are fast, writes are slow, because the OS must write to two different drives simultaneously. Also, you ALWAYS lose 1/2 of your hard drive space. Striping: In striping, you use multiple disks and stripe data across them. So, you may have data spread across four disks. This allows very quick read/writes, therefore, increased performance and extra fault tolerance as you would see in RAID1 (mirror). If this were the only setup, then the loss of one drive would mean a complete loss of your data, but the final drive is used for parity. This gets confusing, but just take it on face value. The parity keeps track of where data 1, 2 and 3 are on each drive. In this way, if you lose one drive, the parity will allow you to rebuild that drive. Disadvantages include your system will slow down if you lose a drive and it takes longer to rebuild. But, you have much more space, because you combine all the drive space minus the parity drive. So, four drives gives you 3 times X for 75% of total, while five drives gives you 4 times X for 80% of the total and so on. This is considered a RAID5. Anytime, you lose a drive, you add another to the computer and the RAID controller will automatically format and rebuild the drive. There are really cool setups called hot swaps, where the hard drive can be slid in while the computer is still running, and you do not miss a beat. There is also a system called "hot spare" in which the drive is already in the computer so if your drive failed during the weekend, the hot spare would be configured automatically. You would still need to replace the drive. But, I digress. There are many, many RAIDs, but we generally talk about RAIDS 0, 1, 5 and 10. RAID0 is simply a striped set of two drives which improves performance but does not increase fault tolerance at all. Lose a drive and lose your data. RAID1 is a mirror. Very common among IT professionals. RAID5 is a series of striped drives. Many people use this for redundancy and performance when they have a lot of data they wish to protect. RAID10 = RAID 1 + 0, which is a two mirrors then striped together. RAID 0 + 1 = two striped drives that are mirrored. Efficient but not nearly as good as a RAID10. Certainly, don't worry about a RAID10 (or any of this for that matter). Also, remember that even though these RAIDS increase performance and allow for one drive to fail and in some instances two if using a RAID10 and the right drives fail, the more drives you have, the more likely a drive failure. OK, that is a summary of RAID. A general rule of thumb is if you don't understand it, you probably don't need it. Sorry, to be harsh -- or at least someone else should set it up for you. To summarize it sounds like XP pro can support some RAIDs with a hardware RAID controller. Is this a card one puts in a tower with extra hard drives to act as synchronous backup? Or is RAID something else. (sorry for the naievity) With that behind us, Gary: just about any OS can support RAID if a hardware controller card is used as it is independent of the OS. Certainly this is true with XP and 2000, although there is some amount of software the OS needs to interact with the controller. The card is put into the computer just like a PCI or PCIe card. It can't be any old card. It has to be compatible with your motherboard. The hardware controller can also be on the mobo, and it will function just fine. It should not be looked at a backup. Yes, the mirrors are the same while the striped drives are not. But, in a backup, if you do an actual backup of your system on Monday, and on Tuesday a file becomes corrupt or someone deletes a file or folder, you can go to the backup and get it back. With a RAID1 (mirror), if you delete a file, it is instantly gone from both drives. If data becomes corrupt it is corrupt on both drives. So, a mirror should NEVER be looked at like a backup. It should be looked at as redundancy so that if a DRIVE crashes, you do not lose all your data. You do not have to spend the entire weekend reinstalling your system and praying your backups are good. You slide in another drive and you are ready to go. My final statements: Much has been stated about RAIDs here (my talking the most). The original question was "I have two PCs. What is the best way to set up my office." How we got on RAIDs, I don't know. To me, the difference between understanding RAID technology and/or setting it up and setting up a peer-to-peer network or simple pseudoserver setup is like the difference between calculus and long division. (Granted I forgot that a long time ago). And, maybe I am overstating the difficulty of RAID. These are some truisms (that only come from my opinions): If you are setting up your database and your network on Windows XP Pro, then you probably shouldn't be setting up RAID. RAID, for the most part, is for server OS and actual servers built to be servers. They are generally used on domains but not always. I am not saying you can't do it on XP Pro, but it doesn't seem to make sense to say I am going to use what I have and keep my budget intact and then go out and purchase four or five hard drives and a controller card. One would be better off setting up a very good backup system. More and more people are setting up RAIDs at home on Windows XP Pro or Vista. But, very few people with a "Small Business" with important data are using RAIDs on XP Pro. I am not mocking anyone using XP Pro, we used a server without a domain at my last job for over six years. But, hey, get two fairly identical hard drives, get a cheap hardware RAID controller compatible with your computer and your SATA drives, which means your computer has to support SATA drives, and set up a RAID at home. Do a RAID1 and break the mirror, then put it back. Do a RAID5 and pull out a hard drive and see if it still runs then format it and put it back in. Experiment first at home. Hope this helps. If anyone really wants to install RAID, then get a good IT guy or you can contact me or others on the board familiar with RAID.
Bert Pediatrics Brewer, Maine
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One does NOT need a real server sever with server software to have the advantages of RAID. If one has a properly configured PC then it is possible. Yes those of us less knowledgable were a little off on the in's and out's of it, but it is possible on good old XP and Vista PC's whether standing alone or acting as the "server" in a P2P enviornment. I agree with you completely. But, it does come down to the type of controller and not the OS. I think the thing that everyone needs to come away with is that in most environments, I don't think RAID is all that necessary. And, if one is going to go to that step, they may as well go all the way. I am fairly confident that the same user who isn't comfortable with RAID will set up a RAID1 and then use it as a backup. That's my main concern. That either they use XP Pro and make a RAID0, pretty much useless with no fault tolerance, or they somehow do get a RAID controller card and make a RAID1 and think their data is safe.  The jeep is still making godawful noises when turning from 0 to 10 mph. When the part is in, I am sure it will be all better.
Bert Pediatrics Brewer, Maine
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Vinny, please read my post more closely. As I stated clearly, yes a hardware controller can run a RAID on nearly anything at least from 2000 up. Easy there, Bert.. sorry if I missed this in your post. That being said, WHY would I want Windows XP handling this in software? I wouldn't ASK XP, home, pro or otherwise, to handle managing my storage, I'd offload this onto a fast hardware controller, which looks like a single REALLY BIG ATA drive to Windows. Within the context of the original post, though, none of this really matters. Get a single high-quality drive for the front desk computer. Regards, V.
Vincent Meyer, MD Meyer, Malin and Associates, PLLC
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Sorry, Vinny. Didn't mean to come across in a belligerent way. Just a bad day with most of it spent on the phone with Child Protective Services, never a lot of fun. I agree completely with your last two paragraphs and, my last two posts which are novels, state just that.  I think VMan got a lot more than he bargained for. As you alluded to, set up the desktop wired, connect to it wirelessly and have fun. Certainly no need for RAID.
Bert Pediatrics Brewer, Maine
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Bert, Your novel writing skills are getting as good as mine.... I'll be running for the door now before you catch me and beat the living CCHIT out of me and my wise mouth. Paul 
"Beware of the Medical Industrial Complex" "The Insurance Industry is a Legalized CARTEL"
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I doubt I could ever catch you. At least not in my Jeep. And, you never did advises me as to places in Maine I could off road and whether it would hurt my lease situation.
Bert Pediatrics Brewer, Maine
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A friend of mine helped me hook everything up yesterday. YEAH!!!Here's what I have now. Front Desk computer which is hard wired with the main database. A laptop with wireless to main database. Also, the laptop can now print wirelessly throuh the network which should work real nice. He suggested I go with this and eventually use the desktop as a server once a server is necessary. I shouldn't have to worry about that for a while. Can someone tell me the simplest way to backup the data? Can I just use a thumb drive and which folders do I need to back up?
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VMan! Hey what is your real name, if you don't mind?
Awesome VMan! Way to go. I am sure your friend just loved reading through our posts. One thing you will find about the AC community is we will read all posts, generally, and are more than happy to help out. Hell, Donna and Paul are even trying to get me a date, although there is a better chance of stamping down CCHIT than getting me a date, lol.
Before anyone gets confused (as I was), it sounds like he talking about possibly moving the desktop to a server role and having another computer at the front desk. Makes sense. I would do it sooner than later.
As to the simplest way to back up your data (which may not be the best way), you just need to copy and paste the AC folder which contains the database to another place on the computer preferably on another drive off the computer. You will find this (most likely by default)on the desktop computer where your main database is located. This folder will contain the six major databases (all the .mdb files). If anything, you want to make sure the AmazingCharts.mdb file is backed up.
This folder can be backed up to:
--Another drive on that computer --Another drive on the network, i.e. copy and paste it to the laptop --Burned to a CD/DVD --Copied to an external hard drive --Copied offsite over the Internet via AC where it is automatically encrypted --Copied to a thumbdrive
The latter is my LEAST favorite way to backing up AC. Many will do this and take it home. I would hate for AC to crash and then think, god I hope I can locate that thumbdrive and it is working. Plus, in order to use it, most will bring it in everyday and have no backup at home.
The biggest problem is that some users will use any backup but especially a thumb drive and back up only ONE copy. You need multiple, multiple backups to do this. I would also recommend backing up the entire computer nightly automatically.
If you are going to back up to a thumb drive and take it home PLEASE download any of the free and/or inexpensvie encryption programs and encrypt it first. If you lose the drive and someone finds it, the files say Amazing Charts right on it. How simple would it be to open them and have all your data.
I will send you another novel on backing up later this evening. Remember, these are just my way of doing it, but I am obsessed with backups. You can never do too many.
Bert Pediatrics Brewer, Maine
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