Home Forums Server vs. stand alone computer for small office

I want to use medical dragon with AC in my office. I will be the only doc using AC. I need to buy a faster computer with more Ram for DNS. Can I use this new computer to act as a dedicated computer (server) as well as dictating into the chart with dragon? The IT person I use says a server is always better. Ultimately, computers at our reception desk, 2 nursing desks, and myself would be using AC at any give time. I don't expect to add any more docs on the system.

I am in a solo FP office and use a peer to peer network. One of the computers is designated as the "server" and is not used as a desktop machine.
I have 4 desktop computers plus the "server" and am happy with the response and simplicity.
They are not cutting edge but no Pentium machines and have 4 GB of RAM or more and are connected through gigabit router.
I have wireless available but not using the laptop in the rooms yet.

Greg

I have a set up with a server that runs Dragon, in my office, and 4 all in ones, one in each exam room, one for the nurse station and one for my secretary. I have run this hardwired for the past 15 months and it has worked well. I am using m-tech hardware. The link is http://mtechlaptop.com/. I would recommend that you call their 800 number and ask for Jerry. They are very knowledeable and helpful. I am not getting any re-imbursement for the recommendation (in the spirit of full disclosure). I have been extremely happy with their equipment and support. Jerry is familiar with Amazing Charts and my setup.

Poz,

You state you have four users, but you don't state how many computers you are using. From your description, it could be four or more. I am guessing you have three rooms with six computers.

First answer. If you are going to do P2P, then don't use the new computer. Just let it work as a "server." It just depends where you are going to dictate. If the new computer will be in your office, then dictating there would probably be OK.

A question. Do you have two nurses working full time?

The server vs. peer-to-peer debate is a long one and probably occupies 20 threads. Personally, I agree with your IT.

You didn't say much about the computer you have. How old is it? Could you just add more RAM to one of them?

Thanks Bert, we don't have any computeres in the exam rooms, only at the nurses stations (2 full time), reception desk and business office. My old laptop is tired and not very fast. The new computer would be at my desk and I intend to do DNS there, not in the exam rooms. Is using DNS on a server as good as on a dedicated computer at my desk? I've dictated throughout my 30 year career. One of the major obstacles that has stopped me from doing EMR has been just that. It seems that AC works well with DNS. I've looked at a number of other EMR programs and don't think they work as well. Poz

Thanks Mel, I will call them tomorrow to hear what they say. Poz

Poz,

It would really make little difference whether you ran it on the server or a desktop. I would recommend not running it on the server, though. A server, by definition, should simply be the central part of a network and should not be used for anything. Ideally, except for updates, one should not touch the server at all, and it could, again with the exception of having to reboot for updates, run over a year without crashing or needing to reboot it. Part of that is because it is a server and is built for that, but also because you don't mess with it. In fact, a server usually is set for "Background services" and NOT "Programs" whereas a desktop workstation is set to "Programs" and NOT Background services." In fact, anyone reading this should make sure there computers are set that way. Both are that way by default.

So, I would just make sure you have the components to use DNS efficiently such as 8GB of RAM and an i5 or i7 processor. An SSD drive would be nice. I am not sure how much RAM DNS needs, but I am just guessing it would need around eight.

One nice thing on here is that you can talk to Tom Hamilton who is in sales with DNS. He pretty much knows anything and everything about Dragon.

Hi Poz,

To add to some of the above comments:

I have been using Dragon for about seven years. I'm currently using it on an i3 computer, eight gigs of RAM, Win7Pro, and it does absolutely fine. My PA has an i5, and I really don't think there's much of the speed difference. SSDs will speed things considerably. As you know, selection of microphone is absolutely essential to be happy with Dragon.

As Bert and others have said, try really really hard to have one computer running only Amazing Charts, and use another one for dictating with Dragon. We use an i7 with 12 gigs of RAM for Amazing Charts, Win 7Pro, this has done very very well.

As Bert made mention, you will get different opinions on running a true server in a server client network, versus running desktops on a peer to peer network. Bert and Sandeep are both strong advocates of running a true server. What they say is certainly true, but these two gentlemen are some of the sharpest people you'll ever meet when it comes to computers and networking. They also are willing to pay quite a bit for their equipment. Several others, including Jon(JBS) and myself, want to go with a lower-cost, lower complexity, but still quite usable system. We have been using peer to peer. Not as elegant, not quite as safe, but very very functional.

If you have interest, there have been several threads about this discussion.

http://amazingcharts.com/ub/ubbthreads.php/topics/46380/1

runs about eight pages.

Hope this helps!

Gene

Hi Gene,

Thanks for the compliments.

Thanks Bert, I sent an email to Tom for his thoughts. Poz

Thanks for the threads Gene, Quite a few are way over my head, but at least I now can understand a little of what my IT guy is talking about. Poz

Does anyone backup to the AC Cloud for $250/year? If so, has anyone experienced a failure and had to use the service? Poz

I back up to a Buffalo Ministation USB 3 1TB harddrive, backup is fast, never had to use it yet cost about $125

My last understanding is that you can't see or obtain your backups. This has to be done by support. I COULD BE COMPLETELY WRONG. But, if it is true, I really don't like backing up to a server where I can't have access to my file.

I don't use the AC back up because it is a pain to get the file. YOu have to call in and get someone from Tech support...then they have to put the file on an accessible link and then it takes forever...i did it the first year and then stopped.

Correct me if I'm wrong, but isn't the purpose of the offsite back-up to safeguard against the total loss of patient records in the event of a fire/other disaster?

backup with USB 3 is fast maybe 90 seconds,then unplug the ministation and put it into my laptop bag and off I go, plug it back in in the AM then again I am on Peer to Peer and the AC database sits on my computer under my desk

Poz,
I use the AC backup, but haven't had a failure. So can't help you there. Cheap insurance plan for data, I think. I do other backups, including external HDDs that rotate and go home, and NASs in 3 different spots of the office.
It's more expensive than other online backup for the size, but it's convienent and easy. When it includes the PM and schedule it will be a no-brainer.
I like seeing the "Backup Successful" every day in the messages.

Damn Dan '3 wars ready' kudos to your preparedness
sorry to say for me 250/yr is a consideration

Yes, it is cheap and like Dan use it as an insurance plan.
Yes failure but not with AC. We had hard drive failure recently on a shared server for our Lytec 11 PM, and were able to do a quick restore with our external HDD. We were down 2-3 hours.
No, have not had to use the AC backup, and hope not to, but if something happens to the external HDD and hard drive on server, it is nice to have redundancy with the offsite, but with that being said, the backup would have to be done during working hours and is dependent on the download speed. So would be much slower than a fast restore with an external HDD.

Here's a good thread on backups:
http://amazingcharts.com/ub/ubbthreads.php/topics/45165/on_line_backup

Yes, it is. But, I do think that these natural disasters are overrated. First, check what are your chances of a flood? Probably low. Fire? Maybe twice as likely. While you ultimately will need your data, if my practice goes down in a fire, I will be so bummed out, I doubt I will work again. All backups back up from 12 hours to 15 minutes. I think taking home a backup hard drive and losing at THE MOST a week's worth of data is tolerable. Certainly, backing up offsite is a good idea. And, the only one I do is to AC.

Are you using RAID? If so, you would not be down at all.

Is this backup with II? How long does it take to download the .enc file? Why would it have to be done during working hours?

Hi koby. I just have a few questions? What is a ministation? What do you mean by plug it back in in the AM?

Dan, how do you do those backups?
_____________________

The problem with AC's offsite backup is the fact that it is not accessible. For $250, one should be able to get their file back. There are three components that are huge in backing up.

1. The actual backup
2. Checking weekly to monthly that they are being backed up
3. Doing a test restore monthly.

You can't do that when you can't download the file.

There is also the possibility of having a security company come in and give you info and a quote on putting a safe into the ground through the floor. Would it handle a flood? How long could it last in a fire? Certainly easier than taking home, and it is HIPAA compliant.

Bert,

I bought 4 external HDD and connect one to my desktop with a backup every night, and I change them every week. Three stay at home. The point was to protect against corrupted data that we didn't realize for a while and against a hacker deleting backups.

That's actually a very good idea. What I was alluding to, though, was how are you doing the backup?

Acronis for SBS

Very nice!

Bert,

Yes we have raid.
Being down had more to do with just that, our IT guy needed to do some other tech stuff to the server so had to get another temporary server as a stand in as he upgraded the server off site.
Yes my imported items are included and the offsite backup is taking about 50 minutes now with about 1.3kb(Sandeep may need to run the math or correct my terminology--ha!!) of data.
You may forget who you are dealing with but before 11/11 I could not even hook up a darn printer to my computer. I can do this now!!! However, I should have been more explicit in my wording. This would need to be done during working hours for my benefit so I could ping AC support if I ran in to any troubles.

Might I suggest a couple of things. The .enc file of everything AC when compared with the Imported Items is roughly 50 times more important. This is just a guesttimate. I know you have likely read this 15 times, but I will repeat it again. My offsite backup takes about two minutes, plus the file, when forgotten about only takes up 75MB rather than 750MBs. Yes, there are 3rd party programs to delete them or scripts.

As you continue to import, your upload time will be 50 minutes, 140 minutes, three hours, 15 hours, etc. There is a good and bad feature to the .enc file. The good is that it is always a full backup, it is always compressed, is always encrypted and ALWAYS backs up SQL Server correctly. I contend that it is the single more important backup for AC whether offsite or onsite. If your server crashes or AC becomes corrupted, you can restore AC in minutes (well, you could if you controlled it). But since it will take you four hours to download it (just picking a time in the future), you will be tempted to use one of your other onsite backups created by the native backup program, Acronis, Backup Assist, etc. Some times this will be beneficial, but most of the time, if it were I, I would feel better restoring from the file which is made exactly for that.

I would back up the II locally to external drives or NAS or SAN. You could still back them up offsite to iBackup or any of the others, but the advantage there is you could use incremental or dedupe backups so you aren't sending the entire file everyday. How long does it take to download them? Who cares? You don't need them for a day or two. And, if they grow and grow, most offsite backup companies will FedEx your files on a hard drive.

And one other idea: UNLIKE the SQL user databases, which cannot be copied and pasted (unless possibly you stop the service), you can just copy and paste the II folder to another location. You could even use SyncToy or another 3rd party program to back them up in minutes.

Just food for thought.

Server vs Stand Alone. I use both. I have 2 offices.

One is peer to peer with the hub using Windows Home Server (WHS) 2011. The other office is server based using Windows SBS Essentials (SBSE) which is basicallly WHS with a Domain Server.

Both do backups of the computers in the rooms. Each backs up AC via Crashplan to the other nightly, so I have off site backup on both. I can remote into both via a website or logmein (LMI)

I truly am not sure which is better. I am not convinced that the domain service has made the server system better than the other. While I have the ability to log into any computer, in general we log into each computer only one way (front desk uses their log in at their computer, I use my log in at my computer.) The office is small enough we know each other's passwords.

SBSE costs about $400, WHS about $50. Both have been discontinued but are still readily available. While I might give the nod to SBSE, at a cost of 8 times WHS, I think it takes more than a nod to really be better.

Might I suggest a few other things?

Of course we do not like to think of ever having to deal with lost data, dishonest employees, or having an employee involved in a MVA in their vehicle while on company time, but I think this current thread is dealing in the what ifs, and preparedness.

We had a group office meeting recently and sat down and reviewed our office commercial policy with a couple of insurance agents and it was eye opening to say the least.

Areas of coverage that pertain to this discussion that one may want to review from time to time.
1. Identity recovery coverage
2. Electronic data coverage to replace or restore corrupted or destroyed data
3. Data compromise coverage
Additional areas to think about.
1. Hired auto and non-own auto liability
2. Employee dishonesty coverage

I think in addition to having a fastidious backup plan it is important to have an office commercial policy that reflects ones's current needs.