Home Forums Discussions General Discussion Advice sought on network design and computer selection for v6.5.

I will likely need to replace every computer in my network to meet the minimum requirements to upgrade from 6.3.3. to 6.5. I would like to go about this in a more intelligent way than when I first started out with AC several years ago with 1 staffer / 1 provider, and then added new computers one by one as my staff grew to 3. As a result, I have 5 different computers in my network running 3 different versions of Windows (7, Vista, XP). Updating OS and other software is a nightmare as it has to be done machine by machine rather than on a single machine and installing that updated image on all other like machines.

What combinations of desktop and laptop computers have worked well for others for V6.5? And have you been able to update Windows/Java/Flash/Reader more efficiently and imaged updated computers successfully to other like computers in the network? Do you need to buy your Windows OS separately from your computers so you have some sort of license and can mount the same image on multiple computers, or as long as Windows came with the computer does it somehow know it is ok to mount an updated image from another computer to a different laptop? Do you need some sort of Server OS on the Main computer to push out updated images of the client computer OS/software to client machines, or do you just walk around with a external hard drive to mount the updated images?

Here is what I am hoping to design:

Office:
Desktop (Main ? all data files for AmazingCharts and general practice use reside here, for all users ? no one stores data files on their clients)
Laptop (Reception ? this could be a desktop, but would simplify update imaging if it was a laptop)
Laptop (Doctor ? moves from office to two exam rooms)
Laptop (Nurse ? moves from nurses station to vitals room)
Laptop (Manager/Biller ? this could be a desktop, but laptop preferred to interchange with others as laptops have been less durable than desktops to date)

Home
Desktop (for software updates to image to other Desktops, and as Test Machine for upgrades and setting changes ? also used as personal computer and to LogMeIn to work)
Laptop (for software updates to image to other laptops, and as Test Machine for upgrades and setting changes ?also used as personal computer for my wife who is Manager/Biller and works half day from home)

I'm hoping all Desktops would have same software so only one needed updating and other could be imaged from it, and all Laptops would have same software so only one needed updating and others could be imaged from it. Because updating Windows/Java/Flash/Reader generally takes the computer out of use during patient service hours and takes me 4-8 hours, I would prefer to do it at home and only once for the Desktop and only once for the Laptop, and then copy the images to the other like office computers. I know it is not good practice, but I generally update Windows, etc once every 12-24 months due to the huge time required the way I am set up now, and the to date inevitable several days of tracking down setting changes to get it all to work again after updates and to downgrade incompatibilities (e.g. Reader XI back to v9 for AC6.3.3).

Any suggestions appreciated.

Mike,

Hi. Thanks for the question. It is a lot to go over, though. First, I have to say I am confused about your imaging for updates. Generally, Java/Flash/Reader, etc. can be done very quickly and, in fact, even automatically, although I am reticent to update Java without research. Same thing with updating Windows. Again, it can be updated overnight and rebooted without any time at all, but except for a service pack, they don't take much time. It also depends whether you trust your users. Personally, I have no problem with my staff doing updates after I have done mine and approved them.

Images (in my opinion) is when you want to do a complete overhaul of a computer especially when you upgrade to a new OS. I agree with you it is much quicker, but I am not sure what you mean, though. I would never install a new version of AC and then update all the computers with an image. It is just far too dangerous as you are now making every computer the same as the one you installed AC on. Besides, the install for the server is different than the one for the clients. You can sit at a computer, using RDC and go around and install 10 computers with AC in less than 30 minutes.

I think it is great that you trial things at home. That is a really good way to keep out of trouble.

I also would try to use as many desktops as possible. Just a suggestion. Using the same computer brand is a great idea and making sure they are all specced out the same is a great idea. So Dell OptiPlex or Lenovo using an SSD with possible a large HDD for storage.

One recommendation would be to use an isolated computer for your main computer. It's not a good idea to have your main computer being used by your receptionist, etc.

Your keeping files on one computer is another great idea. Then you back that computer up and not worry about the others. Of course, this leads to a server/client setup which would be more efficient there. I can guarantee Sandeep will recommend the same.

BUT a warning here. I don't want to get into the P2P vs Server/Client argument here. I mean with the other users. They both can be used well.

Another option that way too many people do not consider is too spend some money up front and let professional networkers set it up. Just a thought, but it is very helpful.

Sandeep spent tons of time on here going over how to build computers, networking, etc. They are at the top of the General forum and on his website. He will fill in the blanks I am sure.

http://sandeep.pdstechadvisor.com/server-buying-guide-march-2013/

I also agree that you should have the same OS and everything should be 64-bit.

Again, I may be misunderstanding but you want consistency and yet you have a lot of reasons why this computer should be that computer, etc.

Just some thoughts. I am sure I can come up with more as you fill in the blanks.

Good luck with your undertaking. Think it through. Write it down. Think about Uninterruptible Power Supplies. Don't use MacAfee or Symantec.

Bert,

Thanks for the many helpful suggestions. Perhaps I can clarify to benefit from any further fine tuning recommendations you or others might have regarding designing my network to decrease time / effort of managing it and updating it.

I try to keep things simple and keep costs to just what it takes to get the job done prudently. I run a small solo practice, low volume (225 visits per month, about 2 per hour, many slow elderly patients on lots of meds), and to control costs while waiting for the phone to ring, I am also the electrician, painter, toilet unclogger, and unfortunately the not-so-bright IT guy as well. This together with my wife's gracious participation as an unpaid manager holds overhead down with two other staffers, as has the low cost of AC. Through version 6.3.3 I have been lucky to get by adding random random budget computers as we grew to my 5 computer peer to peer network, which worked just fine at that pace. I'm hoping to learn enough to put together a serviceable network of replacement computers to meet V6.5's needs, and hopefully do things more efficiently than I have so I am not in the office after hours as much as I have been.

One of my biggest challenges is updating supporting general software (e.g. Windows, Java, Flash, Reader, OpenOffice, Antivirus). The challenge for me is to have some ability to restore the prior version if the update causes problems (taking the time creating a Windows Restore Point, or imaging the HD), avoiding business/appt hour interruptions caused when updating taking computers out of service (just rebooting and logging in to all the concurrent software [AC, Updox, OfficeAlly, webmail] can take 10 minutes), and having the time to test updates against starting all the software that runs concurrently for conflicts after hours before relying on it during patient care ? multiplied by 5 computers. Perhaps I am not doing it right, but my experience has been so dismal and disrupting, that I have adopted a not-so-safe policy of avoiding updates (except antivirus) until forced to, usually just before an AmazingCharts update. Setting automatic schedules after hours to juggle 5 computers to update 6 programs over a single internet connection has been problematical, particularly for those that require a human restart intervention when I am not there. Sometimes it seems updating or running one program (perhaps antivirus) causes changes in settings of others that result in pop-ups in mid day requesting permission to update something else that I previously set to never update. Perhaps 20% of the time after an update, the mileau of programs will not run together requiring debugging and generally adjusting settings that takes 15min to hours that can't be tolerated during business hours. As infrequently as I update Windows, updates not uncommonly take 8 hours requiring constant babysitting to iteratively run Windows Update, install, reboot, and repeat sometimes half a dozen times until all necessary updates are installed. Part of this may be my ATT DSL 1.45Mbps down/0.33Mbps up limitations. All users store files only on the Main Desktop Peer to Peer computer, and this doubles as the physician's office Desktop.

Hence, wondering if the following options would be more efficient:
1.) Since I need two mobile computers that have to be laptops to travel from room to room, make all clients laptops, buy one extra (or just use the home laptop), and rotate them one at a time out of service to update the various software at intervals. That way the updating laptop would not be interrupting business, except perhaps competing for internet bandwidth to download during business hours.
2.) Update one client laptop only, then mount its image to every other client laptop (I think this might be faster than redundantly downloading every update to every computer, and perhaps how schools with 100s of computers do it). Here is where I am uncertain of the Windows licensing requirements to do so, as my OS to date have came from the OEM, not Microsoft. I'm also uncertain if this would mess up the router connecting them all to the Main computer and printers by having them all look the same. Then I would only need to sweat updating the Main computer on weekends, when I could undo things if they conflicted outside of business hours.
3.) I would be willing to learn about servers if they would enable me to somehow ?push? an updated laptop image out to all the other laptops on the network without me needing to babysit each one one-by-one.

I like Bert's implementation of using his staff's time to update their own workstation software.
Regarding Bert's comment ?You can sit at a computer, using RDC and go around and install 10 computers with AC in less than 30 minutes? what does ?RDC? stands for? Personally, when I have done AC client installs from a single external Hard Drive walking around and babysitting the user interface, it has taken me several hours updating machines simultaneously, but perhaps I am doing it wrong.

I'm interested in learning any wisdom I might from how other practices on:
A.) your task work flow to implementing updates to supporting software (Windows, Java, Flash, Reader, Antivirus, office productivity ? word processor/spreadsheets).
B.) how you chose what type of computers to use in what roles for your office network.

Sincerely, Mike

Hi Mike,

I don't know about imaging or servers, but for our P2P network (about 10 work stations), I set Adobe Acrobat update on automatic and AVG update every night at 2AM. I tell everyone to restart their workstation every night. This takes care of those updates and any required restarts.

For the Java & Windows Updates I don't update very often. If I happen to be at another workstation to fix something I'll click install these updates. I haven't had any problems with Windows not having the most current update (but our computers are pretty new).

We don't update Flash. Not sure it's even installed. I don't update MS office either.

I don't want to start messing with imaging. Even though all the computers are the same, I still get a unique problem in one. I tried to create a backup image before but the size was humongous - could not save it on a DVD and I didn't want to take up all that space on our server. When we get a new computer or have to reinstall Windows (this has only happened with our old computers which are now all retired), I just sit there and install all the software. One thing you could do is copy all of your software install files to a server. Then after you've installed/reinstalled Windows, install Logmein right away; then log in from home open those install files.

PS. I took Bert's suggestion before to give your staff user name(s) administrator rights so these update can take place when they're logged in. They don't know they have admin rights and for our staff, no one is savvy enough to go looking and changing things in Windows.

Mike,

Based on what you are looking to do, and the constraints that you have, I will suggest an alternative that we came up with for practices that wanted less headaches/IT work but for a variety of reasons were not able to take advantage of our managed environment.

Invest in one machine of modest performance, install a third-party terminal server solution, and run AC on that machine with the other machines running sessions on that one 'server'.

The second part of this is accessing the server from 'ChromeBooks', cutting your hardware cost by 100-300%. ChromeBooks are ~$250 and require almost no maintenance.

The third part we recommend (but is optional) is making the host OS for the 'server' CentOS (or RedHat if you want commercial support). This gives you a bullet-proof host OS that costs you nothing, high performance virtualization, and the ability to easily image your server regularly. As an added bonus, you can copy the VM, do a AC upgrade, and determine if you like what you get - all without disturbing your existing production system. As Wendell says, "Did I mention that it is FREE?"

This allows you to mix-match other machines, as all they need is a browser.

Of course, you can save yourself time and money by switching to existing old machines to consumer Linux like Fedora or Ubuntu, but that requires a little more expertise.

It is your network, but the industry standard is to NOT allow users to have administrator privileges - that is THE way machines are compromised. In the SMB/Enterprise world once a
machine is compromised, the hard drive is wiped and a fresh install from image is restored - it just takes way too much time to clear a machine, not to mention lingering after-effects and questions.

Thanks Indy. I would have to read at least 10 hours of TechNet to even begin to understand that. Wow.

I will have to say that while likely more IT techs recommend user status and not local admins, there are many that say that, but then don't.

@Mike,

I still don't get a great understanding of your overall goal. I highly recommend hiring an IT company to set things up. You don't do tech and they don't do medicine.


Depending what type of network you want, it may be something you can't learn to do within weeks, certainly not piecing together information from here. Partly the info on here may be over your heard, partly it may not be what you want, and mostly, you will get different suggestions from each person.


I don't see the challenge of supporting general software. If you have to reformat a computer, that can be a project which would require installing Windows. You can image each computer to a backup preferably an external hard drive and not the "server. You can also do an image of the first install which could be compatible with all of the machines, but if things are too different of the target machine, you may need specialized software. Acronis comes to mind. To be honest, I almost always format from scratch, but I don't have to do it very often.

Java, Flash, Adobe, OpenOffice and Antivirus shouldn't take long. I can't recall with AVG, but with my Antivirus, it downloads definitions every 30 minutes. We haven't had to do anything for seven years. OpenOffice, no big deal. With the other three, just run them while you are seeing a patient. It just runs in the background. Be careful with Java. This is where allowing users to be local admins pays dividens. I simply don't want to go around installing those. Updates have to be done, but they don't take long and my four users can do their own updates. If they download something, they are written up. As far as restoring an original, this is where a server with Hyper-V and VMs is much better than Restore Points. I am about 46% for successful restore points. A good backup or image is safer. It doesn't have to be an image. I think you watch is different than mine. If you are sitting at the main computer to install AC, what is ten minutes to do a restore point. Plus, there are already 20 waiting for you. I don't understand the avoiding/business/appt hour interruptions caused when updating and taking computers out off service. We all must do that. You do it after hours.

I again must be missing something. All of those things you describe are things we all must do. You MUST do your updates. AV is simple.

For my server, I do 25% of the updates at a time. But, I fire away on my clients. Again, give your users local admins. When it says to reboot, have them reboot. You do the rest. Updates without SPs are a pain the [censored] during a install but after that they are barely a nuisance. Install them and be done with it. Last patient, install them. Install them on the next computer. Don't avoid updates.


I guess I am still confused. First, what are you scheduling? I have nothing scheduled except a weekly backup of my CLIENTS, but you schedule it once. But, I don't get the Internet connection to update a computer.

Everyone has to log into AC. I actually don't because I lock my computer instead of log off (which is another thing industry standard won't recommend. But, you can keep all of those open with a locked computer. DON'T TURN YOUR COMPUTERS OFF AT NIGHT. Office Ally is a billing program correct? But even if you have to open the other three, do it at the same time. You could even have someone write you a script to do it.

Why are you testing updates? Are you talking about Windows Updates. Update them and forget them. I rarely have a problem with a client update.

Most of these updates have preferences that allow you to reboot and install after hours. Certainly, Java, Adobe, Windows Updates. I almost never have a popup. If I do, I either run it in the background or minimize it.

You are definitely doing something wrong if updates are causing the milieu of programs not to run together. You are DEFINITELY doing something wrong if updating Java, Flash, Adobe and Updates that takes you hours during business days. I would say, I go weeks without having to fix any of my computers during business hours or at any time.

You should run updates that even. Again, you are doing something wrong, way wrong, if updates take hours to reboot. I choose my updates, run them and reboot if necessary. It shouldn't be your DSL. These updates should already be downloaded.

It is highly recommended that you do not use the computer with the database on it as a client computer.

Mike, all of these things that you mention are part of using a computer. It has nothing to do with a network. If you told me your switch was 10Mbs, I would say that is a problem. With all due respect, everyone does these updates and downloads, etc. The only problem is you seem to be describing events that should take two to three minutes but are taking hours.

Mike, I hope you aren't offended, but what I am going to say I cannot say with more emphasis. Or conviction. Somehow there are issues there that affection things.

#1 This does not seem helpful. In fact I beg you not to do number one. You shouldn't have to rotate computers so that one ends up at home for updates. You really want computers to be consistent. In the same place as possible.

#2 Number two is more problematic than number one. Again, what are the issues with the updates. Have you ever imaged a computer. It isn't going to be a walk in the park to continue updating a computer, then imaging it to other computers. You will have huge problems. Huge! Yes, Windows will be OK, if only two or three hardware items are different. But, eventually you will run into a licensing issue. This would not screw up the router. The IP address will be given to the computer no matter where it is. Printers, no issue.

#3 There are advantages to "pushing" out updates, but basically it is the same as each client downloading them. It is very hard to learn a server. You would likely need a domain. That is a domain controller and Active Directory. From your post, I don't think you are ready for that. I don't get the babysitting. The updates will be there either way. And, you still have the other issues.

RDC is Remote Desktop Client or RDP is Remote Desktop Program (I think I botched the last word). This is for remoting from home and for remoting between computers. I put all of my installs and OS on the server on one partition and install from one computer.

Mike, I have installed a few networks. I run mine everyday. It takes me maybe five minutes a day depending on whether it is Microsoft Patch Tuesday.

This, I think, is my final advice. I can't emphasize how much you should do this. Take a $1,000 or so. Maybe more. Look for a tech company that is certified with Microsoft and SBS, etc. Have them come out and read your thread and look at your layout. Then have them install it. If you want then can maintain it remotely. But, most maintain the real server remotely. At the very least let a company who specializes in computers install it and teach you a plan of how to maintain it. You take that time and see patients. I think I read at least two or three places where it took you eight hours to do something. Let's say that is 24 hours in a month. That's 24 billable hours you could easily pay to a corporation. Would you do your own roofing even with help on here?

Most of those third party Terminal Server solutions will get you in trouble. I remember someone used to post about a third party solution called TS Session or something like that. It basically turns a Windows desktop OS into a Terminal Server. I posted something similar. According to MS, while the software is legal, using it with Windows is a violation of the EULA.

There are other downsides to using a Terminal Server OS is that no one can really have admin rights. If one person messes up, everyone gets messed up. Usually, locking it down properly takes some existing knowledge of Terminal Servers.

Sandeep and Bert,

Thanks for all the insight about hardware and software requirements for AC. Like many practices, I will be upgrading our office pc for 10 users. I would like to expand from a Single PC user practice. I think SBS 2011 essentials will be the host OS (server 1) which will have AC and Medisoft PM. Another, (Server 2) will be running SBS 2011 essentials and will be dedicated to cater 10 users using Ncomputing clients (thin or zero) with client AC and will also be a fax server as well using one phone line. The server2 will communicate with server1 to access applications mentioned above. Both servers will have a supermicro MB, single Xeon E3 1230 v2, and a maximum of the following 32 GB RAM ECC, 4 WD 4 TB configured at RAID 5, redundant PS. I kept reading about SBS essentials cannot be a terminal server and if this is the case then to what extent can the 25 user/ devices in the SBS essentials be used for? If this is not possible then what will be a recommended setup? Will AC work when server1 is down? I appreciate your comments.

Thanks.

Charles
Infectious Disease Practice, FL

Sandeep and Bert,


What is the remote web access used for in SBS 2011 essentials used for? Can 2 - 3 users access the second server from home and use AC simultaneously?

Thanks.

Charles
Infectious Disease Practice
FL

I am not sure or am not understanding the user for server 2 in your scenario. I would just run AC on the first server. Plus, you can only have one SBS on an domain as the SBS server will have to have the FSMO. What I would do is build your first domain with everything on the server, then add the second server and either run Windows Server 2008 Standard or the Premium Add-on. The latter allowing SQL Server but really no difference. Not being SBS, it can be a second domain and also function as your TS/RDS server. TS is not used any more. Remote Desktop Services Server is the official name. Then clients both on the network and from home can log in and run their own sessions or see the whole desktop. These users will all need separate CALs.

RWW which in 2011 is now known as Remote Web Access can be used from home to access either computer. RWA is the most secure form of remote access and also gives other advantages once you access the site. However, most people just want access to their desktop or RDS and, therefore, choose RDC which is much faster to connect (maybe three to five seconds) rather than the 30 seconds it will usually take to open RWA and then connect, etc. I still like the Standard version, but mainly because I prefer Exchange and SharePoint to be onsite.

Forgot to mention that AC would have to be TS/RDS compatible, which it is.

"I am not sure or am not understanding the user for server 2 in your scenario. I would just run AC on the first server. Plus, you can only have one SBS on an domain as the SBS server will have to have the FSMO. What I would do is build your first domain with everything on the server, then add the second server and either run Windows Server 2008 Standard or the Premium Add-on. The latter allowing SQL Server but really no difference. Not being SBS, it can be a second domain and also function as your TS/RDS server. TS is not used any more. Remote Desktop Services Server is the official name. Then clients both on the network and from home can log in and run their own sessions or see the whole desktop. These users will all need separate CALs.."


Bert,

Thanks for your reply. I might need some updating with Tech terminology, but what is FSMO? Is it Flexible Single Master Operations? "I am not sure or am not understanding the user for server 2 in your scenario" I am using zero client terminals (hardware) called Ncomputing and need a pc to power these terminals. It does not function like a desktop. In other words, these are dummy terminals without a HDD or applications in it. Since Windows 7 professional is only good for 1 pc 1 user OS, I opt for a server.

So, please allow me to clarify your suggestion. I might just re-word what you said earlier. So can I use SBS 2011 essentials to install all my applications including AC and medisoft for server1? Then, for server2, can I use Windows Server 2008 to function as a terminal server to power my zero/thin clients in the office and to function as a RDS server during late hours or weekends user access from home? With this setup in mind, Will server2 (Windows server 2008) be able to access AC from server1 (SBS 2011 essentials). The thing is Ncomputing only allows for in-office use. I don't think that I will be able to access these terminals while at home. So the users will to access server2 directly and open AC. Would there be a delay or for the processing and communication of these servers. At this time, there will be only two users that will access the server remotely, me and a physician. I don't need exchange nor sharepoint. All i need is for my users to use AC and Medisoft.

Thanks again

Charles
Infectious Disease Practice
FL

I will get back to you, but TS and RDS are the same thing. TS is outdated.

Charles,
We use a set-up very similar to Serene's, and I agree with her opinions regarding updates and imaging. I think you would be happy if you follow her lead.
Although it is unlikely to meet the security criteria of the IT folks here, I also second her idea that giving staff admin rights is not a cardinal sin. Her statement "They don't know they have admin rights and for our staff, no one is savvy enough to go looking and changing things in Windows" is appropriate.
Indy is also suggesting a very elegant, simple, and inexpensive alternative that you should consider, based on the requirements and preferences you describe. (Bert, I don;t even read TechNet, and I understood most of it)!

Jon,

With some of the misconceptions Mike has (and I apologize if that sound JNT-like) there is no way he is going to feel comfortable with Red Hat and Ubuntu and Linux, etc.

Thanks Jon. I'll look and see if Indy's and Serene's are feasible.

Keep in mind that Indy's proposal included two "essentials" and a third idea that is optional. That third option would require more IT skills but would save significant money on OS licensing. That is the trade off, but again, that part was only optional.

Mike,

Here is what I would recommend. First and foremost make sure that your nComputing and your thin clients are RDC compatible and all your apps, e.g. Medisoft PM are RDS compatible.

I would set up your nComputing and connect your thin clients to the domain. Set up SBS 2011 Essentials as your host computer with domain controller, which has all of the FSMO roles. As stated, no other SBS computer can be on the same domain and why would you want to anyway? Use Windows Server 2008 as your RDS server which should have all apps you want to use and all should be connected to the host server if the app, like AC, has a database. All of the apps should be installed on the host server, SBS 2011, as well. You can locate the FSMO roles with netdom query FSMO at an elevated command prompt.

You need to install the terminal server role with the correct licensing on the RDS. A licese server will need to be installed preferably on SBS.

As you stated, your thin clients will access AC and Medisoft and whatever else from the RDS.

If you add a fax server, this can be added to either server. Just make sure it is a Mainpine Fax Board. Not to repeat myself, but make sure it is a Mainepine Fax Board. Obviously, everything should be 64-bit.

One good habit to get into is calling it RDSS. Remote Desktop Services Server. Forget TS ever existed. It is RDS in the office and RDS remotely.

Yes, server 2 (Server 2008) can access server 1 (SBS). This is how the app you RDC to gets its data. No, you cannot remote to the thin clients directly. But, you can remote to RDS or SBS. However multiple users cannot connect to SBS. There should not be much of a delay between the servers. Nor the thin clients once connected.

Another user who doesn't want SharePoint, the greatest app Bill Gates ever made.

Thanks Bert.