Home Forums Separate Physicians without Separate Servers

Does anyone know a semi-elegant workaround that would allow us to have two separate physicians (separate financial entities) without having two separate sets of servers and workstations? For example, can something be done with VM-ware or the like? I would not have a problem having a separate server, but would definitely like to avoid having separate workstations for each employee needed to access AC for each physician. Thank you

You would have to have two separate databases on the server. Probably the easiest way to do that would be to use Windows Server 2012 R2 and set up Hyper-V http://www.sitepoint.com/hyper-v-virtual-machine-tutorial/ and then set up two VMs.

On the workstations, obviously, you could just set up different accounts or run a VM which would then not necessitate logging off and on. But, the different accounts would be cheaper.

I am not completely sure if you could connect separately by connecting to the virtual switch on the Hyper-V.

As far as two people using the same workstation, are the two employees or physicians working at different times?

Thank you, Bert.

I am checking to determine if the physicians have overlapping schedules. My guess is that there would be. So if they are using Win 7 on all machines, perhaps we could use VMware or the like?

Strange that AC does not have a better workaround for this. I would think that it would be not such a rare occurrence.

I guess if the server had Hyper-V and two VMs, you could look at the workstations three ways. I am not sure if they would all work. If you were able to connect to the specific database using the virtual switch, the information would be changed in AC to the database. Two different accounts would seem best, but I suppose you could use the same one. I wouldn't.

You could reset the path to AC, then browse to the correct database.

You could use a VM.

Of the three, a VM would be safest as it could be set via the virtual switch to go to the correct database.

I think that would be the biggest issue. Connecting to the same database by mistake. Of course, the names would be different, etc., but there could always be that chance.

Which leaves the two safest options:

A VM on one account. The accounts would need the username and difficult password, so when a user logged on, they would have to be logged on to the correct AC.

Actually, you couldn't use just two accounts as the path wouldn't be dependent on the account but on AC as you would both access the server.

I suppose the second account could use a second NIC card which ran to the second database on the server.

My best advice would be to PM Sandeep on the Top Posters list on the right and ask him to look at your question. He probably knows 50 times more about this than I. He'll give you the best answer and tell you where I am wrong.

I still don't see how your doctors would not overlap.

You could send a blank message to John's Medical Practice and make the color red so it always stated at the top right. In the other medical practice do the same but make it green. Why both? Because someone may delete the other temporarily.

Thank you again, Bert. I will explore these options. We were definitely not trying to avoid getting another account; we want everything to be legit and legally separate.

Perhaps if the same physicians' account is always in VM, it will avoid confusion, but I also like your idea of the red message.

I will check in with Sandeep as well. Much abliged!

To be clear, when I say other account, I mean logging out of your account on Windows and then logging in on the other physician's account. Nothing to do with licensing.

Also, I just thought if one AC had the physician's login and the other, yours, then they would have to use that AC (if it were a different AC). A little complicated.

I emailed him for you.

? where is the database for AC now; could that drive be partitioned and identified as a separate disk letter then have AC installed onto new partition and then physician 2 be directed to that partition as DB (his/her AC) location?
just wondering outloud

There are four (Win 7 Professional) computers currently: one acting as the server, and another (currently being used for backups is Windows Home Server 2012.

Rather than partition the one acting as server, my thought was to have the 2nd provider's AC database on the Windows Home Server 2012. I would think that would provide a bit better performance.

On each of the workstations, we could have VMware to have a separate instance of Amazing Charts running for the second provider. So the VMware would always be logged into the second provider, whereas the non-VMware instance of AC would be logged into the first.

Does that seem feasable? Thank you.

Thank you, Bert : )

The solution that AC has put forward is the cloud version of AC. It is elegant and the safest solution, if not the cheapest for two entities or two locations.

The cheapest solution is a partnership drawn up between your two entities and comingle your data.
If they don't see each others patients, and want to have separate in-house billers, and want the data in house, then you need all the stuff in the posts above.

I hope you have excellent separate back ups for the datasets, or you could get double the trouble.

Hi Dan,

Thank you for your suggestions. Just to make sure I understand, is AC suggesting that the second physician use the cloud-based version of AC, while the first use the regular (local data base) version?

Thank you,

David

I would hope not, but using the cloud-based (which I always forget) would be a solution. My guess is they would want two cloud-based versions as it is more profitable.

I have never used it, but the advantage (I am guessing) is that you would have one AC program on each machine, and depending on what database you log into would be the data. You would just need good passwords and not share them. I am not sure about the Hyper-V, but if you had two VMs, then I suppose you could have one AC and each doctor log into each database using the switch. The part I don't know is how the computer would know which VM to log into.

Another fairly easy option, since the computers have Win7 Pro, is for one of the physicians to always use Virtual PC and XP with a copy of AC linked to the "other database" (which would be the one you suggest putting on WHS.)

The only issue is that they would have to make sure which "world" they are in, the Virtual PC, or the main desktop world.

Virtual PC is already (or can easily and legally be) installed with Win XP. It will connect to the network easily and should be a fairly straightforward solution. Did I mention it was Free!

Thank you, Wendell. That is a good point. VMware looks like it would be a bit pricey. This would allow for an inexpensive approach to try before committing. Bert had a good idea for having a red colored note to make the appearance different for the second physician's iteration of AC, so that would help to keep users aware of the world they are in.

Got the email

Bert's advice is pretty good with a few minor adjustments. Server 2012/2012R2 Standard would be a good investment.

There's a few possible layouts:

It depends on your requirements and level of separation. I'm not completely clear on the extent of separation. Sharing staff, etc.

Possible scenarios:
1. Shared Access to Files/Programs but only Separate Amazing Charts. Users will share the same base of files shares, printers, etc. You could control folder permissions to ensure he can't see your files and you can't see his.
2. Two completely separate and isolated networks. Makes sense in a limited circumstance. If the same staff are cleared for both practices and staff is shared, then this seems a bit unnecessary.

Scenario 1 Layout:
Server 2012 R2 (Hyper V Host)
->Server 2012 Instance 1 (Other Physician's AC/Database and Remote Desktop Services)
This would host the Amazing Charts/SQL Database in addition to providing AC as a Remote Desktop Application or RemoteApp. Restrict users heavily so they can only execute Amazing Charts and nothing else.

->Server 2012 Instance 2 (Downgrade to 2012 Essentials R2)
This would host your Amazing Charts in addition to being a domain controller. Since you already have all Windows 7 Pro, you get good stuff like Folder Redirection, Network Backup, Group Policy etc.

Experience:
Users will have all the same stuff as before. Except the ability to run 2 copies of Amazing Charts. One will be running locally off Server Instance 2 using Windows 7. The other will run remotely off server instance 1 using RD App. This assumes you want to keep it easy on your staff and simply want two copies of AC on the same computer while leaving all current files and settings in-tact.

Yeah that. And, hopefully you would be around (with your company) to do some hand holding, lol.

I still think you could have two VMs on Hyper-V on 2012. They will ultimately have connections via virtual NICs making virtual switch.

On desktop you could have NO VM and one AC. Then change paths each time. If you set up the change path right (my way, lol), it's pretty fast. Besides the red message, the other doctor and staff are going to notice their patients aren't there. I am sure you could get some HIPAA note that covered the other staff if they go in by mistake.

Sandeep, would one of the log files record who went into what AC?

Scenario 2 Layout
Server 2012 R2 (Hyper V Host)
->Server 2012 Instance 1 (Other Physician's AC/Database/File Storage)
This would host the Amazing Charts/SQL Database in addition to storing the other Physician's files (word docs, etc.) that are not a part of AC.
->Server 2012 Instance 2 (Remote Desktop Server for Other Phys)
Provides full desktops for each user.

Experience:
This is the equivalent of having full desktops for each user. They would remote in from their current desktops. Updating this computer will update for all users. Separate user accounts, separate files, separate desktops, separate servers. Users would remote in as if a second desktop was at there desk. Dual monitors would be recommended in this instance if you practice at the same time. If the physician were to leave, he would need his two VMs and leave. Great mobility in this instance. You could also keep your Windows 7 Server on the shared server as well.


The VMWare Idea is also pretty good but it will require more work and resources. You'll have to maintain an additional 4 computers. Meaning printers, programs, updates, etc. Double the work. Also running two operating systems on machines requires some decent processing power. I don't know the specs of your current desktops so I'm not sure if it is even feasible.

Yes, you can enable auditing on the folder to track who accesses it. Or you could restrict access using permissions. Again, I'm not sure of the extent of separation and the desired mobility. Scenario 2 is almost completely isolated. He could pack up and leave without interrupting anything.

Thank you very much, Sandeep and Bert. One question: If we do not already have Server 2012 R2, and need to be economically-minded, what do you think of Wendell's idea?:

"Another fairly easy option, since the computers have Win7 Pro, is for one of the physicians to always use Virtual PC and XP with a copy of AC linked to the "other database" (which would be the one you suggest putting on Windows Home Server 2012.)

By the way, there is no problem with staff members having access, HIPAA-wise, to the other database. We don't need that much separation.

Thank you again for your help!

David

I'll talk to you tomorrow. Go with a Dell T310 or 410. I have a suggestion for you. Don't go cheap. Hell there are two of you.

Thank you. I should have mentioned before ... The second provider is not as active. She is only seeing about 5-10 patients per day. This is not likely to exceed 15 per day for quite some time.

Well, I do, but they are pricey. Not necessarily more pricey than some of the others. Let me know if I can help anymore. And, please let us know what you decide.

Server 2012 and Hyper-V is a good but expensive solution. It would require a new server, hardware and software, and they would have to buy remote licenses and possibly regular Cals given the number of persons who would need access.

Given what is already in place should be able to meet the need, I stick with my recommendation. One thing is to make sure that both computers hosting AC (the Win7 and SBS2011) have enough RAM.

Another thing I ran across recently was WHS remoteapp2011 (try this link http://www.theofficemaven.com/products/whs-remoteapp-2011 )

One question I have about it is whether it would require RDP licenses or it is separate from the Windows system? With this app, he could simply publish a link on each of the computers and remote to the AC system on the WHS home server.

Thank you, Wendell

This appears to be a similar solution as another product that I am reviewing - http://www.tsplus.org/ which makes use of Remote Desktop. This one related to Windows Home Server seems to not require separate CAL's, although Sandeep, if I understand him correctly, seems to feel that there could still be a EULA issue, in spite of claims to the contrary, although not likely to be enforced.

I agree that this would likely be easier and less expensive than the virtualization route. Thank you for the suggestion.

My guru suggested 2012 with Hyper-V and the two VMs it comes with and use the remote apps with icons on the desktop for each physician.

I agree expensive and the way you both are suggesting would make much more sense. I just took a quick look, so I am probably wrong, but with remote apps and without two databases on VMs or two different servers, won't both physicians be accessing the same databases?

Remote apps should allow multiple users to access the same application. Sorry if I am wrong.

Separate computer for each data base. We already have one of our Win 7 machines as the server for the first physician. We also already have a Windows Home Server 2012, which we can use for the separate data base for the second physician. So we can use Terminal Server access for the second data base, accessible with Remote Desktop connections from each workstation. So each workstation will use the regular desktop icon for the first physician and RDC for the second. With the light activity, it should work fine.

Although now, the physicians are discussing the possibility of an internal agreement to avoid any changes ; ) Would have been nice if they had settled on this before!

David, you're in the big leagues now.

Physicians Management is supposed to be harder than herding cats.

Indeed, coming up with a name that incorporates "Physicians" and "Management" clearly implies an overdose of optimism and perhaps a touch of insanity!