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03/29/2015 11:21 AM
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Hi everyone,
First time here. We have been using AC for some time now at a single office. We are opening our second office and were wondering how everyone set up their remote offices to connect to the main office where AC main computer is located?
I have tested site-to-site VPN between our remote office and the main office (where AC is installed) but it's extremely slow.
What are my options? LogMeIn, TeamViewer, etc. is not an option because only one user can connect to the main computer's desktop at a time and we have more than one users at remote office.
I have thought about running Terminal Services or Remote Desktop Service but that would be my last option since it's costly.
Thank you very much for your input!
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I use Remote Desktop Connection to a computer in the main office. RDP included in Windows 7 or 8 Pro versions, and I use Hamachi (a hosted VPN service from LogMeIn), which is $29/year. Response time is essentially as fast as sitting at the remote computer.
John Internal Medicine
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Thank you for your input. Unfortunately, RDP or LogMeIn only allows one connection at a time. We have more than one users that need to access the main AC computer.
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First, it is helpful when you ask a fairly complex question such as this that you list the architecture of your entire network. I.E. routers, switches, LAN, OS, servers, etc. It makes a difference if your host office is using a server with server software or is using WIN 7 Pro.
Many times VPN can be an alternative to Terminal Services and can be rather fast. But, since it does not seem to be the case in your situation, Terminal Services is your BEST and ONLY option. If you use TS with the apps you need to the remote site to use on the terminal server, you can allow any of the clients to use an RDC connection to the app. Yes, it will cost you possibly for hardware upgrade. And, you will definitely need to purchase CALs, but it is really the only way to go. I hate to say it like this, but setting up a remote office to connect to a host office is simple for Indy and Sandeep, but if you have to ask the question, then do yorself a favor and hire an IT company to consult and do this for you. You are a doctor. You have the money. Your time is better spent seeing that one extra patient per day than spending the next two weeks learning and trying to set this up. If you needed a new roof, you would probably hire a roofer, if you need an extremely secure and efficient network that you don't have to worry about, hire an IT. And, what I mean by that is a local company who deal with Microsoft and has Microsoft Certified ITPs.
I am not sure what your specialty is, but let's assume you are a FP and you make an average of $60.00 a visit after insurance reimbursement. Just a number. Let's say you see only three patients an hour. That's at least $180 per hour and that is probably a conservative guess. A good IT tech likely charges $165.00 per hour. It will be money well spent.
Bert Pediatrics Brewer, Maine
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Hi everyone,
First time here. We have been using AC for some time now at a single office. We are opening our second office and were wondering how everyone set up their remote offices to connect to the main office where AC main computer is located?
I have tested site-to-site VPN between our remote office and the main office (where AC is installed) but it's extremely slow.
What are my options? LogMeIn, TeamViewer, etc. is not an option because only one user can connect to the main computer's desktop at a time and we have more than one users at remote office.
I have thought about running Terminal Services or Remote Desktop Service but that would be my last option since it's costly.
Thank you very much for your input! You have two options, but each come with expenses. TANSTAAFL Terminal Services (either Microsoft or Third-Party) or additional machines in the main office that you remote to from the other locations. We recommend the TS approach as it is cleaner, and there are less machines to maintain long-term. Using TS, you are now free to use Macs or Linux machines to connect, and even mobile devices (if you have the eyes and dexterity for it).
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Just as I said. Indy or Sandeep. And, I mentioned TS. I think, as well, it is the best way to go. But, if you don't have Indy or Sandeep (or others on here to be fair), you need to get a good IT tech to set it up.
The key to a good network is setting it up correctly the first time. DNS and DHCP, especially DNS is key for all these things to work. The guy I work with who has done this for 35 years and works for Microsoft told me that when he went to college (yes, they had computer science back then), he was told by one instructor that when something went wrong on the network, it is DNS, DNS, DNS. At least first.
Agree Indy?
Bert Pediatrics Brewer, Maine
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You have two options, but each come with expenses. TANSTAAFL Except when you have the drug reps.
Bert Pediatrics Brewer, Maine
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blphu, I agree with the advice given above, but I want to clarify something. You said "LogMeIn only allows one connection at a time. We have more than one users that need to access the main AC computer". Can you explain what you mean?
How many users are in office #1? When you go to office #2, how many will be there? Let's say that you and your secretary go to office #2... you realize that with LogMein, you can each log onto your machines in office #1.
Jon GI Baltimore
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Yes, but what I think he is saying is that he wants to be able to access the database of the host office. For retrieval of info, each person in the remote office can log into a client on the host. They could even use AC and have it save to the database. But, every time they needed to see a patient, they would need to log into a computer on the host office. I don't think the LMI would be able to use Exam 1 computer from the remote office while another doctor is using the same computer.
With a TS, all the doctors in room one can access the server just like normal. And, all of the users in the remote office can access the AC app on the TS just like it were in their office. Many users from the remote office would be to access AC on one computer (the TS) without affecting or having to use any client computer.
Does that make sense?
Bert Pediatrics Brewer, Maine
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blphu,
"blphu" is your username. This cannot be changed for this account. However, under your Profile, you can change your Display Name. It is nice, as JBS (Jon) did to address you, like say, Hi blphu. But, it is impersonal and difficult to type.
If possible, for us and for you, could you change that to whatever you want to show up as your Display Name. Just a suggestion. If you have questions, please contact me.
Sorry, just my pet peeve.
Bert Pediatrics Brewer, Maine
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Thank you for everyone's input. Greatly appreciate it.
Make it a great day everyone!
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Bert, I understand what you are saying but it depends on what he/she is trying to do. Right now we are guessing.
Jon GI Baltimore
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We have been using AC for some time now at a single office. We are opening our second office and were wondering how everyone set up their remote offices to connect to the main office where AC main computer is located? Actually, I think it is fairly clear. I agree it could be clearer. But, he isn't stating that he wants to know how to just remote to a client or server to see information as you and I would from home. It appears from his question, he wants to know how a second office can connect to the main office and use the same database. If that isn't his question, then it certainly should be. While VPN is a viable option, in this case and practically all other cases (read about 20 times asked on here), going with a TS is the best way to go.
Bert Pediatrics Brewer, Maine
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I have thought about running Terminal Services or Remote Desktop Service but that would be my last option since it's costly. Since the actual machines aren't doing any processing, you can use cheaper desktops or thin clients. You have 3 main options. 1) Go with a Terminal Server (Self-hosted) 2) Go with a hosting provider for AC 3) Go with a VPS/Cloud Provider 4) See below VPN's are typically not feasible due to Internet limitations. However, if the offices are not too far apart/obstructed, there's something called Wireless bridging where you bridge the network between offices. This is not a new technology but recently has become very affordable. You can actually get full gigabit wireless links with offices as far as 200KM away. The upside is you don't have to pay a provider for the link between offices.
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Sandeep, can you expound on Wireless Bridging?
When I google it, I am coming up with bridging of 2 wireless networks. That's fine for 200 ft perhaps, but not 200 KM.
Wendell Pediatrician in Chicago
The patient's expectation is that you have all the answers, sometimes they just don't like the answer you have for them
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Sure, the more precise term is Point-to-Point (PtP Bridging). It's basically where one specialized access point talks to another access point. It's used for nothing else other than that purpose. Nowadays, we have companies like Ubiquiti that make very affordable outdoor bridges. The main purpose of these is to provide an alternative to running direct lines between locations that need site-to-site capability. Before it was around, people used to just have T1 lines or more. Really expensive. https://www.ubnt.com/products/The NanoBeam AC for example has a 15+ km range and up to 450 Mbps. It's also a $100 only. These types of things used to be in the thousands and maybe ran at a tenth of the speed.
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It's been a while since installed one, but there was an office back in the day that didn't have Internet service available in the area since it was new construction. But the doctor only lived a few miles away. So we setup one bridge on the office and one to his house. Thus allowing the office to have Internet access. You can use this to get an idea if a link is possible. If there are large obstructions, it's unlikely that it will work. http://airlink.ubnt.com/
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Where a T1 is 1.54Mbps, correct?
Bert Pediatrics Brewer, Maine
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Where a T1 is 1.54Mbps, correct? Yes
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Which would mean it is 292 times as fast as a T1, and I would assume just as or more secure given it is point to point. That is blazing fast speed.
With thin clients and RDP, it would be like being there since only the thing transmitted would be the mouse and keyboard commands. Of course, one could still decide to use regular client computers.
Could you combine this with a TS if you used thin clients, if you wanted to add more apps such as Office?
Bert Pediatrics Brewer, Maine
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It's been a while since installed one, but there was an office back in the day that didn't have Internet service available in the area since it was new construction. But the doctor only lived a few miles away. So we setup one bridge on the office and one to his house. Thus allowing the office to have Internet access. Sandeep, Sometimes you scare me.....Remind me never to get on your bad side..... Simply amazing! Gene
Gene Nallin MD solo family practice with one PA Cumberland, Md
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Hi Sandeep, Would this bridging work from a distance of over 50 miles ? I go to a remote clinic where I have to use their wireless which is unreliable thanks Bala
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Which would mean it is 292 times as fast as a T1, and I would assume just as or more secure given it is point to point. That is blazing fast speed. Exactly. It's also really economical. You can still have a remote office if the Internet goes down. You also wouldn't have to punch a hole in your firewall for VPN/RDP. It all operates at Layer 2. You can always get the Airfiber 5 if you want near gigabit speeds. It's pretty reliable equipment, typically used by WISP's (Wireless Internet Service Providers). With thin clients and RDP, it would be like being there since only the thing transmitted would be the mouse and keyboard commands. Of course, one could still decide to use regular client computers. Yep, absolutely correct. Also, if there's any interruptions, there won't be any data loss with RDP. Could you combine this with a TS if you used thin clients, if you wanted to add more apps such as Office? Yes, you would need Volume Licenses of Office to install on a TS. Or you can go open source with OpenOffice/LibreOffice. Tremendous cost savings if you don't need all the bells and whistles of Microsoft.
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Hi Sandeep, Would this bridging work from a distance of over 50 miles ? I go to a remote clinic where I have to use their wireless which is unreliable thanks Bala If you can PM me the addresses of both, we could plug them into the airlink tool ( http://airlink.ubnt.com/) to see if there are any obstructions. The taller the building, the better. Or if one is at a higher elevation relative to the other. You would definitely need the AirFiber 5 at that distance. $1000/unit. If they have wired and it's good, the cheaper thing to do would be to bring your own access point. Maybe Wireless N or AC and plug it into their network. Your wireless problems would likely disappear for a way cheaper price.
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Sometimes you scare me.....Remind me never to get on your bad side..... Pretty hard to do   
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It is my understanding that LogMeIn Hamachi (not standard LogMeIn) establishes a connection over the internet that emulates the connection that would exist if the computers were connected over a local area network. The standard subscription allows 32 members per network. I think that this would allow multiple remote users to login as if they were local clients to any network app, including AC.
John Internal Medicine
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And what machines would the remote users connect to?
Bert Pediatrics Brewer, Maine
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Hamachi is just another VPN solution. blphu tried a VPN and found the performance to be too slow.
Options are TS over VPN/Internet, Cloud, or PtP Bridge.
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Dear Sandeep,
"If they have wired and it's good, the cheaper thing to do would be to bring your own access point. Maybe Wireless N or AC and plug it into their network. Your wireless problems would likely disappear for a way cheaper price."
sorry to sound ignorant , but could you please clarify what bringing my own access point means? I am not sure what Wireless N or AC means thanks Bala
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Okay, I see how that can be confusing ha.
Question 1) Does the Clinic have good/decent wired Internet?
What I am suggesting is that you buy our own wireless router/access point and plug it into an ethernet jack on their switch. That way you can get better wireless performance in the clinic.
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OK, at the risk of sounding like a broken record, but I now have this on CD, lol.
I think connecting two offices so that you use the same database is a bit difficult. It would be beyond my scope of training unless I really researched it. Caveat: Sandeep will wonder why it would be hard for me as it will seem simple for him. So here are the the steps I would follow for anyone considering multiple remote offices unless they have a pretty good background in networking in which case they likely would not be asking here.
1. Decide you want a remote office 2. Consider connecting the two so those in remote office can seamlessly use AC and other apps at host office 3. Have a certified company in your area (Google will find the closest one) come out and give advice and prices 4. Call Sandeep on his website, yes you can call directly, and discuss these options with him to his very knowledgeable take on this. He may even be able to be in on the install and manage remotely. 5. Once you have decided on what you want to do, have the certified company do it. Do what is best for you and your budget, but I would mainly do what is best for your office. 6. Now that everything is set up properly at a cost that you have no choice in because it needs to be done correctly and not done on ACUB, allow the certified company to maintain the network if there are issues. Issues will be less likely given it was done by professionals to begin with.
Bert Pediatrics Brewer, Maine
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Well I will put in another two cents, but at this point, I think we may have scared blphu away.  What I have been trying to understand from the beginning is what he/she is trying to do. In the "Suggestion on AC Setup" thread, the discussion is about two offices, running simultaneously, with multiple providers. If that is what blphu wants, potential solutions are posted there. I interpreted blphu's need as something different; one more like my own. Put it this way: I sublet space in a second office. When I go there with my secretary, we use logmein. I log into my desktop in the main office; she logs into her desktop in the main office, and everyone is happy. Of course the main office clients are connected to the one AC database, in the main office. I am simply trying to make the point that if blphu wants to accomplish something like this, logmein is one way to do it.
Jon GI Baltimore
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Hi everyone,
First time here. We have been using AC for some time now at a single office. We are opening our second office and were wondering how everyone set up their remote offices to connect to the main office where AC main computer is located?
I have tested site-to-site VPN between our remote office and the main office (where AC is installed) but it's extremely slow.
What are my options? LogMeIn, TeamViewer, etc. is not an option because only one user can connect to the main computer's desktop at a time and we have more than one users at remote office.
I have thought about running Terminal Services or Remote Desktop Service but that would be my last option since it's costly.
Thank you very much for your input! Jon, It is possible that bphul has been frightened away, but I doubt it. He has received excellent answers to his questions, and it appears he has decided to implement them or he sees he is in over his head. While an explanation by him would give a 100% definitive answer, short of that, we can only guess. Here is why I don't think it is as simple as how do you remote from home. That question is generally when a non-savvy user wants to log into a "server" with multiple users using LMI or RDP or GTMPC. It appears that he is more technical than that. I base these on the following information. Please see bolded info above. "how everyone set up their remote offices" This seems to clearly indicate that he is referring to a permanent solution for everyday use from a remote office and not for using a solution such as LMI to remote in. "site-to-site VPN between our remote office and our host office" Once a user starts throwing around terms such as site to site VPN, it again appears they have at least a modest technical background and would know how to log in user A's computer and user B's computer. The next bolded quote referring to LMI and Team Viewer potentially could refer to someone's not understanding to remote to a client, but it seems again to indicate otherwise. "running terminal services" (even mentioning remote desktop services) This implies a user with a fairly good understanding of networking to a server which will allow multiple, multiple users connecting to one app. I doubt that someone who understands TS and RDS would not know how to use LMI to a client. I know that this is all speculation. But, it appears as though bhplu is not returning to update his question. He does what most people do who ask questions especially about networking on his or her LAN. They give very little information about their network. They do not give versions of OS, types of clients, is this Client/Server or P2P, depending on which, what type of server and OS are they using, what model is their router, what switch are they using, what ISP carrier are they using, what speeds, how many people are in each office, and KEY: will there be people working in each office. Without this information, it is very difficult to give a solid answer. Unfortunately, he completely ignores the third post where I ask him to give this information. I find it frustrating when I am trying to help someone when they do not continue the thread and give key feedback to questions.
Bert Pediatrics Brewer, Maine
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LogMeIn & Hamachi are two different species. Not trying to beat a dead horse (did I really type that!?), but to respond to Bert's post, I just run Hamachi on my remote computer and one of the office networked computers, which can be in use. My remote computer joins the office network (all the office computers appear on on my Network dropdown menu). I open AC on my remote computer, find the xml file on my office "main computer", and run AC, at near LAN speeds. Of course, this depends on fast internet, which might be biphu's issue after all.
John Internal Medicine
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So, what you are saying is that all of the staff at the remote site could use the same Hamachi account? But, we may never know, because "blphu" has never returned to comment. I wouldn't worry about misspelling his name. As you know this has always been one of my pet peeve. So, I guess I am the one beating the dead horse. 
Bert Pediatrics Brewer, Maine
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John, maybe it would be a good idea to post your speeds so people can get an idea. Also if you have the same ISP in both locations, you'll likely have a better ping. http://www.speedtest.net/http://www.pingtest.net/http://speedof.me/Also, it's important to note that every user is different. People who use Imported Items heavily will experience a greater slowdown over VPN. People have issues with that over WiFi.
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@Sandeep
You change your signature info everyday, lol.
Bert Pediatrics Brewer, Maine
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Here are the screenshots: Speedtest.net (this is BrightHouse home cable, my office has BH business cable, similar bandwidth) ![[Linked Image from amazingcharts.com]](http://amazingcharts.com/ub/attachments/usergals/2015/04/full-636-702-speedtest.png) AC on my home PC, connecting to office server xml file. ![[Linked Image from amazingcharts.com]](http://amazingcharts.com/ub/attachments/usergals/2015/04/full-636-703-ac_to_main_cmptr.png) If I am using a Mac at home, I can't run AC natively, so I have to RDC to an office computer (via the Hamachi VPN) and run that computer in a window, which is slower. But I can run both computers at the same time from home, with a decent response time.
John Internal Medicine
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@Sandeep
You change your signature info everyday, lol. Ha, things are always changing here.
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@John
Those are some incredible speeds. Nearly 100 Mbit download and 12 Mbit Upload. That's way above average. The connection is probably faster when you're connecting from home to office since you have the same ISP in both places.
Still the upload could be an issue to some users. For instance opening a 20 MB PDF file would take ~15 seconds. The latency is also borderline. The more users, the more it would be an issue. Still pretty good for a few users.
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