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Shawnt Offline OP
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Does anyone have expereince in setting up a remote office with VPN runing AC remotely? It seems AC is traferring tons of data that even with a T1 onnection it takes 30 minute to just open the AC. Not sure if we trust synchronizing end of the day, or even if that is fast enough. Are we doing something wrong? does anyone have expereince in this or solution in connecting a remote office?.

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Tell us as many details about your setup as you can. What kind of computers, what kind of OS, what kind of network setup, what kind of work do you do?


Brian Cotner, M.D.
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Main office is running XP64, pretty fast, that also hosts the AC and database file. We are OK in main office. The remote office is running XP pros. We just did a set up of VPN connection through T1 (1.5Mbs) to the main office and path is set to the same as everyone else to the XP64. We did the T1 and VPN just for running AC there. When we open AC at remote office it takes half an hour which is caching tons of initial files (Med list, Codes, etc). Even after that, just to bring up a patient takes many many minutes. We have to find a solution since we are schduled to start there next week.

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A little more info could help:
do you have a server? if so, what is its operating system?
how did you set up the VPN? are you using 3rd party software?
what types of hardware firewalls are in place?

I suspect the issue has nothing to do w/ AC, nor w/ your T1 connection speed. These types of issues are usually networking issues, and the most complete information you could give us would help. Perhaps a diagram of your network....

i.e. internet-->firewall-->server-->clients (main office)
^
|
VPN
^
|
firewall-->network switch-->clients (offsite)

What does your system look like?


Adam Lauer, DO (solo FP)
Twin City Family Medicine
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Originally Posted by Shawnt
Does anyone have expereince in setting up a remote office with VPN runing AC remotely? It seems AC is traferring tons of data that even with a T1 onnection it takes 30 minute to just open the AC. Not sure if we trust synchronizing end of the day, or even if that is fast enough. Are we doing something wrong? does anyone have expereince in this or solution in connecting a remote office?.



This article describes pretty well the limitations of using MSAccess over a Wide area network (WAN). When using a VPN with AC, this is exactly what you are doing:

http://members.shaw.ca/AlbertKallal/Wan/Wans.html

The amount of data transferred over the internet, with the expected temporary disconnections and delays of the internet, will make AC unreliable. This is why Logmein, GotoMyPC and remote desktop are better remote access options for accessing amazing charts than using a hardware based VPN router. When using those products, the only thing going across the internet is the screen shot and related activity. All database traffic stays on the local area network (LAN) so it appears much faster and reliable.

I have tested this configuration and confirmed the delays are unacceptable.


Eric Beeman
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Eric,
Thanks for the link. So I gather you are saying that using and setting up my Windows XP Pro VPN for services back here at the office for the doc to chart at home or for a billing clerk to get data or encounters from is just not going to cut it...

As I said I was just about to start messing around with this over the next few days, weeks. How big a delay were you getting and what kind of VPN were you using if you don't mind my asking? Although it seems pretty clear from the article you pointed us too that type of VPN probably wouldn't matter too much.

Thanks for you insights and help on these matters....

Paul


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The VPN is still a good idea due to enhanced security but you can't use it as if you are in the office (just double clicking on the AC icon).

There would need to be an extra step in the process...once authenticated, you would then use remote desktop to access another computer on the network. This may seem a strange suggestion at first (why bother with VPN at all) but there are security holes in using remote desktop across the internet and the simplest way to mitigate this is through VPN. Many may suggest just using remote desktop is sufficient (I have done this myself) but we should be leery of this on an ongoing basis when there are step by step explanations out there on how to hack into someone's remote desktop session.


Eric Beeman
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Eric,
It seems that you have many of the same good paranoid, look out for your doc type characterists that I do. I guess it is a prereq for being a good practice manager, uh?

I have had many and heard many of our fellow users suggest that folks like myself simply use some form of remote access with or without a middleman program or service. Now might any of these remote access services help deal with any of these security issues that you big up? Or are all remote access things basically a different flavor of the same thing???

Again thanks for your insight and shared research....


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The main remote access offerings, logmein and gotomypc, are fine from a security perspective. They operate differently from the out of the box Microsoft remote desktop session. It appears that one of them will end up being my recommended method after all my remote access testing is completed.

I owe the forum several posts that detail each remote access offering. I haven't forgotten but our federal/state tax preparation got in the way of completing my remote access testing and documentation.:-(


Eric Beeman
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I've used RDP, VPN, and LogMeIn.
LogMeIn is the fastest in my current setup (server-client, SBS 2003, Vista Business Ed.).


Adam Lauer, DO (solo FP)
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VPN is way overrated. You need to sit down and look at what your needs are. If you are running one business as your main business and you have a satellite business that needs to access the same records, then VPN with either a terminal server or some type of third party client such as Citrix is the only way to get a speedy connection. Yes VPN is encrypted and decrypted on both sides, the very thing that slows you down. With VPN files must move back and forth over the net, with programs such as RDP and the commercial ones, you are only seeing changes of the screen shots of the program on the other side.

For simple home to office work, then LogMeIn or GoToMyPC is fine. VNC such as UltraVNC will work as well. RDP is awesome. If you have SBS, then you can't beat Remote Web Workplace for security and speed.

Personally, if you have XP Pro, it already has Remote Desktop available. It connects in less than three seconds and is fairly secure. You can do Remote Desktop via a VPN, but you have the same limitations.

If you have the cash, call Citrix and get some tech help and some pricing. It is pricey, but you will get some great tech help as they want your business.

My recommendation would be this: 1) for techies and 2) for non-techies:

1. If you want help with your setup, pay the $9.95 per month and have 10,000 IT experts on your side using www.experts-exchange.com. You could literally go on and ask, "What is the best way for me to connect to my office?" and you will get IT gurus form England to Australia posting back within minutes. You can ask question after question on RDP, VNC, VPN, LMI, etc.

2. Hire an IT consultant. I think we forget that, although they can run a bit of cash per hour, it can really be worth it rather than trying to figure it all our by yourself.

With all due respect to everyone who talks about security, AND I COMPLETELY AGREE, I think we can get obsessed with this. Remember paper charts. How many of us have a cleaning person with a key to the office? It wouldn't take long to load every chart into a truck or grab a few patient records. If you are doing a really good job with security, then it is all you can do. I mean some are using LinkSys firewalls, they could certainly be using Cisco. Some are using Cisco, they could certainly use two NIC cards and Windows 2003 server or SBS and use ISA which is far more secure than above.


Bert
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Bert,
LogMeIn, LogMeIn, LogMeIn


Adam Lauer, DO (solo FP)
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Mr Scott, Logmein..... My wife is lovin' it....


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Logmein, Logmein, Logmein,

sl slow but more than workable.

Free, if you don't want remote printing. What more can you ask for?


Wendell
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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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EXACTLY! What's not to love about FREE....
I found that's it was a little faster than VPN to my server.

All of the processing occurs on the desktop in the office w/ LogMeIn, only uploading screen shots of the action going on the desktop.

W/ VPN, it's uploading files across the internet, encrypting and decrypting....not fast unless you subscribe to Citrix.


Adam Lauer, DO (solo FP)
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does logmein include smartphone access?

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SF,
What's that??? Smartphone I mean....


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Originally Posted by DoctorWAW
Logmein, Logmein, Logmein,

sl slow but more than workable.

Free, if you don't want remote printing. What more can you ask for?
And cheap, even if you spring for the Pro version! Five PCs for $20 a month:

https://secure.logmein.com/products/pro/


Brian Cotner, M.D.
Family Practice

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