Home Forums Discussions General Discussion Accessing database from another location questions?

Howdy everyone,
Our clinic is expanding and we need to setup access to the main servers from a remote location. I have looked into using things like LogMeIn and TeamViewer and this is not a good option for our office. I have also looked into VPN. Do to decrease in speed, also not a very good option.
From my understanding there is a way to open up a port in the router/firewall so i can access the database remotely. We do have an external static IP and our new location should be getting a static IP as well. Does anyone have any experience with this or can guide me in the right direction?
Thank You,
Yuriy K.

Get fast internet on both ends, then call INDY...not having fast internet on either side makes life miserable....trust me....todd

main location has 100mbps download and 20mbps up (can go any faster) similar spec on remote location

OK, there are really two good solutions here. VPN is generally a bit slower given the transfer of data and more dependent on bandwidth.

If you want to keep the data on premises, then the best way would to be to go with TS/RD. Terminal Services, Remote Desktop. Or Remote Desktop Services. Microsoft has nothing better to do than to change nomenclature every year.

Part of the idea I am going to tell you requires certain hardware. Terminal services now must be in a domain, where back in the 2003 era, it could be separate and on a workgroup.

Basically, you have your home network, hopefully in a domain. It has to be in a domain. So, let's say you have your network with 10 PCs, and a server like Server 2008 R2. It will be much different if you are using 2012 with VMs or even some of the new VDI stuff, but I will let that go for later. So, you have your file/database server that runs SQL Server and other databases and shared folders. All of your client PCs are running Amazing Charts apps, and they all connect to the AC database on SQL server. Each of these PCs are being used so it would be rare or haphazard for users in your remote office to remote to them. And, then someone would need to use that computer. So, how can you share one app? Terminal Services on a Terminal Server.

So you will basically need a second server running a server OS. You can't use Win 7 Pro or Windows 10. These have hacks, but they aren't legal, and I wouldn't recommend going that way.

So, now you drop in a second server with its server OS. Regular PC OS do not have a role for TS. You go into the terminal server and enable the TS/RD role. You now drop in any app that is compatible with TS, which is most. I am pretty sure AC is. I would ask before I went to all this effort and expense. Now that the app is on the TS and terminal services is working, many users can access the app. Those users will each need a license to establish a remote connection. Or you can do it by computer, but better off doing it per user. So, now each user at your remote office has their PC or thin client (I would go with PCs) can use Remote Desktop Client to log into the terminal server and use the app. Each user will see the app as if it is on their own desktop. You can use other software during the same session.

There are also things called RemoteApps which are essentially the same as apps except that when you log in you see only that app filling your whole screen.

Now, unlike transferring data over the Internet, the only bandwidth you are using is for your mouse clicks, your keyboard and your the visualation of the monitor. In other words, almost nothing. So, your bandwidth is plenty.

Terminal services is the way to go, but there are some limitations as stated. You need servers and you have to have client/server domain network. Now, if you don't have this, and you are using a P2P, here is a good opportunity to upgrade to a domain.

The key thing is if you want to go this route, you will likely need to hire someone with IT experience preferably a professional. It's fairly straightforward, but not if you haven't done it before.

Of course, if you did upgrade to a server setup, you would likely get 2012, which runs Virtual Machines, one of which can work as your TS. Then there are VDIs. No need to go there right now. But, if you do have a server running 2012 already with HyperV, etc. then you are really already there.

But, say you did have to put out the expense of a server, etc., it would be worth it to set it up this way. Then, when you get another office, you just purchase more licenses, and you are good to go.

______

Now, the second, far easier way to go is to run AC in the cloud. Amazing Charts hosts a cloud version, and Indy hosts a cloud version. Then, everything is done, and you can access AC from any office, Smartphone, home, Starbuck's, wherever you have Internet access. The cost is per user per connection, so it can get a little pricey. But, you don't have to worry about backups or updates, etc.

Just to add to Bert's answer:

I did a sticky about remote access when you have multiple offices:
Remote Access: Multiple Offices/Locations [2015]

you guys are great

Bert --
I get so confused when I read your detailed explanations, and it always makes me wonder if I am doing something wrong because what I do is so simple.

I just use the built-in Remote Desktop Protocol in Win 7/10 to access my desktop PC at the office when I am in a remote location. My partner does the same thing. We use the router to port-forward to our desktops.

I have no idea how well that would work if there were a lot of doctors trying to access through our little Sysco router, but it works for a small office-- there are only two of us.

I don't imagine it would work very well for an entire office of clerks and nurses -- the staff doesn't need remote access -- so maybe you couldn't use that to power a remote office.

I run Dragon over RDP, and in our location, we only have about 3-4 MB down and 1-1.5 MB up DSL links. Sometimes it is a little dodgy, but most of the time it works pretty well.

Hi Tom,

Well, to answer your question you would be doing something wrong IF you are recommending your method to Yuriy. Basically, you aren't answering the question. remote into our computers remotely using RDP from remote locations, typically from home. Simple, because we have eight computers we can remote to, but most of the time, each will be logging into their own computer.

But, the question was "How can I set up a remote location and connect to the main office?" It would be rather impractical and, in many ways, not doable. Even though we typically have five users, we will use all of the computers during the day.

So, let's say the remote office has four doctors each requiring three exam rooms and an office and seven staff. Eleven users requiring 22 PCs. So, these users would likely have fewer computers at the host office to remote to. That is a major problem because virtually all desktop OS are licensed by Microsoft to run one session at a time. In fact, if someone is logged on, you will likely see:

Logon Message: Another user is currently logged onto this computer. If you continue, the user will be disconnected.....

Or that user can decide to not accept your request, because they would like to continue their session.

Most desktop OS especially after XP are not designed to run concurrent sessions. You can run some 3rd party apps or do a hack, but it is considered illegal by Microsoft and is a breech of the TOS. There would be a myriad other problems.

Or use Remote Desktop Server running Remote Desktop Services. One server with a server OS whose RDS role is enabled. This RD Server can have 1, 10, 100 concurrent sessions, depending only on the number CALS and the resources of the machine. Now, you have 11 staff with 11 CALS who can remote into one server. The Remote Desktop Server can run multiple programs as long as they are compatible with RDS. You could have 11 sessions running at the same time. Or, as Sandeep's excellent article mentions, you can run your session as if the entire computer desktop is available along with its programs, or you can have AC as a remote app.

Your file/database server is also your domain controller and continues to house the databases and shared files. If two years later you open another office with 30 users, you purchase 30 CALS and maybe more RAM. You could also have 100 users, but manage one AC.

By the way, with your port forwarding, are you using the default port 3389? If so, you may wish to close those ports and change to a different random port.

Thank You everyone:)
As Bert has mentions, i do have 10+ PC's at the main location and most of them are in constant use. So any sort of Remote Desktop is not an option. As for the server we are running Windows server 2008 R2 standard, Intel Xeon E5345@ 2.33GHz each is quad core and there are 2 of them and 16GB ram. So the server is maxed out, and i would like to keep the load and users at a minimal for the server. I am planning on upgrading the main server in couple of years as our AC database size keeps increasing exponentially. But that will probably happen when a new version of server OS comes out as Server 2012 is getting a bit old.
Another issue with this is that the clinic is in Albuquerque NM and I am in Reno NV. I'm the one that initially set up everything and i maintain the network through LogMeIn. We have another employe that becomes my hands when it is necessary. I am actually flying out there saturday (7/16/16) morning to setup the new location. Setting up a LAN isn't an issue for me, but setting up port forwarding (i think that's the right term for what i'm trying to do) is out of my scope of expertise.
It has been mentioned that secure FTP might be an option? What about assigning a static internal and external IP to the server/file path (obviously password protected), opening up a designated port in the router and having remote location PCs acces it that way? Any security risks with that?

p.s. Bert, off topic, but i went to high school in Maine, little town called Readfield just outside of Augusta and Winthrop area:) Maybe you heard of it? :)) Your location made me slightly nostalgic=)

A lot more later, but for now:

When you say server you talk about the OS, and you do mention Intel Xeon processors, which would lead me to believe you are using server hardware. But, please tell us a little more about the actual server and the hardware. That will make a bit of a difference. Microsoft versions always seem to lag behind the version year. I mean just like XP previously, I am happy with Win 7 Pro, and you could say that is old. But, we don't have much of a choice there. Microsoft is pushing us to Win 10 regardless. Are you using RAID? Are you on a domain? If not, you should be IN THIS SCENARIO. If you are on a good server, you could easily add more RAM. Why is your database growing dramatically or are you talking about Imported Items. You could move the II folder or even easier if you wanted, just buy a 4 TB hard drive and install AC on it. I doubt you could fill that up quickly.

But, let's say you have a Dell 2900, you are running a RAID 1 and you are set up as client/server on a domain. Then 2008 is fine. You can upgrade your OS down the road to 2016 as planned. We can talk all about the Hyper-V options and VDI and all sorts of stuff then. Sessions that open in VMs that go away when you log off. Really cool stuff.

But, let's say you are at least on a domain. And, I don't see how you are going to run two clinics with two different databases. That can be a nightmare. Ask Wendell. Well, at least it's not the best option. But, the key here is your Remote Desktop Server. That's the one you don't have and need to buy. And, the key here is Remote Desktop Services. That would be a role set up on Windows Server 2012 R2 Standard, which would give you many options. But, you will need to buy a decent server with a decent OS in order to set up the actual Remote Desktop Services. Then you can have all the users in the world remote in using RDP, actually Remote Desktop Client now, remote in from your Albuquerque location.

Or possibly your better option would be to purchase a really high end server with 2012 or 2016 (who knows when out) with 96 GBs of RAM and a 4 TB RAID one with Hyper-V and all of the VMs you want, it comes with two and use it as your file server and domain controller and, of course, your databases. You could convert the older server to a RD Server. It would likely need more RAM if you had 10 users remoting into it.

For what you are trying to accomplish, a very good server at, say, $5,000 is a good deal. Anything less is just not a good option. People spend way too little on their servers.

You really have two good options:

Remote Desktop Services on a Remote Desktop Server -- used to be Terminal Services on a Terminal Server, which would need to run on a domain.

Or, you could forget about the server as far as AC goes and do AC in the cloud as SaaS. But, you really need to look at the per user seat cost of the connections and if you are going to expand. Because now you are looking at everyone at both locations needing connections.

A VPN will be too slow.

So, there are three major points:

1. Decide on which solution. If you are going to do cloud, that is a turnkey solution. Set up your new office, contact AC, and do the cloud from both offices.

2. I would highly recommend you do it now especially since you are setting up the new office. Do it when you are installing computers, running cables, choosing routers and modems, etc.

3. If you choose to go on site, and go with the RDS, then you need to conclude right now that you shouldn't be setting this up yourself. It is straightforward if you know how to do it, but don't take it the wrong way, but it is clear that you aren't familiar or comfortable with RD Server and RDS. Plus, it isn't just getting an RD Server. It's making these big decisions of which OS, do you wait, how much RAM, what processor do you need for RD Server. RemoteApps or complete private sessions. Now that there is 2012 and 2016, this gives you quite a few options. Especially when you start looking at VDIs and one server, etc. I would highly recommend hiring a professional IT, one who works with Microsoft products, maybe is a MCITP or one with a few MVPs. Let him or her help with the best hardware and software, set it up correctly and be around to tweak things from Reno in the beginning. Those in Albuquerque are basically clicking on RDC and logging into the RD Server. As long as they have the 10 down and 2 up and a good switch and router with decent computers, that side is rather simple. You only need to set that office up like its LAN working independently. Then when you are ready, but they some CALS and let them remote to Reno.

Short of that, PM Sandeep and get his opinion or even let him set it up remotely.

Little info on the current server:
Dell PowerEdge 1900
Intel Xeon Quad Core Processor SLAEJ E5345 2.33.0 Ghz 8m Cache X2 (so total 8 of cores @2.33 GHz)
16 GB of PC2-5300F ECC (maxed out, mobo will not take anymore)
6 WD Black 1TB HDDs. Raid 1+0 with 5th drive being a failsafe for the other 4 and 6th HDD is a stand alone and is used as second backup location for the AC database backup. So 2TB is my OS and AC drive. I know this is very redundant, but data loss is not an option or a risk I'm willing to take.
OS is Server 08 R2 Standard SP1.

As for LAN, everything is hardwired in @ 1 Gbps.

New server will be ordered whenever new Server OS comes out with the OS. Which, hopefully, will be in the next 2 years from what i have seen of Microsoft. The PowerEdge will get reconfigured for something else, will cross that bridge when we will get to it.
As for a new server, i was thinking something along the lines of 16+TB of HDD space, 96-128 GB RAM, and whatever will be a decent CPU at the time. Also SSDs should drop even more in price and increase in size. But time will show. And Yes, $5000 to $7000 on a up to date server is to be expected. Also, a decent local server will always be faster compared to a cloud server. So i don't consider that as an option.

Placing everyone on a domain is part of the planned things for this trip. This wasn't needed before. I made the AC folder shared and password protected. So in case of loss of path or addition of a new terminal, path on a the terminal was specified and problem solved.

Also, the reason why i'm here asking these questions is because i'm trying to learn and become more self sufficient.

Some pretty good hardware. On the new server, do you mean 16 TB HDD? SASs are a great idea. The part I am confused about is if you are not entertaining Cloud and you do want to go with Remote Desktop Server, then you will need two servers. Today.

I admire your wanting to learn by doing, and sometimes the saying is just jump in and get your feet wet. But, for this project, I would let the attending do it and you can be the resident.

I would email the email address in the PM.

good catch, corrected, thank you:-)

As for the hardware, Thank You i've learned my lesson with the old server (can't remember what it was). I'm pretty happy with the current rig except that it's running out of HDD space and i wish i could add more RAM. But ow well....
Will shoot him an email soon, thank you

Also something I've been wanting to do for a while. I remember seeing a thread a few years back that gave us step by step instructions on how to batch file that automatically deleted the old backups over X amount of days old. I'm talking about the backup that AC creates automatically on the C drive. Anyone knows where that thread is? I can't seem to find it.
Time to go catch my flight

Hi Yuriu

If you could add an autosig for your name, that would be great. I am pretty sure your first name is different than the beginning of your username. And, if you made the font a little bigger and/or darker. Only because as I get older, the "i" (I think) looks a little like an "l". Which brings up your username. It has Y2K at the end. Is that from the 2000 New Year scare of a worldwide computer crash going from the 20th century to the 21st? If so, why is it in your username. Probably would have been the best thing to happen to the world, and we wouldn't have to deal with Windows 10. Microsoft should have come out with Windows Y2K. If only that was the biggest world problem now.

I don't have a link to that script, but I do have a link to a script I recently wrote. Or the same script is written here:

forfiles /p "D:\Amazing Charts\BACKUP" /s /m *enc* /c "cmd /c Del @path" /D -3

I know this isn't necessary, but full instructions are in the post, and it's a good thread.

I was going to email it to you in a .txt file, but my guess is you have a different path. Probably would have ended up deleting your whole server backups!

But, I thought that was a little overkill.

Enjoy your flight. Albuquerque is a cool town. Interviewed at the University of New Mexico and went up some cool mountain. But, couldn't you have put the new office in the Bahamas or Silicon Valley or some some beautiful city where at least the travel would come with some perks. And, imagine the access you would have to perks and IT technology if your were in the valley.

Fixed:) Yura is a short version for Yuriy in Slavic languages. You are correct on the Y2K bug assumption. Also, because of my initials, this works. I created this username for myself many moons ago, so i just kinda stuck with it.

Thank you for the link to the post:) this will help the main drive from accumulating double backups.
And yeah..... that would have been just a slight overkill. But i think the path is fairly easy to spot and correct in a notepad. I remember the days when we used to write websites in notepad. It would take half a day just making certain that all the links work on the site after an upload to a server. I don't miss those days at all!

As for location, not exactly my choice. I was stationed in Albuquerque (Kirtland AFB) and just stayed there until 2 years ago. In the meantime, i got involved with the clinic as a favor for a family's friend to setup everything and maintain it. So now i'm doing everything that's network/server related even though i got out of doing any sorts of computer related jobs when i moved. But i completely agree with you, I would even settle for Sacramento or San Francisco :))) But albuquerque does have Sandia Labs and Los Alamos is only a few hours drive from here.

Glad you got back safely. I remember in medical school doing all those interviews. I remembered we would kill to get into medical school, now I would kill to get out. But, I would try to plan my interviews in the same areas. Albuquerque, Colorado, Utah. Even had time to ski at Breckenridge. Hilarious, because you would ride up the chair lift, and the person from Vail, Colorado sitting next to you would comment on the icy conditions. Geez, there may have been two or three ice cubes that had fallen out of a cup. Ski at Sugarloaf or any of the many mountains in Vermont. Now, that's ice. Like skiing and playing hockey at the same time at times.

It is ironic that I suggested an auto sig. I had no idea you were a student in mechanic engineering. That's got to carry over into computing somewhat? There is a school in Colorado called the Colorado School of Mining. Never would have known that it was an engineering school. A Friend of mine (no pun intended) went there on the 3-2 program. So, I guess you are at the University of Nevada, Reno.

LOL:) I've spent countless days at Sugarloaf and other mountains when i lived in Maine. Used to be on the High School Ski team. And yeah, north east is icy in comparison. One place i wish i would have gotten a chance to ski would have been Wild Cat. But i haven't head the opportunity to go back to north east. But places like Taos and Santa Fe get pretty horrible as well as this area doesn't get that much snow. Wolf Creek on the other hand is a different story, every time we would go there, always fresh snow with in the few days. And as for Durango (Purgatory), not a huge fan, way too many people. Even though i got a chance to hit few slopes around reno/ lake tahoe area, Wolf Creek remains my favorite. Ow, also, if you want your butt handed to you, check out Silverton. Some of the most amazing skiing I have ever done. But you will get your rear end handed to you unless you are in a top shape and can deal with 4000+ meters elevation.

As for computers,I used to be a database manager and data analyst when i was in the air force and at one point in time worked as a pc tech for about 3-4 years. Kinda got tired of dealing with that, and albuquerque, quit everything, enrolled in school in Reno and moved. So i'll keep PCs as one of my side skills and not my everyday job:) As for engineering, my goal is to get into alternative fuels in racing applications, but still got couple years to go and probably a masters afterwards. As it was said by some engineer "This 4 year engineering degree was the best 6 years of my life":))

well, getting back to the topic:
looks like the new Server 2016 OS will be released by the end of this year. So new server will be taking it new role summer of next year as long as the reviews of it is good.
Also looks like i will be setting up some sort of VPN after all. But one thing i will need figure out is how to limit access points so other employees will only have access from designated locations.
now my question:
Is it possible to setup AC between multiple servers so they synchronize the database at designated time?
Now my brain is actually starting to hurt:)

What part of Maine? I usually skied Sugar Loaf, Stowe, Killington.

Well, I am signing off on this one. Back to VPN? Wow. Limiting access points? And, I would definitely not recommend syncronizing databases daily even at the same time. That seems like a disaster waiting to happen.

The more I read your ideas (and I admire the thought process and ideas behind them), the more I would recommend hiring a consultant to at least set it up.

Your two questions: Limiting of access points and synchronizing databases by themselves could use an onsite consultant.

One thought I would share: While it is flattering to many on here that you trust our input, and there are many on here that can give good advice, but even Indy and Sandeep would have a difficult time mainly because these are singular questions that are being deployed in multipe environments with what I would imagine has multiple setups. I think without a consultant who is completely immersed in your project, which gets more technical and difficult by the day, it will have a high likelihood of problems. It is much more difficult for someone to come in and try to help fix problems who isn't completely aware of your setup, than if you had someone who designed it. Sandeep helps me a lot, and he knows my network and computers better than I do. I remember not too long ago, after I had emailed him a question, he replied, "Bert, you have 20GBs of RAM on your server, not 24, and you have already installed SP1 except for billing." True story. I have been told by multiple network gurus (work for Microsoft) that it is so much easier if it is set up right the first time. That to maintain a network for five years by yourself is far easier than the setup of that network in two days.

I feel like you have tapped into a good source for help with DIY projects (and I don't mean that in a condescending way, but given my knowledge base only scratches the service, and I have been the major contributor is scary. I would definitely not trust myself to do this. And, I hope you don't trust me to give good enough advice.

Hi Bert --

It is always amusing and instructive to read your posts, and the other replies.

I can only say that AC is morphing into something that was probably never envisioned at its inception, when most FP's and IM's and Peds were in 1-3 physician offices in a single location. Those days are so over.

I don't forward to port 3389. Seems dangerous

I have no interest in running a remote office -- I can hardly keep up with the one I have. My interest in "remote access" is limited to being able to do my records at home, and look up stuff when I get after hours calls, so I don't need all that high end hardware = but it is interesting to hear a little about how those big networks work.

Thanks for the post and compliments. I wasn't disagreeing that your way isn't a great solution for what you are trying to accomplish. It's the way I do it so it must be the best way .

I don't have a remote office, and I never will. And I certainly don't have a remote desktop server with remote desktop services. That would be way overkill.

Only asked about 3389 given it is the default port.

OK Bert--
All fine on the upper left edge (NW Oregon).
I do wonder how many larger practices are adapting AC to their needs rather than going to more complex programs.

Compared to everything else I have seen it is so refreshingly straightforward and puts out reasonably sensible notes for improved medical communication. Trying to read notes from almost any hospital is an exercise in pure frustration.

But even in a 3-provider office it slows down if there is a lot of traffic on the Ethernet (like if several clerks are scanning imported items at the same time), so I can imagine that by the time you got to 5 physicians you would have to do some fancy workarounds.

And of course, small offices will be dead in the water soon if Medicare and United HealthCare have their way.

I just sit here waiting for your posts, lol. I couldn't agree with you more. I email those to staff and make fun of those notes. They are a joke. They are simply for protecting their [censored] and coding. I think it actually makes things worse. They enter the meds like four times. Came in with this, we really thought he should have had this, we added this, he left with this. Supposedly, they ask two year olds have they been sexually molested or physically abused and do they drink alcohol, etc.

Now, they include the labs in them, which seems as though it would make sense, but then they are in a column with the ranges, etc. Takes up another 2 1/2 pages.

I always feel bad about templates, but they always write we did a 10 point ROS, all of which were comparable to Lebron James except for the cough he complained of when he came in. See page 4.

My favorite part is where they are forced to say what they considered. Now, it seems like a good idea, to show you thought about Lyme disease, etc. But, then you don't test for it. Many say meningitis. Well, you let them leave and you didn't do a spinal tap. Seems perfect for the lawyers.

Now, we have something I have never seen. It is so strange. And, it has been in the last three ED reports of the patient. And, since she has had multiple seizures, she has had four or five. But, in one of them, before the after the HPI, which is after five sets of VS, part of her neurologist's consult note was inserted. But, and I am not exaggerating, since it was at least 1/2 of her note and contained ROS and meds, etc., you literally couldn't tell where the note stopped and the ED report commenced again. This happens in three separate ED notes. And, the consult was in different places in each.

Most of these ED visits could be:

Presents with cough

Exam revealed wheezes, all other normal.

Impression: Asthmaatic bronchitis

Plan: Proair MDI 2 puffs qid prn cough.

F/U with PCP, return if worsening.

Now,that is a bit too short, but man. Medicolegal stuff is crazy. I will give the template credit that it is hard for them to miss something. But, then they treat GAS pharyngitis with Bactrim.

Hi all,

I think I remember a thread where Sandeep (excellent, btw) mentioned that Microsoft Multipoint Server is like a pre-configured, ready-to-roll RDS/TS server. Maybe something to look into?

I've not tried any of the RDS configurations, so please don't quote me on that

Yes Bert. What I least enjoy is one lab test on an entire page of gobbldygook, including the name of the person who drew the sample-- but not the doctor who ordered it, or the date it was ordered. The date the report was printed (and the clerk who printed it) is easy to find, though, and has led me into error.
I presume this insanity won't stop because someone is making money from it

I also think it won't stop because of the over reaction to medicolegal insanity. At some point, this gets in the way of good medical care. Yes, it helps your coding and yes every little thing is documented. But, at what price? At the price, that while I many times will glance at the first sentence of the HPI, IF I can find it, I read no more.

The entire note is templated. I don't mean the type of templates, where clicking on left OM, produces a full note that one would think would be produced for that. But, you must fill in every blank. VSS are done three to four times, OK, if done, could help patient care and document that you sent the patient home once the fever was lessening.

But, the medication list being included three or four times, drives me nuts. I can't even figure out what was given added, or deleted. In many cases, I will see where they will call it pharyngitis and write for a medication. Then I have to look everywhere to find the result of the RSA. Or if it were done.

While the reconciliation of the meds seems like a great idea, it doesn't seem to be that beneficial in the ED. If I reconcile all meds, my med list is up to date. But, when they do it, great they leave on their medication list, but if I will admit I don't read through the note, see that they took them off something and add something, and then change their med list in AC. I do reconcile if they f/u. I actually try to reconcile at every visit.

We have have one hospital which includes all the labs in the middle. Their notes are dictated and more straightforward (I still find a dictated note to be the best), but they include the labs in the middle. The font is so light, you simply CANNOT read them. They take up two to three pages, and I seriously mean you cannot read them. I have called medical records, and they say, "My gosh, you are right." That was four years ago.