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I have struggled for a while to push my LAN to be faster because it speeds up AC as well as my PM system.
The other day, I found this arcane network adapter setting while searching on google and it really has speeded up my LAN.
Go to device manage, network adapter...properties...advanced...find these in the drop down and set them to disable:Large send offload (IPV4) and Large send offload (IPV6)
Do this on the 'main computer'as well as on the clients.
It will speed up your LAN.

Before I do it, what does it do? Is this "Indy recommended?"

It is James Recommended.

Large Send Offload is not recommended for general use and I'm not certain why so many network cards default with it turned on. In order for LSO to work properly, every part of the network must support it, including switches and other network cards on other devices (good luck with network printers).

LSO is a networking process whereby outbound throughput is increased on high-bandwidth connections by reducing CPU overhead. Large buffers of information are queued up and the network card, rather than the CPU, splits those buffers into separate packets. This is supposed to dramatically increase performance of both the network and the computer's CPU. Sounds awesome so what can go wrong?

Well, in order for this to work the other network devices, such as switches, all have to agree on the frame size of the packets.? The server cannot send frames that are larger than the Maximum Transmission Unit (MTU) supported by the switches.? The server can discover the MTU by asking the switch for the frame size, but there is no way for the server to pass this along to the Ethernet adapter.? The LSO engine on the inexpensive adapters don't have ability to use a dynamic frame size and simply default to the standard value of 1500 bytes, or if jumbo frames are enabled, the size of the jumbo frame configured for the adapter. Since the frame size is often to large for most inexpensive switches and most inexpensive switches are unmanaged so their setting can't be changed, either, the frame size of 1500 is often too large so the switch, upon getting a frame it cannot handle, silently drops the frame.? And this is where our performance enhancement becomes a performance killer.

LSO is great but the network as a whole must support it. And that means everything including the servers, switches, routers, workstations, etc.

JamesNT

Thanks James for the info. I'll have to try with it off and see if the performance appears better. My new PC/Server has a network card with a very different set of options for the Advanced menu. It does not specify it this way. I'm getting 0.327 sec to the DB

You will get a few ms of improvement, if that. In that same section there is Speed and Duplex. Both the switch and the card should be set to Auto-negotiation. Sometimes, it doesn't autonegotiate, and you have to force it to your network speed.

The key phrase in your post is:

I have struggled for a while to push my LAN to be faster because it speeds up AC as well as my PM system.

Why struggle? Your patients get physicals. Your car gets routine maintenance. Why not have it done once and have it done correctly?

Have a Microsoft Certified computer shop come over with their ridiculously expensive "fluke" meter and test the speeds at different connections. I remember one person on here a couple of years ago, who was having issues forever until we told him to check his switch. It was 10 Mbs. You can fool around with your network card forever (not saying you shouldn't), but if the bottleneck is the switch or router or or Ethernet cable, you will never have a fast network. Using the Amazing Utilities/Advanced and then Speed Check, you really should be less than 0.5 or so. You can check that after your upload changes.

One hour of their going around to the switch, the wall jacks the computers and the cables, etc., and you will know how healthy your system is. You could have the fastest, most expensive network ever, and if somehow your Ethernet cable from the server to the switch is Cat5, well....

How much will it cost? Probably two hours of work, if that, at $80.00 an hour. Could probably see two to four patients in that time.

Well, I checked the laptop and it only seems capable of 54Mbp speeds, not "n" speeds like I thought. The laptop is connecting to the DB in 3-4 seconds. It's due for replacement, but like I mentioned in my Exam Room Design post, I'm try to find a way to go hard wired.

I appreciate the question, and since James weighed in on the technical side, I would focus more attention on traffic shaping after the entire network is GIG hardware.

I really am thinking about building a traffic shaping appliance for medical practices. Most practices have no idea how much crap is running in their network that impacts useable performance.

Yes, we also recommend excellent edge devices that accomplish many things including superior security and traffic shaping, but smaller practices won't spend $1000+ for some of those commercial devices.

Someone could make a stack of money making a magnetic quick release Cat5/6 connector. Or, in all of my spare time.....