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#78247 07/13/2022 8:39 PM
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JamesNT Offline OP
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Not an exhaustive list. Not in any order.

* Attempting to upgrade to SQL Server 2016 64-bit upgrade on a 32-bit computer. From what I have seen, this situation is the result of a practice using a workstation as a server and that workstation ran Windows 7 32-bit so SQL Server 2012 32-bit was installed. Later, the practice did an in-place upgrade to Windows 10. The practice never new the computer was 32-bit or forgot.

* Attempting to upgrade to SQL Server 2016 without meeting all prerequisites. SQL Server 2012 MUST be at Service Pack 2 to qualify for an upgrade to SQL 2016. Also, certain Windows Updates must be installed. I've run across several practices who are still running vanilla SQL 2012.

* Too many antivirus programs. Having three or four antivirus programs on the AC server sounds fun. Until your upgrade crashes because they are all fighting to scan the same files.

* AC Server not properly maintained or poor choice made for server. Missing updates, junk programs installed, the list goes on. This often happens when a Windows 10 Home computer was upgraded to Windows 10 Pro or was purchased from a Big Box Store like Best Buy. The computer was never cleaned off and no Windows updates were installed or at least not for a while. In one case, the junk on the machine was preventing installation of updates.

* In-place server upgrade performed to Windows Server 2022. SQL Server 2012, at any service pack level, is not compatible with Windows Server 2022. And now there are issues upgrading to SQL Server 2016.

* SQL Server installed on a domain controller. Good luck with that.

JamesNT


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thanks for the list of issues found and the updates

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I upgraded to SQL Server 2016 Express with no issues. One has to also install SSMS v18 to access it.


Bert
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James says "SQL Server installed on a domain controller. Good luck with that."

I am using Windows Server 16 express, and it was my understanding that the domain controller, DNS server, and SQL server were all on the same box along with the AC program as well as my Medware program. Where else would the domain controller be except on the main server in a tiny system like mine?

Reading Windows documentation is extremely confusing, and at least for me not very helpful.


Tom Duncan
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While it is best practice to keep Active Directory, DNS, DC and usually DHCP on a separate VM partly because you can not allow users to access it. But, in the end, you shouldn't have major issues running SQL server on the same server with your domain controller. I mean not everyone has two servers and not everyone has moved to VMs.


Bert
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@Tomastoria,

A few things.

First, I have never recommended, nor do I support, Windows Server Essentials. While I understand the low-cost temptation of it and the nice little wizards it comes with, Server Essentials is a prime example of something MS should have never offered. Most of the people who call me about Server Essentials is to get them off of it because they already outgrew Server Essentials or they are having the same problem you may have: everything is installed on the thing and it isn't working well.

Secondly, running SQL Server on a domain controller has been against best practices for a long, long time.

https://docs.microsoft.com/en-us/answers/questions/571019/domain-controller-sql-server-2019.html

https://docs.microsoft.com/en-us/sq...llation?view=sql-server-ver16#Install_DC

Obviously, I do not support running SQL Server, even Express, on a domain controller.

The last thing to discuss is cost. I get it. IT can be expensive. Unlike many of my fellow IT colleagues, I understand that doctors aren't great big piggy banks ready to be cracked open to let the cash just flow. I do my level best to keep costs down for my installations. I charge a reasonable hourly rate ($85/hour) and I keep my hands on excellent quality used servers that came out of a datacenter that can be purchased at pennies on the dollar for what they were brand new. And I personally put a 2 year replacement warranty on any used server I sell. My typical set up is a single physical server with two virtual machines: a domain controller and an Applications server for everything else. Last, but not least, the skillset my clients get from me is the same skillset you'll find at companies like Corning Fiber Optic and General Electric Global Nuclear Fuels - companies I've worked at and to this day still utilize solutions I developed years ago. Between formal training at such large companies and a degree in computer science, I feel I have a broader and more in-depth range of skill to offer. Let me know if I can help.

JamesNT

Last edited by JamesNT; 07/16/2022 6:38 PM.

James Summerlin
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Originally Posted by JamesNT
The last thing to discuss is cost. I get it. IT can be expensive. Unlike many of my fellow IT colleagues, I understand that doctors aren't great big piggy banks ready to be cracked open to let the cash just flow. I do my level best to keep costs down for my installations. I charge a reasonable hourly rate ($85/hour) and I keep my hands on excellent quality used servers that came out of a datacenter that can be purchased at pennies on the dollar for what they were brand new. And I personally put a 2 year replacement warranty on any used server I sell. My typical set up is a single physical server with two virtual machines: a domain controller and an Applications server for everything else.

JamesNT

Hi everyone,

I have had a bunch of stuff going on, I know I have been MIA from this forum for a while, part of that has been because....well....AC and our server and network have been running really really well. James speaks the truth in his last post, he provided a superb setup for our office at about 1/2 the price a local IT firm quoted, and it is FAST and flawless.

I would recommend his expertise and dedication to anyone needing help or a new installation.

Gene


Gene Nallin MD solo family practice with one PA Cumberland, Md

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@DocGene,

Thank you for those very kind words.

JamesNT


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@JamesNT

I can vouch for James been a valuable resource for AC users for a long, long time. And, I have heard others give good feedback. I can also tell you that $85.00 per hour is a very good price. Must be the AC discount price. smile And, I am lucky that I do have a server with two VMs already in place. And, AC runs fine on peer-to-peer networks. Boy, that debate kept the board humming for at least six months.

James, in order to help with your offer, there may be many that don't understand how working with IT remotely works. It may be helpful to explain how a good many companies use IT remotely. (I am guessing probably more than local). You may want to touch on:

1. How you remote in using remote software
2. How you can do nearly 99% of the work as if you were onsite (with a little help from the company plugging in ethernet cables and routers, etc.
3. How available are you for emergency tech support?
4. What constitutes emergency support?
5. Do you provide support strictly by the hour or monthly contracts?
6. How you keep track of everything you do when you are setting up and supporting multiple customers? I have seen some IT support who do better keeping track of encryption keys than the company (even though that isn't their job).

My own personal question is when you refer to the Virtual Machine that is the domain controller, does it go unsaid that it contains Active Directory, DNS, DHCP, etc.? I am guessing yes.

The only thing I would mention about the advice as to not put SQL Server on the same server or VM as the DC, there are many that already have only one server with everything installed on one box, and I am sure that comment coming from a SQL Server and IT expert likely scares them or makes them feel less than smart. Just sayin'.

But, definitely James is a very good resource who has helped a lot of us with his knowledge over the years, and I believe it was never to drum up business. Having said that, let the drums begin. smile.

Thanks.


Bert
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James has been a valuable voice for me on this board.
I have every reason to believe that I would have been much better off to go with him from the beginnng, but I wanted to support our local guys. Not always the best plan.

Funny thing is, I never heard that SQL server and domain controller should not be on the same machine -- not until this flap about not supporting SQL12, and not even for a month or more after they first annouced the "simple" plug and play upgrade they first rolled out! I don't think their IT guys had any inkling that some people had the SQL and the DC on the same box.

Also, when I moved from a simple peer-to-peer network to an earlier version of Server Express there were a lot of voices on the internet touting it as the cat's pajamas for small practices. It seemed to work fine, then.

When I upgraded to Server 16 and had the local guys set it up, they said nothing about virtualization or putting the SQL server on a different box. I did discover that they had it all set up so they would "maintain the network" for about $1000/ month -- at which time I said thank you very much and just kept it going myself.

My issue with cost is that Medicare, Medicaid and most insurance companies decide how much to pay doctors based on a formula that includes the cost of office overhead -- but the formulas were derived in a pre-IT era, and despite rosy promises, IT has not reduced overhead or increased efficiency in small family practices -- to the contrary it has INCREASED the overhead by quite a lot. Since we can't charge more for the increse in overhead, we just take home less.

I would hire James in a heartbeat if I weren't so close to the end. At this point I am just limping along, 5 months to go!

Thanks to everyone on this board. AC has been interesting and sometimes fun. I pity the poor souls who are under the yoke of EPIC.


Tom Duncan
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Originally Posted by Tomastoria
My issue with cost is that Medicare, Medicaid and most insurance companies decide how much to pay doctors based on a formula that includes the cost of office overhead -- but the formulas were derived in a pre-IT era, and despite rosy promises

This is true. There is also this, which is one of the most telling graphs in the modern history of medicine:

Note the line for administrators vs the one for physicians.

[Linked Image from researchgate.net]

Last edited by JBS; 07/18/2022 8:10 AM.

Jon
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JamesNT Offline OP
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@Bert,

Thank you for the kind words. To answer your questions:

1. I use three ways to get to a client server. First, I use screenconnect from ConnectWise which is a popular and cost effective remote software. The second is good ol' remote desktop if the client has a Gateway server (I do not publish RDP directly to the internet). Third, all servers I sell are Dell servers. If the server is down or having other issues that will not allow Windows to boot, I establish a VPN connection to their firewall and connect to the server's iDRAC which allows me console access and other tools for troubleshooting. All Dell servers I sell come with the Enterprise iDRAC.

2. Most of any IT work is just configuring whatever software. Once the hardware is set up, there really isn't much more to do with it other than swap out the occasional bad hard drive. I send servers to clients fully configured. For some clients, putting a server in a rack is actually fun as they enjoy the adventure. Other clients contact a local IT person to just have boots on the ground with the understanding that I call the shots. In other, more hilarious cases, a spouse in conscripted into service.

3. I am available most hours of most days. Emergencies rarely happen, but when they do I've been available 95% of the time with no wait period. Another 4% I can fix the issue where I am. The last 1% the client may have to wait for me to drive back to my office. The reason things work out this way is that most of my work is software development. Probably 80%. The last 20% is IT so, yes, I'm home writing C# most days.

4. That depends. For most clients, the server being down is an emergency and everything else is an inconvenience. But that is not always true. I have one client where if one person can't print that is a true emergency. But that's because this company deals with hazardous chemicals. In order to ship those chemicals to a disposal site, they have to print manifests and safety material data sheets on Okidata printers with that special paper that prints three copies at one time and one copy goes to the driver. In one case, they had 14 hours to get the drums on the truck and for the truck to arrive at its destination and be unloaded. 14 hours because that's how long it takes for the chemical to eat through the drums. So, in their case, printing can certainly be an emergency. The point is what constitutes an emergency can sometimes depend on the client.

5. I do both.

6. Keepass for passwords, settings, and things like that. Microsoft OneNote for project notes (use it a lot for development).

7. When I refer to a domain controller, that is the virtual machine that handles Active Directory, DNS, and DHCP.

Things I do NOT support with extremely rare exception (in some cases no exception):

1. Installing other software on a domain controller.

2. Peer-to-peer networks for any network with more than 5 computers.

3. Any Hypervisor other than Hyper-V.

4. Bare metal installations.

5. Windows Server Essentials.

6. Any edition of Windows client other than Pro and Enterprise.

To answer the obvious question of why do I not support those things the answer is simple: Keep Costs Down. The list above may sound awesome to some and they may have cheap upfront price tags, but they have long term maintenance costs. Examples: Peer-to-peer networks once above a few computers start having issues with broadcast storms, people not having access to file shares, and so on. Bare-metal installations carry heavy risk of having to restore from backups if anything goes wrong which can wipe out an entire day as opposed to reverting to a snapshot for a virtual machine that takes only a few minutes. The Home edition of Windows client lacks certain features needed in a business such as remembering file shares between reboots.

Regarding the comment about having everything on one box, allow me to assuage any fears. First, if you have Windows Server Standard you have two Virtual Machine licenses which means from a licensing standpoint you already have everything you need. All we have to do is split things up. And I'm not above sending a client a temp server just for that purpose. Move everything over to the temp server onto two virtual machines and then migrate those two virtual machines over to the production server by copying TWO FILES. Easy peasy mac 'n cheesy. In fact, as soon as I get done writing all this out, I'll be shipping a temp server over to a client just for this purpose.

If anyone has any questions, please reach out. Sometimes the best thing to do is just have a conversation with someone. My contact info is in my profile.

JamesNT


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@Tomastoria,

Thank you for the kind words.

JamesNT


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I'm guessing the vhdx files. And, yes iDrac is incredible.


Bert
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For some reason our 99213s and 99214s just went up 23% for MaineCare.

Of course, they changed their PCPIP (Primary Care Physician Incentive Program) where only private practices would receive ~ $30,000 every six months for doing a list of things to make the world a healthier place.

They replaced it with a list of about 25 things, of which around 24 of them are fairly easy or do or document, but the one thing we simply can't do is dental assessments and adding fluoride varnish to patients first tooth to 18. We just aren't big enough to add that to the schedule.


Bert
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Thanks again for the list. I am not going to say when I upgraded in case the HIPAA police are patrolling.........but it is done.

Thanks to this forum I was able with the help of my local IT guy to get the update done without too much problem. It did take us about 3 hours with all of the time for backup, computer windows update and restarting because the instructions are not clear. I did not have SP2 and had to update this as well. The instructions for AC did not look exactly like my computer.

Thanks James for the other topic about the SQL update because my computer did not look like the AC version in the instructions. We were able to follow your lead for changing the "SQL Server Configuration Manager" to get the area that needed to be changed for AC. below is the link to those instructions in case others need them:
https://acusersforum.com/ub/ubbthre...16-upgrade-failure-suggestions#Post78224

AC instructions have some problems. First the back button is hidden so I kept closing out the window that was brought up after starting from AC Yellow reminder box. This made reading the instructions difficult while trying to look at the update. I should have used my laptop for the instructions, I finally wised up and moved the instructions to a second monitor. Second the AC instruction changes the name from SQL Server to SQL Server Express so I was not sure these were the same product but they appear to be. After the download, the computer has to be restarted with each change and I didn't see this in the instructions. There are 2 steps that seemed to be backwards in the AC instructions. It pertained to the updates and license in the 2016 install. The step that is #7 (MIcrosoft Update) on the AC instruction was actually #6 for my install and the step #6 (License Terms) was step #7. Once the license terms was signed I could not go back to the Microsoft Updates. It did not change the install, so not that big of a deal, just want others to know. The final step shows 4 things with green checks: Database Engine Services, SQL Browser, SQL Writer and SQL Client connectivity SDK. My install only had the Database Engine Services come up with a green check box and then stated Complete.

I hope this helps, my system is up and running but this is not an easy process. I am not very computer literate and without the forum help this would have been an even harder process.

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I ran the AC SQL upgrade software and did not get any error messages. Is there a way to be sure that migration was successful? Where can I look on my Windows PC to verify the migration?

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This PC> C:> Program Files>Microsoft SQLServer> should see MSSQL13.AmazingCharts(That is 2016 version listing) right under MSSQL11.AmazingCharts(2012 Version)

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Good answer:

Here are two other answers:

1. An easy way
2. More complex (but more rewarding, lol)

On the start button scroll down until you see Microsoft Sql Server 2012 and other things under the arrow down and you will see Micrososft SQL 2016 and other things underneath it, can even expand it and right-click on the red tool box one and go to location under more (Microsoft really screwed up on the "More" thing" and it will bring you to the new 2016. Which is basically what Koby is having you do.

The complex but overall better way: Download SSMS v18, you can't use the previous versions. Install it. Then connect to the Microsoft Instance and you will see the "version 13" not the new SQL Server 2016 Express name.

-- you could also do a query there but that is really getting more complicated --

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Last edited by Bert; 07/31/2022 12:14 PM.

Bert
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Eventually, you will want to uninstall SQL Server 2012 Express, but I would have someone do that for you just to be on the safe side to insure no other instance is connected to it. The reason is that Windows Updates will continue to tell you SQL Server 2012 Standard needs updates.

So, in the end, Koby's way is much simpler.

And, yes, this does increase my post count.

Last edited by Bert; 07/31/2022 12:13 PM.

Bert
Pediatrics
Brewer, Maine

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