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Need Advice - Server for Small Office - Medical Records


nlitend1
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My father is looking to implement electronic medical records and will be running Chirotouch from Chirotouch.com. Unfortunately he is about 3000 miles away and so I won't have the joy of building/setting up this box...so i'm looking for advice from those who have more experience in the area of server hardware. What would be the "best" combination of reliability and value for a server that needs to run this software? I realize that it's not a high powered server and it will be running only this software (no exchange, etc), so this is where the value/reliability comes in.

 

He will have 3-5 workstations and run the software mostly from tablets (appears to be ipads) based on the company site. However, scheduling and post exam input will be done at workstations.

 

1. Best OS? I'm thinking windows server 2012 essentials for simplicity and pc backup (SBS 2011e if he plans on keeping windows XP machines in use, as 2012e doesn't support backup of XP machines.) I know we all love 2011/2012, but would a SBS or Server standard be better supported in the future?

 

2. Storage/HDDs? I am torn between RAID 1 and RAID 5. Also, would it be better to go with onboard RAID or spring for a RAID card? Onboard RAID has always been scary in the face of board failure. <_< Additionally, what class of drives would be most practical? enterprise? WD Blacks?

 

3. Does anyone know of a prebuilt (OEM?) solution that would be a good fit for this scenario?

 

4. Any recommendations for online/offsite backup?

 

Thanks guys! I look forward to this discussion.

 

P.S. Budget is not strict; however, I want to be as 'reasonable' as i can with a balance between value/reliability.

 

The Tech Doc is as follows: http://www.chirotouch.com/ChiroTouch-System-Requirements.pdf

 

 

Server Requirements

Minimum

Windows edition Windows 2003/2008 Standard (Service Pack 2)

Processor(s) Intel® Core™ Duo 2.33 GHz

Memory (RAM) 4 GB

Hard drive capacity 80 GB

Network card 10/100 (Not wireless)

Video resolution 1024x768 (see Minimum)

System backup RAID 1 w/ external backup

Microsoft SQL Server SQL Express (9 or fewer workstations)

 

 

Recommended

Windows Small Business Server 2008/2011 Standard/Premium

 

Intel (or AMD equivalents): one or two Core2 Quad 2.8GHz or Xeon® 2.8 GHz

Memory 8 GB (ECC preferred, 12 GB for server 2011)

Hard Drive 250 GB (for scanning x-rays and documents)

Network 100/1000 (Not wireless)

System Backup RAID 5 w/ offsite backup

SQLServer 2005 or higher (32-bit or 64-bit)

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How many users/workstations will be at the location? Actually, you could do a lot of this remotely provided you did the OS install locally and then ship the box.

 

For my money, SBS 2008 would be a great platform to run under adn would give remote access, their own email server, along with SharePoint. The only downside is to SBS since the 2003 version is the requirement of a large amount of RAM in order to support Exchange. You could run any SBS version on an i5 with room to spare. This version also include SQL Express which has some limitations but depending on the needs, could be more than sufficient.

 

Now, of none of that is important to your Dad, then SBS2011E could also be used and if mail was needed you could run Office365 for about $8/user per month. Someone locally will have to have some decent computer skills and most of the heavy lifting could be done remotely.

 

You need to really careful with the offsite storage to make sure you are compliant with HIPA requirements for privacy. Something like CrashPlan might work since it is encrypted.

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My father is looking to implement electronic medical records and will be running Chirotouch from Chirotouch.com. Unfortunately he is about 3000 miles away and so I won't have the joy of building/setting up this box...so i'm looking for advice from those who have more experience in the area of server hardware. What would be the "best" combination of reliability and value for a server that needs to run this software? I realize that it's not a high powered server and it will be running only this software (no exchange, etc), so this is where the value/reliability comes in.

 

He will have 3-5 workstations and run the software mostly from tablets (appears to be ipads) based on the company site. However, scheduling and post exam input will be done at workstations.

 

1. Best OS? I'm thinking windows server 2012 essentials for simplicity and pc backup (SBS 2011e if he plans on keeping windows XP machines in use, as 2012e doesn't support backup of XP machines.) I know we all love 2011/2012, but would a SBS or Server standard be better supported in the future?

 

2. Storage/HDDs? I am torn between RAID 1 and RAID 5. Also, would it be better to go with onboard RAID or spring for a RAID card? Onboard RAID has always been scary in the face of board failure. <_< Additionally, what class of drives would be most practical? enterprise? WD Blacks?

 

3. Does anyone know of a prebuilt (OEM?) solution that would be a good fit for this scenario?

 

4. Any recommendations for online/offsite backup?

 

Thanks guys! I look forward to this discussion.

 

P.S. Budget is not strict; however, I want to be as 'reasonable' as i can with a balance between value/reliability.

 

The Tech Doc is as follows: http://www.chirotouc...equirements.pdf

 

 

Server Requirements

-snip-

Recommended

Windows Small Business Server 2008/2011 Standard/Premium

 

Intel (or AMD equivalents): one or two Core2 Quad 2.8GHz or Xeon® 2.8 GHz

Memory 8 GB (ECC preferred, 12 GB for server 2011)

Hard Drive 250 GB (for scanning x-rays and documents)

Network 100/1000 (Not wireless)

System Backup RAID 5 w/ offsite backup

SQLServer 2005 or higher (32-bit or 64-bit)

 

Note: this is all just my opinion -- free comments are usually worth what you pay for them :)

 

Looking at the ChiroTouch Requirements PDF -- because of the distance from you he should/will need to hire a local a local IT professional that can set up/maintain the system and equipment. He's going to want a good maintence contract and business recovery plan (if there's a disaster of some sort) IMHO.

 

The SBS Diva's blog may be a good place to check for possible ideas/solutions too. There are also lot's of other's on this Board with SB experience who will be posting soon I'm sure.

 

I wouldn't bother with the Minimum requirements and instead base the system/equipment on the recommended server AND workstation requirements.

 

1. Check with ChiroTouch and the local professional but I like the idea of going with the newest OS -- Server 2012 Essentials

 

Their recommendation is Win 7 Pro/Ult 64b -- check with ChiroTouch about Win 8 pro 64b and get the XP machines out of there one way or another even if you have to upgrade them to just Win 7 pro/ult 64b

 

2. Their Recommendation is RAID5 with offsite backup -- the offsite can be something like CrashPlan or physically carrying backup drives to an off site on a daily basis (assuming office procedures could really be put in place to accomplish that) or both plus maybe an additional local backup.

 

If he's paying a local IT Pro to set it up I suspect the relative incremental costs of Enterprise drives over Red or Black drives isn't going to be that much but I don't think it makes a lot of difference -- no matter what eventually drives will fail -- so a solid multilayer backup system is key

 

3. I'm no help here. There are a lot of good namebrand business servers that meet/exceed the recommended requirements so I'm sure others will chime in with their experiences

 

4. JMWills noted an important concern earlier -- ideally your dad could/should hire a local IT Pro who has been installing similar systems and would have some ideas

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I concur with joe_miner; this is a job for a local pro. Given the importance of the data, any other course of action is asking for trouble IMHO. I would ask the ChiroTouch people for recommendations of reliable IT pros in your dad's locale.

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He'll also want someone with a good understanding of HIPAA requirements. It's not brain surgery but when dealing with medical records it's best to have someone who is familiar with the laws and can help point out any risks.

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He'll also want someone with a good understanding of HIPAA requirements.

 

That's why I suggested asking ChiroTouch. Now, I have no idea how HIPAA pertains to Chiropractors, if it applies at all (actually, I have no idea how HIPAA pertains to anything, since we don't have it in Canada ;) ). I presume the people who make the software would know, since I imagine they have to have stuff built into their software that applies to HIPAA.

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How many users/workstations will be at the location?

 

Now, of none of that is important to your Dad, then SBS2011E could also be used...

 

You need to really careful with the offsite storage to make sure you are compliant with HIPA requirements for privacy. Something like CrashPlan might work since it is encrypted.

 

 

 

3 Ipads and 2 Front desk computers for scheduling/billing. (possibly 2-3 more workstations for post-exam data entry.) Probably 3-5 users, depending upon if each receptionist has their own user account.

 

If it was my office, I might be setting up an email or exchange server...however my dad's view on this whole going to electronic medical records is "if i could keep my paper charts, I would". He is in the later stages of his career and is still a hunt and peck typist. :) His reasoning for going to electronic medical records is because Medicare is offering a "carrot" for adopting this now. Now in 1-2 years, that "carrot" will become a "stick" and Medicare will begin taking a percentage of the Medicare reimbursements from practices not implementing electronic health records.

 

HIPPA very much applies to this office.I think a lot of good points have been made to maintain that level of privacy/security and I will have him get in touch with chirotouch to ensure that happens. Thanks for pointing that out.

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Note: this is all just my opinion -- free comments are usually worth what you pay for them :)

 

Looking at the ChiroTouch Requirements PDF -- because of the distance from you he should/will need to hire a local a local IT professional that can set up/maintain the system and equipment. He's going to want a good maintence contract and business recovery plan (if there's a disaster of some sort) IMHO.

 

The SBS Diva's blog may be a good place to check for possible ideas/solutions too. There are also lot's of other's on this Board with SB experience who will be posting soon I'm sure.

 

I wouldn't bother with the Minimum requirements and instead base the system/equipment on the recommended server AND workstation requirements.

 

1. Check with ChiroTouch and the local professional but I like the idea of going with the newest OS -- Server 2012 Essentials

 

Their recommendation is Win 7 Pro/Ult 64b -- check with ChiroTouch about Win 8 pro 64b and get the XP machines out of there one way or another even if you have to upgrade them to just Win 7 pro/ult 64b

 

2. Their Recommendation is RAID5 with offsite backup -- the offsite can be something like CrashPlan or physically carrying backup drives to an off site on a daily basis (assuming office procedures could really be put in place to accomplish that) or both plus maybe an additional local backup.

 

If he's paying a local IT Pro to set it up I suspect the relative incremental costs of Enterprise drives over Red or Black drives isn't going to be that much but I don't think it makes a lot of difference -- no matter what eventually drives will fail -- so a solid multilayer backup system is key

 

3. I'm no help here. There are a lot of good namebrand business servers that meet/exceed the recommended requirements so I'm sure others will chime in with their experiences

 

4. JMWills noted an important concern earlier -- ideally your dad could/should hire a local IT Pro who has been installing similar systems and would have some ideas

 

I will be sure to check SBSDiva's blog. Good resource. Thank you! Do you really feel that RAID5 would be beneficial? Futhermore, does anyone have an input as to motherboard RAID vs Raid card as far as more common in business like this and their reliability/rebuildability if something was to go wrong with the hardware responsible for the RAID? I have to admit i'm a bit unsure on what it would take to rebuild a RAID volume if it's running via a motherboard controller and the motherboard fails.

 

I am definitely going to have a local IT Pro setup the hardware on-site and network the office. My hope by this thread is to do some of the planning/work as far as the hardware in hope to lower the final bill of $75/hr for network deployment....(and because most of us in this forum enjoy working with this sort of planning/implementation as a hobby/pleasure. And i'm drooling at the thought of building a "wish list" for hardware. Maybe i'm wrong, but i think most of us would like the idea that you have a blank check and get to choose/build a small office server :))

 

I concur with joe_miner; this is a job for a local pro. Given the importance of the data, any other course of action is asking for trouble IMHO. I would ask the ChiroTouch people for recommendations of reliable IT pros in your dad's locale.

 

Thanks for the comment.. See explanation above.

Edited by nlitend1
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Since it is a business application, I would definitely recommend hardware RAID. If possible, I would use RAID-1 and set up 2 arrays; one RAID-1 for the OS, and a 2nd for data.

 

Whether you can use RAID-1 for the data depends on how much data there is. If there isn't too much data, then 2x2TB or 2x3TB drives could be used. By having RAID-1 for both the OS and the data, you significantly increase the resiliency of the system to failure, AND you greatly increase the ability to get it back into full production in a timely manner.

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Since it is a business application, I would definitely recommend hardware RAID. If possible, I would use RAID-1 and set up 2 arrays; one RAID-1 for the OS, and a 2nd for data.

 

Whether you can use RAID-1 for the data depends on how much data there is. If there isn't too much data, then 2x2TB or 2x3TB drives could be used. By having RAID-1 for both the OS and the data, you significantly increase the resiliency of the system to failure, AND you greatly increase the ability to get it back into full production in a timely manner.

 

Don't some server motherboards have hardware raid built-in? From yours/anyone's experience... is that not as fail-proof as a third party RAID card? I was thinking along the lines of two RAID 1's like that, but RAID 5 seems to be recommended. Maybe that's just for excessive speed in very busy offices. Based on the PDF, the data will be less than 250GB...so two 500GB drives should be fine for data and maybe a 2nd two for OS.

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