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System Requirements
A MedInformatix installation requires user workstations for each user who
will access the system and a central server computer that retains all the
files and data. At a larger site there may be more than one server needed.
The workstations and server are connected to each other using an operating
system that supports networking. The MedInformatix database will be managed
by a SQL Server application, which is a software package that will run solely
on the server machine. At least one backup storage device are needed to protect
the data in case of a system failure, and possibly archival devices to extract
older data from the server, so that the server hard drive does not get full.
Printers also need to be available to print reports, forms and documents.
A Modem will be required for remote maintenance. The following topics below
will give a more detailed explanation of these equipment and software requirements.
The following hardware configurations can be used as a guide to server and
workstation configurations for MedInformatix Systems. This should be used
as a guide only. The final configuration will depend upon the actual use of
the system including tolerated down time in the event of hard drive or server
failure.
SERVERS
Each Server is unique to its site. The specs will vary greatly depending upon
the traffic. If you have questions regarding a server that you already have,
call MedInformatix to see if it will be sufficient.
An installation requires at least one server computer that will store the
centralized data and program files for the network. A server machine will
provide two functions for the MedInformatix software. It will store the system
files and thus act as a file server. It will also run a database management
application that will manage the MedInformatix SQL database. A server that
runs SQL database software is called a “database server”. On a
small site a single server machine will handle both server functions. In larger
sites, separate server machines will handle each function. MedInformatix currently
recommends Dell servers for the tech support service, value and reliability.
Notes:
For a fail-safe environment in the event of a hard disk and or processor failure,
a Raid 5 installation (for hard disk failures) or a Clustered Processor installation
(for any system failure) is recommended. Other methods of hard drive protection
such as mirrored drives, SQL server replication, etc. can be installed. The
user should review all options and implement accordingly. For Database hard
drive configuration assume 1 GB per Physician per year for systems using EMR
and Practice Management Please review discussion at the end of this document
regarding SQL Server capacity and performance.
SERVER CONFIGURATIONS
1- 25 Users – Server Configuration
Single Server for Network Operating/Apps and SQL
Server Database O/S – Microsoft Server 2000 or 2003.
SQL Database – Microsoft SQL Server 2000 or 2005
Processor – Single Processor to Pentium IV with minimum 700 MHz
Memory – 500 MB - 1 GB of RAM
Drives – 3 Hard Drives a Minimum of 80 GB each; Raid 5
Backup Device
25 - 50 Users
- Server Configuration
Single Server for Network Operating/Apps and SQL
Server Database O/S – Microsoft Server 2000 or 2003.
SQL Database – Microsoft SQL Server 2000 or 2005
Processor – Dual Processors -Pentium IV with minimum 700 MHz
Memory – 1 GB of RAM
Drives – 3 Hard Drives a Minimum of 80 GB each - Raid 5
Backup Device
50 -100 Users
– Server Configuration
Qty 1 – Network Server – Operating System/Apps - Microsoft Server
2000 or 2003.
Processor –
Dual Processors – Pentium IV with minimum 700 MHz
Memory – 1 GB of RAM
Drives – 3 Hard Drives a Minimum of 80 GB each - Raid 5
Network Server Backup Device
Qty 1 – SQL Database Server – Microsoft SQL Server 2000 with Microsoft
2000 Server or 2003 O/S
Processor -
Dual Processors– Pentium or IV with minimum 700 MHz each processor
Memory -1 GB of RAM (1 GB for systems with over 25 Users)
Drives - 3 Hard Drives a Minimum of 80 GB each - Raid 5
100 - 150 Users
– Server Configuration
Qty 1 - Network Server – O/S – Microsoft Server 2000 or 2003.
Processor –
Dual Processors – Pentium IV with minimum 700 MHz
Memory - 1 GB of RAM
Drives - 3 Hard Drives a Minimum of 80 GB each - Raid 5
Network Server Backup Device
Qty 1 –
SQL Database Server – Microsoft SQL Server 2000 or 2005 with Server
2000 or 2003 O/S
Processor - Quad Processors – Pentium IV with minimum 700 MHz each processor
Memory - 1 GB of RAM
Drives - 3 Hard Drives a Minimum of 80 GB each - Raid 5
150+ Users
– Server Configuration
Qty 1 - Network Server – O/S – Microsoft Server 2000 or 2003.
Processor - Quad Processors – Pentium IV with 1 GHz
Memory - 1 GB of RAM
Drives - 3 Hard Drives a Minimum of 80 GB each - Raid 5
Network Server Backup Device
Qty 1 –
SQL Database Server – Microsoft SQL Server 2000 or 2005 with Server
2000 or 2003 O/S
Processor - Quad Processors – Pentium IV with 1 GHz
Memory - 1 GB of RAM
Drives - 3 Hard Drives a Minimum of 80 GB each - Raid 5
Clients with 150 users who are utilizing EMR should consider installing a Server for storage of the Records and RW Directory. Particularly, if the site stores a large number of scanned documents and/or large imaging files.
Qty 1 –
File Server – with Server 2000 or 2003 O/S
Processor - Singe Processor – Pentium IV with minimum 700 MHz
Memory – 500 MB – 1 GB RAM
Drives – to be determined
WORKSTATIONS
Each user that will access the MedInformatix system will need a workstation.
While workstation configurations will vary according to each user’s
needs and duties, the following can be used as a general guideline for end-user
utilization of the MedInformatix system.
Processor
Single Processor -Pentium III or IV with minimum 500mhz
Memory
128 MB - 500 MB RAM
Drives
1 Hard Drives with a Minimum of 20 GB
1 CD Drive
Floppy Drive (Optional)
O/S
Windows 2000 Professional or XP Professional or Vista Business
If there are any questions regarding the particular configuration for workstations
for your site, please contact acentec.
TABLETS
The options available for portable tablets have changed dramatically over
the past few years, and the costs have also become much more reasonable. Medinformatix
is not dependent on a particular Tablet, but most of our clients enjoy using
the convertible style of tablet that provides for either a tablet configuration
or a laptop configuration. We recommend Fujitsu or Toshiba Tablets, but many
practices use other brands.
O/S
Windows XP Pro Tablet PC or Vista Business
Processor
Single Processor –Centrino with minimum 500mhz
Memory
128 MB - 500 MB RAM (if voice recognition is used, increase RAM to 1GB)
Drives
1 Hard Drives with a Minimum of 20 GB
PRINTERS
Any inkjet or laser PC compatible printer will work with the MedInformatix
system. For the purposes of claims and document printing, the Hewlett Packard
LaserJet 4000 or 5000 Series is recommended. Please check with Hewlett Packard
(www.hp.com) or your local hardware vendor for availability and pricing.
For clinical printers, we recommend color laser printers. Most major brands
do an excellent job, but be sure to factor in the costs of replacement toner.
LABEL
MAKERS
The Dymo LabelWriter Model 330 or Model 330 Turbo are very highly recommended.
They print labels up to 2.3" (56mm) wide. The LabelWriter 330 Prints
approximately 16 labels per minute. The Label Writer 330 Turbo model prints
approximately 32 labels per minute. This label maker works nicely with the
MedInformatix system and can be used on a USB or serial port. Please check
with Dymo (www.dymo.com) or your local hardware vendor for availability and
pricing.
SCANNERS
For scanners used for the purposes of scanning documents like medical charts
any scanner that is PC compatible will work with the MedInformatix System.
The following scanner has been recommended by many end-users: Hewlett Packard
ScanJet 7450C. This is a sheet feed scanner. We also recommend Fujitsu scanners,
models in the 5100 and 5500 series.
For scanners purely for the purpose of scanning insurance cards, the Visioneer
Strobe Pro with PaperPort software. comes highly recommended. One of the benefits
of this scanner is that it automatically resizes the image to the actual size
of the insurance card with no action necessary from the user. It comes with
the scanning software and a “mini-version” of their document managing
software as well, at no additional cost. It is compatible with both serial
and USB ports. It is a sheet feed scanner. It is very compact, and takes up
practically no room on your desktop.
You can scan the front and back of an insurance card in approximately 30 seconds.
This scanner is widely used at numerous sites and highly spoken of. Please
check with Visioneer (www.visioneer.com) or your local hardware vendor for
availability and pricing.
SQL SERVER CAPACITY, PERFORMANCE, REDUNDANCY
SQL VERSION 2000 or 2005 Enterprise
OS: Windows Advanced Server 2000 or 2003 (Supports up to 64GIG/RAM using AWE
API.)
RAM: What the cost allows. Minimum Required for Enterprise version 64 MB but
this is very low. Memory is cheap and the more you can afford the better.
For a very small installation 256Megs is ideal, however calculating the memory
requirements for your server is best accomplished by using performance monitor
to gather statistics on the buffer/cache hit ratio. If you notice that a lot
of paging is happening on your server and you have not explicitly configured
how SQL Server manages memory, the purchase of more memory is warranted. If
you override SQL Server’s dynamic memory management and allocate to
much memory to SQL Server you could see the same activity. This is because
other processes outside of SQL Server may need more resources than are available
and will start utilizing the disk cache. It is not recommended to allocate
memory to SQL Server explicitly. Instead let SQL do this for you because it
is highly optimized and has been proven to work very well.
PROCESSORS
Fastest on the market with best SPECint benchmark.
SQL Server is very CPU intensive. It makes sense to purchase the best processor(s)
available just like you would for a workstation or home computer system. If
you expect that the site will outgrow the current processor capacity, the
purchase of a quad capable motherboard may save money in the long run.
Multiple CPU’s (SMP) are ideal for heavy OLTP databases because complex
queries run in parallel. Particular care should be taken when optimizing the
server configuration to account for CPU bottlenecks. For instance it might
make sense to let SQL Server use only some of the processors and to reserve
one for the operating system or other software to avoid contention. Again,
this is something that must be done on a case by case basis using performance
monitor to gather vital statistics.
L2CACHE
Largest available, performance dramatically increases with larger cache sizes.
DISKS
Use SCSI RAID Controllers only if implemented via hardware. Suggested Ratio
of Disks/Channels is 6:1 from Microsoft but said to be more like 5:1 by industry
professionals.
Best performance with strong protection = RAID-10 (Stripe with multiple mirrored
copies) but this costs the most money. For smaller sites RAID-5 should work
well providing the number of disks is large enough to handle the throughput.
In all things
Use dedicated RAID -1 hardware for the transaction log. Multiple mirrored
copies of log preferred for protection and higher throughput. RAID-5 is ok
for data drives but write performance suffers compared to RAID-1.
It is highly recommended that transaction log be installed on a dedicated
RAID-1 array and that it contain multiple mirrored copies. (This is not possible
with software RAID) The reason for this is because the Log file is I/O intensive.
Should you wish to backup the transaction log periodically during business
hours, it can bring a system to a crawl unless proper steps have been taken
to isolate it is I/O from the rest of SQL Server.
Controllers with Write-Back caching enabled can cause database integrity issues
because the guaranteed write could take place after a system outage when the
contents were written to disk but not the transaction log.
NUMBER
OF DISKS
The more the disks, the higher the throughput. A small number of large disks
may handle the storage capacity, but write performance may be very poor. If
you took the storage space required and spanned it over multiple disks it
will increase the throughput and thus the possible transactions per second.
Also important with the number of disks is how many mirrored copies you wish
to keep available in the event of a disk failure.
All RAID solutions should have Hot Swappable drives so that recovering from
a disk failure is very quick. Some systems allow hot switch-able drives which
means the drive is available to take over in the event of a single disk failure.
Even though RAID offers excellent protection against a drive failure, losing
one drive will, in most cases, severely impact performance until the damaged
drive is replaced.
Since RAID is an extensive topic and beyond the scope of this document it’s
best to conduct additional research. The following website is for the RAID
advisory board which contains an exhaustive amount of information regarding
this topic including books and specifications for newtechnologies:
http://www.raid-advisory.com
UPS
An absolute must have to protect from network/system power outages. Graceful
shutdown is the key to keeping data from being corrupted.
CLUSTER
SERVER
Not as useful these days since SQL Server is proven very stable. Only used
when servers must be up 24/7. Clustered servers switch between two or more
SQL Server applications in the event of a software failure. Connection to
the SQL Server appears to be as a single entity and MSCS will route the traffic
to the appropriate server. The clustered servers share the same drive arrays,
so the redundancy is only with software. This is a very expensive solution
used at sites where the SQL Servers must be up 100% of the time. It is possible
to achieve minimal downtime, possibly 1-5%, without using clustered servers
so the decision to purchase the required hardware and licenses for this approach
should be carefully considered.
LOAD
BALANCING AND REPLICATION
Used by large OLTP installations to split the processing between multiple
SQL Server applications and disk arrays. Replication, either through the embedded
Replication features of SQL Server or accomplished by other means such as
log shipping keep two or more SQL Server disk arrays in the same state. Load
balancing should not be necessary on LAN installations unless the transactions
per second and network throughput exceed the capacity of a single system.
Replication can be used for other tasks such as keeping an offline reports
server up to date with a production database.
DLT/NETWORK
STORAGE
It’s
advisable to store crucial data offline and away from the SQL Server in the
event that a disaster such as fire, flood or theft occurs. Even though RAID
is redundant and offers protection against drive failures, should something
happen to the entire machine the only way to restore data will be from a network
backup. It is not advisable to store dumps directly to a network storage device
since they can be corrupted due to network errors or lead to performance issues
with SQL Server should it need to contend with network latency. Instead the
backups to network storage devices should be accomplished with specialized
software that guarantees the validity of the backups.
Battery backups for raid controllers are important. Have spares. Some controllers
allow you to hot swap batteries to avoid downtime.
Please contact
acentec for any hardware questions you may have or if you would prefer to
have acentec provide the hardware and installation for you.