Advice needed on small dental office setup

charms81

Junior Member
Apr 21, 2016
12
0
0
Hi all,

Long time leecher, finally signed up on this forum to get some help on hardware setup for a small dental office.

I'm helping my sister setup her dental office computer hardware from scratch. So there will be 6 computers needed and their software is very basic and does not demand and powerful setup (and probably will not in next 4-5 years). For example - currently I plan to install open dental (http://www.opendental.com/manual/computerrequirements.html) and that should work just fine on pentium. Recently my thinking has been geared towards a micro PC (Dell Optiplex 3020 or 3040 Micro, or HP Prodesk Mini 400 or 600 or 800).

Here is how the setup would be:
1 for front office (Windows) - will use the open dental software, and basic tasks like browser, word processing, billing software, etc. Nothing intensive.
4 operatory terminals (Windows) - Will use the open dental software and other basic tasks
1 server - This can be a regular windows OS or even a Ubuntu is fine. Final software selection will depend on if I want to run a PBX server on this machine or use a cloud setup for the same.

All these machines connected via a managed (non-POE) gigabit switch which is then routed outside via a firewall and or router/ modem.

So the advice I need is:
1. Would it be advisable to use a micro pc setup (http://www.dell.com/us/business/p/optiplex-3040m-desktop/pd). The advantages I can think of are save tons of space, can also be mounted behind the monitor and mounted on the stand. Or would it be good to go for a traditional PC setup like this: http://www.microcenter.com/product/461170/Envy_750-144_Desktop_Computer_Factory_Recertified

2. What kind of machine should I chose for the server ? A Xeon or I5/ I7 ?

3. If I get micro - I plan to swap HD to m.2 SSD.

4. Would a 4th gen Intel i5-4590T be fine or I should prefer Gen-6 i5-6500T ?

5. Any advice on securing the network - Should I use a dedicated firewall or a router with firewall should be enough? None of the office software or machine should be accessible from outside (except for PBX server if installed, and probably access to server via VPN provided out-of-box by the router)

Any other advice about anything I missed or am wrong about, please feel free to give a shout! Thanks for any help
 
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frowertr

Golden Member
Apr 17, 2010
1,371
41
91
My advice is to not whitebox anything and purchase a Dell or HP that gives you warranties and someone to call and yell at when things break. Secondly, how are you handling PCI and HIPAA compliance? Are you sure you don't want to hire a consultant to do this kind of work that is specialized in the healthcare field?
 

charms81

Junior Member
Apr 21, 2016
12
0
0
My advice is to not whitebox anything and purchase a Dell or HP that gives you warranties and someone to call and yell at when things break. Secondly, how are you handling PCI and HIPAA compliance? Are you sure you don't want to hire a consultant to do this kind of work that is specialized in the healthcare field?
Thanks for your reply. What is 'whitebox anything'? I'm planning on getting a 3 year NBD On-Site warranty hardware so hardware support should be covered. For software and any basic 'this does not work' - I can help her out.

If I read he compliance right, I'm not transferring any electronic data outside of office and I protect the server data - should it not be sufficient?

I'm just trying to save my sister a huge amount of money as compared to consultant - which I heard charges around 15K for such basic setup.
 

J3S73R

Senior member
Jan 24, 2000
230
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76
3020s are nice, just ordered 4 for a realtor. External power brick so I can just replace that if those die. I did buy separate ssds to install. Don't worry about m.2 specific drives.

Ideally if money isn't as big of a concern I'd have not purchased anything separately. Also go with the 5yr nbd. If your upgrade plan is 5 years. Sorry typing this on the phone. Also... do they need internet access? seems unnecessary.
 

frowertr

Golden Member
Apr 17, 2010
1,371
41
91
Thanks for your reply. What is 'whitebox anything'? I'm planning on getting a 3 year NBD On-Site warranty hardware so hardware support should be covered. For software and any basic 'this does not work' - I can help her out.
Whitebox means build your own. It sounds like you aren't going this direction which is great! Warranties are the way to go for business level work.

If I read he compliance right, I'm not transferring any electronic data outside
of office and I protect the server data - should it not be sufficient?
I'm just trying to save my sister a huge amount of money as compared to consultant - which I heard charges around 15K for such basic setup.
No idea if it's sufficient or not. This is where you need someone who specializes in the healthcare field to guide you here on what to do. Saving money now could end up costing her much more later if something isn't setup right to begin with.

Check out this thread for something similar: https://community.spiceworks.com/topic/1361266-help-my-dental-office-it
 

charms81

Junior Member
Apr 21, 2016
12
0
0
3020s are nice, just ordered 4 for a realtor. External power brick so I can just replace that if those die. I did buy separate ssds to install. Don't worry about m.2 specific drives.

Ideally if money isn't as big of a concern I'd have not purchased anything separately. Also go with the 5yr nbd. If your upgrade plan is 5 years. Sorry typing this on the phone. Also... do they need internet access? seems unnecessary.
Thanks for first hand info on 3020. I'm almost set for those unless someone tells me any drawbacks for it. Like you, I'll swap HD with a regular SSD rather than use the fee m.2 port and make a hybrid setup. And you're right on getting a 5 year NBD.

For internet access - yes - we'll have one but that is not needed to run the software. It would be used for software updates, etc. Also I may add a web based appointment system in future (ZocDoc).

Whitebox means build your own. It sounds like you aren't going this direction which is great! Warranties are the way to go for business level work.



No idea if it's sufficient or not. This is where you need someone who specializes in the healthcare field to guide you here on what to do. Saving money now could end up costing her much more later if something isn't setup right to begin with.

Check out this thread for something similar: https://community.spiceworks.com/topic/1361266-help-my-dental-office-it
Thanks! I did check on on HIPAA setup and security requirements for in-house dental software (OpenDental, Dentrix, etc) - all say you basically need a good firewall (they are even good with windows firewall), run an encryption software and a good backup plan (I'm planning on Raid-1 backup, external NAS backup (possibly cloud too with a HIPAA compliant provider), and periodic complete ISO backups.

Do you think of anything else not yet mentioned? Again, would you advice using a Dell 3020 Micro with an SSD (so no moving parts, external power supply, mounted behind the monitor itself so will possibly have better air circulation over housing inside a cabinet) and 5yr NBD?
 

charms81

Junior Member
Apr 21, 2016
12
0
0
3020s are nice, just ordered 4 for a realtor. External power brick so I can just replace that if those die. I did buy separate ssds to install. Don't worry about m.2 specific drives.

Ideally if money isn't as big of a concern I'd have not purchased anything separately. Also go with the 5yr nbd. If your upgrade plan is 5 years. Sorry typing this on the phone. Also... do they need internet access? seems unnecessary.
A question for you - I'm planning to buy 5 3020 Micro desktop with 5 Yr NBD on-site support. What is the best place to buy it? (other than Dell's own website)
 

Squeetard

Senior member
Nov 13, 2004
815
7
76
DUDE WAIT STOP!

Check these out first. The Lenovo Tiny-in-one M23 systems. Micro pc and a monitor that can dock them. Just installed 87 of them at work and they are great.
 

charms81

Junior Member
Apr 21, 2016
12
0
0
DUDE WAIT STOP!

Check these out first. The Lenovo Tiny-in-one M23 systems. Micro pc and a monitor that can dock them. Just installed 87 of them at work and they are great.
Yay! Thanks for the input - regarding Tiny-in-one - what is different than mounting the Dell 3020 using vesa bracket on the monitor and then mounting the whole thing on the extended wall mount? I get the docking thing, but in real life we'll never undock things except for when fixing hardware issues.

What Dell Micro gives is that I can mount the micro deskop/ monitor to the swiveling arm mount on the dental cabinets. Is Lenovo better than that or provides something I don't know of?
 

charms81

Junior Member
Apr 21, 2016
12
0
0
Ahh, got it.. Tiny-in-one is the same.. and actually simplifies the power management even more. But I think it would be paying higher price for the monitor and less choices to chose from (Because I was planning to add Dell U2415H monitors which are very beautiful.
 

Kaido

Elite Member & Kitchen Overlord
Feb 14, 2004
46,465
3,465
126
Hi all,

Long time leecher, finally signed up on this forum to get some help on hardware setup for a small dental office.

I'm helping my sister setup her dental office computer hardware from scratch. So there will be 6 computers needed and their software is very basic and does not demand and powerful setup (and probably will not in next 4-5 years). For example - currently I plan to install open dental (http://www.opendental.com/manual/computerrequirements.html) and that should work just fine on pentium. Recently my thinking has been geared towards a micro PC (Dell Optiplex 3020 or 3040 Micro, or HP Prodesk Mini 400 or 600 or 800).

Here is how the setup would be:
1 for front office (Windows) - will use the open dental software, and basic tasks like browser, word processing, billing software, etc. Nothing intensive.
4 operatory terminals (Windows) - Will use the open dental software and other basic tasks
1 server - This can be a regular windows OS or even a Ubuntu is fine. Final software selection will depend on if I want to run a PBX server on this machine or use a cloud setup for the same.

All these machines connected via a managed (non-POE) gigabit switch which is then routed outside via a firewall and or router/ modem.

So the advice I need is:
1. Would it be advisable to use a micro pc setup (http://www.dell.com/us/business/p/optiplex-3040m-desktop/pd). The advantages I can think of are save tons of space, can also be mounted behind the monitor and mounted on the stand. Or would it be good to go for a traditional PC setup like this: http://www.microcenter.com/product/461170/Envy_750-144_Desktop_Computer_Factory_Recertified

2. What kind of machine should I chose for the server ? A Xeon or I5/ I7 ?

3. If I get micro - I plan to swap HD to m.2 SSD.

4. Would a 4th gen Intel i5-4590T be fine or I should prefer Gen-6 i5-6500T ?

5. Any advice on securing the network - Should I use a dedicated firewall or a router with firewall should be enough? None of the office software or machine should be accessible from outside (except for PBX server if installed, and probably access to server via VPN provided out-of-box by the router)

Any other advice about anything I missed or am wrong about, please feel free to give a shout! Thanks for any help
Rolling along with your DIY idea, I'm going to make some weird but interesting recommendations:

1. Computers:

I love mini computers. It sounds like you can get by with pretty cheap systems. I've been using MINIX Z64 boxes a lot lately. $160, Windows 10 Home, 32gb SSD (small, but boots fast), 2GB RAM, fanless, single HDMI output port, recovery partition built-in:

http://www.amazon.com/Neo-Z64-W10-Windows-Mini-PC-Graphics/dp/B017C52JUO

I've been pairing them up with 27" 1080p LED monitors lately ($210). This one has speakers built-in:

http://www.amazon.com/ASUS-VE278H-1920x1080-Back-lit-Monitor/dp/B0099XBO5E

I like this wireless keyboard & mouse set: ($40)

http://www.newegg.com/Product/Product.aspx?Item=N82E16823126188

They sell an optional plastic cover for the keyboard, useful if people like to eat at their desks: ($15)

http://www.newegg.com/Product/Product.aspx?Item=9SIA3AN1196932

I like these surge protectors because they have a lot of plugs & can handle big wall-wart power supplies: ($20)

http://www.amazon.com/Belkin-BE112230-08-12-Outlet-Surge-Protector/dp/B000J2EN4S

Office 2016 is $220:

http://www.amazon.com/Microsoft-Office-Home-Business-Download/dp/B0153V61XU/

So:

* Mini PC
* Monitor w/ built-in speakers
* Keyboard, cover, mouse
* Surge protector
* Office 2016 for Business

$455 per computer. Whole thing uses less than 40 watts of power & boots in under a minute. And the core PC is so cheap ($160) that they can buy a spare for emergencies. As for Office 2016, alternatively you might want to set them up with Google Docs & just use that for Office & email:

https://apps.google.com/products/gmail/

As far as security goes, I'd do at least Windows Defender (included with Windows 10) and Malwarebytes Pro (see Amazon for lifetime licenses if they don't want recurring security bills). If they're willing to pay for better antivirus, Avast is pretty good. Set Chrome as the default browser. The Z64 computers have a built-in Windows recovery partition built-in, so if the computer gets a virus or something else gets screwed up, you can roll it back to factory stock automatically in under an hour & just pop back on their apps pretty easily. They sell cheap UPS battery backups for around $55 each as well, if you want some extra protection. Also, setup Malwarebytes to do a full nightly scan (including for rootkits).


2. Server: I'd suggest a pair of laptops (one primary, one as an emergency spare). You get a built-in keyboard, touchpad, screen, and backup battery. Here's an i7 laptop with 8 gigs of RAM for $680:

http://www.amazon.com/ASUS-Flagship-Performance-i7-5500U-DVD-SuperMulti/dp/B01C4HCBNA/

The onboard Ethernet is only 10/100, but that's plenty for a half-dozen computers running a SQL database (you can get a laptop with Gigabit Ethernet for a few hundred bucks more if you really want to). The onboard drive is slow (5400rpm), so I'd recommend upgrading the primary laptop to a 1TB Samsung Evo ($290) & keeping the original drive as a spare in case of drive failure:

http://www.amazon.com/Samsung-2-5-Inch-Internal-MZ-75E1T0B-AM/dp/B00OBRFFAS

Per the dental software server requirements, it supports all versions of Windows 10, which can take up to 20 connections, so you don't need a dedicated server OS. So next, I would buy at least couple of backup drives (3TB bus-powered for $130 each) - one for daily backups & one for offsite, offline backups (have someone take it home).

http://www.amazon.com/Toshiba-Canvio-Connect-Portable-HDTC830XK3C1/dp/B00SY4L7YW/

Next, buy a copy of Macrium Reflect - Workstation Edition: ($75)

http://www.macrium.com/Business.aspx

This creates a clone of the entire computer (which you can password-protect for security in case someone steals or loses the drive). You can schedule it for a nightly backup (full, incremental, or differential). In addition to a system clone (I'd suggest doing a full clone every quarter & then a nightly incremental clone, to save on space), it looks like you can setup local database backups pretty easily, so you can have both a database backup (say twice a day - noon & night) plus a nightly full system backup:

http://www.opendental.com/manual/backups.html

They have some HIPPA-friendly online backup resources here:

http://www.opendental.com/manual/backupsonline.html

So:

* Primary laptop
* 1TB SSD drive
* Backup laptop
* 3TB nightly backup drive
* 3TB offsite backup drive
* Macrium Reflect license

$1985 for the server setup (plus any OpenDental licensing fees & online HIPAA backup costs).


3. Network: I have a TP-Link wireless router ($235) & really like it:

http://www.amazon.com/TP-LINK-Tri-Band-Wireless-Archer-C3200/dp/B00YY3XSSA/

It has onboard Gigabit Ethernet, wireless, and guest wireless (you can have someone at the office change the visitor password monthly & print it out on a memo board for patients) that is separate from the primary network. Netgear has an excellent 8-port non-POE unmanaged Gigabit switch for $40, I've put in dozens of them with good results:

http://www.amazon.com/NETGEAR-ProSAFE-Gigabit-Desktop-GS108-400NAS/dp/B00MPVR50A

So:

* Wireless router
* Gigabit switch

$275 for the network setup (plus some CAT6 cable off Monoprice). They sell nice range extenders (RE450, $115) if they need more wireless range. You can check out OpenDNS for additional network control (ex. website filtering), or something like the Bitdefender BOX:

http://www.bitdefender.com/box/

They also sell a small UPS for stuff like routers & switches for $40:

http://www.amazon.com/APC-BGE70-Back-UPS-3-outlet-Uninterruptible/dp/B00KH07WRC

So overall total costs:

1. Computers: 5 x $455/ea plus a spare $160 box = $2435
2. Server stuff: $1985
3. Network stuff: $275

Total: ~$4700

Plus as mentioned: online HIPAA backup, Ethernet cabling, and stuff like ISP costs. That gives you:

1. A server with local & offsite backup & a backup server, both with battery backup
2. Five low-maintenance computers, plus a spare computer box
3. A fast network with segregated guest wifi access

If the database borks, restore from the most recent database backup (noon or night). If the system borks, restore last night's image clone. If the boot drive dies, restore last night's image clone to the original hard drive. If the server dies, grab the backup laptop & restore last night's image clone, then restore the most recent database backup (noon or night). If someone's computer crashes, restore to factory using Windows reset. If someone's computer dies, grab the spare box & quickly set it up again with their apps.

Wiring setup will be minimal. An Ethernet line to each device. Power from the monitor & PC box. An HDMI between the Mini PC & screen. Throw in some network printers & you're all set!
 
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charms81

Junior Member
Apr 21, 2016
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Kaido is great!
Wow! Very impressed with your ideas and the time you took to nail everything out. The only thing I'll probably not skimp on are the desktops and server. I can get a Dell refurbished 3040 micro for < 400 each (5 year NBD additional). Server should be additional 400 for a good 4th gen Xeon. Everything else fits the bill.
 

Kaido

Elite Member & Kitchen Overlord
Feb 14, 2004
46,465
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Wow! Very impressed with your ideas and the time you took to nail everything out. The only thing I'll probably not skimp on are the desktops and server. I can get a Dell refurbished 3040 micro for < 400 each (5 year NBD additional). Server should be additional 400 for a good 4th gen Xeon. Everything else fits the bill.
I do a lot of little setups like this. You can make them pretty bulletproof with a bit of planning head. Dell servers are great & warranties are awesome, I use them all the time. For servers, I typically do:

1. Main & spare server
2. Local & offsite/offline backup
3. Battery backup

If one machine dies, then you have a spare to turn on right away (or run in parallel if you want). If you get hit with something like the Crytolocker virus, you have disconnected backups you can pull from. Basically, you can make it mistake-proof pretty easily.

Mini computers are great. I've done them from $99 (Kangaroo X5) up to $1,700 (BRIX 760 with a couple large SSD's & 16GB RAM). Super versatile! I'm doing a setup similar to yours right now (great timing!) with a couple dozen MINIX Z64 boxes. Nice, small fanless boxes. Here's one under a 27" ASUS: (with a few friends on the side)



Personally, I like having the box separate from the screen. It makes turning on the power easier & lets you relocate the computer so you have easier access to the USB ports. Granted, some are easier as they're linked to the other power button, or if they're an AIO PC, iMac-style, then you don't even have to worry about that at all. Amazon has a bunch of AIO computers for $500 to $1,000 if you're looking for something super-convenient. I like the MINIX a lot for really really really basic computers because they sip power (27" ASUS LED + MINIX Z64 = 32 watts together, under load, on my Kill-a-watt) & don't require any maintenance (no fan or vents to clean!), plus they can be easily restored to factory stock if the system barfs. The performance is crap for anything other than a couple simple programs & one or two Internet tabs, but for office use, that's totally fine in a lot of cases. Zillions of options, of course...NUC's, BRIX, Baytrails, Atoms, you name it!
 

charms81

Junior Member
Apr 21, 2016
12
0
0
I do a lot of little setups like this. You can make them pretty bulletproof with a bit of planning head. Dell servers are great & warranties are awesome, I use them all the time. For servers, I typically do:

1. Main & spare server
2. Local & offsite/offline backup
3. Battery backup

If one machine dies, then you have a spare to turn on right away (or run in parallel if you want). If you get hit with something like the Crytolocker virus, you have disconnected backups you can pull from. Basically, you can make it mistake-proof pretty easily.

Mini computers are great. I've done them from $99 (Kangaroo X5) up to $1,700 (BRIX 760 with a couple large SSD's & 16GB RAM). Super versatile! I'm doing a setup similar to yours right now (great timing!) with a couple dozen MINIX Z64 boxes. Nice, small fanless boxes. Here's one under a 27" ASUS: (with a few friends on the side)



Personally, I like having the box separate from the screen. It makes turning on the power easier & lets you relocate the computer so you have easier access to the USB ports. Granted, some are easier as they're linked to the other power button, or if they're an AIO PC, iMac-style, then you don't even have to worry about that at all. Amazon has a bunch of AIO computers for $500 to $1,000 if you're looking for something super-convenient. I like the MINIX a lot for really really really basic computers because they sip power (27" ASUS LED + MINIX Z64 = 32 watts together, under load, on my Kill-a-watt) & don't require any maintenance (no fan or vents to clean!), plus they can be easily restored to factory stock if the system barfs. The performance is crap for anything other than a couple simple programs & one or two Internet tabs, but for office use, that's totally fine in a lot of cases. Zillions of options, of course...NUC's, BRIX, Baytrails, Atoms, you name it!
Cool setup!

I just ordered 5 machines of this config:

Processor: Intel Core 6th Generation i5-6500T Processor (Quad Core, 6MB, 4T, 2.5GHz, 35W)
Windows 10 Pro
500 GB SATA Hard Drive (7200 RPM)
8GB (1x8GB) 1600MHz DDR3L Memory
Intel Integrated Graphics
Optiplex 3040 Micro Desktop
Intel Wireless 8260 (802.11ac) + Bluetooth 4.1
English Keyboard
Optical 2-Button Mouse
McAfee Security Center, 30 Day
OptiPlex 3040 MFF 65W
125V Power Cord
65W AC Adapter
VGA Adapter Card
Wireless Bracket w/Antenna

5 of these monitors : Dell 22 Monitor - P2214H

Price: $377 for each of the desktops, $90 for each of the monitors. $138 for 5 Yr NBD Onsite warranty (for each pair of desktop and monitor).

Total $605 for each computer (desktop + monitor + keyboard + mouse + 5 yr NBS onsite warranty).

I got it over the phone from Dell premier support. They'e selling just the computer for $619 with 1 yr warranty on Dell website. Wow!
 
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Kaido

Elite Member & Kitchen Overlord
Feb 14, 2004
46,465
3,465
126
Cool setup!

I just ordered 5 machines of this config:

Processor: Intel Core 6th Generation i5-6500T Processor (Quad Core, 6MB, 4T, 2.5GHz, 35W)
Windows 10 Pro
500 GB SATA Hard Drive (7200 RPM)
8GB (1x8GB) 1600MHz DDR3L Memory
Intel Integrated Graphics
Optiplex 3040 Micro Desktop
Intel Wireless 8260 (802.11ac) + Bluetooth 4.1
English Keyboard
Optical 2-Button Mouse
McAfee Security Center, 30 Day
OptiPlex 3040 MFF 65W
125V Power Cord
65W AC Adapter
VGA Adapter Card
Wireless Bracket w/Antenna

5 of these monitors : Dell 22 Monitor - P2214H

Price: $377 for each of the desktops, $90 for each of the monitors. $138 for 5 Yr NBD Onsite warranty (for each pair of desktop and monitor).

Total $605 for each computer (desktop + monitor + keyboard + mouse + 5 yr NBS onsite warranty).

I got it over the phone from Dell premier support. They'e selling just the computer for $619 with 1 yr warranty on Dell website. Wow!
That is a lot of machine for the money, very nice :thumbsup:
 

you2

Diamond Member
Apr 2, 2002
4,985
312
126
In terms of processing power you do not need more than a pentinum. An i5 or i7 is over kill. However you do require a reliable backup mechanism for off site backup. Reliable here means you need to avoid bit corruption. I personally would also use raid 1 with file system that support integrity checking (ala zfs is my current choice on linux; no clue what windows has to offer in this department). The problem is that the traditional hard disk and even ssd suffer massive bit rot over the years. It is not so much that individual bits get corrupted but that sectors fail and are remapped. Also the number of machines with parity errors (bad ram) is a bit higher than one would expect.
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With regards to the machine listed above I would chagne three things. The vga adapter card is not necessary (hd4000 or 5000 is fine for office usage); i would have gone with an ssd over the hard drive; specfiically 850 pro - but that would add a bit to your total. Dell has been fairly reliable but i wouldn't mind a bit more head room in the psu.
-
No clue what is the requirement for your office pci compliance; but at this point the only thing I would change is looking into a reliable method of backing up the data. The problem is that even if you take the approach of plugging in a usb stick or usb drive; you really really need to validate that the data copied is correct (if you consider the data critical). Having said this most places don't do backup or 'proper' backup so maybe it doesn't matter (finger crossed). I personally keep a copy of critical data in a different location than my current home and i validate the data upon producing the backup.
 

charms81

Junior Member
Apr 21, 2016
12
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0
In terms of processing power you do not need more than a pentinum. An i5 or i7 is over kill.
Yes, I agree, but it was about a $40 price difference and the power consumption/ heat in 6th gen don't seem to be an issue.

However you do require a reliable backup mechanism for off site backup. Reliable here means you need to avoid bit corruption. I personally would also use raid 1 with file system that support integrity checking (ala zfs is my current choice on linux; no clue what windows has to offer in this department). The problem is that the traditional hard disk and even ssd suffer massive bit rot over the years. It is not so much that individual bits get corrupted but that sectors fail and are remapped. Also the number of machines with parity errors (bad ram) is a bit higher than one would expect.
Yes, I plan on having equivalent of Dell T130 server Xeon E3-1220, 8GB DDR4 ECC (which probably is an overkill) running CentOS native with a minimum 1TB in RAID 1. There will be an exact similar clone of server running offsite (home) which will be in sync with the main server and also have software level data replication (dental software supports that). Would a regular HD be fine in performance or should I use SSD setup on the server?

With regards to the machine listed above I would chagne three things. The vga adapter card is not necessary (hd4000 or 5000 is fine for office usage); i would have gone with an ssd over the hard drive; specfiically 850 pro - but that would add a bit to your total. Dell has been fairly reliable but i wouldn't mind a bit more head room in the psu.
Yes, VGA adapter is not needed and it was included free. I'll be using DP 1.2/ HDMI. The integrated graphic card is HD530 which I think should be sufficient. Yes, I plan to add 128GB SSD to all of the machines (I will need to check if there are lower priced equivalents to Samsung PRO). Initially I was planning to swap out the wireless card with an M.2 SSD, but I might as well swap the 2.5 HD because there would not be need to that much disk space. Regarding PSU - since this is a micro pc - there is no internal PSU, it is a 65W external power brick like laptops. The only thing I'm concerned at this point if any equipments like 3G imaging, digital xrays, intra oral cameras require any installation of a PCI card in the computer - it would not be possible in an micro. I don't see the need of it right now, but I've asked for a confirmation from the vendors.

No clue what is the requirement for your office pci compliance; but at this point the only thing I would change is looking into a reliable method of backing up the data. The problem is that even if you take the approach of plugging in a usb stick or usb drive; you really really need to validate that the data copied is correct (if you consider the data critical). Having said this most places don't do backup or 'proper' backup so maybe it doesn't matter (finger crossed). I personally keep a copy of critical data in a different location than my current home and i validate the data upon producing the backup.
I need to see what all methods are available to validate my backups. But a RAID 1, offsite RAID 1, weekly backups (possibly written to disks) and if possible 1 incremental cloud backup should be sufficient I think.

Thanks for your helpful insights!
 
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DrDoug

Diamond Member
Jan 16, 2014
3,560
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Thanks for first hand info on 3020. I'm almost set for those unless someone tells me any drawbacks for it. Like you, I'll swap HD with a regular SSD rather than use the fee m.2 port and make a hybrid setup. And you're right on getting a 5 year NBD.

For internet access - yes - we'll have one but that is not needed to run the software. It would be used for software updates, etc. Also I may add a web based appointment system in future (ZocDoc).



Thanks! I did check on on HIPAA setup and security requirements for in-house dental software (OpenDental, Dentrix, etc) - all say you basically need a good firewall (they are even good with windows firewall), run an encryption software and a good backup plan (I'm planning on Raid-1 backup, external NAS backup (possibly cloud too with a HIPAA compliant provider), and periodic complete ISO backups.

Do you think of anything else not yet mentioned? Again, would you advice using a Dell 3020 Micro with an SSD (so no moving parts, external power supply, mounted behind the monitor itself so will possibly have better air circulation over housing inside a cabinet) and 5yr NBD?
I handle the hardware & software for a couple of dental offices in a small town. Regarding your backup scheme, I don't know what kind of imaging data she will be collecting but patient databases can grow real fast. An example is one of my new clients who uses CareStream PracticeWorks for their clinic and portable imaging data along with a CS9000 3D imaging camera, related 3D imaging software packages and a dedicated workstation with an Nvidia Quadro video card. The 3D workstation also acts as the 3D image data server for the rest of the workstations. There are six op/hygiene workstations, one front desk workstation, one workstation in the doc's office and the main server that runs the database (Pervasive) and serves the PracticeWorks workstations (there are ten systems in all). Since the main server and 3D image workstation/server are both set up in RAID 1, each night the servers back themselves up to each other and a take-home HDD. No uploading data anywhere which maintains absolute control over that data and it's all updated in about ten minutes, so it's nice and quick.

CareStream recommends simply backing up a single directory on each server to protect the data so a simple Robocopy script handles the duties, quickly updating the clinic data daily (takes about ten minutes). Each server and the take-home drive hold two weeks of backups for the clinic. I wrote another Robocopy script to restore the data, which we recently used to update a new server that I deployed for them.

If your sis has a good connection then uploading/updating backups is an option. In the case of this clinic, they are stuck on DSL so that isn't an option right now. The best part though is that the clinic data is always in their hands, nowhere else.
 

charms81

Junior Member
Apr 21, 2016
12
0
0
I handle the hardware & software for a couple of dental offices in a small town. Regarding your backup scheme, I don't know what kind of imaging data she will be collecting but patient databases can grow real fast. An example is one of my new clients who uses CareStream PracticeWorks for their clinic and portable imaging data along with a CS9000 3D imaging camera, related 3D imaging software packages and a dedicated workstation with an Nvidia Quadro video card. The 3D workstation also acts as the 3D image data server for the rest of the workstations. There are six op/hygiene workstations, one front desk workstation, one workstation in the doc's office and the main server that runs the database (Pervasive) and serves the PracticeWorks workstations (there are ten systems in all). Since the main server and 3D image workstation/server are both set up in RAID 1, each night the servers back themselves up to each other and a take-home HDD. No uploading data anywhere which maintains absolute control over that data and it's all updated in about ten minutes, so it's nice and quick.

CareStream recommends simply backing up a single directory on each server to protect the data so a simple Robocopy script handles the duties, quickly updating the clinic data daily (takes about ten minutes). Each server and the take-home drive hold two weeks of backups for the clinic. I wrote another Robocopy script to restore the data, which we recently used to update a new server that I deployed for them.

If your sis has a good connection then uploading/updating backups is an option. In the case of this clinic, they are stuck on DSL so that isn't an option right now. The best part though is that the clinic data is always in their hands, nowhere else.
Thank you so much for the insight on first hand experience with Dental clinic @DrDoug!

So here's what the planned equipment setup is:

Intrumentarium 3D would be the 3D imaging equipment. It would have it's own computer which will be a fully loaded server with a good dedicated graphic card and RAID 1 for the disk. Initially it would have 1TB HD's, but we'll need to add more. Also I read that they do not support SAN/ NAS, but do support direct attached storage which can be mapped to a drive letter. The 3D software will also have a bridging software like you mentioned which will feed data to our main file and DB server. They also require a SQL Server DB in our main server (I need to find out the licensing details from them).

There will be couple of intra-oral cameras (Gendex ExpertDC or Focus X-ray) which probably will have a USB interface which would be plugged into a workstation through which stored on central file system.

Couple of digital X-ray machines which will work the same way as the intra-oral cameras above.

So for most everything she's planning to use: it is basically backing up 1 directory for each of the softwares (which basically stores all the images, xrays, recordings, etc). That should be good to setup on an incremental backup job and then writing a daily/ weekly backup and possibly a cloud sync. Other thing is to backup MySQL and SQLServer DB which also should be possible using out-of-box tools.

But I need your advice on computer configuration since you have first hand info about it. Would the config I mentioned above be fine work a operatory workstation (without a dedicated graphic card)? What is the general configuration of the system you maintain? Did any of your tools have a requirement to install a PCI card to the workstation computer? Reason I'm worried is I bought a micro-pc and it might be good to switch to a mid-size tower if a dedicated GPU would be needed. This is the config I got:
Processor: Intel Core 6th Generation i5-6500T Processor (Quad Core, 6MB, 4T, 2.5GHz, 35W)
Windows 10 Pro
500 GB SATA Hard Drive (7200 RPM) (Will replace with SSD)
8GB (1x8GB) 1600MHz DDR3L Memory
Intel Integrated Graphics
Optiplex 3040 Micro Desktop
Intel Wireless 8260 (802.11ac) + Bluetooth 4.1
MicroPC - with open PCI slots
The only reason I'm worried is that the 3D imaging documents say that if you want to view and edit the 3D images on a workstation you'll need a dedicated GPU. Would the onboard graphic be fine to view images (albeit slowly) or impossible to even view? My sister said that 3D will only be used for implant patients and seldom will she need to view on the operatory workstation. But I would like to cover her right now since it is easy to change my order.

Any help/ insight you can provide would be great!
 

DrDoug

Diamond Member
Jan 16, 2014
3,560
1,579
136
Thank you so much for the insight on first hand experience with Dental clinic @DrDoug!

So here's what the planned equipment setup is:

...

But I need your advice on computer configuration since you have first hand info about it. Would the config I mentioned above be fine work a operatory workstation (without a dedicated graphic card)? What is the general configuration of the system you maintain? Did any of your tools have a requirement to install a PCI card to the workstation computer? Reason I'm worried is I bought a micro-pc and it might be good to switch to a mid-size tower if a dedicated GPU would be needed. This is the config I got:

The only reason I'm worried is that the 3D imaging documents say that if you want to view and edit the 3D images on a workstation you'll need a dedicated GPU. Would the onboard graphic be fine to view images (albeit slowly) or impossible to even view? My sister said that 3D will only be used for implant patients and seldom will she need to view on the operatory workstation. But I would like to cover her right now since it is easy to change my order.

Any help/ insight you can provide would be great!
Before I start, I want to welcome you to the craptastic world of dental clinic software... :biggrin:

You will need dedicated graphics cards for 3D image editing and manipulation. This Doc has his three op workstations (Dell Vostro 200 Slim w/ T-8300 Core2Duo) equipped with Nvidia Quadros and the 3D workstation (Dell T-3500 w/ Xeon X5650) has a dedicated Nvidia Quadro. He does all image manipulation, edits & saves on these systems. The hygiene workstations have the 3D image software installed to view the saved images (no manipulation/edits) and work fine for the Doc w/o dedicated graphics cards. The only cards I added were Intel gigabit NICs to bring his workstations up to gigabit (when I upgraded his network), no other cards were necessary.

I hope this helps! :)
 

charms81

Junior Member
Apr 21, 2016
12
0
0
Before I start, I want to welcome you to the craptastic world of dental clinic software... :biggrin:

You will need dedicated graphics cards for 3D image editing and manipulation. This Doc has his three op workstations (Dell Vostro 200 Slim w/ T-8300 Core2Duo) equipped with Nvidia Quadros and the 3D workstation (Dell T-3500 w/ Xeon X5650) has a dedicated Nvidia Quadro. He does all image manipulation, edits & saves on these systems. The hygiene workstations have the 3D image software installed to view the saved images (no manipulation/edits) and work fine for the Doc w/o dedicated graphics cards. The only cards I added were Intel gigabit NICs to bring his workstations up to gigabit (when I upgraded his network), no other cards were necessary.

I hope this helps! :)
Perfect. Thanks so much for confirming. And yeah - most of the dental software solutions are so crappy and such a rip-off I feel. I'm myself and open source guy and we build some cool systems for such less dough. Here, everything is an opportunity to make money (like Oracle, HP, IBM do I think). But that gives me some motivation to build something lean and clean cloud solution (again, unlike what Dentrix has done) and probably give it out for free if I can find some UI guys to collaborate with me. But then the government will try to get their share by all their crappy certifications which mean nothing.

Anyway - I think now I'm good with my setup and probably just need to change one of my systems. Initially my sis is building out 4 operatories and this is how I'll set it up:
2 x Micro PC's for front desk. One for main appointment and basic tasks and another for any side tasks like insurance stuff, training etc. No video card needed here.
2 x Micro PC's for operatories for hygienist. No 3D manipulation needed, so no graphic card either.
1 x i7 Nvidia 9xx graphic card desktop for my sister's office.
2 x i7 Nvidia 9xx graphic card desktops for 2 dentist operatories.
1 x Xeon, Nvidea, RAID 1 (or 5+1) file storage, database servers etc.
1 x 3D workstation, i7 Nvidia
1 x Backup Xeon Nvidia offsite server
1 NAS solution, USB HD backups, etc.

I'll just need to cancel one of the micro PC's I ordered (but I may keep them since they're such a good deal and form factor).
 

DrDoug

Diamond Member
Jan 16, 2014
3,560
1,579
136
Perfect. Thanks so much for confirming. And yeah - most of the dental software solutions are so crappy and such a rip-off I feel. I'm myself and open source guy and we build some cool systems for such less dough. Here, everything is an opportunity to make money (like Oracle, HP, IBM do I think). But that gives me some motivation to build something lean and clean cloud solution (again, unlike what Dentrix has done) and probably give it out for free if I can find some UI guys to collaborate with me. But then the government will try to get their share by all their crappy certifications which mean nothing.

Anyway - I think now I'm good with my setup and probably just need to change one of my systems. Initially my sis is building out 4 operatories and this is how I'll set it up:
2 x Micro PC's for front desk. One for main appointment and basic tasks and another for any side tasks like insurance stuff, training etc. No video card needed here.
2 x Micro PC's for operatories for hygienist. No 3D manipulation needed, so no graphic card either.
1 x i7 Nvidia 9xx graphic card desktop for my sister's office.
2 x i7 Nvidia 9xx graphic card desktops for 2 dentist operatories.
1 x Xeon, Nvidea, RAID 1 (or 5+1) file storage, database servers etc.
1 x 3D workstation, i7 Nvidia
1 x Backup Xeon Nvidia offsite server
1 NAS solution, USB HD backups, etc.

I'll just need to cancel one of the micro PC's I ordered (but I may keep them since they're such a good deal and form factor).
The only things I would note is that you might want to check to make sure that the 3D imaging package(s) your sis is using on her 3D workstation (initial image acquisition/editing workstation) are OK with an i7 instead of a Xeon. The op stations should be fine with the i7 & 9xx cards (for 3D image display purposes) so no problem there. If the 3D images are stored on the 3D workstation and served to the other workstations from that point then I would also recommend a RAID 1 setup on it too. The nice thing about that is that you can back up each server (clinic data, portable image captures & 3D image server) to each other, providing for quick recovery in the event something goes TU.

Regarding everything else, use the KISS principle, you'll thank yourself later! :thumbsup:
 

Be Fair

Junior Member
Aug 15, 2019
3
0
6
Rolling along with your DIY idea, I'm going to make some weird but interesting recommendations:

1. Computers:

I love mini computers. It sounds like you can get by with pretty cheap systems. I've been using MINIX Z64 boxes a lot lately. $160, Windows 10 Home, 32gb SSD (small, but boots fast), 2GB RAM, fanless, single HDMI output port, recovery partition built-in:

http://www.amazon.com/Neo-Z64-W10-Windows-Mini-PC-Graphics/dp/B017C52JUO

I've been pairing them up with 27" 1080p LED monitors lately ($210). This one has speakers built-in:

http://www.amazon.com/ASUS-VE278H-1920x1080-Back-lit-Monitor/dp/B0099XBO5E

I like this wireless keyboard & mouse set: ($40)

http://www.newegg.com/Product/Product.aspx?Item=N82E16823126188

They sell an optional plastic cover for the keyboard, useful if people like to eat at their desks: ($15)

http://www.newegg.com/Product/Product.aspx?Item=9SIA3AN1196932

I like these surge protectors because they have a lot of plugs & can handle big wall-wart power supplies: ($20)

http://www.amazon.com/Belkin-BE112230-08-12-Outlet-Surge-Protector/dp/B000J2EN4S

Office 2016 is $220:

http://www.amazon.com/Microsoft-Office-Home-Business-Download/dp/B0153V61XU/

So:

* Mini PC
* Monitor w/ built-in speakers
* Keyboard, cover, mouse
* Surge protector
* Office 2016 for Business

$455 per computer. Whole thing uses less than 40 watts of power & boots in under a minute. And the core PC is so cheap ($160) that they can buy a spare for emergencies. As for Office 2016, alternatively you might want to set them up with Google Docs & just use that for Office & email:

https://apps.google.com/products/gmail/

As far as security goes, I'd do at least Windows Defender (included with Windows 10) and Malwarebytes Pro (see Amazon for lifetime licenses if they don't want recurring security bills). If they're willing to pay for better antivirus, Avast is pretty good. Set Chrome as the default browser. The Z64 computers have a built-in Windows recovery partition built-in, so if the computer gets a virus or something else gets screwed up, you can roll it back to factory stock automatically in under an hour & just pop back on their apps pretty easily. They sell cheap UPS battery backups for around $55 each as well, if you want some extra protection. Also, setup Malwarebytes to do a full nightly scan (including for rootkits).


2. Server: I'd suggest a pair of laptops (one primary, one as an emergency spare). You get a built-in keyboard, touchpad, screen, and backup battery. Here's an i7 laptop with 8 gigs of RAM for $680:

http://www.amazon.com/ASUS-Flagship-Performance-i7-5500U-DVD-SuperMulti/dp/B01C4HCBNA/

The onboard Ethernet is only 10/100, but that's plenty for a half-dozen computers running a SQL database (you can get a laptop with Gigabit Ethernet for a few hundred bucks more if you really want to). The onboard drive is slow (5400rpm), so I'd recommend upgrading the primary laptop to a 1TB Samsung Evo ($290) & keeping the original drive as a spare in case of drive failure:

http://www.amazon.com/Samsung-2-5-Inch-Internal-MZ-75E1T0B-AM/dp/B00OBRFFAS

Per the dental software server requirements, it supports all versions of Windows 10, which can take up to 20 connections, so you don't need a dedicated server OS. So next, I would buy at least couple of backup drives (3TB bus-powered for $130 each) - one for daily backups & one for offsite, offline backups (have someone take it home).

http://www.amazon.com/Toshiba-Canvio-Connect-Portable-HDTC830XK3C1/dp/B00SY4L7YW/

Next, buy a copy of Macrium Reflect - Workstation Edition: ($75)

http://www.macrium.com/Business.aspx

This creates a clone of the entire computer (which you can password-protect for security in case someone steals or loses the drive). You can schedule it for a nightly backup (full, incremental, or differential). In addition to a system clone (I'd suggest doing a full clone every quarter & then a nightly incremental clone, to save on space), it looks like you can setup local database backups pretty easily, so you can have both a database backup (say twice a day - noon & night) plus a nightly full system backup:

http://www.opendental.com/manual/backups.html

They have some HIPPA-friendly online backup resources here:

http://www.opendental.com/manual/backupsonline.html

So:

* Primary laptop
* 1TB SSD drive
* Backup laptop
* 3TB nightly backup drive
* 3TB offsite backup drive
* Macrium Reflect license

$1985 for the server setup (plus any OpenDental licensing fees & online HIPAA backup costs).


3. Network: I have a TP-Link wireless router ($235) & really like it:

http://www.amazon.com/TP-LINK-Tri-Band-Wireless-Archer-C3200/dp/B00YY3XSSA/

It has onboard Gigabit Ethernet, wireless, and guest wireless (you can have someone at the office change the visitor password monthly & print it out on a memo board for patients) that is separate from the primary network. Netgear has an excellent 8-port non-POE unmanaged Gigabit switch for $40, I've put in dozens of them with good results:

http://www.amazon.com/NETGEAR-ProSAFE-Gigabit-Desktop-GS108-400NAS/dp/B00MPVR50A

So:

* Wireless router
* Gigabit switch

$275 for the network setup (plus some CAT6 cable off Monoprice). They sell nice range extenders (RE450, $115) if they need more wireless range. You can check out OpenDNS for additional network control (ex. website filtering), or something like the Bitdefender BOX:

http://www.bitdefender.com/box/

They also sell a small UPS for stuff like routers & switches for $40:

http://www.amazon.com/APC-BGE70-Back-UPS-3-outlet-Uninterruptible/dp/B00KH07WRC

So overall total costs:

1. Computers: 5 x $455/ea plus a spare $160 box = $2435
2. Server stuff: $1985
3. Network stuff: $275

Total: ~$4700

Plus as mentioned: online HIPAA backup, Ethernet cabling, and stuff like ISP costs. That gives you:

1. A server with local & offsite backup & a backup server, both with battery backup
2. Five low-maintenance computers, plus a spare computer box
3. A fast network with segregated guest wifi access

If the database borks, restore from the most recent database backup (noon or night). If the system borks, restore last night's image clone. If the boot drive dies, restore last night's image clone to the original hard drive. If the server dies, grab the backup laptop & restore last night's image clone, then restore the most recent database backup (noon or night). If someone's computer crashes, restore to factory using Windows reset. If someone's computer dies, grab the spare box & quickly set it up again with their apps.

Wiring setup will be minimal. An Ethernet line to each device. Power from the monitor & PC box. An HDMI between the Mini PC & screen. Throw in some network printers & you're all set!

Kaido is great!
I know it is a very old discussion but Kaido if you check this, can you please tell me if you would do anything different from what you suggested? (not so much on the hardware part but on the software side)

I would really want to have Open Dental totally on the cloud. Like probably installing it on AWS - EC2 but every IT company that I spoke is telling me that this is not a good idea and there will be glitches so I have to have a local server in the office ( planning to have 12-15 computers that will need access to the patients data).

Does anybody thinks that Open Dental can be run totally on the cloud?

Thanks!
 

Kaido

Elite Member & Kitchen Overlord
Feb 14, 2004
46,465
3,465
126
Kaido is great!
I know it is a very old discussion but Kaido if you check this, can you please tell me if you would do anything different from what you suggested? (not so much on the hardware part but on the software side)

I would really want to have Open Dental totally on the cloud. Like probably installing it on AWS - EC2 but every IT company that I spoke is telling me that this is not a good idea and there will be glitches so I have to have a local server in the office ( planning to have 12-15 computers that will need access to the patients data).

Does anybody thinks that Open Dental can be run totally on the cloud?

Thanks!
It's been 3 years since that post, but the same logic applies - just with newer hardware. Some links to the newer gear:

* 31.5" 1080 IPS screens with VESA mounts @ $185/ea
* Logitech MK320 wireless keyboard & mouse set @ $25/ea
* Newer MINIX @ $295/ea
* Netgear Orbi wi-fi system (main & then separate guest wi-fi) @ $280/ea

You can run anything in the cloud..."cloud" just means the server computer is somewhere else, not on premises. There are just a few issues to be aware of:

1. If your Internet connection goes down, you are hosed. I've had several customers migrate to cloud servers...for the most part, the big cloud networks rarely go down, but sometimes your local Internet does, so you need to be prepared with a backup Internet option, like a cheap DSL or cable line, or a 3G modem. I'd also recommend investing in a good Fiber or maybe a Layer 2 Ethernet solution, if that's available in the area. All depends on how much money will be lost every business hour their Internet is down. If the shop runs at $10k/hr & they are Internet-dependent to work, then you need a solid primary Internet solution, as well as a backup Internet solution. Also, shop speed is dependent on a variety of connections, but primarily Internet speed, so you need to spec out the proper requirements to keep a solid connection going. If the shop runs $1k/day & has a local server, then a single standard fiber-backed cable Internet connection should be fine, because if it goes down, no biggie.

2. HIPAA compliance gets a little bit tricky with dental clients...I only have a couple at the moment & they are both on local servers. You want to make sure their insurance covers cybersecurity breaches & that you have some PII scanning & PEN testing type of stuff setup. You don't want to be an amateur at compliance stuff & security stuff with medical files!

3. Your promise of support is only good as your cloud vendor. Most of the time, the big ones like Google & Amazon are pretty good. You have to ensure that you're not leaving anything open (just look at all of the cloud hacks at major companies over the past few years). You are also now the middleman, so you'll have to take the heat if things goof up & you can't fix them because it's not hardware you can put your hands on. You'll still want to come up with an off-site backup system & some protection against stuff like cryptolocker ransomware viruses. In addition...if you stop paying the monthly fee, then your servers go away...

The Open Dental software requirements are still pretty tame:

https://www.opendental.com/resources/HardwareRequirements.pdf

A pair of mini servers, a HIPAA-compliant automated cloud backup service, and a dozen client computers with some spares would be a nice route to go. I would suggest prohibiting access to the Internet on all clients machines, given the sensitivity of medical files & the risk of a zero-day exploit eating a local machine because a client opens an infected site or email attachment or USB stick or whatever. There are some tricky things you can do to create a clean security profile, like using a Gen1 Hyper-V VM on a Terminal Server with DeepFreeze or paying for a browser-as-a-service or some different things like that. It all depends on what the situation calls for...if the users need Outlook access or require Internet access or whatever.

If you're really set on the cloud, Microsoft is previewing Windows Virtual Desktop on their Azure platform right now:

https://azure.microsoft.com/en-us/services/virtual-desktop/

For something with as simple requirements as Open Dental, I'd personally just build off a secure, off-Internet network with a solid backup system, solid spare parts system, and then encrypt all of the computers with Bitlocker. That way HIPAA compliance & security (both digital & physical) are pretty easy & you can easily restore any physical or digital damage that your client runs into in pretty short order!
 

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