In a well-designed client/server network, workstations should not be storing any data, they should only be responsible for your applications, and any directly attached peripherals. You should not spend more money than you need to on your workstations - for many SMEs, a basic business class machine for office work will be more than enough. If you require manipulation of digital images, or other processor intensive tasks, that may justify better specification hardware. Furthermore, if you often run more than one application at the same time, the machines need to be specified with plenty of RAM memory, or they will slow down under load.
With the advent of dual core processors, and faster I/O systems, it is fair to say that, even cheap, entry level machines are more than adequate for most tasks these days. The only machines that should be avoided, in our opinion, are machines with Celeron processors – these budget machines give noticeably poor performance – and with the additional load of, for example, antivirus software, can be very slow to use. In general however, modern PCs are very fast, stable and, if you choose mainstream well-built machines such as HP, will be on the whole predictable and reliable. But it is important to remember that they are not servers… they are not built for resilience, they have not built in backup or redundant hardware, and no critical data should ever be stored on them. That is the job of your server.
When choosing the right workstation for your dental practice, it is just as important to consider issues or power, noise, and aesthetics, when deciding on the most appropriate workstation solution.
Issues of power, and noise
With the current price of fuel, people are increasingly considering the power usage of their business machines, and this includes, of course, the PCs you operate. Some of the modern, dual core, processors, are hugely more power efficient than previous Pentium 3 or Pentium 4 processors. Modern computers, and the operating systems that run on them, are better designed to go into lower power modes when not being used intensively. And workstations should never be left on overnight, which is simply pouring money down the drain. Some IT people recommend 24x7 operation for computers, with the belief that errors often occur at boot-up. While this is undoubtedly true, if you have, for example, a hard drive that fails on boot-up, chances are it was going to fail sooner or later anyway. If your workstation cannot stand regular rebooting, I would say that it is not of a good enough build quality to be in production use. Servers should stay switched on, but they are very animals to workstations.
Lower power, and better built PCs, are also very often much quieter than traditional towers. Manufacturers such as HP, or Dell, build systems that are properly integrated, and their fans and other moving parts, will be chosen to match the specifications of the case chassis, and the component parts. These modern PCs are often virtually silent in use, making them much more appropriate for the modern clinical environment.
The traditional view of the PC as a tower, with a monitor, is increasingly out of date. Modern computer builds offer a host of choices, many of which are much more suitable to the modern dental practice treatment room layout, design, and furniture, than the old “box in a cupboard” approach. This was always a bad idea anyway, since a computer housed in a small cupboard is probably overheating, and will be noisier and not last as long, as a computer that is running cooler. Furthermore, housing the PC in the cabinetry, often means putting large holes through your (possibly very expensive) worktop, running ugly and awkward cabling through or behind panelling, and making future maintenance and replacement potentially more difficult.
Dental IT are increasingly recommending alternative, more suitable designs, such as the USDT, ultra slim HP models, that can be mounted just behind the PC monitor. Or, the Apple iMacs (reinstalled with Windows XP), that are all-in-one, and require no separate tower at all.
These type of machines have a smaller footprint, can be quickly deployed, and do not take up valuable workspace or cabinetry space. There is less cabling involved, and installation and maintenance is much simpler. Furthermore, they look much better – and, in the case of the iMacs, patients notice and admire them as well – increasing the “wow” factor of the modern, minimalist, dental surgery.
The most radical solution of all, is to not use PCs at all, but to use very small terminals called “thin clients”. This is a workstation which provides access to the network but does not offer all the facilities of a full-scale PC. They are extremely small and can fit almost anywhere. They can also be mounted behind the monitor, under the desk, or on the wall. They have no moving parts; no hard drive, no fans and no CD-ROM drive, so they are extremely reliable. They are less flexible than other solutions, as they rely on the server to run the application. Most external devices cannot connect to them, so they would not be suitable if you are considering, for example, intra-oral cameras or other directly attached peripherals.
Increasingly, people are choosing laptops where you might have expected to see a traditional PC. They are, of course, smaller, more flexible, and neater than the traditional PC, with separate keyboard, mouse and monitor. It used to be the case that laptops were always slower than their “PC” equivalent, but this is less and less true. Modern laptops can be just as appropriate for all-day use as an equivalent PC. As with the thin clients, however, they may not be suitable for your deployment, depending on the other technologies you need to interoperate with. It is not possible, for example, to install a capture card, or proprietary serial card into a laptop. They are also much easier to steal, as well! Many of our practices have at least one laptop, however, as they are fantastic as “hot spare” machines, installed with all your practice applications, and able to be deployed anywhere at a moment’s notice.
Expect failure and plan accordingly
Whichever model of machine you use, it is important to remember that workstations should be considered essentially disposable. Client machines, unlike highly specified servers, are not usually designed for extremely high reliability, and you have to expect that they might fail, even when they are new. There are a number of strategies that Dental IT deploy to address this issue:
- We always ensure that, as much as is possible, all client machines are standardised. All application installs are stored on the server, all configuration details and license keys are logged on the server, and all the machines have a similar "build". All Dental IT networks have full Windows domains, and no data is stored exclusively on the client machines. Swapping the machine out, therefore, becomes much simpler and there is a quicker recovery time.
- We always recommend that there should be one spare machine somewhere in the business - either by allocating one machine in a function or space that is not always used, so that machine can be redeployed quickly, or by having a dedicated spare, ideally a laptop as discussed above, that can be pressed into service at short notice.
Most basic client machines should offer you three to five years of service. Expecting more than this is likely to prove false economy, as support, recovery and repair costs are likely to become much more of an issue at this stage.
Upgrading existing machines
Sometimes when installing an IT upgrade, we can re-use existing systems, and where they are useable, we certainly do not insist that perfectly good machines are scrapped. Sometimes machines that are just a few years old, just need a small upgrade, such as the installation of more RAM memory, to improve their performance. Upgrades such as this, are very cost-effective.
Last edited: 28 November 2013