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I provide IT consulting for a small dental office where there is one provider who is the owner. There are five users and about ten workstations. The current “server” is a Windows 10 Pro workstation with decent enough specs that helped it last 12 years. CPU is an Intel Core i7 3rd Gen. Storage is hardware RAID (Adaptec) configured in RAID 1 with three 2 TB drives (one is a hot spare). Boot drive is a 512 GB SSD. RAM is 16 GB. The backup system is an RDX cartridge system. It’s time to replace it since Windows 10 is going out of support. So, I’m looking for some advice.

First is the hardware. I could replace the computer with another up-to-date workstation (with solid components and specs that will hopefully last another ten years). In theory, this should work fine as the current system meets all of their needs. I would probably double the storage and RAM in the new system for future growth… Maybe keep some spare parts on hand in case of a hardware failure.

I’m trying to decide whether to consider server-class hardware, but I don’t think it’s really necessary for a small office like this. It would be more expensive. Is it even worth it?

Second is the OS. I could stick with a workstation OS and maintain the status quo. It has met their needs so far. The only thing I find lacking with the current configuration is no central management of the user accounts. Whenever I add a new user or stand up a new workstation, I have to create the account on all of the workstations on which the user needs access as well as the server and then set the passwords the same to enable transparent authentication. Active Directory would be a way to solve this. They don’t really need the other capabilities of Windows Server, though. Is there a way to accomplish this without Windows Server? Are there alternatives?

Unfortunately, it sounds like Windows Server Essentials (which was geared toward small businesses) is no longer an option, so I’m looking for alternatives that aren’t needlessly expensive. Windows Server Standard seems like overkill and expensive.

Thanks

Edit 1:
Sorry, I neglected to specify what’s running on the server. Here’s a list:

  • Open Dental 23.3 Practice Management System – client/server using MariaDB 10.5
  • CS SoftDent 12.5 - legacy PMS w/ CTree database (going away eventually :pray:)
  • PracticeWorks License Server and SDTaskMan for SoftDent
  • VixWin Platinum imaging software (for x-rays and camera images) – comprised of client software, patient & images databases (DBase3), and file storage, not bridged
  • Vyne Sync - CRM module that hooks into OD
  • HDX Will-Master, OnDemand3D, etc. – software for CBCT (don’t know a lot about this yet, but it appears to use a Sentinel LM)
  • Tandberg AccuGuard RDX backup system (uses SQLAnywhere, I think)

The system requirements for everything are pretty light. Some of the software is old or has been around a long time (e.g. VixWin, SoftDent… even Open Dental has been around over 20 years) and their requirements are easily met by modern hardware; other components require very little from the server.

Email: Both the office and the dentist use Gmail. The office email account is shared; nobody has their own mailbox except the dentist.

Remote Desktop: Currently no need for the office. Though we did recently install TruGrid on a workstation for an accounting consultant. So far, this is working fine.

VPN: None.

Everything is on-prem. No cloud services except O365 Business, but I might change licensing since they mostly only need it for Outlook. (Before changing ownership, the office used to use O365 with Exchange Online, but the new owner decided to go with Gmail.)

Edit 2:
I should clarify that at least two workstations do not use the “server” for file sharing and are dedicated to controlling instruments. Also, I counted the server as one of the workstations. So, by ten, I meant nine workstations and one server. All a mix of Windows 10 or 11 Pro.

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But the question would be what is going to be running on the server(s) ?

You can use Synology NAS as DCs if they really need DCs ?

Are all the machines running MS Win11/10 Pro ?

Why 5 users and 10 PCs (I dun think they got workstations) ?
Would it be more cost effective if each user is given a lappy instead ? They can bring their assigned lappy to where ever they will be seated for the session instead of getting a PC for each location ?

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You may consider a HP Microserver G10 or G10+ as the ‘server’, small, support for 4 drives and quiet.

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I guess you could do that with something like ansible in a workstation based environment too.
one of the workstations would be your control node, but it does not have to be a server.
then you could keep up the rather less expensive workgroup setup.

you might want to have a look at this: ansible.windows.win_user module – Manages local Windows user accounts — Ansible Community Documentation

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Might be worth looking at a Microsoft 365 subscription, that would give you Entra ID (AD) and you could use Sharepoint for file management. They would need a reliable internet connection though.

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Are they accessing applications that are hosted by the current Win10 “server”? If it’s just shared file and folder access, you have more options.

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A workstation OS is not going to be an option because the Windows 10 and 11 terms of use specifically prohibit using them as a server for remote access. I would second the other suggestions about looking at Microsoft 365. What are they currently doing for email? If they use Microsoft 365, they may already have SharePoint. Just ensure that it is configured in whatever method is necessary for them to remain HIPAA compliant.

The other option would be to look at a single physical DC (though I always recommend at least going Hyper-V even in small environments for future-proofing). The advantage there would be fewer recurring software costs. If they are using special medical software on-prem right now, confirm with the vendor that virtualization is supported.

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I second this suggestion or some similar cloud offering, particularly because a Dentist’s office needs to comply with HIPAA. O365 is not HIPAA compliant by default, but it can be (here’s a decent article: https://www.hipaajournal.com/microsoft-office-365-hipaa-compliant/#:~:text=Microsoft%20Office%20is%20not%20HIPAA,Microsoft%20Office%20365%20HIPAA%20compliant. )

Moving to cloud would also simplify hardware maintenance moving forward.

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Wouldn’t that require M365 Biz Premium or higher? It may even require additional add-ons?

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This ^ without knowing what the server is used for I can’t really make any recommendations.

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HIPAA compliance is the primary concern. Start with what you need to do to fill current gaps, or what you want to do to enhance what is already there.

Does the dentist practice software have all the necessary HIPAA controls? Nothing is tied back to these “shared” computer logins?

If just accessing the Windows machine doesn’t give them any access to anything covered by HIPAA, then centralized control via AD doesn’t seem to be necessary. It would certainly enhance security in the environment, but by itself wouldn’t be a reason to fail a HIPAA compliance audit.

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I think there’s an issue with terminology that needs clarification. OP states he’s using a workstation OS for his “server”, which is legal up to 20 peer connections. See https://www.microsoft.com/content/dam/microsoft/usetm/documents/windows/10/oem-pre-installed/UseTerms_OEM_Windows_10_English.pdf&ved=2ahUKEwiCjoLqoqOMAxUIIDQIHXfmBHsQFnoECBUQAQ&usg=AOvVaw1xNPmjNO3FQ_6RhxxVTp7O) paragraph 2 d iii. I think he’s using a peer network and 5 users with 10 legally licensed workstation OS launch the app from the from the 11th workstation where the app is centrally located. Calling it a server is a common misnomer, it’s really a file share. You might want to look at refurb high end workstations. I just bought a Dell 5820 Xeon 6 core Win 11 Pro 1 TB SSD for $360 from Discountelectronics.com and looks like what OP is looking for at a great price.

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What practice management software are they running? Something like Dentrix and Eaglesoft is going to run 1000% smoother with a proper server OS. Do they do digital xrays, take digital pictures, have a milling station, what do they do their accounting in?

Even something like a Dell PowerEdge T160 or T360 is going to be an excellent investment for that practice.

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What does the current server actually do? That could help with suggestions.

As for user management, you could use Copilot 365 or Google Workspace accounts to log in to Windows if each user automatically is also getting an email address. Or you could use a simple RMM with scripting to automate creating a user across all the machines at once (Action1 would work for this and be free at your scale).

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And accounting…quickbooks? external? sql? those things need thought also…

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Without knowing what the server is going to be called upon to do, it is difficult to make any recommendations.

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Yeah need to know what software the office runs. My opinion OP should be looking towards the software vendor to get minimum/recommended specs.

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Sorry, I added the list of what’s running on the server to the original post. Nothing too hefty.

Cool, I didn’t realize a Synology NAS could act as a standalone DC. I’ll bear that in mind. I’d still need Windows to run the various client/server and license manager components, though.

Yes. The Win10 systems are too old to upgrade to Win11, so they’re being replaced.

It’s a mix of desktops and laptops (some recently added). Desktops are where it makes sense for things to be in a fixed position, laptops for where portability is helpful. Some machines have a dedicated function. I’m sure there’s a more efficient arrangement. We might make adjustments in the future. We’re still figuring things out.

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Updated original post with more info.

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I do not think it is a legal term but more of a TCP or network connection…

We once had over 600 PCs connected to a Win10 “server” for lab purposes without any issues during a MS licensing audit. The issue is that max of 20 concurrent connections. No issues if sharing files as long as 20 machines opening files at one time, so can have 100s users opening files…but the limit is like only 20 can open/save files at same time.