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Microsoft SQL Server

SQL Server is Microsoft's premiere software system for scalable multi-user relational database management (RDBMS).  It comes in several "flavors", much like how Windows comes as Home, Professional and Ultimate.

The basic version (SQL Server Express) can be downloaded for free from the Microsoft website and is used by Doxio for most of its data management.  It is provided as part of the Doxio application with permission from Microsoft as a re-distributor license.  For a physician practice of up to five providers, SQL Server Express should be adequate.  Even larger groups can start off with SQL Server Express and upgrade only when needed. 

SQL Server Express can handle a clinic size of > 50,000 patients and several hundred thousand physician encounters (clinic notes, phone calls, messages, etc) based on our extrapolations of actual clinic data in our practice.   As the database grows, server performance can be improved with fairly inexpensive hardware upgrades such as more memory and a fast solid state drive.

As the database grows in size and complexity (i.e. more users and more patients), SQL Server can be upgraded to SQL Server Workgroup, Standard or Enterprise.  Prices for those upgrades start at around $800.  Fortune 500 companies use the Enterprise version of SQL server for its large-scale data management needs.  Yes, Doxio works with that too.

Doxio was developed and tested extensively around SQL Server 2005 but should have no problems running alongside SQL Server 2008 as well as the two editions are highly compatible.

For even more information on SQL Server, follow these Microsoft links:

SQL Server 2005 Express Edition

SQL Server 2008 r2 Express

The main difference between the two Express editions is that 2008 allows for database sizes up to 10GB while 2005 sets a limit of 4GB.  Either version should be adequate for most group practices.  Based on my own estimates, 2005 can store roughly 60,000 patient charts in a 4 GB database, more or less depending on the number and nature of written encounters, tasks, linked documents and other chart data.  Bear in mind that SQL Server can be upgraded later in case the need arises.

All things considered, which of the two editions of SQL Express do we recommend?  SQL Server 2005 Express.