Recommendation for server setup in small dental office. Only 15 workstations.

I'm am looking to replace an aging server and would like to hear some thoughts/comments on the "best" way to proceed.
We currently have a pretty simple setup with 1 server running Windows 2008 R2, which is used as our DNS, DHCP, and Domain Controller. In addition we run our client database software (for a dental practice) including print services and general file sharing.
I am in the market to replace this and considering all my options. I'm considering whether HA would be a good idea for something like this or if it's overkill for the $$. I like the idea of having failover as I am approx 4 hours away from this location if something were to go wrong. Of course this would require 2 phyiscal servers/hosts with shared storage (ie QNAP NAS etc.)
Another option would be to continue similar to how we're setup now, with a new Server 2016 server. If I go that route I would setup the local storage RAID 5 (with a hotspare?). From what I'm reading I would be able to then install 2 virtual machines using hyper-v so I can separate my roles/services etc. If I go this route I would opt for 24/7 4 hour support in the event anything were to wrong.
I'd like to hear comments on whether or not HA would be a viable/affordable option or if I should just go with the 4 hour support.
Thank you!
bkdavisAsked:
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Sam HaqueSr EngineerCommented:
Just move the entire server environment to Azure or AWS. You will save more money.
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Scott SilvaNetwork AdministratorCommented:
And see if you can find a local tech or shop that can provide you some occasional support if you do stay in house...
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Cliff GaliherCommented:
A QNAP (or any Nas) is just a custom computer and OS. A single point of failure. Not suitable for HA. True HA won't come cheap. If they want to pay for it then it is worth it. If they don't then it's not. Leave that choice to them. Don't make it for them.. Or you'll be on the hook either way.
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arnoldCommented:
Medical field, have to be HIPAA compliant.

What is the existing hardware in use, is the sole access web based to a HIPAA compliant billing/record keeping?

Using Virtualization might be a way to mitigate your costs. i.e. buying pre-owned server. vmware essential package 2/3 hosts with 2 processors each.

do not go RAID 5, provides single point of failure and depending on the HD size, the performance gets a hit and takes a significant time to ...

IMHO, before providing recomendation, you have to quantify your needs for storage, resources.

yes using a 2016 you can get a hyper-V with two VMS....

Look at getting a VMWAre and cost of licensing of a VM for windows would mean that you could potentially run 4 VMs with windows 2016 on a single host by paying the 4x2CPU license for virtualization....
versus a single .....
veeam for VM backup,,,,...

you could build redundancy within the VM environment.....
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Lee W, MVPTechnology and Business Process AdvisorCommented:
IF the database software doesn't support cloud use for whatever reason, cloud is not an option.
1. You must virtualize.  Period.  HA or not.
2. If the budget is not there for high availability (and that's very expensive), you can setup an old server/old PC with enough RAM and install the free Hyper-V server and enable replication.
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fred hakimRetired ITCommented:
HA is a question of what would you lose in case of a hardware outage and how much time to recover from it.  Put a value on that time, then you can answer.

Assuming, on a standalone server you would have regular data backups and raided drives, the impact of a single disk outage would be low.  So that leaves Motherboard, Memory, PC Power Supply (some servers have dual PSUs) or CPU outages that you stand to protect from with an HA rig.  Other issues, like network or building power won't be mitigated by an HA rig, unless you want spend some seriously big bucks with dual ISPs and Dual Power sources or generators.    

So in the rare event your server Memory fails your down time would say one day (two if you are remote and can't get a tech quickly) with just one server.  

With a second (backup) server, the down time would be how long it takes to restore the last backup + how long it takes to decide to switchover + how long it takes to get back in sync with data bits between the last backup and now.   (probably hours -- barring any issues).  You can greatly reduce switchover issues and decrease switching time, by regularly switching over.    Make it even lower by restoring data to the backup server as part of the backup process.  You could even go so far as to keep it synced in near real time.  

Then the HA solution, which depending on how its done may or may not be entirely seamless.  The closer to instantaneous the more expensive the HA rig.   The Ultimate being multiple servers sharing the workload simultaneously from different physical locations with enough power to service everyone while others are down.  That can get pretty tricky, requiring  dynamic load balancing switches etc.  You can go really nuts with this stuff.  

The point is, can you live with a couple hours down time and just have a backup to switchover to or not?
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bkdavisAuthor Commented:
Would there be any reason to use VMware vs. Hyper-V?
Thank you for the replies!
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Lee W, MVPTechnology and Business Process AdvisorCommented:
The only reason to use VMWare is that you like spending money and you know it CONSIDERABLY better.  For a small business, the performance and management differences are negligible.
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arnoldCommented:
When using Hyper-v much depends on whether you will be install core or the host will also be performing services, application....... and then the host will have to be a member of the domain, but where will the DC be a VM running within?

available hardware or what hardware you are planning on purchasing ........
Are you looking at new Server purchase, or pre-owned?

four hour drive, and to have resiliency/redundancy by way of remote management.......
much of the existing environment, application, in house storage requirements, imaging? (x-ray, etc.) that are taken and need to be stored/attached to the PT...... records....
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Scott SilvaNetwork AdministratorCommented:
I think for a dentist office HA would be a less critical thing than reliable backups and maybe even hourly snapshots. For a short term outage paper records could be used temporarily, and at a minimum a second small PC to run the digital xray system if you have one. That way you could still service clients fairly well, and with decent new hardware you can get pretty quick warranties on the hardware... I have had Dell AND HP out within 4 hours in the past. IBM in less than one hour, but that is for our midrange server.
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fred hakimRetired ITCommented:
If you are going to buy a small system to backup the xray, how much more would just having a second backup server?  If you do and you keep the data pretty much in sync (using file syncs or backups), it should be able to get up and running in a short time.
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Sam HaqueSr EngineerCommented:
Owner didn't respond for a long time.
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fred hakimRetired ITCommented:
Many valid answers here, how does only the first become the solution?
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