Best Configuration and Platform for Production OpenERM 6.1

I have seen many flavors of OpenEMR installation and setup.

Aws Lightsail
Virtual Platforms: VMware, Hyper-V
Different OS: Windows, Linux, Mac

I would like to ask the Forum which setup gives the best and most stable installation of OpenEMR that is upgradable.

Windows server with XAMPP
Windows server with LAMP Stack
Ubuntu 20.04 with LAMP Stack
Ubuntu 20.04 with Lightsail and Docker
Docker containers on Windows on Linux

Which Virtual platform:
Other Linux Flavors

Also in your setup and installation and daily use which combination works best for you:
Physical server, Hypervisor or Cloud?


I have been using the following Combo for the main setup:
Production: UBUNTU xx.04 for Server OS + LAMP + OpenEMR.

I have one running direct on metal (for 5 years now) and it is very very very stable, been trough the updates and upgrades. When i say stable, i mean the I-would-stick-my-hand-in-fire-for-that kind of stable. I have 1 Combo running in VirtualBox on Lubuntu and 2 in a ProxMox VM. All very stable. However I had to do all the OpenEMR updates with a lot of manual work, because i did not know how to write modules at that time i started those projects. This means those systems might always be a bit of a headache to update/upgrade, since i have to keep track of and test all my changes for each (important) upgrade.

Development: I use Xampp on Windows for development, for a few different reasons, the main being that i also need to see the system through the browsers (and a few other things) that the client-systems will.

So to answer the final question, which one works best for daily use?
I would say I love the Production Combo i mentioned earlier, regardless of where it is setup, but i noticed that I am loving the ProxMox VM more each day.

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Thank you for your detailed response. Right now I’m running on Windows 2019 server with Xampp. But I want to move to Ubuntu 20.04 with LAMP.

As you said Ubuntu is very stable but upgrade is a hassle. I like the idea of having a Windows setup so you can how things work with the file system and database.

Right now I’m testing a lightsail local instance on Ubuntu and trying to restore Openemr from the Windows server install to lightsail on Ubuntu with docker.

I would never say that upgrade of OpenEMR on Linux, or of Linux in general, is a hassle. I think the reason he was saying upgrade was a hassle is because it sounds as though he’s made lots of invasive customisations of OpenEMR.


Hey Pete, Thank you for your response.

Waht’s your OpenERM platform? When it’s time to update/upgrade you just follow the instructions and they work? I’m assuming you use linux and don’t have to many customizations.

@LMoonsammy . @PeteBoyd is 100% right. Let me be very clear that the upgrade-hassle has nothing to do with OpenEMR or Ubuntu themselves, but are due to the fact that i made a lot of “invasive” changes to core OpenEMR files. At the time i was working on those projects, i had not learned to write OpenEMR modules yet.

I do consider UBUNTU+LAMP+OpenEMR the most reliable, secure and easiest to manage combo in a production environment.

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Thanks for your recommendation. I have been able to install OpenEMR 6.1 on Ubuntu 6.1. Now I have to import my database from my Windows install.

I got an error when I go to the Manage Modules menu. ‘Pagenot found’

Check this thread out. Modules page show a Page Not Found - apache2.4

Your apache needs to be setup to support .htaccess files.

Thanks for the tips. I’ll check them and let you know.

@LMoonsammy For each upgrade, I follow the few steps described in the relevant Linux guide linked to from:

I keep a list of any current customisations I make, of the type that would be wiped out by an upgrade, in my own list.

Thanks Pete for the tip.