Microsoft OS and SQL Server Compatibility Matrix
Pracsoft is distributed with the free Microsoft SQL Server 2014 SP3 Express Edition.
- Some customers have reported performance issues after installing MedicalDirector applications on a SQL Server 2025 instance or upgrading their existing MedicalDirector application's SQL Server installation to SQL Server 2025. MedicalDirector applications perform normally on SQL Server 2022 and earlier versions. After investigation, the performance issues appear to be related to changes in SQL Server 2025’s query processing engine that were introduced in an update late in 2025. At this time, it is not recommended that MedicalDirector customers upgrade to SQL Server 2025. MedicalDirector is investigating the matter further and recommends that customers install only the SQL Server versions listed in the matrix below.
- SQL Server 2014 SP3 Express Edition has a maximum database limit of 10GB. For larger databases, full Microsoft SQL Server is required. If you want to use a full Microsoft SQL Server product, consult the compatibility matrix below.
- The SQL Server installation cannot be made on read-only, mapped, or compressed drives, and SQL Server setup via Terminal Services Client is not supported.
- Ensure you have a minimum .NET 3.5 installed in order to run the SQL Server 2014 installation.
- The SQL Server 2014 installation will install .NET4.0 automatically if not already present. This requires an active internet connection for the .NET4.0 installation files to be downloaded.
- If you have a Server Core installation of Windows Server 2008 R2 SP1 or Windows Server 2012, you must install .NET 4.0 manually, before you install SQL Server Express.
- Always install the latest Service Pack.
| OS-SQL Compatibility | SQL 2005 SP3 | SQL 2008 R2 | SQL 2012 | SQL 2014 | SQL 2016 | SQL 2017 | SQL 20191 | SQL 2022 |
|---|---|---|---|---|---|---|---|---|
| Server 2003 Service Pack 2 (including SBS) (32-bit) | - | - | - | - | - | - | - | - |
| Server 2008 R1 | - | - | - | - | - | - | - | - |
| Small Business Server (SBS) 2008 (64-bit) Pracsoft requires at least Service Pack 2 |
- | ✓ | ✓ | ✓ | - | - | - | - |
| Server 2008 R22 | - | ✓ | ✓ | ✓ | - | - | - | - |
| Server 20122 | - | ✓ | ✓ | ✓ | ✓ | ✓ | - | - |
| Server 2012 R2 2 | - | ✓ | ✓ | ✓ | ✓ | ✓ | - | - |
| Server 2016 | - | - | ✓ | ✓ | ✓ | ✓ | - | |
| Server 2019 | - | - | - | - | - | - | ✓ | ✓ |
| Server 2022 | - | - | - | - | - | - | ✓ | ✓ |
| XP Home Service Pack 3, (32-bit) Standalone or peer-to-peer w/ other XP Home only |
- | - | - | - | - | - | - | - |
| XP Pro Service Pack 2, (32-bit) | - | - | - | - | - | - | - | - |
| XP Pro Service Pack 3, (32-bit) | - | - | - | - | - | - | - | - |
| Windows Vista Business/Ultimate/Enterprise3 Service Pack 1 *Requires Service Pack 2 |
- | - | - | - | - | - | - | - |
| Windows 74
*Pracsoft requires at least Service Pack 1 |
- | ✓ | ✓ | ✓5 | - | - | - | - |
| Windows 8 Excludes Windows RT |
- | - | - | - | - | - | - | - |
| Windows 8.1 Excludes Windows RT |
- | ✓ | ✓ | ✓5 | ✓6 | ✓6 | - | - |
| Windows 10 | - | ✓ | ✓ | ✓7 | ✓6 | ✓6 | - | ✓ |
| Windows 11 | - | - | - | ✓ | ✓ | ✓ | ✓ | ✓ |
1 You will require a minimum 6GB hard drive space to install SQL
Server 2019, plus a minimum 5GB space for the MedicalDirector database. SQL
requires at least a 1.4 GHz processor, with 2.0GHz recommended.
2 Microsoft provides only a 64-bit
version.
3 Home
Basic/Premium will install Pracsoft 4.3 but is not recommended. Should not
be used in a Server role for Pracsoft.
4 Home Premium has limited functionality,
recommended only for Standalone Servers, or in a simple network with other
Windows 7 Home Premium PCs.
5 SQL Server 2014 Standard only.
6 Operating System does not support SQL
Server Enterprise Editions.
7 Any version. SP1 is required.