But I'm sympathetic to using the basic4ppc developer tools.
What do you mean? You have choice to use the new B4X development tools.
As replied by Cableguy, Basic4PPC is no longer supported. If you insisted, you need to contact Anywhere Software. Basic4PPC is a tool to develop PocketPC app running on Windows Mobile. Are you sure this is what you are looking for?
I've always worked with visual studio this time.
You mean all the while you are using language like VB.NET, C# or VB6 kind of language? If you are familiar with VB.NET or VB6 then you would feel at home. Learning B4X would be easier for you. Just download and start using B4J or B4A for free.
Thus, I will be able to get rid of rewriting the same code for different environments in one language (web, desktop mobile).
If this is your goal, then B4X is the right tool for you!
Start with B4J for writing desktop application then reuse the same code (90%) to develop for Android mobile using B4A and iOS mobile app using B4i. You can also develop the web application using B4J as web back-end or front-end.
My concern is do I have a performance shortage in our hospital where there are a large number of users?
My short answer is No. It will perform as fast or even faster than other languages because it is compiled as native applications.
You have joined in 2014 and you are not a new member. I guess B4X has evolved a lot since you are away. Welcome back and continue to explore B4X!