I can't speak to the other commenter's experience but I've been using Visionary in my one physician office for over 5 years. It is efficient, I don't have to pay for updates, and they offer free training webinars. I have had to wait a few times on support calls, but I have to wait when I call the cable company too. Visionary has an EMR with CCHIT and very affordable too. Recently they added appointment reminders, and automatic back up service. I recommend this company.