I am glad (upset too) that finally another user group is confirming the problem that we are facing in the past few weeks. Our staff and IT spent hours and hours testing the network and server. Multiple calls to AC and multiple remote log in failed to solve the problem. We cannot see any limitations in our Server 2003 or the wired network. The problem seems to be the software problem of AC V5 and SQL Express. Can some one explain the 16 instance limitation? If we cannot solve the issue, we may have to switch to other EMR sadly.