The separate database tuner is a major flaw to the deployment of the AC installation. It's been this way ever since they moved from MSAccess to MS SQL. It was a good move to SQL, however this methodology of install is (as you learned) NOT intuitive at all. And all upgrades must use their own version of database tuner. Sounds like your lesson was learned the hard way. Keep this in mind w/ future upgrades.

Hopefully in the future, AC developers make this upgrade and installation process like most other programs (without separately self-tuning the database).

Adam Lauer, DO (solo FP)
Twin City Family Medicine
Brewer, ME