I will leave it to the more tech savvy to explain how they can do this when the databases on your desktop
Look at it this way. First, every time you sign in, you may get a message that says 6.6.5 is the latest version. Or you haven't backed up to the cloud in 50 days. This is because, when you install AC, it is designed to talk to the "mothership" Same as when you download a free piece of software, each day it says 1 day out of 30, 2 days out of 30.
Now they don't get info from your desktop, there is no info. When you log in, you log in to your databases. If they can get to your EMR, then can get to your databases same way.