First caveat: I am not even close to being a SQL expert. I agree that pushing data rather than pulling it can be faster. I doubt that AC support would be able to help there as they don't tend to have SQL technician support.
As far as koby is concerned, there are practices which have used Standard versions of SQL and had a significant increase in performance. Especially large practices. But, SQL Server 2012 Standard is $2,800 with 10 CALs. There is simply no way 8,000 users are going to be able to swing that.
The number of practices that need/afford full SQL will be a sub-set of the installed base, but as one practice expressed, upgrading to full SQL is less expensive and disruptive than changing EMRs.
AC and we are announcing several things; I commend John Squire and AC for embracing the option of using full SQL as this enables them to extend the reach and capability of Amazing Charts.
Some people may not know that our largest AC client has between 45-70 users with ~150 desktops. At scale, performance is a holistic activity that requires several significant and distinct skill sets for success.
That said, I hear from AC a serious focus on fixing and improving performance and long-standing influences the balance of 2015. We wish them success in that, even as we take a more active hand in helping practices adequately prepare for upgrades.
