I installed this for a client and there are a good amount of bugs in it. One is that the Superbills are not generating properly (some patients it takes a day to be visible, others is like 2 weeks) and they are also having an issue with printing prescriptions. Not really any performance upgrades that I can see as one of my clients has a 40 core/80 thread server with 128GB of RAM and nothing but solid state drives and orders and prescribing screens still take between 10-30 seconds to load.