We implemented Ethos 4 years ago with a customized platform. We had some growing pains because the system was complex for our administrators, but things improved drastically about two years ago. The system is much more user friendly now. We have an excellent relationship with the Ethos team. They are always friendly and responsive to our needs. Their scheduled release updates are good and security updates are up to date and implemented quickly. Their settings are robust and supports CME accreditation. Because of our customizations, one area we would like to see improved is in the area of reporting. We are hoping for ad hoc reporting with better filters in the future. We recently launched a major initiative where we enrolled close to 10,000 learners into a Self-Directed Learning Activity. It has gone smoothly with 9,000 learners completing it.