Quality Systems Inc. (QSI) and its subsidiary NextGen Healthcare develop and market computer-based products for medical and dental practices as well as hospitals. QSI is a key player in the Healthcare Information Technology (HIT) sector, which includes the emerging Electronic Health Record (EHR) technology. The cover is an abstraction, represented by a fractal, of the connectivity and scalability of the various products offered by QSI. This visual creates energy and dynamic visual interest (fractals are inherently cool) and we also avoided the regular clichés of Drs and Medical Equipment imagery. QSI has a very compelling message and opportunity, which the shareholder letter addresses very succinctly. Five pages of the shareholders letter were dedicated to comprehensive testimonials that not only included a photo and a quote from the client but also a description of the services provided. Diagrams and bar charts are adjacent to the relevant text and the overall layout of the shareholder letter is directly tied to the cover but not too predictable. We feel the overall look and feel of the QSI 2011 annual report is consistent with the dynamic growth potential and quality customer service QSI provides its shareholders and clients.