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I found on Medisoft v20 if you have the service McKesson MSL Mobile API Server (plutoserver) running, then there is a 2-minute delay in starting up Medisoft. If you find and stop this service under Windows Start -> Control Panel -> Administrative Tools -> Services, then Medisoft will startup immediately as expected. Set the startup type to Manual to prevent the service from starting up when you reboot your computer.

I am not sure if this will affect other versions of Medisoft, but since the service was for the old Medisoft Mobile which is no longer functioning, then you might as well stop this service on any version of Medisoft. There is another service that runs for the current Medisoft Mobile services that is only available for those on Medisoft v21 or newer.

That's a great tip, thanks Gavin, it does work with Medisoft v.22, I'm saving perhaps 5-15 sec per opening. If there was a 2-minute delay, I'd say I would want my money back.
On another note, what happened to Tools -> Services -> Mobile in Medisoft? Mine disappeared completely about 1 month ago. I cannot see any API screen at all. Is there a time bomb that ticks off nearing 1 year from update of the last version, urging all of us Medisoft users to upgrade to the next version?

Make sure the eMDs MSL Connectivity Service is running on both the workstation and the server. If you are using multiple Medidata root folders then you have to log into Medisoft 1-time using that MediData root and then restart the service on both the client and server.