eTHOS ^tm – The Stroke Report and Registry

Hospital Site/Subscriber Agreement and Policies
12/2000

 

This document describes the responsibilities of all eTHOS subscribers/end users and The Stroke Group.  Any Hospital organization wishing to participate in eTHOS must agree to the policies set forth in this agreement.

 

1         Policies, Definitions, and Responsibilities

1.1        General Description of eTHOS

eTHOS is the first national acute stroke treatment registry and performance measurement program for hospitals. It uses a web-based platform to provide clinicians, QA directors, clinical managers and other hospital personnel the ability to capture, analyze, access and compare their data with that of other institutions on a national basis.

eTHOS is designed to enable hospitals to enter data at any time and immediately see multiple reports which clearly document their hospital’s performance. The Stroke Group has carefully selected the data elements to benchmark time-to-treatment, clinical decision-making, system performance and HCFA identified quality measures.

eTHOS is easy to use and provides meaningful reports in graphical presentation quality formats. Hospitals may enter patient data and review their own reports and registry comparisons twentyfour hours a day, seven days a week, using an assigned password code to access a secured area of the website.

eTHOS allows hospitals to track and compare their acute stroke treatment performance against hospitals with similar or disparate characteristics participating in the registry. Because all hospitals use the same Ethos data entry screen, comparability of data across institutions is ensured. Confidentiality for patient and hospital data is built-in by blinding all hospital data entered into the registry and complying with federal HIPAA patient confidentiality standards by avoiding collection of patient identifier information.

The eTHOS reporting capability includes two categories of reports; Hospital Reports and Comparison Reports. Hospital Reports display individual Hospital Site-entered data and are not available to other eTHOS hospital participants, except as aggregate data combined with other hospitals. Comparison Reports allow eTHOS participants to select criteria to compare their hospital with others in the registry on an aggregated data basis. Comparison Reports employ the following selection criteria:

a)      Geographic Location:  State, Regional, and National

b)      Hospital Size: Number of Beds

c)      Academic or Non-Academic Setting

d)      Time Period: YTD/Current or Specific Period

e)      Stroke Unit Status

 

1.2        Charter Subscriber Program

The Stroke Group is offering its Charter Subscriber program to selected academic and non-academic hospitals. The Stroke Group’s objective is to immediately enroll one hundred (100) hospitals into eTHOS. AstraZeneca is underwriting the cost for these hospitals to participate in the registry for one year. There is no obligation to for hospitals to continue participation after the first year.

 

1.3        Definition of Hospital Site or Site

Hospital Site or Site refers to the Hospital, personnel and programs therein gathering data and using eTHOS.  

1.4        eTHOS Site Coordinator

Each Site assigns an eTHOS Site Coordinator as their liaison person with eTHOS personnel at The Stroke Group.  The eTHOS Site Coordinator is responsible for:

1)      Coordinating all aspects of hospital participation in eTHOS.

2)      Authorizing and monitoring hospital employee access to the Site’s password-protected secured area of eTHOS for the purpose of entering and editing data, viewing reports and using other functions of eTHOS.

3)      Insuring that the Site and all of their personnel that participate in eTHOS abide by this agreement.

4)      Protecting the confidentiality of the Site’s confidential eTHOS Hospital Password.

5)      Protecting the confidentiality of the reports obtained by the Site from eTHOS.

6)      Serving as the primary contact between the Site and The Stroke Group.

 

1.5        Definition of Users

Users are the individuals at each Site authorized by the eTHOS Site Coordinator to access the Site’s confidential eTHOS area using the confidential eTHOS Hospital Password. Users and Site Coordinators are responsible for familiarizing themselves with and complying with all related Ethos policies herein.

1.6        Confidential Hospital Profile

Hospital Sites agree to complete and submit a Confidential Hospital Profile to The Stroke Group. The Confidential Hospital Profile provides information about their hospital and stroke program. The Stroke Group will use this information to categorize the patient data entered by that Site for Site hospital reports, and  to aggregate the data with other Sites in Comparison Reports. The Confidential Hospital Profile also provides contact information and identifies the eTHOS Site Coordinator. The Stroke Group will keep all information contained in the Profile and received by The Stroke Group confidential.

1.7        Definition and Description of Information Types, Accessibility and Display

eTHOS contains and displays three types of information:

a)      Hospital Information. Hospital Information is Site data entered into eTHOS that is displayed in specific Hospital Reports for individual eTHOS hospital subscribers. Hospital Information is confidential information, only accessible to the specific site entering the data, and eTHOS administrators at The Stroke Group. The Stroke Group will protect the confidentially of all Hospital Information within eTHOS and will not release eTHOS Hospital Information from any Site without the express written consent of that site, with the exception described in the following eTHOS Quality Improvement Project. The Site agrees to allow data contributed by its Site to be combined or aggregated with that of other hospital sites and displayed as an average, mean or median in Comparison Reports, accessible to all eTHOS Sites.  Individual Hospital Information will not be identified in these Comparison Reports.

b)      Comparison Information. Comparison Information includes aggregate data that is viewable in the Comparison Reports section of eTHOS. Comparison Reports are accessible to all eTHOS subscriber hospital Sites, but are not available to the public or non-subscribers to eTHOS, with the exception noted in the following Public Information paragraph.

c)      Public Information. Public information consists of selected Comparison Information chosen by The Stroke Group to be displayed on The Stroke Group website in a general domain area available to any individual accessing the website. Public Information is intended to provide information that is of general interest to the healthcare community which will, through its display, increase subscription to and participation in eTHOS.

 

1.8        Data Entry Screen

Hospitals enter generic patient data into the eTHOS database via the Ethos Data Entry Screen that is located in the secure area of the eTHOS web site. Hospitals can enter new data or revise old data using the Data Entry Screen. Hospital Sites can only access their own data. They cannot view or change other subscribing Hospital’s data using this screen.

 

1.9        Reports

eTHOS  has very powerful reporting functions. Sites have many options for viewing and analyzing data.  In addition to viewing individual Site Hospital Reports, Sites may use Comparison Reports to compare their hospital to other institutions in the registry as well as to national averages. Using the Site Hospital’s unique confidential eTHOS Hospital Password, a Site may access their own individual Hospital Reports as well as see how their institution compares to other hospitals with similar or disparate selected characteristics.

Hospital Reports display previously entered individual Hospital Site data residing in the eTHOS database. Users may choose from a variety of reporting formats and may determine which time period of data entry they wish to see displayed. The Hospital Report displaying individual Hospital Site data is only identifiable by and only accessible to the Site entering that data.

Comparison Reports combine or aggregate data with other Sites for comparison purposes. The data that is displayed is “blinded”, which means that the identification of individual hospitals or their data is impossible.

Hospitals may choose from following Report Selection Criteria when requesting reports:

a)      Hospital Reports – Contain and display all eTHOS data elements for individual Hospital Sites – accessible and identifiable only to each individual Hospital Site.

b)      Comparison Reports - Display cross comparisons of Hospitals by Selected Characteristics including:

i.         Number of Hospital Beds: 0-150     151-250    Over 250

ii.       Location of Hospitals by State, Region, National

iii.      Academic or Non-Academic Status

iv.     Stroke Unit Status

v.       Time Frame: Current, Year-to-date or specific time period

 

1.10    Confidentiality of Patient Data

eTHOS is compliant with "Standards for Privacy of Individual Identifiable Health Information” under the Health Insurance Portability and Accountability Public Act 104-191 (HIPAA).

Under this law "identifiable" information, (defined as any information that has any components that could be used to identify the subject) include: name, street, e-mail addresses, names of relatives, name of employers, birth date, telephone or fax numbers, social security number, medical record number, health plan beneficiary number, account number, certificate or license number, vehicle serial number, URL or IP address, finger or voice prints, photographic images, and any other unique identifiers or coded identifiers.

eTHOS does not collect any patient identifier information including hospital generated patient ID codes. When a Hospital Site enters a new patient into eTHOS, a eTHOS generated unique Patient Registry ID # is assigned to the patient data in the registry. This Patient Registry ID # is provided to the Hospital site to maintain for their records and to use to access and/or edit that individual patient record.

1.11    Confidentiality of Hospital Sites and Accessibility to Secured Site Area

When a Hospital enrolls/subscribes to eTHOS, The Stroke Group will assign the hospital a unique userid that Hospital personnel will use to access the secure area of eTHOS. Then the Hospital Site Coordinator will select a confidential eTHOS Hospital Password and submit it to The Stroke Group. Passwords should be hard-to-guess to prevent unauthorized access to the secured area. When approved and authorized, this Password will provide access by the Hospital Site and Hospital Users to the secured eTHOS data entry and report viewing area unique to the individual Hospital Site. Users login to this area using the “eTHOS Login” area of the website. Within this secured area, Hospital sites may enter data, edit data, and access Hospital and Comparison Reports.

1.12 eTHOS Passwords

Subscribing Hospital Sites choose two passwords six to ten characters in length and provide the passwords to The Stroke Group. The first password allows the user to enter data and view reports. The second password, generally used by personnel who don't use or aren't supposed to view reports, allows data entry only.  In selecting a password, Sites may wish to consider the following:

Do:

a)      String words together.

b)      Shift a word up, down, left or right one row on the keyboard.

c)      Bump characters in a word a certain number of letters up or down the alphabet.

d)      Transform a regular word according to a specific method, such as making every other letter a number reflecting its position in the word.

e)      Combine punctuation or numbers with a regular word.

Do Not:

a)      Spell out the name of your institution.

b)      Use variations of eTHOS.

c)      Use a password used for some other purpose in your institution.

d)      Use common “stroke” or treatment themes without altering their constituent elements.

 

1.13    Password Storage

Passwords are stored in the eTHOS authentication database. Passwords for each Hospital Site are maintained by The Stroke Group in a secured, off-line file within each Hospital Site’s Confidential Hospital Profile, accessible only to the individual Hospital Site and The Stroke Group.

1.14    Changing Passwords

Site Coordinators may change a password at any time. They may transmit the change to The Stroke Group via email, fax or phone.  It is suggested that should personnel authorized as Users at a Site leave the employment of the hospital, that the hospital Site change its passwords. The Stroke Group recommends that eTHOS Site Coordinators regularly review patient records entered into eTHOS  to insure that only authorized personnel are entering data.

1.15    Forgotten Passwords

Forgotten Hospital Site passwords may be obtained via email from The Stroke Group or by using the “forgot my password” link on the eTHOS login web page. Note that when a password is requested, The Stroke Group eTHOS administrator will contact only the specified Site Coordinator to inform them of the new one. Neither individual Users or anyone other than the Site Coordinator shall be contacted or receive any password information.

1.16    Sharing Passwords

The Site agrees to share or reveal their password only to authorized Users associated with their institution .  No user may access the system with an eTHOS Hospital Password that was assigned to a Site other than the User’s own Site.

1.17    Invalid Login Attempts

A third consecutive invalid login attempt for a specific eTHOS Hospital Password will lock out any further attempts.  The User attempting to log on will be notified of the temporary lockout.  All lockouts will be logged and reported to the Hospital eTHOS Site Coordinator.

1.18    Timeouts and Automatic Logoff

eTHOS employs an automatic logoff feature which logs-off the User after a defined period of User inactivity to help manage User traffic, insure accessibility to all Users, and enhance security.

1.19    Single Sign On

The Stroke Group recommends that Hospital Sites only allow a single User to log in and establish a session to the system at any one time. While possible, concurrent access by multiple users from the same institution should be avoided to prevent data “race” conditions or other data errors.

1.20    Accuracy of Data Entry

Hospital Sites, Site Coordinators and Site Users agree to use the eTHOS data entry screen only within their password protected area to enter data into eTHOS. Hospital Sites further agree to use their best efforts to provide and enter accurate information and to complete all data fields on the eTHOS data entry screen for each set of patient data entered.

1.21    Logging of Assigned Patient ID #s; “eTHOS Patient Matching Roster”

eTHOS  maintains a list of all patients a Site enters data for in a log titled “Log of Patients Entered”. This list is available to each Hospital from the “Show Patient Records” link in their secure area of eTHOS. The log shows Patient Registry ID#s and the date of entry. When a User clicks on an ID#, the User is immediately linked to the patient’s data record previously entered into eTHOS. This feature allows the Site to maintain a record of all patients entered and provides a convenient way to navigate patient records for editing. The Site agrees to establish, maintain and keep confidential, an “eTHOS Patient Matching Roster”. This Hospital Site-maintained roster lists patients entered into eTHOS with associated hospital admission numbers or other hospital patient identifiers and attaches the eTHOS Patient Registry ID #s to these patients. The Site’s list should resemble the following:

 

Patient’s Hospital Admission #    eTHOS  Patient Registry ID #         Date Entered into eTHOS

Hosp.12345                                   eth3309 (assigned by registry)    11/10/00
            Hosp.12346                                   eth3310                                     11/11/00

 

1.22    Printable Paper Data Capture Form

eTHOS  provides a downloadable, printable data entry form which mirrors the data entry screen. This paper form provides a convenient means of collecting and organizing data in preparation for entry into the eTHOS website. We recommend that Sites using these paper forms record the Patient’s hospital identifier ID (often the hospital admission number) and Patient Registry ID # where indicated on the form and retain them for possible later internal reference. The Hospital should enter these two patient reference IDs, hospital and registry number, on a master patient registry entry log that is maintained by the Site (see “Logging of Registry Assigned Patient ID #s).

1.23    Report Printing and Reproduction

Printing and reproduction of eTHOS reports by Hospital Site Users is authorized. However publication of information is restricted as set forth in other areas of this agreement. 

1.24    Protection of Data in the Database

The Stroke Group agrees to take all prudent precautions and steps necessary to protect and maintain the integrity of the data contained in the eTHOS database.  Security measures may include but are not limited to:

1)      Tape backup system and regular database backups.

2)      Mirrored disks.

3)      Security systems and monitoring to discourage and prevent entry from unauthorized users.

4)      Data protection and verification software to secure the database from unauthorized data entry, data corruption or intrusion.

5)      Appropriate virus protection software.

6)      Continually maintained and tested disaster recovery plan.

1.25    eTHOS Quality Improvement Project

The Stroke Group will provide the eTHOS database to an eTHOS Publications Committee comprised of prominent neurology researchers from leading institutions across the country who will periodically analyze the eTHOS database to determine various quality characteristics and treatment patterns of acute stroke treatment throughout the nation. The eTHOS Project personnel are bound to the confidentiality tenets of this agreement. Because of the structure of the eTHOS database, individual hospitals are not identifiable to the team, nor are individual hospital identities otherwise disclosed by The Stroke Group to the Publications Committee. The eTHOS Publications Committee will develop a manuscript covering its findings and submit it for publication in a major medical journal. The Stroke Group will place the manuscript in the eTHOS website so that it is available to all eTHOS subscriber Sites. The Stroke Group will provide the opportunity to the participating Sites for listing in the manuscript as contributors of data to eTHOS and the eTHOS Project.

1.26    Publishing of eTHOS Data by Hospital Sites

Hospital Sites may use their individual eTHOS Hospital Reports and Site information for purposes of quality improvement, research and publication. Hospital Sites may not use eTHOS Comparison Information for research and/or publication without the express written permission of The Stroke Group. Hospital Sites may make written requests to The Stroke Group to use eTHOS Comparison Information for such purposes. The eTHOS Publications Committee will review all such requests and grant permission as the Committee and The Stroke Group deem appropriate.

1.27    Prohibited Activities

Hospital Sties and their Users must not test, de-compile, reverse engineer, or attempt to compromise eTHOS computer or communication system security measures, program code or other computer software or web site pages belonging to, installed by, or created by The Stroke Group. Incidents involving unapproved system cracking (hacking), password cracking (guessing), file decryption, unauthorized coping or printing of any confidential information, or any other similar unauthorized attempts to compromise security or confidentiality measures may be unlawful, and will be considered serious violations of eTHOS policy and may cause the Site to immediately lose access to eTHOS and the termination of eTHOS-related agreements between the offending site and The Stroke Group. The data previously entered into eTHOS by any offending Site will remain in the eTHOS database and as such will remain the property of The Stroke Group. Pranks and practical jokes involving the compromise of systems or data accuracy and integrity, are prohibited. Any Site violating these or any other policies set forth in this document is subject to immediate termination of the Site’s participation in eTHOS.

1.28    Reporting of Violations to this Agreement and/or Policies

The Site agrees to immediately report to The Stroke Group, suspected eTHOS policy violations by Users that might compromise the integrity of the eTHOS system or database.

1.29    Ownership of eTHOS and eTHOS Database :

All eTHOS-designed information applications, related copyrighted, trademarked or otherwise protected information, processing system design, related source codes and applications of information, the eTHOS database and information contained therein are owned by The Stroke Group.

1.30    Term of Service to eTHOS Subscribers/Hospital Sites:

This eTHOS service agreement covers the period of one year.  The Stroke Group will provide services to the Subscriber/Hospital Site for the period of one year beginning with the earliest date of patient records the Site enters into eTHOS. At the end of this one-year period, the Site may elect to renew this agreement, with any modifications hereto.

2         Hospital Site/Subscriber Agreement

2.1        Introduction

This Subscriber/End User Agreement (the “Agreement”) sets forth the principles, guidelines and requirements of the Terms of Service of The Stroke Group, Inc. an incorporated company (the "Company") doing business as The Stroke Group, governing the use by the Subscriber/end user ("Subscriber") of Company's ETHOS Products/Services ("ETHOS Products/Services"). This is a legal agreement between you (either an individual or an entity) and The Stroke Group, Inc. (the "Company") regarding the use of Company's software, ETHOS Stroke Report and Registry (ETHOS) electronic data collection and reporting Product/Service (and all successor products/services), as the case may be which may include user documentation provided in "online" or electronic form. These Terms of Service have been created to promote the integrity, security, reliability and privacy of Company's facilities, network, and Subscriber data contained within. The Company believes it provides the best services in the industry, and provides the following policies in the best interests of the Company and the Company's clients. The Company retains the right to modify these Terms of Service at any time and from time to time and any such modification shall be automatically effective as to all Subscribers when adopted by Company and published at http://thestrokegroup.com.  Company shall be the sole and final arbiter as the interpretation of the following. By utilizing the Company's ETHOS Products/Services, the Subscriber agrees to be bound by the terms herein outlined.

a.       ETHOS IS PROVIDED "AS-IS" WITHOUT ANY EXPRESS OR IMPLIED WARRANTY        WHATSOEVER REGARDING ETHOS AVAILABILITY, ACCESSABILITY, OR PERFORMANCE. THIS INCLUDES ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, THAT THE COMPANY’S ETHOS PRODUCTS/SERVICES WILL NOT BE INTERRUPTED OR BE ERROR FREE; OR THAT IT IS COMPATIBLE WITH ANY PARTICLAR HARDWARE OR AS TO THE ACCURACY, OR RELIABILITY OF ANY INFORMATION SERVICE, DATA OR MERCHANDISE CONTAINED OR PROVIDED THROUGH THE COMPANY’S SERVICE, UNLESS OTHERWISE EXPRESSLY STATED IN THIS AGREEMENT. NOR DO WE MAKE ANY WARRANTY AS TO THE RESULTS THAT MIGHT BE OBTAINED FROM THE USE OF THE COMPANY’S ETHOS PRODUCTS/SERVICES. YOU HEREBY ACKNOWLEDGE THAT ETHOS MAY NOT BE OR BECOME AVAILABE DUE TO ANY NUMBER OF FACTORS INCLUDING WITHOUT LIMITATION PERIODIC SYSTEM MAINTENANCE, SCHEDULED OR UNSCHEDULED, ACTS OF GOD, TECHNICAL FAILURE OF ETHOS, LOSS OF DATA,TELECOMMUNICATIONS INFRASTRUCTURE, OR DELAY OR DISRUPTION ATTRIBUTABLE TO VIRUSES, DENIAL OF SERVICE ATTACKS, INCREASED OR FLUCTUATING DEMAND, AND ACTIONS AND OMISSIONS OF THIRD PARTIES. YOU ASSUME ALL RISKS AND RESPONSIBILITIES FOR SELECTION OF ETHOS TO ACHIEVE YOUR INTENDED RESULTS AND FOR THE USE OF, AND RESULTS OBTAINED FROM ETHOS.

b.       THE SOLE CUMULATIVE LIABILITY OF THE COMPANY FOR ALL CLAIMS MADE BY THE SUBSCRIBER, OR ANY OTHER PARTY, REGARDLESS OF FORM, (INCLUDING, WITHOUT LIMITATION, DAMAGES FOR LOSS OF BUSINESS PROFITS, BUSINESS INTERRUPTION, LOSS OF BUSINESS INFORMATION, LOSS OF GOODWILL; WORK STOPPAGE; HARDWARE OR SOFTWARE DISRUPTION IMPAIRMENT OR FAILURE, REPAIR COSTS, TIME VALUE OR OTHER PECUNIARY LOSS) INCLUDING ANY CAUSE OF ACTION BASED ON CONTRACT, TORT OR STRICT LIABILITY, SHALL NOT EXCEED THE TOTAL AMOUNT OF ALL FEES AND CHARGES PAID TO THE COMPANY BY THE SUBSCRIBER.

c.       Grant of Access to Ethos. During the term of your subscription license, subject to the payment of the applicable fees and your compliance with the terms hereof, this Agreement permits you access to ETHOS Products/services for internal purposes only. We reserve all rights not expressly granted herein.

d.       Copyright. ETHOS Products/services is owned by the Company and is protected by United States copyright laws and international treaty provisions. We own and retain all right title and interest in and to the Software, including patents, trademarks, copyrights, trade secrets and other intellectual property rights embodied or contained therein. Therefore, you may not use ETHOS without authorization.

e.       Restrictions. You may not rent, lease, or loan your ETHOS access passwords to parties unaffiliated to you (end user). You may not reverse engineer, de-compile, or disassemble any aspect, part or function or ETHOS. You may not modify, or create derivative works based upon ETHOS.

f.         In addition to the other requirements of these Terms of Service, Subscriber may only use ETHOS Products/Services in a manner that, in the Company's sole judgment, is consistent with the purposes of such ETHOS Products/Services. If Subscriber is unsure of whether any contemplated use or action is permitted, please contact the Company as provided above. By way of example, and not limitation, uses described below of the ETHOS Products/Services are expressly prohibited.

2.2        System and Network

a.       Introduction of malicious programs into the Company's network or server (e.g., viruses and worms).

b.       Effecting security breaches or disruptions of Internet communication. Security breaches include, but are not limited to, accessing data of which Subscriber is not an intended recipient or logging into a server or account that Subscriber is not expressly authorized to access. For purposes of this Section, "disruption" includes, but is not limited to, port scans, flood pings, packet spoofing and forged routing information.

c.       Executing any form of network monitoring which will intercept data not intended for the Subscriber's server.

 

d.       Circumventing user authentication or security of any host, network account or Subscriber other than yourself or your entity.

 

e.       Using any program/script/command, or sending messages of any kind, designed to interfere with, or to disable, a user's terminal session, via any means, locally or via the Internet.

 

f.         Creating an "active" full time connection with ETHOS by using artificial means involving software, programming or any other method.

 

g.       Any action, which the Company determines, in its own judgment, will reflect poorly on the Company or negatively impact its operations.

 

h.       Any action which the Company deems to be an unacceptable use of resources, business practice or otherwise unacceptable to the Company.

 

i.         Furnishing false or incorrect data on the order form, contract or online application.

 

j.         Reselling or giving away ETHOS-generated data with the exception of publishing data in which case the Company must give its express written consent to a request for publication from the end user.

 

2.3        Company Rights

 

a)       The Company may take whatever steps necessary to provide its services, and to provide for the enjoyment of such services by all of the Company clients, and to ensure that certain clients do not utilize services to the detriment of other clients. Subscribers that do not comply with these simple rules, will, at the discretion of the Company, have their rights to use ETHOS terminated.

 

b)       The Company will be the sole and final arbiter as to Websites or usage of resources that constitute violation or intent to violate our policies. Users, which the Company suspends or cancels due to violation of these rules, are not eligible to receive a refund from the Company. Acceptance of these Terms of Service, and/or use of Company's services constitute an acceptance of these policies.

 

c)       Company reserves the right to change rates without notice; however no rate changes will be made to an end user’s rate during the period that the annual agreement is in force. Rate changes can only be assessed at the time of renewal of the annual agreement, and will go into effect immediately for new Subscribers/end users. Subscriber agrees that the Company reserves the right to change its fees, features, and discount offerings and the Subscriber agrees to be bound by any changes of fee, feature, and/or discounts subject to the aforementioned limitations on rate changes within an agreement period.

 

d)       The Company reserves the right to terminate this agreement, and to remove the User and User’s passwords from ETHOS, immediately upon the occurrence of any of the following events:

 

a.       Non-payment of any charges due from User.

b.       Breach of any term or condition of this agreement by Subscriber.

c.       Commencement of any lawsuit or proceeding against Subscriber arising from or relating to its use of ETHOS, whether or not such suit names the Company as a party or seeks any recovery from the Company.

e)       Payment for any charges is due within 30 days of signup and renewal respectively. All payments must be in U.S. Dollars. Accounts, which have balances outstanding, shall be deemed to be in default and subject to termination of service.

2.4        Indemnification of Provider/Relationship of Parties

a.       Subscriber agrees to indemnify and hold the Company harmless from any lawsuit, claim, charge, or expense, including reasonable attorney fees and costs of defense, for any matter arising from or relating to Subscriber's use of ETHOS provided hereunder.

b.       Nothing contained herein shall be deemed to create a relationship between the Company and User in the nature of a partnership, joint venture, editor/publisher or otherwise.

2.5        Security/Software

a.       Subscriber agrees to take all steps reasonable, necessary, and prudent to protect User's login ID and passwords.

b.       User agrees not to attempt to undermine or cause harm to any server, software, system or User of the Company.

c.       Subscriber agrees to maintain Subscriber’s computing equipment responsibly, including running virus software.

d.       Uploading a virus to a Company server will result in account termination, service charges and/or prosecution.

2.6        Violations

Any attempt to undermine or cause harm to the Company server or another Subscriber's Web presence is strictly prohibited. Any violation of the above Terms of Service will result in grounds for account termination, with no refunds given; the Company reserves the right to remove any account without p