The problem is a bad feedback loop. Doctors need to demand an adequate user-experience, and buyers of these systems need to include user-experience "intangible

The problem is a bad feedback loop. Doctors need to demand an adequate user-experience, and buyers of these systems need to include user-experience "intangibles" into their decisions. I'll play sort of a devil's advocate here as someone who's worked in this field: the feature-gaps identified aren't all that bad. - 1k-assessment limit: It's not ridiculous; assessment-notes are usually 0-2 acronym-laden sentences, probably under 200 characters in general. Writing a 1k-long assessment note seems extremely unusual and I think in many situations would be completely loathed by co-practitioners, who need to very quickly read visit notes (the assessment is just one field out of dozens or hundreds). An inexperienced doctor could easily be reprimanded for such verbosity. However, there are many different working and documentation styles which work better for certain patient populations, specialties, institutional needs, etc. -- this doc may absolutely be justified in wanting to be thorough in this situation. A call from an experienced doc should be investigated and most probably addressed in future versions of the software. - Reviewing past visits: The EMR probably does have some kind of history report/index view into the list of past visits, but the problem here seems to be that the index doesn't have the right data in it. The doc wants to review in detail the "thickest" or most important notes, so you need to display that into the index. It's a good feature idea, but not an obvious one. - Dictation: It's disruptive and awkward to dictate in front of patients. So typing/writing while talking to the patient is generally more efficient, even if the doc has to wrap up after the patient has left. For work that is entirely done when patients are not present, dictation is a fine solution and in fact is used by many, many docs, integrated into EMRs, etc. One issue, not explicit in the article but possibly relevant, is that managers often use constraints in enterprise software in order to control end-users. Field-lengths sometimes come out of these ("They're wasting time! They should move onto the next [patient/customer/widget/etc.]!"). But the problem there is poor communication & lack of agreement between management and workers, rather than an outright deficiency in the IT itself.