> writing notes and ordering meds This is something that is obscure to mostly young, mostly healthy people. When you think of "going to the doctor", you think

> writing notes and ordering meds This is something that is obscure to mostly young, mostly healthy people. When you think of "going to the doctor", you think of a checkup, or a UTI, or an annual gynecologist visit, or something else that happens in a clinic. Or maybe you think about your grandmother being admitted with pneumonia. And in that case, yes, it is largely writing a note and ordering meds (and a diet, and labs, and nursing order parameters for as-needed medications). But nurses are recording vital signs, and those should be searchable under vital signs. Ideally, they should flow directly from the machines taking those vitals - in anesthesia, for instance, we record vital signs at least every five minutes if not more often, which in a hairy case with a lot going on means treating the patient or treating the computer, with the understanding that you have ten or twenty minutes of data entry to follow an hour of actually treating the patient. EVERY code situation has a nurse (an RN, not an LPN or nurses' aide) whose entire job is to sit there and record the times that events occurred so that everyone else can go back after the fact and record meds given, interventions taken, etc., accurately. It takes much less time on a piece of paper than it does on a computer, because paper anesthetic records were designed to minimize cognitive workload and computer ones were not. As for ordering meds, all of those orders have to be checked by a pharmacist and cross-referenced to ensure that there are no unexpected interactions. That's their legal obligation; they're not going to short-circuit it. And that has to be tied into billing (even in a national health system, you need to know what to order more of), and Medication Administration Records (the MAR). And every one of those notes needs to be classified by who wrote it and what department they were from, as well as the note type, so you can filter out the ones you don't need to see for one purpose or another. Intraoperative anesthetic records and surgical operative notes are the two most relevant to me as an anesthesiologist; what happened last time, and did they run into unexpected troubles? We don't like being surprised. Billing is more complicated in the US than in most countries, but it's part of the game too (it factors into metrics, and you can't reasonably hold a neurosurgeon doing tumors to the pace of pediatricians doing well-baby visits). The paper medical record, for all its faults, was a highly refined system, and it's not just a matter of "make a text file containing this note".