[cknight]

That medical software is simply bad is also my experience, having been an IT Manager for a clinic management company for a few years now.

In Australia at least, 85%+ of medical practices run one of two practice management systems. Both of these systems were originally developed by the same guy, and both have their centre of operations in the same small regional town in Queensland.

I don't think it's a surprise that top-tier developers are unlikely to be willing to move to the middle of nowhere. My experience with the version we use is that its UX is unpleasant, the platform isn't reliable, and it doesn't perform well at scale for larger clinics like ours.

I completely understand that the monolithic design of the software is mandated by too many competing interests (and regulations) for it to be simple. But I am sure it could be better.