[qzio]

These type of software is regulated, and hospitals and clinics can't easily move to a competitor if they are not happy with their current system.

Journal systems "is a thing" with lots of hairy issues such as integrations between different hospitals and primary care givers, privacy issues etc.

These are not really solved yet, (even on a regional basis) and on top of this comes the probably most important thing, UX for the actual users such as doctors and nurses.