I have done all paper, all EMR, and a combination of the two. The combination is the worst. So far paper alone is the winner for most situations, although even crappy EMRs have advantages over paper. Most of the problems, as I see them, come from the general baggage of enterprise software (not sold to the people who use it, likely focus of dev time is on accounting/billing stuff I never see) and an attempt to slavishly emulate paper in digital form.