The problem as I see it is the comparison between a small app and the closeness of its community to the end product and how a much larger application such as Microsoft Outlook works with its consumers.
In some ways, we as users forget that with an Outlook, we could create a user board and ask for changes till the cows come home, and we would hear nothing back until version 2003 changed to 2007. For instance, I have emailed Microsoft about something that drives me crazy: the fact that I can't change the Reading Pane in every section, e.g. Inbox, Outbox, etc. with one click but have to go to every section to do it. How, 10,000 Microsoft employees don't notice that as well is beyond me. But, that is a small thing.
But, with AC, we tend to go on the idea that we should be able to ask for changes constantly and have them acted on. And, maybe that is not possible.
But, the problem is I can understand why Microsoft can't act upon a simple request and AC may be able to. I have no idea if anyone is understanding what I am trying to express here.
I would think from AC's point of view, you would look at user feedback (if you could act upon it) in two or three sections.
For instance, I would LOVE to have kgs and lbs in two different columns. But, we peditaricians who need that are few and we can probably live without that. So, that would go in your things to think about in an upcoming version. But, you should have another section of HUGE things. This is where users get frustrated as AC moves forward in a direction that is necessary, e.g. CCHIT and PM, etc. Things like the letter writer. Things like the prescription writer. And, if I may speak for Leslie, the SEARCH FEATURE, which is not only not useable, it is dangerous.
I have not seen one user write on the board that if AC never changes the weight/mass VS section to kgs in one column and lbs in another, they would not use AC. In fact, maybe three of us have even brought it up. But, whether or not some think that Osler may be too negative (I don't think so -- hang in there Osler), you have verifiable proof that certain huge populations of users, e.g. specialists may not purchase AC due to its letter writer.
As a global moderator and I believe the user with the longest track record, I receive calls and emails from all over the nation. I have personally spoken with at least 50 physicians about AC on my own time about the merits of AC. As would be expected, I give it glowing marks and always encourage them to download the program. But, they ALL ask about the letter writer and, I am not able in good faith, to recommend it on that part.
While this post is not only about the letter writer, this is how serious I think some users find it. When looking at reasons why you are unable to pay attention to certain improvements and/or annoyances due to huge things you are working on such as:
CCHIT
Practice Management
Other government requirements
ePrescribing
I would actually change that list to say:
CCHIT
PM
Other government requirements
ePrescribing
Letter writer
Search function
MJK talks about an advisory board and I have had discussions with AC about this. But, here is an advisory board for AC:
I think I can speak for the ENTIRE AC nation when I say that the Letter Writer and the Search Function (or not function) are the two most important things for AC to look at.
When a physician sees a patient for an annual checkup, and diagnoses a new problem such as high cholesterol, he or she still looks back at the asthma and makes sure it is in check and being treated properly. I would think it would be the same with AC. Sure, moving forward on new projects must bring much more excitement than looking at what things are still lacking in Version 4, but try to remember that even when you add CCHIT certification and a PM, a new user will not know the difference between features and usability from version 1 to that of version 5.
