I have been using AC for long enough that I cannot compare it to paper. What I can say is that my notes are much more accurate. I rarely leave a note unfinished and I leave on time (unless the patients are late/slow/problematic)
I had done extensive research over the years and still find that AC is comparable to the 20K systems. Everyone has a point that they do well, AC's is simplicity.
I prefer having my database on site.
Although practice fusion (PF) is "FREE" you get ads. I am told they are not that distracting but, looks bad to patients when you are ad bombarded while charting. If you pay %100 per month to get rid of the ads, AC is cheaper. Not sure if PF is fully MU certified. I think so, but verify this. They were claiming it long before they actually were.
You should play with AC and see if you like it. You can see demo's of the other ones but it is not like doing it for yourself. Check out the field. Then we will see you back. Of course, we are a jaded group, we have shelled out the money and feel we have the best deal (which we do.)