I've been told the capacity for last note backup has been purposefully removed due to security concerns -- MU-2 won't allow it.
I have resisted upgrading for that reason, as well as other things I have read on this board about all upgrades past 6.3.3.
Eventually, I suppose I will have to upgrade to get ICD-10 capability, but that is still a future event. I gave up participating in Meaningful Use, so 6.3.3 is stable and quite functional.
I am curious how many physicians have adopted my approach.