We see patients from around the world and have no idea where they will go to have the tests performed. So an order may consist of 10-15 tests which we customize to include both the LabCorp and Quest test code numbers. Eliminates dealing with lab paperwork. When I factor in AC charges and Updox charges, these other systems are not that much of stretch. I had to create workarounds for AC and custom much of it so I expect the same with the next system. Actually I prefer a system that allows me to customize it because then I am in control. The other issue is that our patients are very complex with different problem sets from one to the other which makes templated note creation useless for us. Another of my main hot buttons is that I see our clinical notes not as just medical records but also marketing. So if another MD sees the note, they know what we specialize in and it reflects who we are. I demand that notes look professional and not some data dump that so many systems produce. We also burn into every note certain wording that stresses our limits and places responsibility onto the patient. It is up to them to own their healthcare and follow through. The only concern holding me back and continuing to demo other systems is ChARM's customer service. Reported as difficult so I am currently testing their CS and waiting to see how they respond. So in an ideal world the company would be US based as well. I will invest looking MedPointe over. The use of AI, ability to customize, and being US based is interesting. I would like it more if it was in the $300-$350 per month range. I will need to see what comes with it since ChARM is loaded.