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The problem is that hospitals, like any other business (and yes, even if they are non-profit, they are still businesses) must justify their capital expenditures. Would you expect a bank or other business to invest millions in a business improvement that would not yield any extra revenue? The economic downturn is affecting hospitals too, because more patients are paying late/ not paying & their investments are tanking. Hospitals here are laying off employees (doctors, support staff, administrators) & closing entire departments. In this financial climate a new EMR system is not a simple proposition, especially considering the time required to learn & customize the system & the inevitable loss of efficiency (and, according to the article, lives) during that time.