Maine EMS mandated all services use some NEMSIS Gold standard software. They have gotten Federal grant money that allowed services (mine included) to buy toughbooks with Imagetrend for $1000. I do not 3.8 but 4.0+ was a mess. I used it at another service and the medics made so much noise about suckage that we went back to 3.8. We will have to make the jump to whatever version they have now in April as they will stop supporting it. I like it enough. It is much faster if you make up some templates and as you build your database the pre-population feature is cool. Hopefully they figure out how to make the jot pad stay viewable.