I am also a nextgen user and share many of the frustrations expressed in these posts. Unfortunately we are too deeply invested in NextGen in our practice to move to another EMR. Our solution was to develop a new front end to NextGen that runs as a native iPad app. I have been using this product in my high volume practice for 6 months. It solves many of the problems we have with work flow and with the consumption of patient data. Check it out: iConx-solutions.com. (Full disclosure, we developed and sell this product....I don't usually post about it in forums, but this thread really hit close to home for me.)