The Jira analogy falls a little bit flat, because the information entered into an EMR is often the actual product, not just documentation. Orders entered into the EMR directly affect the outcome of the patient, and errors can be fatal. Having a free-text hand-written system for something like that just seems pretty crazy. It'd be like going to a dev shop where no one used linters or wrote tests and the check for deploying to prod with no rollback option was one (admittedly extremely skilled) guy in the basement signing off after a quick code review.