I am a bit confused by some of these comments. My service has been using ImageTrend for almost 3 years now. I can understand that there is a learning curve but saying that it takes 45 minutes to complete a run form might be a stretch. Our service was able to design our run forms and create different run forms for different types of calls (i.e. canceled calls and other forms). When we were evaluating other software that was on the market, we didnt find one that had a medical spell check in it but that certainly would be nice. ImageTrend has had amazing customer support and has been more than willing to assist us whenever we needed help. After attending their user conference, we spent time with a lot of their customers. They have some large cities that they work with and this helped us out considering we only do 3500 calls a year, in regards to sharing of new ideas and work flow.
There is a demo as well on their website but you have to request it:
http://www.imagetrend.com/default.cfm?PID=1.3.1
On the left hand side of the page it mentions for a trial of the EMS software.
Hope that helps. Don't give up hope.
Stay safe.