This feels very rough around the edges, especially for a project with several releases. The documentation is very uneven and sparse, with certain sections like accounting, administration, etc having no documentation at all. Security is suspect even out of the box, with demo users added by default. Other problems are that you need to restart the server if you add a language package, a short support cycle -- two years is a tiny length of time for things like health care, synchronization is not real-time, etc. Yes, it's interesting in that it is open source, but I would very much not want to have to support this in production, it's just too admin and user unfriendly.