There are many innovative ideas for new features and functions that you may have had. Hospital U LMS has adapted the Moodle “plugin” model, where thousands of programmers around the world have similar needs in their LMS environment, and therefore they create, test, install that new feature, and more importantly they share that feature as a plugin for the rest of the global community to simply plug in to their existing LMS environment. 
Remember, at any given time, a proprietary LMS provider has a very small group of actual programmers working on their code. They simply cannot compete with an open-source community of hundreds of programmers making constant upgrades, improvements, and adding features on an ongoing basis.
When we do a Hospital U LMS install, we provide you with a list of possible plugins you may want to adapt. Or just to give you ideas what type of features you may want to try down the road. And it is as easy as choosing from a menu.