Guess the situation differs from country to country..but in Europe (and Germany especially), HEMS-pilots do not fly that much.
120-180, maybe 200 hours-thatīs the absolute minimum you need to stay current and proficient.
Most of their pilots are ex-military, with a lot of IR-and Night flying experience.
With these experienced pilots retireing soon, they are replaced by (cheaper) civil trained pilots-that do not have the same experience level.
Putting more stuff into a helicopter does not make this situation any safer.
Give the pilots more opportunities to train, give them simulator-training, and let them do some REAL IF-and night flying (just for training)-that is safer than any computer **** you can put in...