How important is the job of issue tracking for a Project / Program Manager ?

In the course of work, I have had several interviews, and also interviewed a number of people, mainly for the post of project manager or program manager. One of the most significant questions that is posed is about the SDLC, and whether people understand what the Software Development Life Cycle is all about.
For me, the life blood of a project (and the issue that can cause the most harm to a project) is about effectively tracking the open issues that happen in a project. You know them, right ? You have a project where there are a lot of open ends, a lot of design and architectural meetings where questions are posed and answered, and then these are not captured in some sort of minutes. Or you have an important new concept, and there are a lot of questions, and then a few months later, you find that that the same questions are again being asked, and people have to scramble to answer these questions. Further, if it turns out that some people in the group have changed, then new people have to answer these questions, and there may be changes that may happen in the specs or design because of these questions. Consider an example, where a design is done in a specific manner (and not in the blatantly obvious way) because of some limitations. Later, when a design review is done, you can be sure that the same question would be asked (and this could happen months later), and then, there are no easy answers to these questions.
Now consider the case where you presented a design concept, there were some important queries that were raised, and then, in the excitement, nobody captured these queries (or there were queries regarding some part of the schedule, or about some follow up with a vendor or even the customer), and nobody followed up to get these queries answered; it is only later that it is realized that these were important questions, and the lack of follow up meant that some problems that were detected via the queries were never really caught.
So, how do you solve this ? For a Project Manager or a Program Manager, it is critical that the tracking of open issues and queries be set as an ongoing process, and that there are no failures in this area. For this purpose, whatever tool, whatever process, all these need to be decided and set in stone. For example, I know people who have bought issue tracking tools, other use Excel or even a notebook to capture important issues, still others use flagging inside Outlook to track open items. And people set aside dedicated time to look at their issues and follow these up.