Electronic Medical Record

[S. David Ahn]

Is anyone aware of any electronic medical record (EMR) software with
practice management features developed in Revolution?  I'm interested in an
EMR that runs on Macs, is customizable to my particular needs, and
extensible with features I may need to add.  I was considering writing it
myself in Revolution, but realized what a daunting task this will be, and
didn't want to reinvent the wheel.  Anyone?  :)

If  not, any guidance would be appreciated in setting up the basic structure
of this project.  I was thinking of using MySQL as a back end (it does need
to be networkable, multiuser), but don't know exactly how to integrate all
of the features I need.

An electronic medical record contains a myriad of diverse data types:
formatted text (history of present illness, past medical history, physical
exam), structured text (diagnoses, medications), numbers (laboratory values,
vital signs, etc.), images (patient's photo, rashes, scanned/faxed
documents, etc.).  All of these need to be date-stamped, and most need to be
electronically signed.  Many pieces of information are tied together
(progress notes includes history, vital signs, physical exam, possibly a
photo, diagnoses, plan, etc.), others are not (medication list, diagnosis
list, demographics).  I was thinking of using a demographics table, a
separate medical summary table with static and semi-static info (diagnoses,
medications, etc.), but I wasn't sure how to do the progress notes due to
the long text strings needed, etc.  Also, it all needs to be password
protected.

One other puzzle is how to show family relationships.  Many illnesses are
hereditary, and others are communicable, so it would be nice to query family
or household members' charts for illnesses.  But it's important to
distinguish blood relatives from unrelated housemates.  I was thinking of a
scheme involving 3 digits: 1st digit is generation (1 is parent, 0 is
sibling), 2nd digit is gender (1 is male, 2 is female), 3rd is legal (1 is
biological full, 2 is half-biological, 3 is step, 4 is adoptive, 5 is
foster, 6 is legal guardian, etc.).  Or a whole table of predefined
relations (1=father, 2=mother, 3=stepfather, 4=stepmother, etc.).

Any input would be appreciated, and helpful input would be even more
appreciated.  :)  Thank you all in advance.

David