This section is acutally going to be the HOW-TO of this HOW-TO document. I intend to include instructions or refer to insttruction on installing what available systems that are readily usable at this point.
The OIO system starts a higher level of abstraction - starting with modeling "forms". The forms are then used to model/build progress notes etc. The OIO system makes use of a relational database backend (PostgreSQL) - 1) making the data/metadata/presentation separation more distinct, 2) making integration with other system (e.g. legacy systems, GnuMed, SQL Clinic etc) easier, 3) making query construction/extension easier (via SQL).
If you search the OpenHealth mailing list archives, you will see extensive discussion regarding this in the context of GEHR and OIO. GEHR uses the same approach but calls this intermediate level of abstraction "archetypes". The advantage of the OIO/GEHR approach is that the metadata components can be plug-and-play - meaning that the system can be easily extended/customized AND portable medical records become easier to implement.
This is the second application that I see that I think is actually useful for the medical office. (One of my main concerns, as I will be using it exactly for that.)