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Does this count? http://gnumed.org/

Brilliant idea, although maybe the internet connection doesn't have to be always on - this is good for getting information in, but it could be expensive. Would basic needs be better met by just having a lot of recycled computers set up in a MAN sized wifi network - so that for example a doctor or local council could have a database of people and could therefore use this for planning things out and just co-ordinating local work? GnuMED?

There is other medical FOSS out there - GnuMed http://www.gnumed.org/ and OSCAR McMaster http://www.oscarhome.org/ (or http://www.goemr.com/ if you're in the USA) are two that come to mind off the top of my head.

Debian-med has a fairly big list -- http://www.debian.org/devel/debian-med/

Euspirit http://www.euspirit.org/ had a huge list... but the site seems to have evaporated.

I wrote a lengthy article about that FOSS in medicine-- it can be found here: http://www.utmj.org/issues/82.3/Technology_Review_ _82-3-202.pdf

At the X11 layer, Apple should provide good window management,

clipboard integration

keycode management

printing

and a small extension that would let X11 apps access Apple-native features through the X11 protocol.

One already can hook an X11 app into Carbon and Cocoa pretty much the same way any other app does it: including the headers and calling the functions. Virtually nobody does, because most developers place a high value on either consistency with the platform (i.e., not X11) or consistency across platforms (i.e., not Carbon and Cocoa).

Getting back to the original point, though, few modern mainstream applications use X11 per se. They use cross-platform, high-level toolkits: GTK, Qt, Swing, wxWidgets, XUL, VCL, etc. It's a lot smarter to integrate platform-specific code once at the toolkit level (again: like so) than to force hundreds or thousands of application developers to duplicate that work (even ignoring the cost to Apple).

The rest (menu bars, etc.) the Gnome and KDE developers would do if Apple's legal department only would let them.

See, that's one of the problems with Apple's X11 server: it is so big, heavy, and inefficient.

The nice thing about open-source software is that you don't have to spend precious time and money re-inventing the wheel---you could at least improve upon an already existing design. That said, at least check out GnuMed. It doesn't have the backend that you're looking for, but at least will give you ideas. It's a system developed by physicians. Won't you consider contributing to a open-source project? It'll make the world better---at least with a unified open-source system, patients will be better-off due to ease of document transfer from clinic to clinic.

Check their website for more infos : http://www.gnumed.org/

I tend to think CS is better as a hobby... and especially so if you still want to see patients.

There are plenty of opportunities and interesting projects out there if you want to do some technical work... and you don't even have any formal training to get involved and make a contribution:

OSCAR McMaster
GPLed software for the family practice. I went to one of their workshops... led by a engineer/MD from my alma mater. :-) Based on MySQL, Tomcat & Java.

GnuMed
My personal favourite. wxPython & PostgreSQL based. Led by an engineer/MD.

Tk Family Practice
The creator has an amazing collection of free eMedicine links.

The future of eMedicine is going to look like this - picture of Dr Tux. The British Medical Journal thinks so -- Medical software's free future

If you want to do engineering, I'd go the biomedical engineering route--that is where I'm coming from... and will continue to do some work.

You might also try Medical Consulting. If the IT work you have been doing for yourself is useful, it will be useful to other doctors. So, if you can't land a job at Harvard or the local University, you can be working in IT for yourself. If you are relatively self sufficient IT wise, you can be helping others.

There's a very real need for clueful Medical IT people. The average private practice is a train wreck of propriatory garbage executed on Windoze. Most of them are plauged with the ususal keylogging viruses and spyware and have virtually zero chance of protecting patient records or being HIPPA complient. I visited one office where the doctors and staff were using Kazaa and had full page porn ads poping up in front of patients. I have also seen windoze done well, but it was a medium size place that could afford a full time IT dude. Free software,of course is cheaper, easier and more secure.

Have you seen GNUMed? They have a nice patient database and are working on assisted diagnosis. It's from Austrailia, so I don't know how well it takes care of Byzant^H^H^H^H US paper work.

Be careful to look before you leap. A man's gotta eat. IT is very competitive. There's plenty of work that needs to be done, but you have a huge pile of BS to wade through in order to get it done right. Every dinky little M$ shareware downloading clerk thinks they are an IT expert. Disruptions in IT are not something the average doctor wants to deal with and most just want to ignore the problem an hope it goes away. Being a doctor, you have a leg up, but you might want to try helping a buddy out over the weekend or vacation before you switch professions.

These folks need help. And they are much nicer and far more competent than any EMR vendors I've run across. Take a couple of weeks off, and work on this project for 60 hours per week. See if you still like it.

And I can't blame you for bailing on medicine. Things are going to get much rougher in the industry before they get better.

Been waiting on this one forever. Judging by the progress report it's still a fair way off.

Been waiting on this one forever. Judging by the progress report it's still a fair way off.

http://www.gnumed.org
how to implement it
Then there's this from openhealth.com that you might find interesing.

While Imedix is a cool product, I don't think it will meet his needs for a general purpose EMR.

The ACS (or OpenACS) can be customized to suit a variety of tasks, but no EMR module yet exists. So be prepared to do a little bit of hacking/data model extension. Drop me mail if you are interested in taking this route.

A better bet for what you're trying to do (at this point) is probably GNUmed. It uses Postgresql for its database layer (passes the ACID test). Dr. Horst Herb and his crew have built the software in a very thoughtful fashion -- they've clearly used lots of commercial products before.

One final thing to remember for those who wish to go it alone & code their own product is the importance of security.

Good security is critical for all EMR software, but is of particular concern in the USA, where HIPAA rules are starting to be implemented.

Because of these rules, the task of developing an EMR for use as a permanent medical record has become more time consuming, and complex. The law is, ultimately, a consumer protection act, and should lead to higher-quality, standards-driven EMRs in the future. Be sure to examine the rules before setting out on any healthcare project.

hope it helps.