Electronic Health Record for public agency

Electronic Health Records are brought up in this post http://drupal.org/node/47402 - I'm wondering if there have been any further ideas on the matter...

I'm a graduate student in social work and public health in California, US. I first started using Drupal about two years ago, and am still amazed at what it does - even for such a novice as myself. Everywhere I go, I see applications for its use.

The database system in the Mental Health program where I am working/interning is so old that it's DOS based. We have such a need for something to keep track of client data that will enable case managers to enter in client data for records that automatically generates billing sheets for Medical (Medicaid) that match the notes (and ensures all required fields are input properly). There are a few other important tasks that it needs to do, but this one is primary.

Basically, what we're talking about is an Electronic Health Record. At its most basic level, case managers would need to have access to their clients, clerical staff would need access to all clients for data entry, and program managers would need to have access to all clients, and be able to assign/reassign cases to different CM's, as well as generate various kinds of reports that help assess CM productivity, client load, etc. Down the line, it might make sense for primary care providers (or other specialty care providers such as board and care operators) to have roles assigned to them, so they can see certain parts of a client record (designated by program managers) and can also add notes about the client that case managers can see. For example, a psychiatrist might update/change medications - and would be able to add his/her notes while looking at certain parts of that client's record. In addition, we'd want to build in functionality that would allow for associating scanned paperwork - or some other format of keeping track of paperwork electronically - to each client record. This is probably way too much information - but I want to try and give you an idea of what I'm thinking.

It seems to me that Drupal could be modified to do these tasks properly, but it's way above my head to do. I've looked at a couple of other opensource programs - to be honest, I couldn't get opensource emr running - so I don't know if it would do the job. The other ones that I found really didn't seem to offer the right combination of notes, billing capabilities, and role assignment with various levels of access to client data.

My feeling is that government should hire knowledgeable people to configure open source software that works for them, not pay enormous amounts of money to license software that's generic (and then put that modified software back out there - say, for other counties to take advantage of...). I'd like to put together some notes for my supervisor - to provide her with some useful information in beginning to think about setting up a proper electronic information infrastructure for this program.

1. What questions should we be asking ourselves to determine if this could be the right path for this program at this time using Drupal?

2. What kinds of information would developers want to know from us in order to begin thinking about a project like this?

3. What questions should I be asking that I don't know yet to be asking in starting in on this research?

Any thoughts/ideas/suggestions would be much appreciated.
Thanks,

Eva