I think you are confusing software architecture with technologies - just because two projects use PostgreSQL, Hibernate and JBoss - that does not mean they have the same software architecture.
Software architecture is far more complex - it is the relationship between the packages, systems, layers. It is the function of the core classes that define how the system works. It is the design patterns that control the inner workings. It is often influenced by the relationships of the tables.
The software architecture significantly affects how the system can handle change especially with complex workflow, internationalization, localization, translation to multi-byte languages etc.
Unless you look at the code, learn how the applications work, and effectively learn the system you cannot compare and contrast.
Now briefly looking at OpenMRS, I can see it has a professional architecture, a strong structure, strong data model that is in line with the excellent reputation of Regenstreif.
Through the architecture PatientOS dynamically generates all of the Swing code in real time based upon database settings. You can use the GUI to change any form - even the tools themselves (the recursive effect is interesting).
Thus how we manage and interact with the system is fundamentally different. For example I just read this post on adding a tab while in OpenMRS you edit files, in PatientOS (hey they rhyme) you use the Dialog Builder - a rich client GUI to navigate the dialog hierarchy and add a new panel of type tab. You can customize menus, toolbars, controls on a form, add scripting behind controls, all through the GUI.
All of that one could add to OpenMRS no doubt - but the design patterns are very different (and I am not saying one is better than the other - impossible to say while the products are so young).
OpenMRS and other web applications are going to shine brighter than PatientOS in developing world as the client (browser) requirements are a tiny fraction of the processing power of the PatientOS Swing client.
Now shiny ball in the form of Ultimate EMR is looking slick for an Open Source EMR - but the license link is not working for me...
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