To switch OpenEMR to work with SQL Server would be very difficult.
Although OpenEMR uses ADODB as an abstraction layer to the database, which does have SQL Server drivers, there are a number of MySQL specific features in use, such as Autoincrement.
Here is the code where OpenEMR chooses which database driver to use.
Changing this to be SQL server instead of MySQL is where you would start, but there are a lot more things you would have to do in order to get it to work, even partially.
Modifying the .sql that creates the empty schema to be compatible with SQL Server would be a next big step.
You might be able to overcome that problem by exporting a working database from MySQL and importing it into SQL Server and using that as a baseline.
I don’t know your motivation for wanting to use SQL Server instead of MySQL, so you are going to have to weigh the difficulty in making the changes with the advantages of SQL Server. The issues I mention here are but a few of many other problems you are likely to encounter.