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IntroductionElectronic health records are being introduced in Europe, North America, Australasia, the Middle East, and elsewhere.1 2 There is no universally accepted definition of the term electronic health record, but we use it to mean a digital, longitudinal record of a patient’s health and health care that can be shared by different healthcare providers.3 Although electronic health records are widely viewed as central to modernising the organisation and delivery of sustainable, high quality health care, the uptake of such records in hospital has tended to be slow.4 Approaches to deployment of electronic health records vary from home grown systems in single organisations with the necessary technical and managerial capacity; to interoperability standards for linking multiple information technology (IT) systems; to top down, government driven, national implementations of standardised, commercial software applications. The last approach was chosen in England in 2002: the nationwide implementation of electronic health records, known as the National Health Service (NHS) Care Records Service, is the cornerstone of the 12.7bn National Programme for IT.5 6

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