Abstract
Caring for patients' health problems relies increasingly on sharing information between clinical departments and disciplines and with managers. The medical record of the future will need to provide a flexible and shareable framework for recording and analysing the consultation process. The advanced informatics in medicine (AIM) programme seeks to encourage research and development in telemedicine in areas that are beyond the scope of any one country. It includes many European projects attempting to define the best storage and transmission formats for such diverse data types as laboratory results, biosignals, x ray images, and photographs, and in clinical specialties varying from intensive care to medicine for elderly people. One example, the good European health record project, is developing a model architecture for computerised health records across Europe that is capable of operating on a wide variety of computer hardwares and will also be able to communicate with many different information systems. The ultimate European health record will be comprehensive and medicolegally acceptable across clinical domains, hold all data types, and be automatically translated between languages. In the future, a French patient on holiday could walk into your consulting room and present you with an optically printed card containing his entire medical file, which is written in French and uses ICD-10 classification terms. Sitting at your consulting room desk, using an updated version of your current computer system, you place his card into your card reader. Your system presents to you (with familiar screens) the file in English and with matched Read terms. You will be able to see the medical summary created by your French counterpart, but your system will also have scanned the record and created its own summary in your favourite predetermined way. If you need to see a recent radiograph on the patient, your system can dial up …

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