title: The emergence of national electronic health record architectures in the United States and Australia: models, costs, and questions.
abstract: Emerging electronic health record models present numerous challenges to health care systems, physicians, and regulators. This article provides explanation of some of the reasons driving the development of the electronic health record, describes two national electronic health record models (currently developing in the United States and Australia) and one distributed, personal model. The US and Australian models are contrasted in their different architectures ("pull" versus "push") and their different approaches to patient autonomy, privacy, and confidentiality. The article also discusses some of the professional, practical, and legal challenges that health care providers potentially face both during and after electronic health record implementation.
authors.affiliation: Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
authors.forename: Tracy D
authors.initials: TD
authors.lastname: Gunter
authors.forename: Nicolas P
authors.initials: NP
authors.lastname: Terry
mesh_terms: D001315:Australia; D003219:Confidentiality; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000458:organization & administration; D006291:Health Policy; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration; D014481:United States