In this paper, the requirement for delivering an Integrated Electronic Health Record (I- EHR) service in the 21st century is emphasized and the technological issues related to the development of the required computational infrastructure, enabling the creation and consistent use of a life-long I-EHR service, are addressed. A fundamental requirement for achieving continuity of care is the seamless sharing of clinically significant multimedia information. Thus, in the context of the emerging global information society, many countries consider the creation of and access to the I- EHR of a citizen to be of high priority. This paper discusses the technological infrastructure required for providing access to the life-long I-EHR, consisting of all the health data acquired during interactions of an individual with the healthcare system. In addition, an I-EHR implementation is presented, and issues related to the security of the I-EHR service are also addressed, based on experiences with deployment of the service within HYGEIAnet, the integrated regional health information network of Crete. D 2004 CARS and Elsevier B.V. All rights reserved.
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