There have been a variety of initiatives in Belgium to get the records in electronic format. But the model is not monolithic and there is no central repository. The GP is seen as the most logical place to aggregate a patients records with the external feed coming from the hospital specialist.

The initial push has seen the development of several packages with reasonable acceptance among physicians (read: the inc\ufffdntives were right). Following a boost of those subsidies, big pharma caught the smell of money and most of the majors each bought out one of the package developers. So there is little risk left that one of the packages will be left orphaned.

The way it technically works is that all the packages have a clearly defined data interchange protocol with most being able to understand several of the other's protocols as well.

The data exchange is currently handled by two companies. Both rely on PGP encrypted mail for data transfer. One uses a central server with tracking, the other can use any mail server in the middle but offers no tracking. Choice of either is up to the receiving GP.

The system essentially has a distributed backup because the records of the visited specialists are kept at the hospitals. Up 'til now I've only had to recover for one fried HDD whose operator had never hear of backups.

So far things are going reasonable given that the target public and computers do not necessarily agree well with each other despite all those years of university education...

Record at our hospital are kept in custom written software. We pool funds with 15 other public hospitals in a central IT development/support organization. The current generation of software used a specialist centric view of things in the sense that each specialty is a separate database. The UI consist of a lowest common denominator base plus extensions to handle the different needs. The version we're in the process of rolling out takes a patient centric view and aggregates all data in a single scheme.