How can we best capture the richness and diversity of health information in a new generation of electronic health record systems? How can we ensure that person centric shared care across multiple sites is safely supported by relevant information? Why is it still proving so hard to deliver a national electronic health record in any country? In this module we examine the latest internationally recognised approaches to the management of clinical information, focusing on the expanding roles for the health record and the development of electronic health record architectures to meet these. The module deals with practical issues such as standardisation, security, barriers to adoption and the professional challenges in developing clinical data standards for shared electronic healthcare records.