Centralised versus decentralised management of patients' medical records.

For more than 20 years, many countries have been trying to set up a standardised medical record at the regional or at the national level. Most of them have not reached this goal, essentially due to two main difficulties related to patient identification and medical records standardisation. Moreover, the issues raised by the centralisation of all gathered medical data have to be tackled particularly in terms of security and privacy. We discuss here the interest of a non-centralised management of medical records which would require a specific procedure that gives to the patient access to his/her distributed medical data, wherever he/she is located.