Ethics and the Electronic Health Record: Description of An Integrating System of Electronic Health Records in Argentina and a Proposal to Shift Towards a Patient-Centered Conception.

The Electronic Health Record (EHR) constitutes a complete information system useful for patient care, epidemiological studies and public health policies development. We describe the Integrating System of EHRs of the Autonomous City of Buenos Aires (CABA), established by Law 5669, of 2016. Although we consider the Integrating System of EHRs implemented by CABA very appropriate, we propose, first, that health services no longer store comprehensive EHRs. Instead, complete information would reside in one or several servers sheltered by civil society. Second, information would become integrated only when patients require it and grant access. The patient would now be in a position of strength (complete autonomy). Instead of asking for his data he would be asked for them. In this sense, the patient will have to exercise the emerging responsibility of reciprocity to the benefit of his own care and the care of others.