England's Electronic Record Development and Implementation Programme has the overall aim of piloting electronic health record systems and concepts. This involves exploring issues associated with developing and implementing an electronic health record and using information drawn from various electronic patient record systems. As England's South Staffordshire demonstrator site illustrates, determining content for an electronic health record is a very complex process. There are also issues of consent, access and completeness - to name a few - that also need to be addressed. The electronic health record is a long and arduous journey; this article examines the many challenges that England faces.

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