Abstract
Many years ago I spent an entire day in a crowded hotel room at a world informatics conference in New Orleans. The topic was who owns the digital medical record or, more specifically, how and where it should be stored. This was well in advance of any hope of actually creating such a repository but that didn't keep the conversations from getting quite lively! I clearly remember one thing in particular: the Europeans mostly favored giving each patient a "smartcard" on which their record would be stored and carried around in their possession, while the Americans mostly favored a "Cheyenne mountain" like approach where everyone's records were stored in a massive database.