Pressing needs of cost-effectiveness in healthcare and opportunities of emerging electronic health record technologies offer unprecedented chance for progress. Ongoing health care improvement and patient safety initiatives demand new information collection and communication technologies (e.g., Centers for Medicaid and Medicare Services, Joint Commission, National Patient Safety Foundation, public health surveillance). Particularly, desire for faster action and cost-effective health care drive unprecedented investments in electronic patient records worldwide. Recognizing these opportunities, many countries and the World Health Organization have launched several major health care improvement initiatives that are driven by new electronic record technologies. In the United States, historic $19 billion investment is provided through the American Recovery and Reinvestment Act of 2009. Models of sharing electronic patient data and citizen expectations for personal electronic health records will be reviewed. Regional health information networks and other information sharing initiatives depend on the interoperability of systems. Ultimately, the recent flood of health information standards needs to be balanced with actual interoperability opportunities. It is anticipated that the current policy discussions on the "meaningful use" of electronic health records will have major beneficial technical and also reimbursement implications.