The goals and objectives of the work are discussing for creating an electronic health record (EHR). The key parameters of the system architecture of conducting EHR follow from these goals. The advantages and disadvantages of the two-level (medical organization — Federal integrator) and the three-level (with the inclusion of the regional level) architecture options are considered as well as characteristics of the organization of centralized or distributed storage of information in EHR. The key issues related with conducting IEMK: shared responsibility are analyzed, namely: sharing of responsibility, ratio of reliability and completeness, the problem of trust and problem traceability information in EHR. Principles that can help solve these problems are proposed: the principle of long-term storage, the principle of rational regulation of access, the principle of the priority of the reliability over completeness. The draft national standard «Electronic Health Record» is represented.