OBJECTIVES: This article discusses current planning activities in Austria after legislation has been passed to introduce the electronic health record (EHR). METHODS: After describing similar activities in several other countries, the authors explore the current situation of healthcare telematics and imminent steps toward the implementation of a lifelong EHR. RESULTS: Substantial efforts have been made to coordinate healthcare telematics in Austria since the mid-1990s. One result of these efforts was the definition of a framework for electronic data exchange. A number of standardization projects were also implemented. Major steps have been taken as part of an ongoing healthcare reform to promote the use of healthcare telematics. One important example is a national initiative whose objective is to implement the EHR. This initiative is extensively discussed along with other national activities related to healthcare telematics. CONCLUSION: This EHR initiative has prepared the ground for extensive planning that is currently under way to implement a lifelong EHR in Austria on a national level. Introducing the EHR will have a strong impact on Austrian healthcare and should be performed in concert with international activities. The authors offer a number of practical recommendations for the implementation of an EHR on a national level.