In Germany, for example, medical records are scattered across medical practitioners, hospitals and health insurance providers. There's no central, distributed or federated EMR system. Each practice or hospital basically runs its own system, sometimes dating from the 1980s. MS-DOS is still widely used in surgeries.
Data transfer (i.e. lab results, consultation results) happens mostly on paper, that is the patient usually gets handed a letter with the results to present to their GP.
Lots of information is lost this way. Examinations and analyses often are duplicated or done repeatedly.