BACKGROUNDA standard in the field of Heath Informatics which has been taken for grantedup until this point may be disappearing and a new paradigm may begin to take shape as paper-based medical record (PMR) systems are changing to the electronic health record (EHR)systems. Although the PMR has played a critical role in recording patientâ€™s clinical information,now many studies report that EHR systems improve quality of care beyond PMRs. For thisreason, the governments across the world have initiated various approaches accelerating EHRadoption. However, there have been a small number of studies explaining which factors affectEHR adoption and use in health institutions.rnOBJECTIVE The objective of this study is to investigate theactual practice of patientâ€™s healthrecord handling throughout the health institutions in Ethiopia and see the gap between the paperbased medical record and electronic health record and developing architectural framework forelectronic health record.rnMETHOD The necessary data is collected using questionnaire and interview within and aroundAddis Ababa to get the overall picture of the health data record handling of health institutions,like hospitals.rnRESULT The result of the study disclosed that almost all health institutions are exercising paperbased health record handling and extremely few institutions are using technological devices tohandle some part of their records, like patient registration, together with paper based patientmedical record which is highly subject to be misplaced, time taking and the like.rnCONCLUSION Architectural framework for electronic medical record is a must to have to allhealth service providers in all levels in order to improve their performance and to provide up tothe standard services to the community at large. The concerned management should provide thenecessary attention to it. All health institutions should be ready to implement technology basedfacility which is believed to be a must to have.