First of all, let me congratulate you for being the first to post on this forum :-)

In terms of patient record, there are several aspects to consider. Are you talking about the clinical repository structure of the clinical data exchange?

In the first case you might want to consider the HL7 RIM as a source of your inspiration. I say inspiration because the HL7 RIM, while a very comprehensive information model for healthcare, it still represents a partial view of the information that you might need for your application. Many of the concepts that you will need are already defined there.

The second aspect is focused on the information exchanged on the wire and the main activities are in HL7 with CDA CCD/CRS and ASTM CCR.

hope this helps

Ciao,
-RR