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The paper presents the architecture of a distributed software system that manages patientspsila health records and assures remote and interactive access to medical services. In order to cover the complex relationships between different medical concepts (symptoms, diseases, treatment, medication, etc.) and also to include ldquointelligencerdquo in the software system an ontology-based approach was adopted. This solution together with the adoption of some widely accepted medical standards (e.g. HL7, LOINC, etc.) assure interoperability and transparent data exchange between various medical applications. The paper presents a distributed healthcare system model in which patients, doctors and software components interact in order to assure better medical services. The key factor in the implementation of this model is the extensive use of the domainpsilas ontology as the bases for database definition and medical data processing. In order to show the usefulness of the proposals as well as their effectiveness in electronic management of patientpsilas health records an experimental implementation of the proposed methodology is in work in the filed of cardio-vascular diseases.