Abstract: A system and method is provided for synchronizing a data set across a distributed, electronic, health record system which includes creating and storing the data set at a first deployment, assigning a unique identifier to the data set, designating the first deployment as a home deployment for the data set, and transmitting a copy of the data set, the unique identifier, and the home deployment designation to a master index server. The method also includes causing the master file index server to transmit the copy of the data set, the unique identifier, and the home deployment designation to the second deployment if it is determined that the data set should be transmitted to the second deployment, and causing the master file index server to synchronize the data set between the first deployment and the second deployment.