— This paper addresses the problem of understanding preservation and reconstruction requirements for computeraided medical decision-making. With an increasing number of computer-aided decisions having a large impact on our society, the motivation for our work is not only to document these decision processes semi-automatically but also to understand the preservation cost and related computational requirements. Our objective is to support computer-assisted creation of medical records, to guarantee authenticity of records, as well as to allow managers of electronic medical records (EMR), archivists and other users to explore and evaluate computational costs (e.g., storage and processing time) depending on several key characteristics of appraised records. Our approach to this problem is based on designing an exploratory simulation framework for investigating preservation tradeoffs and assisting in appraisals of electronic records. We have a prototype simulation framework called Image Pro...