# The Electronic Health Record (EHR)
The Electronic Health Record (EHR) is a digital version of a patient’s medical history, maintained over time by healthcare providers. It contains detailed information such as demographics, medical history, diagnoses, procedures, medications, and diagnostic test results and images. EHRs can streamline data collection and management, enable high-quality patient care, and facilitate communication between healthcare professionals. The EHR can provide an abundance of real-world data for observational research to study disease progression and treatment effectiveness.
## Some Considerations in Using EHR Data for Research
* EHRs aggregate data from various sources and systems within a healthcare system and can provide a broad view of patient health.
* In extracting data from the EHR, large sample sizes may be obtained at a fraction of the cost of primary data collection.
* EHRs can provide a longitudinal record of a patient's health. However, it is important to consider that the entirety of a patient's healthcare interactions may not occur within a single health system.
* Variations in EHR systems and standards can hinder data integration across institutions.
* EHRs are optimized for collecting and utilizing data in the care of an individual patient. Extracting and staging data for research can be challenging.
* As is true of all datasets, incomplete, inconsistent, or inaccurate data can impact the validity of research findings. Research results based on data from a single healthcare system can rarely be directly applied in another setting.
* EHRs reflect real-world healthcare settings. As such, the data reflect the clinical practices of the healthcare organization and the population it serves.
* Handling sensitive patient information requires strict compliance with privacy, confidentiality, and security policies and procedures.
## Resources
### Books
* **Secondary Analysis of Electronic Health Records** \[Internet]. Cham (CH): Springer; 2016. Available from: doi: 10.1007/978-3-319-43742-2.
### Articles
* Ehrenstein V, Kharrazi H, Lehmann H, et al. **Obtaining Data From Electronic Health Records**. In: Gliklich RE, Leavy MB, Dreyer NA, editors. Tools and Technologies for Registry Interoperability, Registries for Evaluating Patient Outcomes: A User’s Guide, 3rd Edition, Addendum 2 \[Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2019 Oct. Available from:
* Kohane IS, Aronow BJ, Avillach P, Beaulieu-Jones BK, Bellazzi R, Bradford RL, Brat GA, Cannataro M, Cimino JJ, García-Barrio N, Gehlenborg N, Ghassemi M, Gutiérrez-Sacristán A, Hanauer DA, Holmes JH, Hong C, Klann JG, Loh NHW, Luo Y, Mandl KD, Daniar M, Moore JH, Murphy SN, Neuraz A, Ngiam KY, Omenn GS, Palmer N, Patel LP, Pedrera-Jiménez M, Sliz P, South AM, Tan ALM, Taylor DM, Taylor BW, Torti C, Vallejos AK, Wagholikar KB; Consortium For Clinical Characterization Of COVID-19 By EHR (4CE); Weber GM, Cai T. **What Every Reader Should Know About Studies Using Electronic Health Record Data but May Be Afraid to Ask**. J Med Internet Res. 2021 Mar 2;23(3):e22219. doi: 10.2196/22219. PMID: 33600347; PMCID: [PMC7927948](https://pmc.ncbi.nlm.nih.gov/articles/PMC7927948/).
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