Electronic Health Record (EHR)

Key facts

Federal certification

ONC Health IT Certification Program, 45 CFR Part 170

Adoption driver

HITECH Act (2009) and the Medicare and Medicaid EHR Incentive Programs

Core data set

United States Core Data for Interoperability (USCDI)

Certified API standard

HL7 FHIR for patient and population data access

What is an electronic health record?

An EHR holds the clinical and administrative information a care team records about a patient: problem lists, medication and allergy lists, vital signs, immunizations, lab and imaging results, orders and progress notes. Unlike a paper chart, it can be searched, shared and analyzed, and it can send information to other systems.

Most EHRs also run the workflows around that record, including computerized provider order entry, electronic prescribing, clinical decision support, scheduling and billing interfaces. Hospitals and practices buy EHRs from health IT developers and configure them heavily, so two sites on the same product can work very differently.

U.S. adoption accelerated after the HITECH Act of 2009 created incentive payments for providers that made meaningful use of certified EHR technology. Most hospitals and office-based physicians now use a certified EHR.

How EHRs are certified and connected

The federal government does not build EHRs, but it sets the rules that certified products must meet:

• The ONC Health IT Certification Program, run by the Assistant Secretary for Technology Policy and Office of the National Coordinator for Health IT (ASTP/ONC), certifies EHR functions against criteria in 45 CFR Part 170.
• Certified products appear in the Certified Health IT Product List (CHPL) with the criteria each version meets.
• CMS programs such as the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS) require providers to use Certified EHR Technology (CEHRT).
• Certified EHRs must support USCDI data elements and standardized HL7 FHIR APIs that let outside apps retrieve patient and population data.

Why EHRs matter

The EHR is where most clinical data is created, so it shapes what data exists downstream.

• Health IT and AI companies need to know which EHR a hospital or practice runs, because integrations, app marketplaces and API access differ by product.
• Market analysts track EHR developer share by facility type, size and region to size replacement cycles and partnership opportunities.
• Compliance teams watch certification status, because a product losing certification can affect a provider's CMS program reporting.
• Real-world evidence studies depend on EHR-derived data, whose completeness varies with how each site documents care.