Electronic health record databases

Electronic health record databases are longitudinal patient record databases that are used by clinicians in caring for their patients and secondarily used for the purpose of research, often in anonymized format. Information from electronic health record databases is thought more likely than data from administrative databases to reflect patients' true clinical state given that the data are collected by clinicians in the context of patient care as opposed to solely for billing purposes. Further, these databases often include information not found in administrative databases, such as symptoms and signs of illness, health-related behaviors including smoking, body mass index, indications for prescribed drugs, and laboratory results. In this chapter, we describe the characteristics of electronic health record databases and their role in pharmacoepidemiologic research, focusing on primary care databases from Europe and a national database for veterans from the United States.