<s>
An	O
electronic	B-Application
health	I-Application
record	I-Application
(	O
EHR	O
)	O
is	O
the	O
systematized	O
collection	O
of	O
patient	O
and	O
population	O
electronically	O
stored	O
health	O
information	O
in	O
a	O
digital	O
format	O
.	O
</s>
<s>
EHRs	B-Application
may	O
include	O
a	O
range	O
of	O
data	O
,	O
including	O
demographics	O
,	O
medical	O
history	O
,	O
medication	O
and	O
allergies	O
,	O
immunization	O
status	O
,	O
laboratory	O
test	O
results	O
,	O
radiology	O
images	O
,	O
vital	O
signs	O
,	O
personal	O
statistics	O
like	O
age	O
and	O
weight	O
,	O
and	O
billing	O
information	O
.	O
</s>
<s>
For	O
several	O
decades	O
,	O
electronic	B-Application
health	I-Application
records	I-Application
(	O
EHRs	B-Application
)	O
have	O
been	O
touted	O
as	O
key	O
to	O
increasing	O
of	O
quality	O
care	O
.	O
</s>
<s>
Electronic	B-Application
health	I-Application
records	I-Application
are	O
used	O
for	O
other	O
reasons	O
than	O
charting	O
for	O
patients	O
;	O
today	O
,	O
providers	O
are	O
using	O
data	O
from	O
patient	O
records	O
to	O
improve	O
quality	O
outcomes	O
through	O
their	O
care	O
management	O
programs	O
.	O
</s>
<s>
Due	O
to	O
the	O
digital	O
information	O
being	O
searchable	O
and	O
in	O
a	O
single	O
file	O
,	O
EMRs	O
(	O
electronic	B-Application
medical	I-Application
records	I-Application
)	O
are	O
more	O
effective	O
when	O
extracting	O
medical	O
data	O
for	O
the	O
examination	O
of	O
possible	O
trends	O
and	O
long	O
term	O
changes	O
in	O
a	O
patient	O
.	O
</s>
<s>
Population-based	O
studies	O
of	O
medical	O
records	O
may	O
also	O
be	O
facilitated	O
by	O
the	O
widespread	O
adoption	O
of	O
EHRs	B-Application
and	O
EMRs	O
.	O
</s>
<s>
The	O
terms	O
EHR	O
,	O
electronic	B-Application
patient	I-Application
record	I-Application
(	O
EPR	O
)	O
and	O
EMR	O
have	O
often	O
been	O
used	O
interchangeably	O
,	O
but	O
differences	O
between	O
the	O
models	O
are	O
now	O
being	O
defined	O
.	O
</s>
<s>
The	O
electronic	B-Application
health	I-Application
record	I-Application
(	O
EHR	O
)	O
is	O
a	O
more	O
longitudinal	O
collection	O
of	O
the	O
electronic	O
health	O
information	O
of	O
individual	O
patients	O
or	O
populations	O
.	O
</s>
<s>
While	O
there	O
is	O
still	O
a	O
considerable	O
amount	O
of	O
debate	O
around	O
the	O
superiority	O
of	O
electronic	B-Application
health	I-Application
records	I-Application
over	O
paper	O
records	O
,	O
the	O
research	O
literature	O
paints	O
a	O
more	O
realistic	O
picture	O
of	O
the	O
benefits	O
and	O
downsides	O
.	O
</s>
<s>
The	O
increased	O
transparency	O
,	O
portability	O
,	O
and	O
accessibility	O
acquired	O
by	O
the	O
adoption	O
of	O
electronic	B-Application
medical	I-Application
records	I-Application
may	O
increase	O
the	O
ease	O
with	O
which	O
they	O
can	O
be	O
accessed	O
by	O
healthcare	O
professionals	O
,	O
but	O
also	O
can	O
increase	O
the	O
amount	O
of	O
stolen	O
information	O
by	O
unauthorized	O
persons	O
or	O
unscrupulous	O
users	O
versus	O
paper	O
medical	O
records	O
,	O
as	O
acknowledged	O
by	O
the	O
increased	O
security	O
requirements	O
for	O
electronic	B-Application
medical	I-Application
records	I-Application
included	O
in	O
the	O
Health	O
Information	O
and	O
Accessibility	O
Act	O
and	O
by	O
large-scale	O
breaches	O
in	O
confidential	O
records	O
reported	O
by	O
EMR	O
users	O
.	O
</s>
<s>
When	O
users	O
log	O
in	O
into	O
the	O
electronic	B-Application
health	I-Application
records	I-Application
,	O
it	O
is	O
their	O
responsibility	O
to	O
make	O
sure	O
the	O
information	O
stays	O
confidential	O
and	O
this	O
is	O
done	O
by	O
keeping	O
their	O
passwords	O
unknown	O
to	O
others	O
and	O
logging	O
off	O
before	O
leaving	O
the	O
station	O
.	O
</s>
<s>
Sharing	O
their	O
electronic	B-Application
health	I-Application
records	I-Application
with	O
people	O
who	O
have	O
type	O
2	O
diabetes	O
helps	O
them	O
to	O
reduce	O
their	O
blood	O
sugar	O
levels	O
.	O
</s>
<s>
Electronic	B-Application
medical	I-Application
records	I-Application
could	O
also	O
be	O
studied	O
to	O
quantify	O
disease	O
burdens	O
–	O
such	O
as	O
the	O
number	O
of	O
deaths	O
from	O
antimicrobial	O
resistance	O
–	O
or	O
help	O
identify	O
causes	O
of	O
,	O
factors	O
of	O
,	O
links	O
between	O
and	O
contributors	O
to	O
diseases	O
,	O
especially	O
when	O
combined	O
with	O
genome-wide	O
association	O
studies	O
.	O
</s>
<s>
Privacy	O
:	O
For	O
such	O
purposes	O
,	O
electronic	B-Application
medical	I-Application
records	I-Application
could	O
potentially	O
be	O
made	O
available	O
in	O
securely	O
anonymized	O
or	O
pseudonymized	B-General_Concept
forms	O
to	O
ensure	O
patients	O
 '	O
privacy	O
is	O
maintained	O
even	O
if	O
data	O
breaches	O
occur	O
.	O
</s>
<s>
There	O
are	O
concerns	O
about	O
the	O
efficacy	O
of	O
some	O
currently	O
applied	O
pseudonymization	B-General_Concept
and	O
data	O
protection	O
techniques	O
,	O
including	O
the	O
applied	O
encryption	O
.	O
</s>
<s>
Documentation	O
burden	O
:	O
While	O
such	O
records	O
could	O
enable	O
avoiding	O
duplication	O
of	O
work	O
via	O
records-sharing	O
,	O
documentation	O
burdens	O
for	O
medical	O
facility	O
personnel	O
can	O
be	O
a	O
further	O
issue	O
with	O
EHRs	B-Application
.	O
</s>
<s>
This	O
burden	O
could	O
be	O
reduced	O
via	O
voice	B-Application
recognition	I-Application
,	O
optical	B-Application
character	I-Application
recognition	I-Application
,	O
other	O
technologies	O
,	O
involvement	O
of	O
physicians	O
in	O
changes	O
to	O
software	O
,	O
and	O
other	O
means	O
which	O
could	O
possibly	O
reduce	O
the	O
documentation	O
burden	O
to	O
below	O
paper-based	O
records	O
documentation	O
and	O
low-level	O
documentation	O
.	O
</s>
<s>
Theoretically	O
,	O
free	B-Application
software	I-Application
such	O
as	O
GNU	B-Language
Health	I-Language
and	O
other	B-Application
open	I-Application
source	I-Application
health	I-Application
software	I-Application
could	O
be	O
used	O
or	O
modified	O
for	O
various	O
purposes	O
that	O
use	O
electronic	B-Application
medical	I-Application
records	I-Application
i.a.	O
</s>
<s>
Decision-support	O
:	O
Electronic	B-Application
health	I-Application
records	I-Application
could	O
also	O
support	O
clinical	O
decision	O
support	O
systems	O
.	O
</s>
<s>
mHealth	B-Device
integration	O
:	O
They	O
could	O
be	O
coupled	O
with	O
mHealth	B-Device
mobile	O
applications	O
and	O
wearable	B-Operating_System
technology	I-Operating_System
.	O
</s>
<s>
Screening	O
:	O
Artificial	O
intelligence	O
systems	O
could	O
use	O
this	O
data	O
among	O
other	O
integrated	O
data	O
to	O
screen	O
for	O
potential	O
diseases	O
via	O
multimodal	B-Algorithm
learning	I-Algorithm
.	O
</s>
<s>
According	O
to	O
Dr.	O
Bob	O
Kocher	O
,	O
as	O
of	O
2021	O
there	O
are	O
"	O
1,000	O
different	O
electronic	B-Application
health	I-Application
record	I-Application
systems	O
in	O
the	O
U.S.	O
,	O
and	O
almost	O
every	O
hospital	O
and	O
clinic	O
has	O
a	O
slightly	O
different	O
system	O
tailored	O
to	O
its	O
own	O
needs	O
"	O
which	O
caused	O
difficulties	O
and	O
delays	O
during	O
COVID-19	O
vaccinations	O
,	O
with	O
similar	O
problems	O
being	O
reported	O
in	O
other	O
countries	O
.	O
</s>
<s>
Electronic	B-Application
Medical	I-Application
Records	I-Application
may	O
include	O
access	O
to	O
Personal	O
Health	O
Records	O
(	O
PHR	O
)	O
which	O
makes	O
individual	O
notes	O
from	O
an	O
EMR	O
readily	O
visible	O
and	O
accessible	O
for	O
consumers	O
.	O
</s>
<s>
Some	O
EMR	O
systems	O
automatically	O
monitor	O
clinical	O
events	O
,	O
by	O
analyzing	O
patient	O
data	O
from	O
an	O
electronic	B-Application
health	I-Application
record	I-Application
to	O
predict	O
,	O
detect	O
and	O
potentially	O
prevent	O
adverse	O
events	O
.	O
</s>
<s>
This	O
type	O
of	O
event	O
monitoring	O
has	O
been	O
implemented	O
using	O
the	O
Louisiana	O
Public	O
health	O
information	O
exchange	O
linking	O
statewide	O
public	O
health	O
with	O
electronic	B-Application
medical	I-Application
records	I-Application
.	O
</s>
<s>
For	O
example	O
,	O
actor-network	O
theory	O
would	O
see	O
the	O
EHR	O
as	O
an	O
actant	O
in	O
a	O
network	O
,	O
and	O
research	O
in	O
computer	B-Protocol
supported	I-Protocol
cooperative	I-Protocol
work	I-Protocol
(	O
CSCW	B-Protocol
)	O
sees	O
the	O
EHR	O
as	O
a	O
tool	O
supporting	O
particular	O
work	O
.	O
</s>
<s>
Several	O
possible	O
advantages	O
to	O
EHRs	B-Application
over	O
paper	O
records	O
have	O
been	O
proposed	O
,	O
but	O
there	O
is	O
debate	O
about	O
the	O
degree	O
to	O
which	O
these	O
are	O
achieved	O
in	O
practice	O
.	O
</s>
<s>
Several	O
studies	O
call	O
into	O
question	O
whether	O
EHRs	B-Application
improve	O
the	O
quality	O
of	O
care	O
.	O
</s>
<s>
EHRs	B-Application
may	O
also	O
improve	O
prevention	O
by	O
providing	O
doctors	O
and	O
patients	O
better	O
access	O
to	O
test	O
results	O
,	O
identifying	O
missing	O
patient	O
information	O
,	O
and	O
offering	O
evidence-based	O
recommendations	O
for	O
preventive	O
services	O
.	O
</s>
<s>
Doubts	O
have	O
been	O
raised	O
about	O
cost	O
saving	O
from	O
EHRs	B-Application
by	O
researchers	O
at	O
Harvard	O
University	O
,	O
the	O
Wharton	O
School	O
of	O
the	O
University	O
of	O
Pennsylvania	O
,	O
Stanford	O
University	O
,	O
and	O
others	O
.	O
</s>
<s>
In	O
2022	O
the	O
chief	O
executive	O
of	O
Guy	O
's	O
and	O
St	O
Thomas	O
 '	O
NHS	O
Foundation	O
Trust	O
,	O
one	O
of	O
the	O
biggest	O
NHS	O
organisations	O
,	O
said	O
that	O
the	O
£450	O
million	O
cost	O
over	O
15	O
years	O
to	O
install	O
the	O
Epic	O
Systems	O
electronic	B-Application
patient	I-Application
record	I-Application
across	O
its	O
six	O
hospitals	O
,	O
which	O
will	O
reduce	O
more	O
than	O
100	O
different	O
IT	O
systems	O
down	O
to	O
just	O
a	O
handful	O
,	O
was	O
"	O
chicken	O
feed	O
"	O
when	O
compared	O
to	O
the	O
NHS	O
's	O
overall	O
budget	O
.	O
</s>
<s>
The	O
U.S.	O
military	O
's	O
EHR	O
,	O
AHLTA	B-Application
,	O
was	O
reported	O
to	O
have	O
significant	O
usability	O
issues	O
.	O
</s>
<s>
Furthermore	O
,	O
studies	O
such	O
as	O
the	O
one	O
conducted	O
in	O
BMC	O
Medical	O
Informatics	O
and	O
Decision	O
Making	O
,	O
also	O
showed	O
that	O
although	O
the	O
implementation	O
of	O
electronic	B-Application
medical	I-Application
records	I-Application
systems	O
has	O
been	O
a	O
great	O
assistance	O
to	O
general	O
practitioners	O
there	O
is	O
still	O
much	O
room	O
for	O
revision	O
in	O
the	O
overall	O
framework	O
and	O
the	O
amount	O
of	O
training	O
provided	O
.	O
</s>
<s>
Mobile	O
devices	O
are	O
increasingly	O
able	O
to	O
sync	O
up	O
with	O
electronic	B-Application
health	I-Application
record	I-Application
systems	O
thus	O
allowing	O
physicians	O
to	O
access	O
patient	O
records	O
from	O
remote	O
locations	O
.	O
</s>
<s>
Other	O
advanced	O
computational	O
techniques	O
have	O
allowed	O
EHRs	B-Application
to	O
be	O
evaluated	O
at	O
a	O
much	O
quicker	O
rate	O
.	O
</s>
<s>
Natural	B-Language
language	I-Language
processing	I-Language
is	O
increasingly	O
used	O
to	O
search	O
EMRs	O
,	O
especially	O
through	O
searching	O
and	O
analyzing	O
notes	O
and	O
text	O
that	O
would	O
otherwise	O
be	O
inaccessible	O
for	O
study	O
when	O
seeking	O
to	O
improve	O
care	O
.	O
</s>
<s>
One	O
study	O
found	O
that	O
several	O
machine	O
learning	O
methods	O
could	O
be	O
used	O
to	O
predict	O
the	O
rate	O
of	O
a	O
patient	O
's	O
mortality	O
with	O
moderate	O
success	O
,	O
with	O
the	O
most	O
successful	O
approach	O
including	O
using	O
a	O
combination	O
of	O
a	O
convolutional	B-Architecture
neural	I-Architecture
network	I-Architecture
and	O
a	O
heterogenous	O
graph	O
model	O
.	O
</s>
<s>
Per	O
empirical	O
research	O
in	O
social	O
informatics	O
,	O
information	B-General_Concept
and	I-General_Concept
communications	I-General_Concept
technology	I-General_Concept
(	O
ICT	O
)	O
use	O
can	O
lead	O
to	O
both	O
intended	O
and	O
unintended	O
consequences	O
.	O
</s>
<s>
EHRs	B-Application
are	O
almost	O
invariably	O
detrimental	O
to	O
physician	O
productivity	O
,	O
whether	O
the	O
data	O
is	O
entered	O
during	O
the	O
encounter	O
or	O
sometime	O
thereafter	O
.	O
</s>
<s>
Similarly	O
,	O
it	O
's	O
important	O
to	O
recognize	O
that	O
the	O
implementation	O
of	O
electronic	B-Application
health	I-Application
records	I-Application
carries	O
with	O
it	O
significant	O
legal	O
risks	O
.	O
</s>
<s>
Larger	O
EHR	O
providers	O
(	O
or	O
government-sponsored	O
providers	O
of	O
EHRs	B-Application
)	O
are	O
better	O
able	O
to	O
withstand	O
legal	O
assaults	O
.	O
</s>
<s>
Different	O
countries	O
may	O
have	O
diverging	O
legal	O
requirements	O
for	O
the	O
content	O
or	O
usage	O
of	O
electronic	B-Application
health	I-Application
records	I-Application
,	O
which	O
can	O
require	O
radical	O
changes	O
to	O
the	O
technical	O
makeup	O
of	O
the	O
EHR	O
implementation	O
in	O
question	O
.	O
</s>
<s>
The	O
majority	O
of	O
the	O
countries	O
in	O
Europe	O
have	O
made	O
a	O
strategy	O
for	O
the	O
development	O
and	O
implementation	O
of	O
the	O
Electronic	B-Application
Health	I-Application
Record	I-Application
Systems	O
.	O
</s>
<s>
The	O
idea	O
of	O
a	O
centralized	O
electronic	B-Application
health	I-Application
record	I-Application
system	O
was	O
poorly	O
received	O
by	O
the	O
public	O
who	O
are	O
wary	O
that	O
governments	O
may	O
use	O
of	O
the	O
system	O
beyond	O
its	O
intended	O
purpose	O
.	O
</s>
<s>
ISO	O
–	O
ISO	B-Architecture
TC	I-Architecture
215	I-Architecture
provides	O
international	O
technical	O
specifications	O
for	O
EHRs	B-Application
.	O
</s>
<s>
The	O
U.S.	O
federal	O
government	O
has	O
issued	O
new	O
rules	O
of	O
electronic	B-Application
health	I-Application
records	I-Application
.	O
</s>
<s>
A	O
common	B-Application
data	I-Application
model	I-Application
(	O
CDM	O
)	O
is	O
a	O
specification	O
that	O
describes	O
how	O
data	O
from	O
multiple	O
sources	O
(	O
e.g.	O
,	O
multiple	O
EHR	O
systems	O
)	O
can	O
be	O
combined	O
.	O
</s>
<s>
Sentinel	O
Common	B-Application
Data	I-Application
Model	I-Application
:	O
Initially	O
started	O
as	O
Mini-Sentinel	O
in	O
2008	O
.	O
</s>
<s>
OMOP	O
Common	B-Application
Data	I-Application
Model	I-Application
:	O
model	O
that	O
defines	O
how	O
electronic	B-Application
health	I-Application
record	I-Application
data	O
,	O
medical	O
billing	O
data	O
or	O
other	O
healthcare	O
data	O
from	O
multiple	O
institutions	O
can	O
be	O
harmonized	O
and	O
queried	O
in	O
unified	O
way	O
.	O
</s>
<s>
PCORNet	O
Common	B-Application
Data	I-Application
Model	I-Application
:	O
First	O
defined	O
in	O
2014	O
and	O
used	O
by	O
PCORI	O
and	O
People-Centered	O
Research	O
Foundation	O
.	O
</s>
<s>
Many	O
first	O
generation	O
EHRs	B-Application
were	O
designed	O
to	O
fit	O
the	O
needs	O
of	O
primary	O
care	O
physicians	O
,	O
leaving	O
certain	O
specialties	O
significantly	O
less	O
satisfied	O
with	O
their	O
EHR	O
system	O
.	O
</s>
<s>
An	O
important	O
consideration	O
in	O
the	O
process	O
of	O
developing	O
electronic	B-Application
health	I-Application
records	I-Application
is	O
to	O
plan	O
for	O
the	O
long-term	O
preservation	O
and	O
storage	O
of	O
these	O
records	O
.	O
</s>
<s>
The	O
field	O
will	O
need	O
to	O
come	O
to	O
consensus	O
on	O
the	O
length	O
of	O
time	O
to	O
store	O
EHRs	B-Application
,	O
methods	O
to	O
ensure	O
the	O
future	O
accessibility	O
and	O
compatibility	O
of	O
archived	O
data	O
with	O
yet-to-be	O
developed	O
retrieval	O
systems	O
,	O
and	O
how	O
to	O
ensure	O
the	O
physical	O
and	O
virtual	O
security	O
of	O
the	O
archives	O
.	O
</s>
<s>
Additionally	O
,	O
considerations	O
about	O
long-term	O
storage	O
of	O
electronic	B-Application
health	I-Application
records	I-Application
are	O
complicated	O
by	O
the	O
possibility	O
that	O
the	O
records	O
might	O
one	O
day	O
be	O
used	O
longitudinally	O
and	O
integrated	O
across	O
sites	O
of	O
care	O
.	O
</s>
<s>
The	O
required	O
length	O
of	O
storage	O
of	O
an	O
individual	O
electronic	B-Application
health	I-Application
record	I-Application
will	O
depend	O
on	O
national	O
and	O
state	O
regulations	O
,	O
which	O
are	O
subject	O
to	O
change	O
over	O
time	O
.	O
</s>
<s>
While	O
it	O
is	O
currently	O
unknown	O
precisely	O
how	O
long	O
EHRs	B-Application
will	O
be	O
preserved	O
,	O
it	O
is	O
certain	O
that	O
length	O
of	O
time	O
will	O
exceed	O
the	O
average	O
shelf-life	O
of	O
paper	O
records	O
.	O
</s>
<s>
Two	O
models	O
have	O
been	O
used	O
to	O
satisfy	O
this	O
problem	O
:	O
a	O
centralized	B-Operating_System
data	I-Operating_System
server	I-Operating_System
solution	I-Operating_System
,	O
and	O
a	O
peer-to-peer	O
file	B-Application
synchronization	I-Application
program	O
(	O
as	O
has	O
been	O
developed	O
for	O
other	O
peer-to-peer	O
networks	O
)	O
.	O
</s>
<s>
The	O
ability	O
of	O
electronic	B-Application
health	I-Application
record	I-Application
systems	O
to	O
provide	O
this	O
function	O
is	O
a	O
key	O
benefit	O
and	O
can	O
improve	O
healthcare	O
delivery	O
.	O
</s>
<s>
In	O
2011	O
,	O
Moscow	O
's	O
government	O
launched	O
a	O
major	O
project	O
known	O
as	O
UMIAS	B-Application
as	O
part	O
of	O
its	O
electronic	O
healthcare	O
initiative	O
.	O
</s>
<s>
UMIAS	B-Application
-	O
the	O
Unified	O
Medical	O
Information	O
and	O
Analytical	O
System	O
-	O
connects	O
more	O
than	O
660	O
clinics	O
and	O
over	O
23,600	O
medical	O
practitioners	O
in	O
Moscow	O
.	O
</s>
<s>
UMIAS	B-Application
covers	O
9.5	O
million	O
patients	O
,	O
contains	O
more	O
than	O
359	O
million	O
patient	O
records	O
and	O
supports	O
more	O
than	O
500,000	O
different	O
transactions	O
daily	O
.	O
</s>
<s>
With	O
the	O
newly	O
enacted	O
Directive	O
2011/24/EU	O
on	O
patients	O
 '	O
rights	O
in	O
cross-border	O
healthcare	O
due	O
for	O
implementation	O
by	O
2013	O
,	O
it	O
is	O
inevitable	O
that	O
a	O
centralised	O
European	O
health	B-Application
record	I-Application
system	I-Application
will	O
become	O
a	O
reality	O
even	O
before	O
2020	O
.	O
</s>
<s>
However	O
,	O
the	O
concept	O
of	O
a	O
centralised	O
supranational	O
central	O
server	O
raises	O
concern	O
about	O
storing	O
electronic	B-Application
medical	I-Application
records	I-Application
in	O
a	O
central	O
location	O
.	O
</s>
<s>
Cross-border	O
and	O
Interoperable	O
electronic	B-Application
health	I-Application
record	I-Application
systems	O
make	O
confidential	O
data	O
more	O
easily	O
and	O
rapidly	O
accessible	O
to	O
a	O
wider	O
audience	O
and	O
increase	O
the	O
risk	O
that	O
personal	O
data	O
concerning	O
health	O
could	O
be	O
accidentally	O
exposed	O
or	O
easily	O
distributed	O
to	O
unauthorised	O
parties	O
by	O
enabling	O
greater	O
access	O
to	O
a	O
compilation	O
of	O
the	O
personal	O
data	O
concerning	O
health	O
,	O
from	O
different	O
sources	O
,	O
and	O
throughout	O
a	O
lifetime	O
.	O
</s>
<s>
Epic	O
Systems	O
will	O
supply	O
integrated	O
electronic	B-Application
health	I-Application
records	I-Application
with	O
a	O
single	O
digital	O
record	O
for	O
every	O
citizen	O
.	O
</s>
<s>
In	O
UK	O
veterinary	O
practice	O
,	O
the	O
replacement	O
of	O
paper	O
recording	O
systems	O
with	O
electronic	O
methods	O
of	O
storing	O
animal	O
patient	O
information	O
escalated	O
from	O
the	O
1980s	O
and	O
the	O
majority	O
of	O
clinics	O
now	O
use	O
electronic	B-Application
medical	I-Application
records	I-Application
.	O
</s>
<s>
Veterinary	O
electronic	B-Application
medical	I-Application
record	I-Application
data	O
are	O
being	O
used	O
to	O
investigate	O
antimicrobial	O
efficacy	O
;	O
risk	O
factors	O
for	O
canine	O
cancer	O
;	O
and	O
inherited	O
diseases	O
in	O
dogs	O
and	O
cats	O
,	O
in	O
the	O
small	O
animal	O
disease	O
surveillance	O
project	O
(	O
Veterinary	O
Companion	O
Animal	O
Surveillance	O
System	O
)	O
at	O
the	O
Royal	O
Veterinary	O
College	O
,	O
London	O
,	O
in	O
collaboration	O
with	O
the	O
University	O
of	O
Sydney	O
(	O
the	O
VetCOMPASS	O
project	O
was	O
formerly	O
known	O
as	O
VEctAR	O
)	O
.	O
</s>
