India has had official EHR standards since 2013. Most clinic software sold here would struggle to tell you which version it follows. That gap matters more than any feature list if you're choosing between EHR systems for your practice. An electronic health record is only as useful as its ability to make sense to the next doctor, lab or hospital that sees your patient.
At the simplest level, an EHR system stores a patient's clinical story across visits: problems and diagnoses, medicines, allergies, vitals, lab values, imaging, procedures. Any clinic app can hold that information. The hard part is holding it in a form another system can read without a human retyping it.
What the Indian standards say
The Ministry of Health and Family Welfare notified the first Electronic Health Record Standards for India in September 2013 and a revised set in December 2016. The National Resource Centre for EHR Standards (NRCeS) publishes the documentation. The 2016 revision is still the reference point, and it names specific standards, not general principles:
| Area | What the 2016 standards name |
|---|---|
| Clinical terminology | SNOMED CT |
| Disease classification | WHO ICD-10 (and related WHO classifications) |
| Lab tests and observations | LOINC |
| Imaging | DICOM (PS3.0-2015) |
| Messaging and documents | HL7 v2.8.2, HL7/ASTM CCD, openEHR |
Two corrections to things you'll often read. First, the 2016 document lists ICD-10, not ICD-11. Many vendors now also support ICD-11, which is fine, but it isn't what the Indian standard names. Second, FHIR, the newer format for packaging health records so other systems can read them, isn't in the 2016 document. It entered the Indian picture later through the Ayushman Bharat Digital Mission. NRCeS publishes a FHIR Implementation Guide for ABDM, built on FHIR R4, which defines how records like an OP consultation, a prescription, a diagnostic report or a discharge summary are packaged for exchange.
In practice, a clinic EHR in 2026 should speak both languages: the coded vocabulary from the 2016 standards (SNOMED CT, LOINC, ICD) and the FHIR record formats ABDM uses to move data between facilities.
"EHR" on a brochure can mean three different things
When a vendor says their product "has EHR," they usually mean one of these:
- A digital file. Visits, notes and prescriptions are stored per patient and searchable by name. Diagnoses are free text. This is better than paper, but nothing in it can be counted, coded or shared.
- A structured record. Diagnoses come from a coded list, lab values are saved as numbers with units, and each medicine is tied to an entry in the software's master list of drugs. You can ask "how many of my patients with type 2 diabetes had an HbA1c above 8 last quarter?" and get an answer.
- An interoperable record. The structured data can also be packaged in ABDM's FHIR format, linked to the patient's ABHA, so it reaches a personal health record (PHR) app or another facility with the patient's consent.
Level 1 is common. Level 3 is what the standards are aiming for. When you evaluate a product, find out which level it reaches, and make the salesperson show it on screen.
Four checks to run in a demo
Type a diagnosis and watch what happens. If "HTN" stays as those three letters, the diagnosis isn't coded. If it resolves to a SNOMED CT or ICD-10 concept, it is.
Order a lipid profile and look at the result screen. Are LDL and HDL stored as separate numeric values you can trend over time, or as one scanned PDF?
Ask for an ABDM record push. Create a test OP consult and have the presenter show it arriving in a test PHR app linked to an ABHA. A CSV export button isn't interoperability.
Time a routine follow-up. Have a doctor on your team log a stable hypertensive review. If it takes longer than the paper equivalent, the structured data will quietly stop being entered by week three, and the coding won't matter.
Getting old records in
Nobody starts an EHR with a blank slate. Most clinics bring years of paper files or a legacy system with messy data, and there are three workable ways in.
You can scan everything upfront. That keeps the full history, but it's slow and expensive, and scanned pages aren't structured data; ABDM's HealthDocumentRecord type exists precisely for this kind of unstructured legacy document. You can start fresh and pull paper files when needed, which is fast but leaves old history unsearchable. Or you can digitise active patients first: anyone seen in the last 12 to 18 months gets their key problems, medicines and allergies entered as structured data, and everyone else is scanned or stays on paper until they return.
A solo GP with a few thousand active patients can often manage the first route. A busy multi-doctor practice usually does better with the third. Whatever you pick, get the included migration help written into the quote. It's the part demos tend to skip.
At ExaHealth, migration help covers patient records, visit history, prescriptions and templates, along with appointment and billing history. Medicines on a new prescription come from a structured list, not typed free text, and linking a patient's ABHA lets the clinic bring in and send out records with the patient's consent. Run the four checks above on ExaHealth the same way you would on any other product.
What to take away
A useful EHR stores diagnoses, lab values and medicines as coded data, and can send a record out through ABDM when the patient consents. Test for that in the demo, not in the brochure. Then plan the migration before you sign, because that decides how much of your history comes with you.
ExaHealth's prescriptions, ABHA linking and migration help are listed on its features page for doctors.
See also EMR vs EHR: What Indian Doctors Actually Need and Electronic Medical Records in India: an ABDM-Ready EMR Checklist.
Where the figures come from
- MoHFW: Electronic Health Record Standards for India, 2016
- NRCeS: EHR Standards for India
- NRCeS: ABDM FHIR implementation guide
- NRCeS: EHR Standards for India (PDF)
Frequently Asked Questions
What is an EHR system, in plain terms?
It's software that keeps a patient's clinical history (diagnoses, medicines, allergies, test results, imaging) in one digital record that builds up over every visit. A good one stores that history as coded data, not free text, so it can be searched, trended and shared.
My clinic app stores prescriptions and notes. Is that an EHR?
It's a digital record, but it may not be an EHR in the standards sense. Check whether diagnoses are coded, whether lab values are stored as numbers, and whether the system can send a record through ABDM. If all three answers are no, you have a digital filing cabinet.
How is an EHR different from a hospital management system?
The EHR is the clinical record. A hospital management system wraps an EHR together with admissions, bed management, pharmacy, billing and inventory. Almost every hospital system includes some EHR, but how closely it follows the standards varies a lot.