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Electronic Health Records (EHRs) facilitate the accessibility and sharing of patient data among various healthcare providers, contributing to more coordinated and efficient care. EHRs are designed not only to collect and store health information but also to support other care-related activities like evidence-based decision support, quality management, and outcomes reporting. The adoption of EHRs has been encouraged globally as a critical component of modern healthcare systems, aiming to improve the accuracy and efficiency of patient care and to support better health outcomes. Over the past 25 years, EHRs have successfully been translated from digital records to scientific achievements. In this review, we examined the evolution of EHRs and their interoperability over the past 25 years. We explored the advancements in EHR technology, emphasizing how they have facilitated better management and understanding of diseases through comprehensive data collection and analysis. Challenges such as common data models, system compatibility, connection, linkage and privacy issues were discussed in detail. This review also highlighted the significance of these records in epidemiological studies, pragmatic clinical trials and health economic studies particularly in creating a more accurate representation of clinical practices and patient populations. Moreover, it considered the limitations of EHRs, including data cleaning complexities and potential biases arising from inconsistent records. Improved resource sharing and collaborations among healthcare providers were advocated, underscoring the need for consistent data formats and policy development in healthcare networks to maximize the potential of EHRs in clinical research and healthcare improvement.