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What is a Headless EHR?

May 11, 2023


Hospitals and Healthcare Organizations use Electronic Health Records (EHRs) to store medical information. If you’ve ever been a patient at a hospital or clinic, it’s likely your data is stored in an EHR. Here’s an example of what a technician at a doctor’s office might find when taking notes on a patient:

A screenshot of an electronic health record with sample patient medical information. There are inputs, including for "Digestive auscultation" and for a patient's name.

Source: Wikimedia

What is a headless EHR?

A headless EHR is an EHR without a user interface — all data is accessed programmatically. It provides APIs (Application Programming Interface) for retrieving and updating medical data. User-facing applications are built using the APIs.

Headless EHRs provide flexibility when building simple or complex healthcare applications — with a traditional EHR it can be challenging to interact with medical information and other systems, but headless EHRs are designed to be interacted with programmatically. You can choose how and when your backend data exchange interacts with frontend systems, such as a website or patient app, using an API.

We’ve built a headless EHR called ZapEHR.

Comparison with a traditional EHR


Building from scratch is a riskier path, but the largest pro of building healthcare technology with a headless platform is that it lets clinical organizations customize their EHRs and clinical workflows. Traditional EHRs may ‘customize’ out-of-the-box offerings for individual organizations, but this short-term solution can only do so much contrasted with custom software built with unique use cases in mind from the get-go. Traditional EHRs often come with a large number of features that make their system bulkier and harder to use — and even then the EHR may be missing features organizations want.

With a headless EHR, you have control to design and build the entire system. This means you can choose which features to build – and what to exclude or delay as your organization grows. We believe headless EHRs will continue to grow — and if they do, it’s likely applications will be built on top of them that you will be able to use.

Another advantage of headless EHRs is cost: while the upfront cost to build may be higher, the long-term costs are likely significantly lower than with a traditional EHR. When you sign up for a traditional EHR, you risk being siloed into an EHR you’re unhappy with until the end of the contract period. Transitioning to another traditional EHR carries the same risks, plus the added costs of converting and exporting patient data between potentially non-interoperable formats. ZapEHR provides the cloud infrastructure and APIs and has a per-API-call usage-based pricing, making this low cost and scalable. If you decide you aren’t happy, you can switch to another EHR because you haven’t signed any contracts, and the records are stored as industry-standard FHIR for easy exportation.Moreover, headless EHRs offer enhanced interoperability, which is crucial in providing quality care in today's healthcare landscape. Healthcare providers often need to exchange patient data with various systems and stakeholders, including other healthcare facilities, laboratories, pharmacies, and government agencies such as Medicaid and Medicare. A headless EHR, with its FHIR-based API, facilitates seamless data exchange by adhering to industry standards, ensuring compatibility and smooth integration with external systems.


While we think that building on top of a headless EHR will give you a better functionality and application in the long run of your organization's growth, some companies may not want to take on the risk of going with a headless EHR. Unlike a traditional certified EHR, which comes with a pre-built user interface, an organization that chooses to go headless may need to build and customize an EHR, or to work with an already-built frontend.

Moreover, with the lack of a predefined front-end, ensuring HIPAA compliance can be more complex with a headless EHR. The Health Insurance Portability and Accountability Act (HIPAA) mandates strict regulations for the handling and protection of patient health information (PHI). While headless EHRs provide robust backend infrastructure for storing and managing PHI, organizations must take it upon themselves to ensure that any frontend applications built on top of the EHR comply with HIPAA regulations. This includes implementing stringent security measures, conducting regular risk assessments, and maintaining comprehensive audit trails to safeguard patient data against unauthorized access or breaches.

The planning involved in creating a complete and flexible headless EHR system means that the time to get up and running is longer. Traditional EHRs give you a fast speed to market with something that “works just enough”.

All in all, the up-front costs to getting started with a headless EHR will likely be higher than with a traditional EHR. We know that headless EHRs aren’t for everybody. But if you’ve tried building on top of traditional EHRs — and gotten frustrated just as we did — a headless EHR may be worth considering.

Frequently Asked Questions (FAQs):

What is a headless EHR, and how does it differ from traditional EHR systems?

A headless EHR is an electronic health record system that operates without a pre-built user interface. Instead, it provides APIs (Application Programming Interfaces) for accessing and managing medical data programmatically. Unlike traditional EHR systems, which come with built-in user interfaces, headless EHRs offer greater flexibility and customization options, allowing healthcare organizations to tailor the system to their specific needs.

What are the advantages of using a headless EHR in the healthcare industry?

Headless EHRs offer several advantages for healthcare organizations, including enhanced customization, scalability, and interoperability. By providing APIs for data access, headless EHRs enable seamless integration with other systems and applications, facilitating efficient data exchange and collaboration across the healthcare ecosystem. Additionally, the flexibility of headless EHRs allows organizations to adapt the system to evolving healthcare needs and support innovative care delivery models. Applications and its data such as patient scheduling, telehealth, billing, and payments can now be all connected, automated, and managed under one roof. 

What are the key considerations for implementing a headless EHR in a healthcare setting?

Implementing a headless EHR requires careful planning and consideration of various factors. Healthcare organizations should assess their specific requirements, such as data security, compliance with regulatory standards (e.g., HIPAA), and interoperability with existing systems. Additionally, organizations should evaluate the technical capacity, expertise, and resources needed for developing and maintaining custom user interfaces or integrating frontend applications with the headless EHR backend.

How does a headless EHR impact the user experience for healthcare providers and staff?

The impact of a headless EHR on user experience depends on how effectively organizations design and implement frontend applications or user interfaces. While headless EHRs offer flexibility and customization options, organizations must ensure that the user interface is intuitive, efficient, and supports the workflows of healthcare providers and staff. Investing in user experience design and usability testing can help optimize staff efficiency and increase patient satisfaction when using a headless EHR.

Can a headless EHR integrate with other digital health solutions and third-party applications?

Yes, one of the key advantages of a headless EHR is its ability to integrate with other digital health solutions and third-party applications seamlessly. By providing APIs for data access and manipulation, headless EHRs enable interoperability with various systems, such as telemedicine platforms, patient portals, and analytics tools. This integration enhances the overall functionality of the EHR system and supports collaborative care delivery across different healthcare settings.

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Mordechai Raskas
Mordechai Raskas

Chief Medical Information Officer at PM Pediatric Care