The EHR (Electronic Health Record) is the system of record for clinical care: the patient's charts, clinical notes, orders, lab and imaging results, medications, problem lists, and scheduling, maintained over time and intended to be shared across the care team. In the US market a handful of vendors — Epic, Oracle Health (formerly Cerner), athenahealth, and MEDITECH among them — dominate, which means "integrating with the EHR" in practice means integrating with one of these specific platforms and its conventions.
For a telemedicine video product, the EHR integration is frequently the factor that decides enterprise deals. A health system expects telehealth visits to appear in the patient's chart, clinical documentation from the consult to land in the correct encounter, and scheduling to stay synchronized in both directions. A polished video experience that leaves the clinician double-charting into a separate system will not survive procurement, because it creates exactly the documentation burden hospitals are trying to reduce.
The technical implication is that you will work across two generations of access. Modern, standardized access runs through FHIR APIs, which US regulation now compels certified EHRs to expose for the USCDI (United States Core Data for Interoperability) data set, making patient-access and app integrations feasible without bespoke per-site engineering. Deeper or legacy data flows often still ride on HL7 v2 interface feeds maintained by the hospital's integration team. The common pitfall is scoping an integration against a vendor's marketing rather than against what a specific site has actually enabled and is willing to expose.
