# Patient medical record

> What a patient medical record contains, how it differs from EHRs and EMRs, and how patient, data, applications and consent relate in Anpheros — including families, portability and deletion.

Source: https://developers.anpheros.com/guides/patient-medical-record

**A patient medical record is the complete, structured history of one person's health — measurements, results, diagnoses, medications, documents and encounters — kept over time.** In Anpheros every patient has exactly one such record, stored as HL7 FHIR R4 resources. The record belongs to the patient's care, not to one application: applications write into it and read from it, and a patient decides, through consent, which applications may do so.

## EHR, EMR and patient-held records

| Kind | Who keeps it | Typical scope |
|---|---|---|
| Electronic medical record (EMR) | one clinic or practice | what that provider recorded |
| Electronic health record (EHR) | a hospital or health system | what the organisation's providers recorded |
| Personal / patient-held record | the patient | everything the patient collects: results from many labs, home measurements, documents, medications |

Anpheros is closest to the third kind, with an important difference: it is not an app-specific diary. It is **infrastructure**: the same record can be written by the patient's own app, by a laboratory, by a clinic and by an AI assistant, each through the API and each within the limits the patient allows. Anpheros is not a hospital EHR and does not replace one.

## What the record contains

| Part of the record | FHIR resources in Anpheros |
|---|---|
| The person and the people close to them | `Patient`, `RelatedPerson` |
| Measurements and results | `Observation` (vital signs, laboratory, symptoms, wellbeing, daily activity and sleep), `DiagnosticReport` |
| Problems and their course | `Condition`, `EpisodeOfCare` (for example a pregnancy or a long-term illness), `Procedure`, `FamilyMemberHistory` |
| Treatment | `MedicationStatement`, `MedicationAdministration` (each dose taken or skipped), `Immunization`, `CarePlan`, `Goal`, `ServiceRequest` |
| Safety | `AllergyIntolerance` |
| Care | `Encounter`, `Appointment`, `CareTeam` |
| Documents and questionnaires | `DocumentReference` (immutable originals), `QuestionnaireResponse` |
| Governance | `Consent` (one per grant), `Provenance` (one per write) |

Every item is coded where a standard exists — LOINC for measurements and lab results, ICD-10 for conditions, ATC for medications, UCUM for units — and keeps its original text as well. See [FHIR code systems](https://developers.anpheros.com/guides/fhir-code-systems).

## The relationship between patient, data, applications and consent

```
                  ┌──────────────── consent: which app, which data, how long ───────────────┐
                  │                                                                          ▼
Patient ──► Anpheros Daily (or any patient app) ──► Anpheros API ──► the patient's FHIR record ◄── other apps, clinics, labs, AI
                                                                            │
                                                     access log visible to the patient
```

- **The application that created a record** can read and write it with its API key.
- **Any other application** needs the patient's consent: an OAuth grant with explicit scopes (resource types and actions, optionally a category such as `laboratory`), for 30, 90, 180 or 365 days.
- **Every write** is attributed: patient, practitioner, device, import or AI, with the organisation and source system.
- **Every read** — including reads by the creating application and context built for AI models — appears in the patient's access log, per application.
- **The patient can revoke** an application at any time; the next request is refused.

## Families and dependents

A person can hold records for others — children, an elderly parent. Each dependent has their own `Patient` record, linked to the guardian's; the patient-side API lists "my records and my dependents'" (`GET /me/patients`), with who has access to each. Consent is always given per record.

## Portability

Because the record is standard FHIR, it can leave Anpheros intact: `Patient/{id}/$everything` returns the whole compartment, and `Patient/{id}/$summary` returns an International Patient Summary, a document format designed to be read by clinicians elsewhere.

## Deletion

Deleting a `Patient` deletes every resource of that record. Documents, once finalised, cannot be modified, only deleted.

## Related

- [Digital medical record infrastructure](https://developers.anpheros.com/guides/digital-medical-record)
- [Medical data infrastructure](https://developers.anpheros.com/guides/medical-data-infrastructure)
- [Consent and access model](https://developers.anpheros.com/guides/consent)
- [FHIR platform](https://developers.anpheros.com/guides/fhir)