All countries are investing in the development of electronic health (clinical) records, but only some countries are moving forward the possibility of data extraction for research, statistics and other uses that serve the public interest. This study reports on the development and use of data from electronic health records in twenty-eight countries. It reports on the prevalence of technical and operational factors that support countries in the development of health information and research programmes from data held within electronic health record systems, such as data coverage, interoperability and standardisation. It examines data quality challenges and how some countries are addressing them and it explores the governance of electronic health record systems and data, including examples of national statistical and research uses of data. The report provides an overall assessment of the readiness of countries to further develop health information from data within electronic health record systems and describes the outlook for the future. Ten countries are identified as having high readiness that enables them to develop world-class health information systems supporting health system quality, efficiency and performance and creates a firm foundation for scientific research and discovery.