Format Documentation per 45 CFR § 170.315(b)(10)
4D EMR Version 6.0 provides the ability to export a patient's complete electronic health information (EHI) or an entire practice's patient population data through the Practice > Settings > Download Data feature. The export is designed to fulfill the requirements of 45 CFR § 170.315(b)(10) by enabling the export of all electronic health information that can be stored in the system at the time of certification.
The export supports two modes:
All exported data is packaged as a single ZIP archive (filename: data.zip) delivered as a browser download. The ZIP archive contains the following file types:
| File Type | Format | Description |
|---|---|---|
| Structured Data | CSV (Comma-Separated Values, UTF-8, all fields quoted) | Patient demographics, appointments, and practice-level reference data |
| Chart Notes | PDF (Portable Document Format) | Clinical chart notes compiled into one PDF file per patient |
| Patient Photos | JPEG / Native format | Clinical photographs in their original stored format |
| Scanned Documents | Native format (PDF, JPEG, PNG, etc.) | Scanned documents in their original stored format |
The exported ZIP archive is organized as follows:
data.zip ├── Patients.csv ├── Appointments.csv ├── ProviderProcedures.csv (population export only) ├── ReferringDoctors.csv (population export only) ├── SupplyItems.csv (population export only) ├── MarketingSources.csv (population export only) ├── Facilities.csv (population export only) ├── ChartNotes/ │ ├── {PatientId} {FirstName} {MI} {LastName}.pdf │ └── ... ├── Photos/ │ ├── {PatientId} {FirstName} {MI} {LastName}/ │ │ ├── photo1.jpg │ │ └── ... │ └── ... └── Scans/ ├── {PatientId} {FirstName} {MI} {LastName}/ │ ├── document1.pdf │ └── ... └── ...
Contains demographic and contact information for each patient. Available in both single-patient and population export modes.
| Column Name | Description | Format |
|---|---|---|
| First Name | Patient's first name | Text |
| MiddleInitial | Patient's middle initial | Text |
| LastName | Patient's last name | Text |
| NickName | Patient's preferred name / nickname | Text |
| Gender | Patient's gender | Text |
| DOB | Date of birth | MM/dd/yyyy |
| OtherLastName | Alternate / maiden last name | Text |
| AdminNotes | Administrative notes about the patient | Text |
| Patient's email address | Text | |
| Address | Street address line 1 | Text |
| Address2 | Street address line 2 | Text |
| City | City | Text |
| State | State / province | Text |
| Zip | Postal / ZIP code | Text |
| Country | Country | Text |
| Custom1Title / Custom1Data | Practice-defined custom field 1 (label and value) | Text |
| Custom2Title / Custom2Data | Practice-defined custom field 2 (label and value) | Text |
| Custom3Title / Custom3Data | Practice-defined custom field 3 (label and value) | Text |
| DateFirstSeen | Date patient was first seen | MM/dd/yyyy |
| Occupation | Patient's occupation | Text |
| Referred By | Referral source name | Text |
| PhoneNumber | Primary phone number | Text |
| PhoneType | Type of primary phone (e.g., Mobile, Home, Work) | Text |
Contains scheduling and appointment data. Available in both single-patient and population export modes.
| Column Name | Description | Format |
|---|---|---|
| AppointmentId | Unique appointment identifier | Integer |
| StartDate | Appointment start date and time (practice local time) | DateTime |
| EndDate | Appointment end date and time (practice local time) | DateTime |
| NameOfSchedule | Provider/resource schedule name(s), pipe-delimited if multiple | Text |
| TypeCategory | Appointment type name | Text |
| PatientNumber | Patient ID number | Text |
| PatientName | Patient full name | Text |
| Subject | Appointment subject line | Text |
| Description | Appointment description and subtype details | Text |
| Status | Appointment status (e.g., Confirmed, Cancelled) | Text |
| Location | Facility location name | Text |
| CreatedDate | Date and time appointment was created (practice local time) | DateTime |
The following CSV files are included only when performing a population-level (Download All Data) export:
| File | Contents |
|---|---|
| ProviderProcedures.csv | Provider procedures including CPT codes, procedure names, fees, duration, and provider name |
| ReferringDoctors.csv | Referring physician directory with contact information |
| SupplyItems.csv | Inventory and supply item catalog with pricing |
| MarketingSources.csv | Patient referral and marketing source list |
| Facilities.csv | Practice facility locations including name, address, phone, city, state, ZIP, and active status |
Clinical chart notes are exported as PDF documents, one file per patient. The file is located in the ChartNotes/ directory within the ZIP archive, named using the patient's ID and full name (e.g., 123 John A Smith.pdf).
Each PDF contains all chart notes for the patient compiled into a single document. Notes that were deleted within the system are still included in the export and are annotated with the deletion date, the staff member who deleted the note, and the reason for deletion.
Photos are exported in their original stored format (typically JPEG) and organized into patient-specific subdirectories within the Photos/ folder, named by patient ID and name.
Scanned documents are exported in their original stored format (PDF, JPEG, PNG, or other native format) and organized into patient-specific subdirectories within the Scans/ folder, named by patient ID and name.
The EHI Export feature is governed by the following role-based permissions:
| Permission | Description |
|---|---|
| CanDownloadData | Base permission required to access the Download Data feature |
| CanDownloadPracticeData | Enables population-level (Download All Data) export |
| CanDownloadPatientData | Enables single-patient export |
| CanReadClinicalNotes | Required to include Chart Notes in the export |
| CanAccessVIPs | Required to include VIP-flagged patients in the export |
| Attribute | Value |
|---|---|
| Archive Format | ZIP (using SharpZipLib) |
| CSV Encoding | UTF-8 |
| CSV Quoting | All fields quoted (RFC 4180 compliant via CsvHelper) |
| Date Formats in CSV | MM/dd/yyyy for date-only fields; DateTime for timestamps (practice local time zone) |
| Chart Note PDF Generation | DevExpress RichEditDocumentServer (RTF to PDF conversion) |
| Delivery Method | HTTP streaming download (PushStreamContent) via browser |
| Content Type | application/octet-stream, Content-Disposition: attachment |
4th Dimension EMR, Inc.
10300 W Charleston Blvd, Suite 13-146, Las Vegas, NV 89135
Phone: (844) 878-2434
Email: support@4d-emr.com
Website: https://4d-emr.com
