Passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009 resulted in the rapid adoption of electronic health record (EHR) systems. With this, came the promise of increased access to patient data for beneficial secondary uses such as research and quality improvement. However, clinicians and researchers interested in leveraging HIT for such purposes often find EHR data as heterogeneous and complex. As such, EHR clinical data often remain underutilized. Biomedical and Health Informaticians are developing systems and techniques to use the EHR for clinical knowledge discovery and dissemination. Applicable approaches may require biostatistical, programming, and other technical knowledge, as well as information technology data infrastructure often consisting of the institution's clinical data repository (CDR). Other techniques can also be instituted by practicing clinicians to leverage EHR systems including the use of clinical decision support (CDS) tools and standard knowledge representation for surgical applications.