 The electronic health record, EHR, has the potential to expand infection detection beyond current settings of care. This paper reviews the process of leveraging EHRs to detect infections in other settings, as well as the challenges associated with this approach. It discusses the development of objective and reproducible infection surveillance definitions, the use of unstructured text data, and the potential for automation. Barriers to fully automating infection detection systems and challenges with intra and inter-facility reliability and missing data are also addressed. This article was authored by Westin Branch Elemen, Alexander J. Sunderman, Jenna Wiens, and others.