Adoption of electronic health records (EHR) in hospitals and ambulatory practices has been slow, despite recommendations from influential organizations and popular support. This survey of outpatient practices in Florida investigated the adoption of EHR and the specific features used by practices with an EHR. Only one quarter of practices surveyed had implemented an EHR, and among those, most did not use more advanced features such as computerized provider order entry or clinician decision support. The authors discuss the implication of these findings in the context of sociological models of technology adoption.