Implementation of electronic health records (EHRs) is considered a high priority in order to improve patient safety and quality of care. However, EHR uptake has been slow in both hospital and ambulatory settings. This national survey of more than 2000 physicians found that only 17% were using any form of EHR, and only a small proportion of those were using systems with advanced capabilities such as clinician decision support. While users generally viewed EHRs as beneficial for patient care, implementation costs were identified as the major barrier to use of EHR, corroborating findings of prior research.