Moving from paper records to electronic health records (EHRs) has been a challenge for many Alabama hospitals. Implementation of this innovative technology will assist in providing better patient care by allowing for and providing more accurate and available patient information. The purposes of this study were to assess the status of implementation of EHRs among Alabama hospitals;the factors that are associated with EHR implementation; andthe benefits of, barriers to, and risks of EHR implementation.A self-completed survey was mailed to 131 directors in the health information management (HIM) department of Alabama hospitals. Of 91 responding hospitals (69 percent response rate), only 12.0 percent have completed implementation of EHRs. The key factor driving electronic health record (EHR) implementation was to improve clinical processes or workflow efficiency. Lack of adequate funding and resources was the major barrier to EHR implementation. Rural hospitals were less likely to implement EHRs when compared with urban hospitals (p = .07). Adoption of EHRs should be evaluated in depth for hospitals, and particularly for rural hospitals. Ways to seek appropriate funding and provide adequate resources should be explored.