For the past decade, adoption of electronic health records (EHRs) has been proposed as one of the most viable approaches to improving the United States health care system. Although there is evidence that EHR adoption is slowly progressing, current methods of assessing adoption have yielded significant variance in estimates of EHR utilization. We conducted an environmental scan consisting of a review of the literature as well as a series of discussions with health center and health center network representatives and experts in the field to understand the current state of EHR adoption and use in the United States and assess the feasibility of developing a systematic approach to tracking EHR usage.