The need to adopt an electronic health record (EHR) system in United States (U.S.) hospitals seems to be more and more obvious when evaluating the benefits of improved patient safety, quality of care, and efficiency. The purpose of the study was to identify the status of EHR systems in U.S. hospitals in regard to the core functionalities implemented (as identified by the Institute of Medicine) and to determine if there was a significant relationship between perceived level of benefit and risk with the use of each core functionality, as well as if there was a significant relationship between the status of the EHR system and size of hospital. A national survey of U.S. hospitals was conducted to answer the research questions. The results showed that 37% had some components in all of the core functionalities of an EHR system, while 27% were using at least some functionalities. Health information and data, administrative processes, and results management were the three core functionalities that a majority of hospitals had as a part of their EHR system. A significant positive correlation between perceived benefits and risks was found in all of the eight core functionalities. There was no significant relationship found between status of EHR system and size of hospitals.