Dr. Patrick Feehan discusses the electronic health record (EHR) mandate and its impact on small to medium-sized dermatology practices. He summarizes the Health Information Technology for Economic and Clinical Health (HITECH) Act and upcoming deadlines. An explanation for "meaningful use" of EHR systems also is provided as well as the objectives identified by the Centers for Medicare & Medicaid Services. The penalties of not complying are given and Dr. Feehan addresses the costs of implementing EHR. Specialty health care societies, including the American Academy of Dermatology Association, have advocated for practical changes to the mandate and Dr. Feehan discusses these efforts.