This study reports the extent of EHR implementation and use in a randomly selected sample of 1,497 Rural Health Clinics (RHCs) surveyed in 2013. Results show that RHCs are approaching parity with other physician practices, with nearly 72 percent reporting EHR adoption and use, and 63 percent indicating use by 90 percent or more of their staff. Among RHCs without an EHR, almost 44 percent plan to implement one within the next 12 months. In general, respondents performed well on Stage 1 meaningful use measures related to clinical care and patient management but lagged on the exchange of clinical information, reporting quality measures, implementing clinical decision support rules, conducting formulary checks, transmitting lab orders, and generating patient registries. This study suggests that RHCs without an EHR have continuing technical assistance needs to support EHR adoption. RHCs with an EHR need support to fully utilize the capabilities of their systems and meet the continually evolving standards for meaningful use.