Early versions of electronic health records (EHRs) were developed in the 1980s. The potential to use such technology to improve care—especially preventive care and outpatient chronic disease care—has been widely assumed since the publication of two landmark Institute of Medicine reports in 1992 and 1994. However, nearly two decades later, the potential for EHR technology to improve chronic disease care—in particular, care of adults with type 2 diabetes—remains unrealized.