Purpose: The purpose of this study was to examine the relationship between the electronic health record system components and patient outcomes in an acute hospital setting, given that the current presidential administration has earmarked nearly $50 billion to the implementation of the electronic health record. The relationship between the electronic health record system components and the effects on patient outcomes in an acute hospital utilizing a specific set of diagnoses was investigated. Theoretical Framework: The theoretical framework of this study is based on the research foundations of Normal Accident Theory and High-Reliability Theory. Methodology: The secondary data for this research study was obtained from Health Information Management Systems Society Analytics (HIMSS Analytics) and Office of Statewide Health and Planning (OSHPD) in the state of California. The HIMSS Analytic database provided the researcher with 378 acute hospitals in the state of California that utilized any components of an EHR system as well as provided the researcher with adequate documentation to request secondary data from OSHPD to confirm or reject the research questions. A total of 8 hospitals were utilized for this study, 4 hospitals with EHR system components and 4 without. OSHPD provided the researcher with secondary data for near 57,000 de-identified patient records for this study. Findings: Examination of quantitative, qualitative, and comparative data from hospitals with EHR system components were compared to the hospitals without EHR system components. The findings revealed that there were no significant differences in the patient outcomes in the areas of mortality, length of stay, and complications in patients for the identified diagnoses of acute myocardial infarction, congestive heart failure, diabetes, and pneumonia. Analysis determined that the hospitals with EHR system components performed equally with patient outcomes as the hospitals without EHR system components. Conclusion and Recommendations: The study data and analysis supported the conclusion that there is no significant difference in hospitals with EHR components and hospitals without EHR system components. Further research advised addressing access of data, retention and utilization of data within hospitals with EHR system components and hospitals without EHR system components. Also, it is recommended this study be replicated with fewer subjects (de-identified patient records). [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]