Background and Objectives: The American Recovery and Reinvestment Act of 2009 accelerated the implementation of electronic health records (EHRs) in pediatric offices. We determined the prevalence and functionalities of EHRs, as well as pediatricians' perceptions of EHRs. Methods: An 8-page self-administered questionnaire was sent to 1,619 randomly selected non-retired US American Academy of Pediatrics members in 2016. Responses were compared with similar surveys in 2009 and 2012. Results: The percent of pediatricians, who were using EHRs, increased significantly from 58% in 2009 and 79% in 2012 to 94% in 2016. Those with fully functional EHRs including pediatric functionality more than doubled from 7.8% in 2012 to 17.6% in 2016 (p=0.001). Fully functional EHRs lacking pediatric functionality increased from 6.5% to 29.2% (p<0.001), while the percentage of pediatricians with basic EHRs declined (30.7% to 14.7%, p<0.001). The percentage of pediatricians who lacked basic EHR functionality or who reported no EHR declined (55.0% to 38.4%, p<0.001). On average pediatricians spent 3.4 hours per day documenting care. Conclusions: While the adoption of EHRs has increased dramatically and is nearing 100%, over 80% of pediatricians are still working with EHRs that do not provide optimal functionality and over 38% of pediatricians are not using EHRs with even basic functionality. EHRs lacking pediatric functionality may affect the health of children through increased medical errors, missed diagnoses, lack of adherence to guidelines, and reduced availability of child-specific information. The pediatric certification outlined in the 21st Century Cures Act may result in improved EHR products for pediatricians.