Regional extension centers (RECs) were created to help physicians implement electronic health record (EHR) systems and achieve meaningful use. However, RECs face limitations including short-term funding, endorsement of select EHR vendors, and lack of experience with all systems. The Veterans Health Administration (VHA) offers a successful example of large-scale EHR implementation through a collaborative development process tailored to clinician needs. While RECs aim to support physicians, their assistance may be constrained without long-term, sustainable support.